[A new general orthopedic universal intramedullary nail for the tibia. Clinical development and experiences]

The new AO-Universal-Nail was developed through intensive cooperation between fundamental research, technicians and clinical application. We are now able to transfer the concept of a Universal-Nail (initially for the femur) to the tibia as well. The existing technique of the medullary nail was maintained as far as possible. Special features to be highlighted: The new AO-bend obtains better impact behavior and a more anatomical stabilization of the bone cavity. The tapered tip eases the gliding of the tip of the nail along the inner wall of the dorsal corticalis and past the fracture. Proximal locking is obtained through three transverse extending holes. They offer many choices for optimal placement of the locking bolts. Interlocking from anterior to posterior has been logically abandoned, due to danger for nerves and vessels. Distal looking offers a large selection for stabilization through one a.p.-hole and two transverse holes for the locking bolts. The design from anterior to posterior entables the protection of the soft tissue. The Universal-nail can either be inserted with or without interlocking. A free decision is possible during the operation. The new AO-Universal-Nail for the tibia (as for the femur) maintained reliable aspects and was consequently converted to meet new demands and findings. The basic fundamentals of the AO, namely the observance and application of biomechanical principles and safe operation procedure were attained through simple instrumentation and have been proved successful for clinical application.