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January 2025 chhunga North America-a Distal Tibial Intramedullary Nails (DTN) 10 zingah a tha ber
January 2025 chhunga North America-a Distal Tibial Intramedullary Nails (DTN) zinga top 10 zingah a tel
Views: 0 Author: Site Editor A chhuah hun: 2025-06-17 A chhuahna: Hmun
Distal Tibial Intramedullary Nail (DTN) hmanga enkawlna hmuna zirchianna
Surgical Technique, Outcome, leh A hman dan kimchang taka thlirletna
June 17, 2025-a tihchhuah a ni
Distal Tibial Intramedullary Nail (DTN) hi tibial condition hrang hrang tan hman a ni a, chung zingah chuan simple, spiral, comminuted, long oblique, leh segmental shaft fracture (a bik takin distal tibia-a awm), distal tibial metaphyseal fracture, non-/mal-unions te pawh a tel a ruh chhiatna emaw, kut leh ke sei inang lo (sei emaw, tawi emaw ang chi) enkawlna atan pawh hman theih a ni a, a tam zawkah chuan hmanraw bik hmanga hman theih a ni.
Locking Plate te pawh a awm
Soft tissue chhiatna nasa tak, infection rate sang, dam rei tak
Antegrade Nails te chu a awm
Khup ruh hliam, fixation tha tawk lo, malalignment awm awlsam
DTN Solution a ni
Retrograde insertion design hmanga tih theih loh khawpa invasive approach
1Distal tibial fracture hi a awm fo a, traditional treatment-ah pawh hian tihkhawtlai a awm
Distal tibial fracture hi ke hnuai lam ruh tliak chi khat a ni. Traditional treatment locking plate leh antegrade intramedullary nail te hian an that lohna an nei vek a. Locking plate hian operation hnua infection emaw soft tissue necrosis emaw a thlen thei a, dam rei theihna a siam thei a; antegrade nails hi a invasive tlem hle nachungin, khup ruh a tichhe thei a, natna a thlen thei a, fixation tha lo emaw malalignment emaw hlauhawmna a keng tel a, chu chuan dam lehna a tikhawlo thei a ni.
2A chinfel dan thar: Distal Tibial Nail (DTN) tih a ni.
Treatment option thar—Distal Tibial Nail (DTN)—chuan a retrograde design danglam tak hmangin distal tibial fractures enkawl dan tur thlirna thar a pe a ni.
Fig. 1: DTN retrograde hmanga dah luh dan tur
II. Surgery tih dan tur
1Damlo awmna tur leh tihtlem tura inbuatsaihna
Damlo chu supine position-ah dah a ni. Displaced fractures chu kut hmanga tihtlem theih a ni tur a ni; a tul chuan DTN dah hmain reduction forceps hmangin tanpui rawh. Fibular fracture a awm chuan fibular alignment dik tak chuan tibial reduction a pui thei a ni.
Ngaihtuah tur pawimawh: Supine position, a tul chuan reduction forceps hmang rawh. Tibial reduction dik tak neih theih nan fibular fracture management hi dah pawimawh hmasa rawh.
2DTN dah luh dan tur
Medial malleolus tip-ah 2–3 cm a sei incision siamin superficial deltoid ligament chu a lang chhuak thin. Guide pin chu malleolus tip-ah emaw, a medial-ah emaw, articular surface atanga 4–5 mm-a hlaah dah a ni.
Incision na hmun: 1.1.
Medial malleolus tip-ah longitudinal cut a ni
Guide pin awmna tur: 1.1.
Joint surface atanga 4–5 mm a hlaah a awm
Fixation tih dan tur:
Screw inzawmkhawm chu proximally leh distally-ah a awm
Fig. 2a: Guide pin dah dan
Fig. 2b: A sir lam atanga thlir
Fig. 2c: Reaming kalpui dan
III. Post-op Rehabilitation neih a ni
0-6 a ni
Kar khat chhunga Non-weight Bearing
Ankle joint mobility nghal leh ke atanga floor contact
6-8 a ni
Kar khat chhunga Partial Weight-bearing
50% weight-bearing capacity thlenga hmasawnna
8-12 ah a awm
Kar khat chhung Full Weight-bearing
Calus siam dan leh natna enfiah lai hian
Rehabilitation Protocol siam a ni
Ankle joint activity hi operation zawh nghal a ni
Kar 4–6 chhung chu rit phurh loh tur
Kar 8–12 chhungin full weight-bearing-ah zawi zawiin a inthlak thin
Zirna pakhatah chuan damlo 10 an enfiah a ni. Thla 3 post-op-ah chuan case 7 an dam tawh a; damlo zawng zawng hian thla 6 chhungin damna an nei vek a ni. Varus leh recurvatum deformities pakhat ve ve a awm a. Reduction hloh, infection, implant-related complications, iatrogenic injuries emaw hmuh tur a awm lo.
70% a ni.
Thla 3 chhungin a dam leh ta
100% a ni.
Thla 6 chhungin a dam tawh
0% a ni.
Infection awm thei te
Outcome Measure
DTN Results
Hmanlai thil tih dan
Union Rate (thla 3) a ni.
70% a ni.
40-60% vel a ni.
A inmil lo (>5°) .
20% a ni.
25-40% vel a ni.
Hri kai zat
0% a ni.
5-15% vel a ni.
AOFAS Score a ni
92.6
73-88 ah a awm
V. Case Report chungchang
Kum 69 mi mipa damlo a ni
Fracture chi hrang hrang: Transverse tibial fracture + fibular fracture a ni
Complication: Soft tissue crush hliam
Post-op: Incision tenau 6 chauh, kum 1 chhungin a dam kim vek
Enkawl dan tlangpui
DTN hi minimal incisions hmanga implanted a ni a, soft tissue preservation tha tak a awm bawk. Fibular fracture chu intramedullary nail hmangin a stabilise a. Damlo chu a dam kim a, harsatna a awm lo.
Pre-op Imaging hmanga tih a ni
Post-op nghal a ni
Thla 3 chhung Follow-up neih a ni ang
Kum 1 chhung Damdawi
VI. Sawiho
1Biomechanical lama a dinhmun a nghet thei
Retrograde nail hian medial locking plate leh antegrade nail te aiin axial leh rotational stiffness a nei tha zawk a ni. Greenfield leh a thawhpuiten an sawi. biomechanical testing an nei a, DTN-a distal screw pahnih hman hian screw pathum nena khaikhin chuan compressive stiffness 60–70% leh torsional stiffness 90% a nei tih hmuhchhuah a ni.
2DTN hman thatna
Locking plate nena khaikhin chuan intramedullary nail hian soft tissue a tichhia tlem zawk a, a bik takin damlo tar leh high-energy trauma avanga soft tissue hliam na tak nei tan a tha hle. He procedure hian khup flexion a ngai lo va, reduction loss hlauhawmna a ti tlem a, khup motion tlem nei damlo tan pawh a tha hle.
3Clinical lama tehkhin dan
Antegrade nail-a nonunion leh malalignment rate chu 0–25% leh 8.3–50% a ni a; locking plate atan chuan 0–17% leh 0–17% a ni. He zirchiannaah hian case zawng zawng hian union an nei vek a, 20% chauhvin deformity >5° an nei a, hei hi traditional method nena khaikhin theih a ni.
VII. Tawpna
A tawi zawngin, DTN hian locking plate leh antegrade intramedullary nails aiin a thatna a pe a, distal tibial fracture enkawlna atana solution tha tak a ni. DTN hian invasiveness a nei tlem hle a, stability sang tak a nei a, a dam chak hle bawk. Traditional treatment aia hlu tak a ni a, tihlar tlak a ni.
DTN Product Line hmanga siam a ni
A rilru a buai em em a, a rilru a hah em em bawk a. Distal Tibial Intramedullary Nail (DTN) .
Mimal thil tawn (personalized experiences) chu full control-ah a awm.
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