a. Close Femoral Incisions & Debride Tibial Fracture

b. Locate Entry Point for Tibial Nail

c. Insert Guide Wire

d. Ream Tibia

e. Insert Nail

1. Tibial Nail

a. Place Traction Pin

b. Closing

2. Traction Pin and Closing

The tibia is particularly susceptible to open fractures because of its subcutaneous location. The status of the overlying soft tissue is regarded as the key determinant of fracture management strategy. Intramedullary nailing is widely recognized by the orthopedic community as the treatment of choice for most displaced, open, tibia shaft fractures due to the extent of soft tissue damage and the risk of infection. Both open and closed fractures are amenable to nailing. Occasionally, plates and external fixators are required to manage certain tibial fractures.
This article describes the stabilization of an open tibia shaft fracture using an intramedullary nail. After copious irrigation and debridement of the fracture site, a transpatellar tendon split is used to expose the nail entry point. This is followed by fracture reduction, sequential reaming, and nail insertion and locking. Finally, the technique for proximal tibia traction pin insertion is demonstrated on the contralateral tibia.


Brigham and Women's Hospital

Intramedullary Nail for Open Tibial Fracture

0098b - 2015-07-28 - Weaver - Tibial Nail - Final Candidate.mp4

0098b - Weaver Tibial 

The tibia is particularly susceptible to open fractures because of its subcutaneous location. The status of the overlying soft tissue is regarded as the key determinant of fracture management strategy. Intramedullary nailing is widely recognized by the orthopedic community as the treatment of choice...

Intramedullary Nail for Open Tibial Fracture | Journal of Medical Insight

DOI
Publication Date	N/A
Article ID	33
Production ID	0098.2
Volume	N/A
Issue	33
https://doi.org/10.24296/jomi/33

Intramedullary Nail for Open Tibial Fracture

Procedure Outline

Table of Contents

Tibial Nail

Traction Pin and Closing