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Theodore Baker
Theodore Baker

How Integra Panta Nail Improves Fusion Rates and Outcomes for Ankle Fusion Surgery

Integra Panta Nail PDF Download: A Comprehensive Guide for Patients and Surgeons

If you suffer from severe ankle arthritis or deformity, you may have heard of a surgical procedure called tibio-talo-calcaneal (TTC) arthrodesis. This is a surgery that fuses the bones of your lower leg, ankle, and heel together to create a stable and pain-free joint. However, this surgery can be challenging and complex, requiring a reliable and effective method of internal fixation to ensure a successful fusion.

integra panta nail pdf download


One of the options available for internal fixation is the Integra Panta Nail, a novel intramedullary nail that uses a shape-memory alloy to provide sustained compression and stability to the fusion site. The Integra Panta Nail has been shown to offer some advantages over other intramedullary nails in terms of fusion rates, time to fusion, and patient outcomes.

In this article, we will provide you with a comprehensive guide on what Integra Panta Nail is, how it works, how to use it, and what results you can expect from it. We will also answer some frequently asked questions about Integra Panta Nail and provide you with a link to download a PDF document that contains more detailed information on its surgical technique.

How does Integra Panta Nail work?

The Integra Panta Nail is an intramedullary nail that is inserted into the medullary canal of the tibia (the larger bone of your lower leg) through a small incision near your knee. The nail extends from your knee to your heel, passing through your ankle joint. The nail has two main components: a titanium alloy outer tube and a nickel titanium (NiTi) inner rod.

The NiTi inner rod is a shape-memory alloy that can recover large amounts of deformation via shape-memory or pseudoelasticity. This means that it can change its shape according to temperature or stress. The NiTi rod has two modes: a straight mode when it is cold or unstressed, and a curved mode when it is warm or stressed.

When the Integra Panta Nail is implanted, the NiTi rod is in its straight mode. However, as it warms up to body temperature, it transforms into its curved mode, creating an arch inside the outer tube. This arch applies compression to the fusion site, pushing the bones together and enhancing bone healing. The compression is maintained throughout the healing process, even if there is bone resorption or settling, as the NiTi rod can adapt to the changes in the bone length and geometry.

The Integra Panta Nail also provides stability and rigidity to the fusion site, as it has a locking mechanism that secures the nail to the bones with screws. The nail has four distal locking options and two proximal locking options, allowing for different configurations and orientations of the screws. The nail also has a proximal dynamization option, which allows for some axial movement of the nail to stimulate bone healing.

The Integra Panta Nail is different from other intramedullary nails in that it uses a shape-memory alloy to provide adaptive and sustained compression to the fusion site. Other nails rely on static compression mechanisms that can lose compression over time due to bone resorption or settling. Studies have shown that a loss of compression can lead to lower fusion rates and longer time to fusion. The Integra Panta Nail aims to overcome this limitation by using a dynamic compression element that can adjust to the changes in the bone length and geometry.

How to use Integra Panta Nail for tibio-talo-calcaneal arthrodesis?

If you are considering using Integra Panta Nail for your TTC arthrodesis, you should consult with your surgeon and discuss the indications, contraindications, risks, and benefits of this option. You should also follow the preoperative, intraoperative, and postoperative instructions provided by your surgeon and medical team. Here are some general guidelines on how to use Integra Panta Nail for TTC arthrodesis:

Indications and contraindications

The Integra Panta Nail is indicated for TTC arthrodesis in patients with severe ankle arthritis or deformity that is not amenable to other treatments, such as ankle replacement or osteotomy. The nail can be used for primary or revision TTC arthrodesis, as well as for salvage procedures after failed ankle replacement or infection. The nail can also be used in conjunction with structural allografts or bone graft substitutes to fill large bony defects.

The Integra Panta Nail is contraindicated in patients with active or latent infection, inadequate bone quality or quantity, vascular insufficiency, peripheral neuropathy, or hypersensitivity to metal implants. The nail is also contraindicated in patients who are unable or unwilling to follow postoperative instructions or comply with weight-bearing restrictions.

Preoperative considerations and planning

Before the surgery, you should undergo a thorough physical examination and medical history review by your surgeon. You should also have some imaging tests, such as X-rays, CT scans, or MRI scans, to assess the condition of your bones and joints. Your surgeon will use these tests to plan the surgery and determine the appropriate size and configuration of the Integra Panta Nail and screws.

You should also inform your surgeon about any medications or supplements you are taking, as some of them may interfere with blood clotting or bone healing. You may need to stop taking some of them before the surgery. You should also avoid smoking, drinking alcohol, or using recreational drugs, as they can impair your healing and increase your risk of complications.

You should also prepare for your recovery after the surgery by arranging for someone to drive you home and help you with your daily activities. You should also have a comfortable and accessible place to rest and elevate your leg. You should also have some items ready, such as crutches, walker, ice packs, pain medications, wound dressing materials, and antibacterial soap.

Surgical steps and techniques

The surgery is usually performed under general anesthesia or spinal anesthesia. You will be lying on your back on the operating table with your leg elevated and supported by a traction device. The surgery may take about two hours, depending on the complexity of your case.

The surgical steps and techniques for implanting Integra Panta Nail are as follows:

  • The surgeon will make a small incision near your knee and insert a guide wire into the medullary canal of your tibia.

  • The surgeon will use a reamer to enlarge the canal and create enough space for the nail.

  • The surgeon will make another incision near your heel and expose the calcaneus (the heel bone).

  • The surgeon will use a drill bit to create a hole in the calcaneus for the distal end of the nail.

  • The surgeon will prepare the ankle joint by removing any cartilage, bone spurs, or loose bodies that may interfere with fusion.

The surgeon will insert the Integra Panta Nail into the tibia through the proximal incision and advance it until it reaches the calcaneus through the distal hole. 71b2f0854b


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