Distal Tibial Shaft Fracture via Intramedullary Nail with Suprapatellar Approach

Enhance your skills in the treatment of distal diaphyseal tibial fractures, especially in elderly patients, aiming for early rehabilitation and ambulation. This training offers a technical immersion in intramedullary nail osteosynthesis with a suprapatellar portal, optimizing alignment and minimizing invasiveness.

Training Focus:

• Treatment of distal diaphyseal tibial fractures in elderly patients.
• Intramedullary nail fixation.
• Suprapatellar access technique.
• Optimization of alignment and stability for early rehabilitation.
• Minimization of invasiveness and protection of soft tissues.

Detailed Content:

• Strategic Patient Positioning: Methodology for positioning with the knee in semi-flexion and alignment of the diaphysis guided by palpation of the tibial crest, crucial to avoid complications with the soft tissues.
• Precise Creation of the Suprapatellar Portal: Skin marking techniques and access with an electric scalpel, positioned in the lower region, near the trochlea and the apex of the patella, using a protective sleeve to preserve the articular cartilage.
• Optimized Angle of Attack: Benefits of suprapatellar access for a superior angle of attack, facilitating the passage of the guide wire and milling with greater comfort and ease.
• Reduction and Insertion of the Guide Wire: Methodology for percutaneous reduction with forceps, with progression of the olive guide wire and verification of its centralization in the AP and lateral views, aiming at the center of the ankle.
• Milling and Introduction of the Intramedullary Rod: Milling techniques to widen the medullary canal and introduction of a larger diameter rod, maintaining the protective sleeve and safeguarding the articular cartilage.
• Proximal and Distal Blocking: Execution of proximal blocking percutaneously with the patient keeping the leg in a stable position, and "free-hand" technique for the distal locking screws, with precise skin marking to avoid friction with soft tissues.
• Optional Fixation of the Fibula: Indication and technique for fibula fixation with TEN rod in distal fractures to optimize stability and allow early loading and ambulation.
• Closure and Rehabilitation: skin closure and rehabilitation that allows for full weight-bearing ambulation and a favorable prognosis.

Included Material:

• Complete Technical PDF: A complete step-by-step of the procedure, from patient positioning to surgical closure.

Elevate your level in trauma surgery. Enroll now and master the technique of distal tibial diaphyseal fracture fixation with intramedullary nail via suprapatellar access, optimizing outcomes and rehabilitation.