Description
The transcript captures a presentation by Dr. Alex Trompeter on the techniques and advancements in nailing distal tibial fractures, with a focus on improving alignment and outcomes. He begins by introducing the topic, stating he will discuss distal tibial fractures instead of the more commonly addressed proximal tibial fractures. Dr. Trompeter discusses the challenges of malalignment and presents evidence supporting the use of nailing techniques over traditional plating, notably referencing the FixDT trial, which showed that nailing offers faster recovery and lower disability.
The presentation delves into the importance of precise entry points and trajectories when performing nailing, emphasizing that proper alignment can significantly reduce malunion rates. He highlights findings from their studies using Stryker's SOMA software to analyze CT scans of tibias, determining optimal exit paths for the nail shaft that often land more laterally than traditionally taught.
Dr. Trompeter provides insights on surgical techniques, such as the ideal knee flexion angle for nailing and the practicality of transverse skin incisions for better postoperative results. He advises attendees to be cautious about the trajectory of reaming instruments during surgery to achieve optimal results, suggesting techniques to lock the trocar in place correctly.
Overall, Dr. Trompeter's presentation highlights the evolving practices in orthopedic surgery regarding distal tibial fractures, advocating for refined entry and exit points that enhance patient outcomes.