The advantages of using intramedullary fixation for the treatment of proximal femur fractures include less. The technique combines traditional ilizarov distraction osteosynthesis with the convenience of a tibial intramedullary im nail and requires only of the external fixator. Operative technique t2 femoral nailing system this publication sets forth detailed recommended procedures for using stryker devices and instruments. Numerous reduction techiques are available to achieve an anatomic. The location of the 3 distal locking holes is the same as the standard nail.
In addition to the t2 femoral, tibial, and humeral nailing systems, stryker trauma developed the t2 arthrodesis nail to provide treatment. Not limiting the approach to a certain nailing technique. The affixus natural nail humeral system is a long bone nailing system that is built on the natural nail and affixus intramedullary platforms. The center point of the portal is located slightly medial to the lateral tibial spine as visualized on the ap radiograph and immediately adjacent and anterior. Furthermore, the development of the t2 femoral nailing system offers the competitive. The t2 tibial nailing system offers the competitive advantages of. Check with local representative regarding availability of sizes and nail types. Stryker triathlon surgical manualline pdf download. T2 8mm nails require the use of 4mm fully threaded locking screws distally and 5mm proximally.
Preoperative evaluation of intramedullary tibial nail measurements. It offers guidance that you should heed, but, as with any such technical guide, each surgeon must consider the particular needs of each patient and make. The t2 tibial nailing system represents strykers latest and most comprehensive development of the original intramedullary principles presented by prof. T2 tibia spi offers two size options of drill sleeve available to accommodate nail diameters 8mm.
T2 ar humeral nails require all 4mm locking screws. Asls, the angular stable locking system, is indicated in cases where increased stability is needed in fractures closer to the metaphyseal area or in poor quality bone. T2 alpha tibia nailing system, t2 alpha femur antegrade gtpf nailing system, imn screws system, imn instruments system. The best sleeping position for back pain, neck pain, and sciatica tips from a physical therapist duration. Suprapatellar versus infrapatellar approaches in the. The t2 knee arthodesis nail system is a long intramedullary nail designed for fixation of femur and tibia. Retrospective analysis was performed in patients with tibial. T2 pocket reference yker nailing cards university of iceland.
The core instruments of the t2 system provide the platform for all current and future stryker trauma nailing systems, thereby reducing complexity and inventory. Dec 12, 2015 statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Except for the addition of a small number of dedicated instruments, the t2 femur instrument platform is used for the t2 recon nail. The purpose of this article is to present a simple technique for suprapatellar nailing spn of tibial fractures providing stepbystep instruction supplemented with relevant illustrations. In addition to the t2 nailing systems for femoral, tibial, and humeral fractures, stryker osteosynthesis has developed the t2 knee arthrodesis nail and, more recently, the t2 ankle arthrodesis nail to provide the option for tibiotalocalcaneal fusion with a retrograde intramedullary nail. Recently, suprapatellar nailing in the semiextended position has been suggested as a safe and effective surgical technique.
The t2 instrument platform offers advanced precision and usability, and features ergonomically styled targeting devices. Establishing an appropriate starting point is a crucial part of the surgical procedure. The t2 proximal tibial nail may also be used for very proximal and very distal fractures. The t2 tibial nailing system is indicated for long bone fracture fixation, specifically. The t2 instrument platform offers advanced precision and usability, as well as ergonomically styled targeting devices. Tibial shaft fractures are routinely managed with intramedullary nailing imn. The t2 alpha tibia nailing system offers a combination of innovation, simplicity, and efficiency that is designed to suit your various needs. From june 2007 to january 2011, 56 fractures 55 patients underwent intramedullary nailing of a tibia fracture with a semiextended approach through a sp portal. Type ii annodization allows for enhanced fatigue strength 1.
Although based on the wellknown t2 platform, the t2 proximal humeral nail design incorporates a. The proxi mal tibial nail does not feature an oblong hole for optional controlled dynamization and appositioncom pression. The t2 arthrodesis nail is inserted with the existing t2 basic set, long together with the femur indication set. It offers guidance that you should heed, but, as with any such technical guide, each surgeon must consider the particular needs of each patient and make appropriate adjustments when and as required. These nails can be inserted over the ball tip guide wire gamma3 nails as well. The t2 alpha tibia nailing system, previously cleared in k191271, is a fracture fixation system and includes sterile implants tibial nails in various diameters, compression screw tibia and end caps as well as nonsterile instruments targeting devices. Note as template magnification levels are set at 117%, all measurements are estimates of true size.
Suprapatellar nailing of tibial fractures is a simple method with many advantages over traditional tibial nailing. Providing locking options for all types of fractures, plus the. Used with the t2 tibial nailing system, the t2 tibia suprapatellar instrument system offers an alternate method for the insertion of tibial spi nails in a. Sirus intramedullary tibia nail system surgical technique. Operative technique t2 supracondylar nailing system 3 this publication sets forth detailed recommended procedures for using stryker devices and instruments. Except for the addition of a small number of dedicated instruments, the t2 femoral instrument platform is used for the t2 ankle arthrodesis nail. Phoenix tibial nail system featuring corelocktm technology. Of these, 55 patients 56 fractures underwent imn using a semiextended approach through a sp portal. To complement the t2 nailing system, stryker trauma has created a new generation humeral implant. T2 alpha tibia nailing system and imn screws system whe imaged with a spin echo or gradient echo pulse sequence and a 3.
February 23, 2020 stryker trauma gmbh sanja jahr senior. Expert tibial nail surgical technique depuy synthes 11 3 confirm nail length and diameter instrument 03. Stryker trauma has created a new generation locking nail system, bringing together all. It incorporates a curvature which allows the nail to curve the length of the limb and is compatible with other stryker t2 instrumentation. The information presented is for educational purposes only. Class 2 device recall stryker t2 femoral nail system. Surgical technique instruments and implants approved by the ao foundation.
T2 tibial nailing system operative technique, 325 corporate dr. Treatment was with the induced membrane technique using gentamicinloaded palacos bone cement zimmer biomet, warsaw, in, usa, realignment of the leg, and internal fixation via the transplantar retrograde implantation of a t2 tibial nail stryker, kalamazoo, mi, usa, after resection down to bone devoid of macroscopic dystrophy. Tibial interlocking nail ii trauma orthopedic impant. In addition to the t2 nailing systems for femoral, tibial, and humeral fractures, stryker osteosynthesis has developed the t2 knee arthrodesis nail and, more recently, the t2 ankle arthrodesis nail to provide the. An accurate selection of tibial nail and screws measurements is. Before the operation, it is recommended to examine patellar laxity on the injured leg, or as an alternative the healthy leg. Stryker orthopaedics extends its sincere thanks to the global triathlon ts knee system surgeon panel for their dedication to the development and refinement of the triathlon knee system and instrumentation. Stryker has created a next generation locking nail system, bringing together all the capabilities and benefits of separate nailing systems to create a.
The instruments are designed for a minimally invasive surgical technique and may increase or efficiency. Ao percutaneous iliosacral screw insertion, supine upper sacral segment duration. Used with the t2 tibial nailing system, the spi instruments. Refer to the t2 femoral nailing system operative technique ref b004 and t2 tibial nailing system operative technique ref b005 for. In addition to the t2 femoral nailing system, stryker trauma developed the t2 supracondylar nail scn for the treatment of complex distal femoral fractures. Use the following guide wires with stryker nailing systems. This system offers a complete portfolio of implants and instruments, which treats a wide range of humeral fractures using simple and efficient instrumentation. An accurate selection of tibial nail and screws measurements is paramount. T2 tibial nailing system operative technique stryker yumpu. Femoral nail, ar t2 femur 011x280 mm t2 femoral nailing system is one of the first femoral nailing systems to offer an option for either an antegrade or a retrograde approach to repair fractures of. Refer to the t2 femoral nailing system operative technique ref b004 and t2 tibial nailing system operative technique ref.
Used with the t2 tibial nailing system, the t2 tibia suprapatellar instrument system offers an alternate method for the insertion of tibial spi nails in a suprapatellar approach with the patients in a semiextended position. The strasbourg team has implanted over 5200 gamma3 nails. Measurements included bone healing, tibial alignment, knee range of. The t2 femoral nailing system is one of the first femoral nailing systems to offer an option for either an antegrade or a retrograde approach to repair fractures of the femur. The 2 sets of instruments required for the broken tibial nail removal technique described in this article are the standard t2 tibial nailing system stryker and the. The annual participation in the stryker training and education gamma and t2. This publication is not intended for distribution in the usa. T2 nails may all require additional reaming for the proximal driving section beyond 1 to 1. Stryker gamma3 and t2 intramedullary nailing 2010 surgeon. Omar al bardan only the paranoid survive 9,674 views. Intramedullary nailing of the tibia with suprapatellar entry and semiextended. Stryker, kalamazoo, michigan of 10mm diameter was inserted over the guide wire into the talus.
They share the same platform as the stryker t2 and s2 intramedullary. In of 15 patients, arthroscopy was performed before and after nailing, and no cartilage changes were seen. The major advantage of the instrument system is a breakthrough in the integration of the instrument platform which can be used not only for the complete t2 nailing system, including the t2 scn system, but will be the platform for all future stryker nailing systems, reducing complexity and inventory. Rontis hellas distributes the following nailing systems from stryker.
One implant, two approaches stryker has created a next generation locking nail. The nails are inserted using an opened or closed technique and can be statically, dynamically and compressed locked. As an addition to the t2 nailing system, stryker trauma has created a new generation femoral implant. Stryker trauma nailing systems, reducing complexity and inventory. T2 ankle arthrodesis nail the t2 ankle arthrodesis nail offers strong biomechanical intramedullary stabilization using cannulated implants for the tibiotalocalcaneal fusion. The t2 tibial nailing system is the realization of superior biome chanical intramedullary stabilization using small caliber, strong cannulated implants for internal fixation of long bones. General notes the following notes apply to all t2 im nails except t2 kids unless separately delineated either below or on the important facts page for each nail. Gilbert taglang, multidisciplinary trauma surgeon, consultant designer of strykers. The t2 ankle arthrodesis nail should not be used if following conditions are present. Ankle arthrodesis using antegrade intramedullary nail for. May 10, 2017 stryker continues to build on its history of innovation with the introduction of the t2 tibia suprapatellar instrument spi system.
Remove the revision tibial resection guide from the tibia. Radiographic and clinical followup examinations were performed at a minimum of 1 year after the index procedure. This enhanced design will continue to offer both simplicity and efficiency while allowing you to achieve more with less. Choice of this technique was at the discretion of the treating surgeon, based on fracture pattern, familiarity with the technique, and. Radiolucent targeting arms with easy assembly and friction lock technology. Place the assembly on the resected tibial plateau and using the headed.
T2 alpha tibia nailing system the t2 alpha tibia nailing system is a fracture fixation system and includes sterile implants intramedullary nails in various diameter, compression screw and end caps as well as nonsterile instruments targeting devices. The proximal tibial nail does not feature an oblong hole for optional controlled dynamization and appositioncompression. Position the carm for an ap view of the distal tibia. T2 standard tibial nail and t2 distal tibial nail knowing that 7mm of active appositioncompression is possible, prior to determining the final length of he tmf i p. T2 flexible nail is intended for the temporary stabilization of bone segments or fragments until bone consolidation has been achieved for upper and lower extremity fractures of pediatric patients. Lengthening over a nail lon or transport over a nail ton are relatively new techniques and were first described in the femur by paley and herzenberg in 1997. Suprapatellar nailing of tibial fractures is a simple method.
Stryker trauma has created a new generation locking nail system, bringing together all the capabilities and benefits of separate antegrade and retrograde nailing systems to create a single, integrated surgical resource for fixation of longbone fractures. The t2 tibial nailing system represents the latest and most comprehensive development of the original intramedullary principles presented by prof. For more details regarding the intramedullary fixator principle, please consult the asls technique guide 036. The t2 nailing platform is designed to treat a wide range of fractures in the upper and lower extremities. Pediatric nailing system intramedullary nail for treatment of middiaphyseal, proximal and distal fractures of the femur, tibia and fibula in pediatric patients. Introduction the triathlon knee system instrumentation has been developed based on stryker s 30year orthopaedic history. An increasingly accepted technique is the suprapatellar sp approach. Intramedullary nail for treating proximal, distal, as well as midshaft tibial fractures. T2 alpha tibia nailing system the t2 alpha tibia nailing system offers a combination of innovation, simplicity, and efficiency that is designed to suit your various needs.
Operative technique the t2 arthrodesis nail is inserted with the existing t2 femoral instrument set. There is room for development of the method and improvement of instruments, thus increasing safety and indications. Salvage of congenital pseudarthrosis of the tibia by the. Stryker t2 tibia system nail insertion sleeve, elastic, sterile, a ref 18061406s, spi 0811 and b ref 18061407s, spi 08. Surgical technique implant selection the trigen tan 71180884 and trigen fan 71180497 radiographic templates may be used to assist with preoperative implant selection. Used with the t2 tibial nailing system, the spi instruments offer an alternate method for the insertion of tibial nails in a suprapatellar approach. Stryker gamma3 and t2 intramedullary nailing gamma 3 2011. A stepbystep run through of the surgical technique is described, including. Refer to the t2 femoral nailing system operative technique cat.
The t2 tibial nailing system is intended to provide temporary stabilization of various types of fractures, malunion and nonunion of the tibia. Verify and confirm location under biplanar fluoroscopic guidance. Stryker gamma3 and t2 intramedullary nailing 2011 surgeon course program surgery transmission and cadaver demonstration. Each method has its disadvantages, and most are lacking in.
The main advantages of the technique are limited soft. Nail length, locking screw length and nail cap size may be determined. Universal tibial nail ii surgical technique youtube. Stryker has created a next generation locking nail system, bringing together all the capabilities and benefits of nailing systems to create a single, integrated surgical resource for fixation of longbone fractures. Phoenix tibial nail system the phoenix tibial nail system is indicated for alignment, stabilization, and fixation of fractures caused by trauma or disease, and the fixation of long bones that have been surgically prepared osteotomy for correction of deformity and for arthrodesis. One implant, two approaches stryker has created a next generation locking nail system, bringing together. Introduction the main advantages of the technique are. Nail, t2 supracondylar nail, t2 recon nail, the indications have extended from shaft fractures to fractures of the metaphyseal regions. Stryker gamma3 and t2 intramedullary nailing gamma 3. From june 2007 to january 2011, 501 tibial shaft fractures were treated with an imn at our level i trauma center. Semiextended intramedullary nailing of the tibia using.
T2 tibia nailing system the t2 im nailing platform offers a combination of innovation, simplicity and versatility that is designed to suit your various needs. T2 alpha the t2 alpha femur antegrade gtpf nailing system introduces a hybridimplant concept, providing you with versatile locking configurations in a consolidated implant offering. Semiextended intramedullary nailing of the tibia using a. The distal tibial nail has 2 distal locking holes at 5mm and mm centered from the distal tip. The tibial insert impactor 654148, which is available in the standard triathlon primary instrument set, may be used for the final seating of the tibial insert. The core instruments of the t2 system provide the platform for all current and future stryker nailing systems, thereby reducing complexity and inventory. A major advantage of the system is the stateoftheart instrument platform. Surgical technique phoenixtm tibial nail system featuring corelocktm technology each nail features corelocktm technology, a preassembled, embedded locking mechanism for locking all proximal oblique screws, which can also be used to internally mechanically compress up to 5mm for a variety of tibial fractures. Ankle arthrodesis nailing system this publication sets forth detailed recommended procedures for using stryker devices and instruments. T2 8mm nails require the use of 4mm fully threaded locking screws. Increased proximal locking options more distal locking pattern with most distal hole remaining 5mm from tip up to 7mm of active internal compression angular. Trigen metanail tibial nail specifications driving end of nail all knee and distal tibial top view of nail nondriving end of nail ml view ap view set does not include all sizes. Gilbert taglang, multidisciplinary trauma surgeon, consultant designer of stryker s.
Assemble the appropriate tibial augment trials to the distal surface of the universal tibial template. T2 s2 nails with diameters larger thanequal to 9mm do not require guide wire exchange. A more distal entry point may result in damage to the posterior cortex during nail insertion. The nailing system s targeting device is made of radiolucent carbon fiber and features our patented friction locking mechanism. T2 alpha tibia nailing system 8mm nails nonclinical testing has demonstrated that the t2 alpha tibia nailing system and imn screws system are mr conditional.
The t2 im nailing platform offers a combination of innovation, simplicity and. The purpose of this study was to compare the clinical and functional outcomes of knee joint after tibia imn through an suprapatellar sp or traditional infrapatellar ip approach. Removal of the distal aspect of a broken tibial nail mdedge surgery. According to the fracture type, the system offers the option of different locking modes.