Tibial Intramedullary Nail - Infrapatellar Approach

The stabilization of diaphyseal tibial fractures requires precision in the entry portal, axial alignment, and soft tissue protection. This training presents, in an objective and practical way, the technique of intramedullary nail implantation via the infrapatellar approach, with a detailed demonstration of surgical steps, radiographic control, and minimally invasive execution from a technical perspective.

Training Focus:

• Strategic patient positioning for optimal knee flexion;
• Anatomical marking and precise definition of the tibial axis;
• Infrapatellar access with preservation of the paratendon and patellar tendon;
• Safe introduction of the guide wire and olive-tipped wire with radiographic control;
• Soft tissue protection during reaming and milling;
• Correct measurement and appropriate reaming of the medullary canal;
• Insertion of the intramedullary nail and checking of its positioning;
• Proximal and distal locking with a minimally invasive approach;
• Anatomical closure and post-operative evaluation.

Detailed Content:

• Optimized Patient Positioning: Strategies for achieving adequate knee flexion, facilitating alignment and access to the entry portal;
• Precise Anatomical Reference: Marking techniques with dermographic pen and Kirschner wire to ensure anteroposterior and lateral alignment;
• Safe Infrapatellar Access: Linear incision with preservation of the paratendon and patellar tendon, allowing for anatomical closure and reduced morbidity;
• Efficient Radiographic Control: Methods to prevent posterior guidance of the guide wire and ensure centralization of the olive-tipped wire;
• Tissue Protection During Reaming: Proper use of the soft tissue protector to prevent tendon injuries and anterior cortical damage;
• Precise Medullary Canal Reaming: Parameters for choosing the ideal diameter and preparing the canal without risk of fissures;
• Nail Insertion with Stability: Techniques to prevent prominence, ensure adequate advancement, and minimize trauma when removing the olive-tipped wire;
• Minimally Invasive Proximal and Distal Locking: Execution of crossed and distal locking with small portals and intensifier control;
• Post-Implant Evaluation: Criteria to confirm stability, alignment, and absence of nail prominence.

Included Material:

• Detailed PDF with technical sequence, anatomical references, reaming parameters, and soft tissue care.

Elevate your precision in tibial osteosynthesis. Enroll now and enhance your execution of the infrapatellar technique with safety and efficiency.