Liam Carter
Tibial nails are used for the fixation of tibial fractures. They are designed to provide stability to bone segments or fragments until bone consolidation is achieved. Various companies manufacture tibial nails, including Stryker, OrthoXel, Globus Medical, DePuy Synthes, and Orthofix. These companies offer different tibial nailing systems, such as the T2 Alpha Tibia Nailing System, Apex Tibial Nailing System, AUTOBAHN™ Tibial Nailing System, Titanium Cannulated Tibial Nail, and Centronail Titanium Tibial Nail. These systems aim to provide innovative and effective solutions for tibial fracture treatment, offering features like versatility, stability, and enhanced healing.
| Characteristics | Values |
|---|---|
| Company | Product |
| Globus Medical | AUTOBAHN™ Tibial Nailing System |
| DePuy Synthes | Titanium Cannulated Tibial Nail-EX |
| Stryker | T2 Alpha Tibia Nailing System |
| OrthoXel | Apex Tibial Nailing System |
| Orthofix | Centronail Titanium Tibial Nail |
| MedicalExpo | Tibia / Targon® TX Intramedullary nail system, Targon® T Interlocking nail system, Multi-Dimensional Tibial Suprapatellar Approach Intramedullary Nail System, Tibial Intramedullary Nails (X Series) |
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What You'll Learn
Tibial Intramedullary Nails
Stryker
The company offers the T2 Alpha Tibia Nailing System, which is designed for temporary stabilisation of bone segments in cases of tibial fractures. The system offers innovation, simplicity, and efficiency, catering to various tibial fixation needs. The T2 Alpha Tibia Suprapatellar system provides drill sleeve options to accommodate nail diameters ranging from 8 to 13mm.
OrthoXel
OrthoXel introduces the Apex Tibial Nailing System, which promotes secondary bone healing with controlled axial micromotion and torsional stability. Their system is the first to offer these features in intramedullary nails, enhancing healing compared to traditional nailing methods.
Globus Medical
Globus Medical offers the AUTOBAHN™ Tibial Nailing System, which provides versatile implant solutions with innovative instruments for multiple approaches. It features an Anterior Oblique Locking Hole and distal locking holes, offering a fixed-angle locked construct for distal and proximal fractures, while also reducing soft tissue irritation.
DePuy Synthes (J&J MedTech)
DePuy Synthes, a part of J&J MedTech, offers the Titanium Cannulated Tibial Nail-EX, which includes titanium locking screws and bolts for IM Nails.
Orthofix
Orthofix presents the Centronail Titanium Tibial Nail, which utilises nail-connected distal targeting for accuracy in all anatomical sites and minimises fluoroscopy time.
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Tibial Nailing Systems
Tibial nails are used for tibial fractures and temporary stabilization of bone segments or fragments until bone consolidation is achieved. There are several tibial nailing systems available from different medical device manufacturers. Here is an overview of some of the tibial nailing systems on the market:
T2 Alpha Tibia Nailing System by Stryker
The T2 Alpha Tibia system is an intramedullary nail designed for temporary stabilization of tibial fractures. It offers a combination of innovation, simplicity, and efficiency, catering to various tibial fixation needs. The T2 Alpha Tibia Suprapatellar system provides drill sleeve options to accommodate nail diameters ranging from 8 to 13mm. It also features an elastic nail insertion sleeve to protect the joint space and WCH-coated fixation k-wires for secure fixation in the tibial plateau.
Apex Tibial Nailing System by OrthoXel
The Apex Tibial Nailing System is a significant advancement in fracture fixation. It is the first and only tibial nailing system that promotes secondary bone healing through controlled axial micromotion and exceptional torsional stability. The system allows for implantation via both suprapatellar and infrapatellar surgical approaches and features bespoke instrumentation designed specifically for these approaches. Patients treated with Apex nails in micromotion locking mode have demonstrated faster healing and zero nonunions compared to conventional locked nails.
AUTOBAHN™ Tibial Nailing System by Globus Medical
The AUTOBAHN™ system provides versatile implant solutions with innovative instruments for multiple approaches. It features an Anterior Oblique Locking Hole and distal locking holes, offering a fixed-angle locked construct for far distal and proximal fractures. The system is designed to reduce soft tissue irritation and includes a one-piece pre-assembled cannula for tibial and femoral anchoring options.
Centronail Titanium Tibial Nail by Orthofix
The Centronail™ family utilizes nail-connected distal targeting, ensuring accuracy in all anatomical sites and minimizing fluoroscopy time.
Tibial Intramedullary Nails by Various Manufacturers
Several medical device manufacturers offer tibial intramedullary nails for specific indications, such as proximal lateral tibial shaft fractures, tibial diaphyseal comminuted or segmental fractures, and pediatric and adolescent patients with temporary fixation of fractures. These nails often feature dynamic continuous compression and the option for dynamic or static locking.
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Tibial Nail End Caps
The use of end caps in ESIN was introduced to address complications that can arise from secondary fracture displacement, which can lead to limb shortening, malrotation, and malalignment. The AO expert group (Osteosynthesis Association, Davos, Switzerland) designed cylindrical, hollow-threaded end caps to be inserted at the tip of the nails, providing a more stable construct for treating fractures.
One example of a tibial nail end cap is the Meta-Nail Tibial Nail End Cap (Smith & Nephew). However, there have been reported complications with this device, including incomplete insertion of the end cap and bending of the proximal locking screw upon insertion.
Another product is the ATN-Intramedular Tibia Nail End Cap, which comes in various sizes, including 0 mm, 5 mm, and 10 mm. The AUTOBAHN™ Tibial Nailing System by Globus Medical also offers implant solutions with innovative instruments for multiple approaches, providing tibial and femoral anchoring options.
In conclusion, tibial nail end caps are an important component of ESIN procedures, providing stability and helping to prevent complications associated with tibial fractures. Various companies offer tibial nail end caps as part of their medical device portfolios.
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Tibial Nail Systems for Paediatric Patients
Tibial nail systems are used to treat fractures in the tibia, or shinbone, which is the larger of the two bones in the lower leg. These fractures can occur due to various reasons, such as sports injuries, accidents, or trauma.
Pediatric Tibial Nail Systems:
Pediatric tibial nail systems are designed specifically for treating fractures in children and adolescents. These systems take into account the unique anatomy and growth patterns of young patients, ensuring that the treatment is safe and effective for their developing bones. Here are some of the tibial nail systems available for paediatric patients:
Titanium Elastic Nails (TENs):
TENs are a popular choice for treating pediatric tibial shaft fractures. They are made of titanium, a lightweight and biocompatible material. The elasticity of these nails allows for flexible intramedullary nailing, which has gained popularity due to its clinical effectiveness and low risk of complications. TENs are inserted through small incisions, preserving the fracture hematoma and utilising a physeal-sparing entry point. This technique promotes rapid healing, with an average healing time of 11 weeks and an acceptable rate of complications.
Pediatric Nailing Platform (PNP) Tibia System:
The PNP Tibia System, developed by OrthoPediatrics Corp., offers a range of rigid cannulated nails with diameters from 7mm to 12mm. This system is designed to treat fractures and deformities in the lower extremities of pediatric patients. The versatility of the PNP system allows surgeons to address the needs of children of all sizes, from smaller statured kids to taller teenagers. The system includes specialised instrumentation to facilitate multiple surgical techniques.
Flexible and Rigid Intramedullary Nails:
There are two types of intramedullary nails commonly used in paediatric tibial fracture treatment: flexible and rigid nails. Flexible intramedullary nails are suitable for long bone fractures and have advantages such as closed insertion and preservation of the fracture hematoma. Rigid intramedullary nails, on the other hand, provide stable fixation and are often used in more complex fractures. The choice between flexible and rigid nails depends on the patient's specific needs and the surgeon's assessment.
Tibial Intramedullary Nails:
Tibial intramedullary nails are designed for fractures in the proximal lateral of the tibial shaft, including tibial diaphyseal comminuted or segmental fractures. These nails can be used for temporary fixation, helping with fracture healing and ensuring stability. The dynamic continuous compression (DCC) ankle fusion nail is one example within this category, offering the option of dynamic or static locking.
The development of specialised tibial nail systems for paediatric patients has revolutionised the treatment of tibial fractures in children and adolescents. These systems are designed to address their unique anatomical needs, promote faster healing, and minimise complications, ensuring the best possible care for young patients.
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Titanium Tibial Nails
The ACE titanium tibial nail, manufactured by DePuy International Limited, Leeds, UK, has been used to treat tibial fractures in 221 patients between 1995 and 2003. The results showed no increase in complications compared to other treatments. In fact, only 32% of patients developed knee pain compared to the previously reported 40-57%.
Titanium elastic nails (TENs) have also been used to treat tibial shaft fractures in children. A study conducted between 1998 and 2005 identified 19 patients with an average age of 12.2 years who were treated with TENs. The results showed that elastic stable intramedullary nailing with titanium elastic nails is an effective surgical technique that allows rapid healing of tibial shaft fractures with an acceptable rate of complications.
The AUTOBAHN™ Tibial Nailing System by Globus Medical offers versatile implant solutions with innovative and unique instruments for multiple approaches. The system includes an Anterior Oblique Locking Hole and distal locking holes that provide a fixed-angle locked construct for far distal and proximal fractures.
In summary, titanium tibial nails are a promising treatment option for tibial fractures, especially unstable or displaced fractures. While there were initial concerns about increased complications, studies have shown that titanium nails are safe and effective, with acceptable complication rates.
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Frequently asked questions
A tibial nail is a medical device used for tibial fractures. They are intended for the temporary stabilization of bone segments until bone consolidation has been achieved.
OrthoXel, Stryker, DePuy Synthes, Narang Medical, and Apex are some companies that manufacture tibial nails.
Tibial nails are often made of titanium alloy to improve mechanical and fatigue properties.
There are several types of tibial nails, including intramedullary nails, interlocking nails, and suprapatellar tibial nails.
