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Global Avancé Tibia Nailing Instruments Kombo 2025 Top 6 Innovations

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Ba fractures ya tibiale .

Arbre tibiale ezali moko ya ba sites oyo emonanaka mingi mpo na ba fractures, oyo esali 13,7% ya ba fractures nionso na nzoto. Tibia distale ezali na ba caractéristiques anatomiques lokola mauvaise compensation ya fourniture ya makila mpe couverture minimal ya tissus mous. Soki fracture esalemi, kobebisama ya ba tissus mous mpe makila ya esika oyo ebebi ekoki kobakisa mpasi ya kobika ya fracture. En plus, probabilité ya likolo ya ba fractures fibulaires concurrentes mpe instabilité esalaka que pona approche chirurgicale oyo ebongi ezala essentiel.

Section transversale ya arbre tibial ya kati na likolo ezali triangulaire, nzoka nde troisième inférieur ezali quadrilatéral. Bokutani ya ba trois ya katikati mpe ya nse ezali relativement moke mpe ezali komonisa mbongwana na lolenge, yango wana ezali esika oyo bato mingi babukaka.

Moto ya misato ya liboso ya tibia ezipami bobele na loposo kozanga ete misisa ezipama, mpe yango esalaka ete ezala na likoki ya kofungola ba fractures epai mikuwa epasukaka loposo. Ata na ba fractures fermées, mingi ya ba fractures tibiales ezo accompagner na ba dégâts ya loposo na tissu subcutané. Mid-Tibia ezangi couverture ya muscle, mpe ezali na ba compartiments fasciaux minei oyo etali tibia na fibula. Incidence ya syndrome ya compartiment ezali mingi na ba fractures tibiales soki tokokanisi yango na ba fractures mosusu.

Classification ya Fracture .

Classification ya dislocation ya fracture ya AO/OTA .

Bokaboli ya ba nombres arabes ya AO/OTA elakisaka ba fractures ya arbre tibial lokola 4 (tibia) 2 (arbre). Type A ekokani na ba fractures simples na ligne ya fracture moko, oyo ezali type oyo emonanaka mingi. Ba fractures ya type B ezalaka na fragment ya forme ya wedge intermédiaire. Ba fractures ya type C esalemaka na ba traumatismes ya énergie makasi mpe ezali ba fractures segmentaires commiminées.

Classification ya Gustilo mpo na ba fractures ya polele:

  • Lolenge I: Bolai ya mpota na nse ya 1 cm, mbala mingi mpota ya kotɔbɔla oyo ezali mpenza pɛto te na nsɔngɛ ya mikuwa oyo ebimi na kati ya loposo. Kobebisama ya ba tissus mous ezali moke, na kozoka ya konyata te. Fracture ezali simple, transversale, to oblique mokuse, sans comminution.

  • Lolenge II: Mpota eleki 1 cm, na kobebisama ya ba tissus mous mingi kasi na bokeli ya avulsion to ya lambeau te. Ba tissus mous elakisaka ba blessures ya écrasement ya moke to ya moyenne, contamination ya moyenne, mpe comminution moyenne ya fracture.

  • Lolenge III: Kobebisama monene ya ba tissus mous oyo esangisi misisa, loposo, misisa ya makila, mpe misisa, oyo ezali na contamination makasi.

    • Type IIIA: Atako ba blessures ya avulsion ya monene to formation ya flap, to traumatisme ya énergie makasi sans considérer taille ya mpota, ezali na couverture ya tissus mous adéquats likolo ya fracture.

    • Lolenge IIB: Kobebisama ya ba tissus mous ya monene mpe kobungisa, na kolongolama ya périoste mpe na mokuwa oyo emonisami, elongo na contamination makasi.

    • Type IIIC: oyo esangisi na ba blessures artérielles oyo esengaka kobongisa.

Ba options ya traitement .

Ba traitements non chirurgicals mpo na ba fractures tibiales ezali ba braces, fixation extérieure ya plâtre, traction, réduction manuelle, mpe usage ya ba cadres ya fixation ya libanda. Options ya lipaso ezali fixation interne ya plaque fermée mpe ko clouer intramédullaire, parmi basusu.

Fixation ya ba clous intramédullaires .

Fixation intramédullaire de clous ezali favorisé na ba chirurgiens orthopédiques ebele ya traumatisme en raison ya procédure na yango ya lipaso simple, ba petits incisions, ba traumatismes minimales, mpe kolongolaka convenable ya nsuki sima ya guérison ya fracture. Ezali kopesa fixation interne makasi, ko permettre exercice fonctionnel post-opératoire précoce mpe ko éviter ba complications locales mpe systémiques. Ba avantages wana ezo aligner na ba principes ya AO ya traitement.

Czmeditech Tibial Intramédullaire Solution

Ensemble de ongles & instruments intramédullaires d'intramédullary .

1.Proximal Oblique Ekatami .

Kokata oblique antérieure na suka ya proximal epekisaka irritation na ligament patellar.

2. Conception ya Locking ya liboso .

Conception proximale ya proximal ematisaka stabilité oyo olingi pona fragment proximal.

3. Lock ya oblique distal .

Option ya blocage oblique distal mpo na kopekisa kobebisama ya ba tissus mous mpe komatisaka stabilité ya fragment distal.

4. Vis ya filet double .

Vis ya blocage oyo esalemi na fil ya plomb double mpo na insertion ya pete.

Approche suprapatellar Tibial Intramédullaire Ongles & Instrument Set

Mecanisme ya kokanga .

Conception ya blocage pona fixation ya makasi, réduire dislocation ya fragment post-opératoire.

Lisungi ya ba points ebele .

Multi points de fixation epesaka stabilité angulaire mpe soutien stable mpo na palteau tibial.

Ba phases ya compression .

Appareil yango ezali na fonction ya réglage adaptatif, na ba changements morphologiques na yango oyo elakisami na ba illustrations na ba conditions nionso mibale avant compression (état de loose) mpe ba conditions post-compression (oyo esimbami makasi).

fixation proximale-distal .

Méthode multi fixation à partir ya proximal na distal, elakisaka ba fractures tibiales proximales et distales ultimes.

Ongles intramédullaire tibial distale (DTN) & ensemble ya ba instruments

Design plat mpo na kokɔtisa yango na pɛtɛɛ nyonso .

Nsuka ya mosika ya nsuki ya ntina ezali na motindo ya patatalu, mpe yango ezali kosala ete bákɔtisa yango na pɛtɛɛ nyonso na kati ya libenga ya médullaire.

Ba vis ya kokanga angulaire .

Ba vis mibale ya blocage angulaire na suka ya proximal epekisaka rotation mpe déplacement ya segment ya fracture.

Curvature anatomique .

Curvature anatomique spéciale e assure ba ongles principal ezali optimalement positionné na kati ya cavité médullaire.

Ba vis ya blocage ya angle oyo ezo intersecter .

Ba vis ya blocage ya angle oyo ekatanaka na suka ya mosika epesaka soutien mpe fixation efficace.

Ensemble de ongles & instruments intramédullaires tibiaux .

versatilité:

Ebongi mpo na mingi ya ba fractures ya arbre tibiale (arbre ya katikati mpe mwa ba fractures distale/proximales), nzokande mitindo mosusu (ndakisa, DTN to nsuki ya expert) esalemi mpo na ba régions anatomiques spécifiques to ba fractures complexes.

Technique ya lipaso oyo ekoli:

Approche standard (parapatellar to transpatellar) elandi procédure oyo esalemi malamu na courbe ya apprentissage ya se, nzoka nde ba approches spécialisées (ndakisa, suprapatellar) esengaka formation technique ya kobakisa.

Ntalo ya mosolo:

Comparé na ba ongles spécialisés lokola expert ongles to DTN, ba ongles intramédullaires tibial standard ezalaka typiquement plus abordables, esala que ezala approprié na ba cas routiniers.

Compatibilité ya implant ya monene:

Compatible na instrumentation universelle (ndakisa, ba vis ya blocage, ba dispositifs ya ciblage), alors que ba ongles spécialisés (par exemple, ba nsɛlɛlɛ ya expert na ba systèmes ya blocage multi-directionnels) ekoki kosenga ba outils propriétaires.

Type Meilleur Indications Ba avantages ya moboko .
Nail ya expert . Fractures de arbre complexe, Osteoporose . Locking multi-planaires, stabilité ya likolo .
Nail suprapatellar . Fractures proximales, ba malades obeses . Approche suprapatellar, ekitisaka ba complications ya genoux antérieur .
DTN . Fractures Distal (Sertien de cheville près de) . Locking distale multi-directionnel, ezali ko résister na mokuse .
Nail standard . Fractures simples ya arbre ya milieu . Fonctionnement simple, coût-efficace .

Classification ya ba instruments ya ba ongles ya Tibia .

  1. Bisaleli ya kotimola biloko : Esangisi bits ya forage, ba reamères, mpe bisaleli mosusu oyo basalelaka mbala moko mpo na kotimola mikuwa.

  2. Ba dispositifs ya ciblage : Ba instruments ya positionnement mpe ya guidage ya forage to placement ya implant, lokola ba fils guides, ba manches ya guide, na ba appareils ya visant.

  3. Bisaleli ya kokanga biloko : Bisaleli oyo basalelaka mpo na kokangisa, kokanga, to kobongisa biloko oyo batyaka na nzoto, na ndakisa ba joints universels, ba clés, ba vis, mpe ba marteaux.

  4. Bisaleli ya komeka : Bisaleli mpo na komeka bozindo, positionnement, to kosunga na lipaso, lokola ba jauge ya bozindo, ba pinces ya kokitisa, mpe ba awls ya mikuwa (AWL).

Ba instruments ya fixation .
Bisaleli ya kotimola .
Bisaleli ya komeka .
Ba dispositifs ya ciblage .
    

Etape na litambe ya lipaso ya lipaso .

1. Bobongisi ya liboso ya lipaso .

Evaluation ya imagerie : Rayon X/CT préopératoire pona ko confirmer type ya fracture, diamètre ya canal médullaire na longueur, na mesure ya tibia contralatérale comme référence.

Positionnement: Position ya supine na flexion ya genoux 90°-120° mpe mwa adduction ya hanche (po na ko réduire tension ya tendon patellar). Cadre radiolucent triangulaire ekoki ko soutenir fosse popliteale pona traction.

Draping stérile : stérilisation ya maboko standard mpe draping, ko assurer mobilité ya arme C.

2. Bokiti ya fracture .

Ba techniques ya réduction fermée .

Traction manuelle : Assistant a appliquer traction longitudinale alors que chirurgien a palpamaka crête tibiale na surface antéromesal pona ko ajuster alignment (longueur, rotation, angulation).

Lisungi ya bisaleli:

  • Technique ya joystick : ba vis ya Schanz oyo ekotisami na ba fragments proximaux/distal pona réduction ya levier.

  • Clamping percutané: Ba pinces ya réduction pointue mpo na ba fractures obliques/spirales.

  • Distracteur : Distracteur ya munene etie na coronalement (vis proximal schanz parallèle na plateau tibial, broche distale na talus to tibia distale) mpo na ko maintenir longueur.

3. Localisation ya point d'entrée .

Ba repères:

  • Point d'entrée 1cm distal na bord ya plateau tibial antérieur, aligné na axe médullaire.

  • Confirmation fluoroscopique: AP View aligns na crête tibiale, vue latérale parallèles Axe tibial.

Bisaleli ya kofungola:

  • Perceuse cannulée sur guidewire (na manche ya protection) to AWL solide courbe.

  • Ba reamères ya maboko (6-8mm) pona ba fractures ya kala na occlusion ya canal.

4. Bokotisi ya nsinga ya motambwisi & Reaming .

guidewire Placement: Balle-tipped guidewire bent 10-15mm na pointe pona passage ya fracture. Confirmation fluoroscopique na cicatrice physale distale (centre ya cheval).

Protocole ya ko réaming:

  • Ba réamères flexibles kobanda na 8mm, incrementing 0,5mm tiii cortical 'chatter' (typiquement 1-1,5mm > diamètre ya nsuki).

  • Liyebisi: Kobima na ntango mosusu elongolaka biloko oyo ebebi; Bokima nécrose thermique.

5. Kokɔtisa nsuki .

Boyebi ya bolai:

  • Mesure intra-opératoire: Méthode de chevauchement de guidewire to règle fluoroscopique (point d’entrée na articulation ya cheville).

  • Assurez-vous que pointe ya ongles ekoma na cicatrice physaire sans protrusion proximale.

Technique ya insertion:

  • Kokende liboso na mabɔkɔ likoló ya guidewire; Bobongisa réduction soki résistance esalemi.

  • Bobatela kokitisa na ntango ya passage mpo na ba fractures ya mosika.

6. fixation ya vis ya interlocking .

Stratégie ya sequence .

  • Fractures stable-stable: Locking proximal liboso (vis moko epesaka nzela na dynamisation).

  • Bolai-ekoki kofandisama te/ba fractures ya comminution: Locking distal elandami na 'backslap' mpo na ko compresser.

Locking ya proximal .

  • ≥2 vis via dispositif visant (multidirectionnel pona ba fractures proximales).

Locking ya mosika .

  • Technique fluoroscopique: faisceau central perpendiculaire na ba mabulu ya vis ('Cercle parfait'), perçage percutané.

  • ≥2 vis mpo na ba fractures distale (ekoki kosangisa ba orientations AP/Obliques).

7. Misala ya nsuka .

Bouchon ya suka: Insertion optionnelle (epekisaka ingrowth ya mikuwa), sala que protrusion ya articulation ezala te.

Cloture ya ba mpota : réparation ya tendon patellar couché na ba sutures sous-cutanées oyo ekangami te.

8. Bokambami ya sima ya lipaso .

Réadaptation ya liboso:

  • elevation ya maboko ya makolo; Monitor mpo na syndrome ya compartiment na kati ya 24hrs.

  • Kobanda mobilisation active ya articulation (pompe à chemin, flexion ya genoux) na POD 1-2.

Protocole ya komema kilo:

  • Komemaka kilo ya ndambo na boumeli ya pɔsɔ 6 (ebongisami mpo na stabilité moko), kokende liboso tii ntango Callus abimi.

Bolandi : Evaluation clinique/radiologique na poso 2, 6, mpe 12.

Variations spécifiques ya marque .


Depuy Synthèses (Johnson & Johnson)

Siège: Raynham, Massachusetts, États-Unis

Flagship Biloko ya kosala:

  • Expert Tibial Nail (ETN) – oyo esalemi mpo na stabilité na ba fractures tibiales complexes.

  • T2 Tibial Nail – epesaka fixation mpe compression oyo ebakisami.

Bokasi ya ntina : R&D ya makasi, bopanzani ya mokili mobimba, mpe bosangisi na ba solutions ya traumatisme.

Logo-1.
★★★★★
Depuy Synthèses (Johnson & Johnson)
Expert Tibial Nail (Etn)
T2 Tibial Nail .

Stryker .

Siège: Kalamazoo, Michigan, États-Unis

Flagship Biloko ya kosala:

  • T2 Ongle Tibial – Système modulaire mpo na ba fractures ya arbre tibial.

  • Gamma3 Tibial Nail – esangisaka nsɛtɛ ya intramédullaire na ba options ya blocage.

Bokasi ya ntina: Robotique ya liboso (MAKO), ba solutions oyo ezo invarer mingi te, mpe portefeuille ya ba traumatismes ya makasi.

Logo-2.
★★★★★
Stryker .
T2 Ongles Tibial
Gamma3 Ongles Tibial . 

Smith & mwana ya ndeko na ye ya mobali .

Siège: Londres, Royaume-Uni

Flagship Biloko ya kosala:

  • Trigen Tibial Nail – Esalemi mpo na pete ya kokotisa mpe stabilité.

  • Im tibial Ongle – Fixation intramédullaire mpo na ba fractures tibiales.

Bokasi ya ntina: Kotya likebi na nkisi ya masano mpe na mpasi ya motema, biloko ya sika.

Logo-3.
★★★★★
Smith & mwana ya ndeko na ye ya mobali .
Trigen Tibial Nail
Im Tibial Nail .

Czmeditech .

Siège: Changzhou, Chine

Flagship Biloko ya kosala:

  • Ongle intramédullaire tibial distale (DTN) – optimisé mpo na ba fractures distale.

  • Expert Tibia Intramedullary Nail – Conception ya alliage ya titane ya makasi.

  • Approche suprapatellar Tibial Ongle intramédullaire – insertion minimalement invasive.

  • Ongle intramédullaire tibial – Ba options ya fixation versatile.

Bokasi ya ntina: ba solutions ya talo moke, kopanzana ya présence mondiale.

Logo-6.
★★★★★
Czmeditech .
Distal Tibial Intramédullaire Ongle (DTN)
Expert Tibia Intramédullaire Ongle
Suprapatellar Approche Tibial Intramédullaire
Ongle Tibial Ongle Intramédullaire

Biomet ya Zimmer .

Siège: Varsovie, Indiana, États-Unis

Flagship Biloko ya kosala:

  • Znn Tibial Nail – Conception anatomique mpo na kobongisa malamu.

  • Système ya ba ongles naturels – ezo imiter mécanique ya mikuwa naturel.

Bokasi ya ntina : makasi na reconstruction ya articulation, intégration ya biologiques, mpe ba solutions personnalisées.

Logo-4.
★★★★★
Biomet ya Zimmer .
ZNN Tibial Nail
System Na Nail System .

Orthofix .

Siège: Lewisville, Texas, États-Unis

Flagship Biloko ya kosala:

  • Lon Tibial Nail (Ongle orthopédique latérale) – oyo esalemi mpo na approche ya entrée latérale.

Ba forces clés: Spécialisée na stimulation ya croissance ya mikuwa, correction ya déformité ya makolo.

Logo-5.
★★★★★
Orthofix .
Lon Ongle Tibial (Ongle orthopédique latérale)

Maloba ya nsuka

CzmediTech epesaka ba solutions ya zolo ya tibial ya mobimba mpo na ba fractures proximales, distales, mpe complexes, na ba designs ya sika (ndakisa, blocage multi-directionnel, approche suprapatellar) oyo ekokani na ba marques ya liboso ya mokili mobimba na biomécanique mpe ba résultats cliniques.

Ba références .

[1].德康医疗. 德康医疗胫骨骨折解决方案——胫骨髓内钉. 德康康疗, 26 septembre 2024, https://mp.weixin.qq.com/s/g7pe8xf-25zsvlbxbluc9q.

[2].Fondation ya AO. (ND). Kokanga na kati ya nsɛlɛlɛ ya kati mpo na kopangusa arbre tibial Fracture spirale simple [technique chirurgical]. AO Référence ya lipaso. Ezwami o mokɔlɔ 10 yúli 2024, na https://surgeryreference.aofoundation.org/orthopedic-trauma/trauma-adult/arbre-tibial/Fracture-Fracture-spiral/intramédullary-nailing?Sechurl=/resultats ya bolukiluki

Contactez-nous .

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Biloko ya kosala .

Mosala

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