Meta Nail Flashcards
The design rational
Respect anatomy with specific implants
Increase stability with advanced locking solutions
Offer fracture compression through the nail
Designed to address :
Issues associated with metaphysical fractures
*expands the fracture types you can fix
Meta tibia nail specs
10 degree herzog curve
2 degree distal bend
4 proximal holes
3 distal holes
Meta tibia nail sizes and lengths
Proximal diameter 12mm (8.5,10,11.5)
-13mm for 13
Lengths: 16-50cm
What are the color codes for meta tibia nail?
Grey for 8.5mm
Gold for 10,11.5,12mm
What are the planes in the proximal locking holes in tibia nail?
25 and 45 degrees
How many holes proximally and the options in tibia nail?
Within 40mm
1 compression slot
3 threaded holes (1 poly bushing)
How many holes are there distally and the options in the tibia nail?
2 medial lateral
1 anterior posterior
Most distal ML hole is threaded to prevent wagging-5mm from the tip
What is the starting point for a tibia nail?
High on the tibia at the edge of the plateau
Just medial to the lateral tibial spine
In line with the anterior cortex
Why is the starting point on the tibia so important? Too lateral? Too medial? Too distal?
Relatively lateral position “lines up” with the tibial diaphysis
Too medial-valgus
Too lateral-varus
Too distal-anterior hyper flexion, posterior translation
META-NAIL retrograde femoral nail specs
2.0mm AP bow
No herzog bend-excellent entry point
Retrograde femoral nail sizes and lengths
Proximal/driving end diameter 12mm (10,11.5)
13 for 13
Lengths: 18-50cm
What is the color code for retrograde femoral nails?
Gold
What are the proximal locking options in retrograde femoral nail?
2 static AP holes
No dynamization
No threads or bushings
Use sure shot is possible
What are the distal locking options in the retrograde femoral nail?
3 options within 40mm All threaded Top 2 with poly bushings Multiplayer 25 degrees Most distal screw locks with nail cap set screw
What is the starting point for the retrograde femoral nail?
Centered or slightly medial in the intracondylar notch
Anterior to the femoral attachment of the PCL
Guide pin must be anterior to blumensaats line
In line with the shaft
Why is the starting point on the retrograde femoral nail so important ?
Reduce potential for angular deformity
Major concern is the joint surface
Nail must be countersunk 5-10mm or it will invade structures inside the joint
What approach is used with a standard drill guide?
Percutaneous for tibia or retrograde femur
For fracture compression
Semi extended guide use?
With tibias only
No quad pull
How many mm of compression can you get with the tibia nail?
Up to 7mm with the compression driver through the guide
What are the color codes for the radiolucent anterior drop?
Femur
Tibia
Knee
How far is the herzog Bend in the nail from the tibia ?
27mm on the concave side
35mm on the convex side
How far is the most distal screw from the tip of the tibia nail? Why?
5mm to maximize coverage over distal fractures
When does the tibial nail go from 2cm increment to 1cm?
16-28cm x 2cm
28-50cmx1cm
Where is the driving end of the nail?
The end that is attached to the jig
