The stabilization of tibial shaft fractures requires precision in the entry portal, axial alignment, and soft tissue protection. This training presents, in an objective and practical manner, the technique for intramedullary nail implantation via the infrapatellar route, with a detailed demonstration of the surgical steps, radiographic control, and minimally invasive execution from a technical perspective.

Training Focus:

• Strategic patient positioning for ideal knee flexion;
• Anatomical marking and precise definition of the tibial axis;
• Infrapatellar access with preservation of the paratenon and patellar tendon;
• Safe introduction of the guide wire and olivary wire with radiographic control;
• Protection of soft tissues during drilling and reaming;
• Correct measurement and adequate reaming of the medullary canal;
• Insertion of the intramedullary nail and positioning check;
• Proximal and distal locking with a minimally invasive approach;
• Anatomical closure and postoperative evaluation.

Detailed Content:

• Optimized Patient Positioning: Strategies to obtain adequate knee flexion, facilitating alignment and access to the entry portal;
• Precise Anatomical Reference: Marking techniques with a dermographic pen and Kirschner wire to ensure anteroposterior and lateral alignment;
• Safe Infrapatellar Access: Linear incision with preservation of the paratenon and patellar tendon, allowing for anatomical closure and lower morbidity;
• Efficient Radiographic Control: Methods to avoid posterior directioning of the guide wire and ensure centering of the olivary wire;
• Tissue Protection During Drilling: Proper use of the soft tissue protector to avoid tendon and anterior cortical injuries;
• Precise Reaming of the Medullary Canal: Parameters for choosing the ideal diameter and preparing the canal without risk of fissures;
• Nail Insertion with Stability: Techniques to avoid prominence, ensure proper advancement, and minimize trauma during olivary wire removal;
• Minimally Invasive Proximal and Distal Locking: Execution of cross and distal locking with small portals and image intensifier control;
• Post-Implant Evaluation: Criteria to confirm stability, alignment, and absence of nail prominence.

Included Material:

• Detailed PDF with technical sequence, anatomical references, reaming parameters, and soft tissue care.

Elevate your precision in tibial osteosynthesis. Enroll now and improve your execution of the infrapatellar technique with safety and efficiency.