Proximal tibia fracture Nailing combined with plating.pptx

proximal tibia fractures

1. Nailing With Plate Augmentation

2. Biomechanical Perspective Load Distribution: Combines axial load-sharing of the intramedullary nail with buttressing and angular stability provided by the locking plate. Reduced Stress on Individual Implants: Load-sharing between implants decreases the risk of hardware failure. Enhanced Rotational Control: Stabilization of both metaphyseal and diaphyseal components improves resistance to torsional forces.

3. Indications Complex Proximal Tibial Fractures: Fractures with metaphyseal and diaphyseal extension ( Schatzker types V and VI). Segmental Fractures: Situations requiring stabilization of both articular and shaft components. Coronal Plane Fractures: Challenging to stabilize with a single implant. Varus/Valgus Malalignment: Dual implants provide enhanced stability to correct alignment. Patients with Osteoporotic Bone: Ensures better fixation in cases of poor bone quality. Failed Previous Fixation: Salvage procedures where a single method is insufficient.

4. Advantages of Combining Plating with Nailing

5. Surgical Tips & Tricks Preoperative Planning: Use 3D imaging (CT scan) for accurate fracture mapping and implant choice.

6. Complications and Disadvantages Increased Surgical Time: Longer operative time due to dual implant fixation. Increased exposure to Radiation. Malalignment: Potential for varus/valgus malalignment if reduction is inadequate. Cost Considerations: Dual implants and extended surgical time increase overall treatment cost. Complex Revision Surgery: If complications arise, revising dual implants is challenging.