Design Type 2 Anodized Titanium Implants for increased strength in multiple diameters and lengths to accommodate various patient anatomies Threaded distal locking holes in Nail help prevent screw backout or migration Multiple syndesmotic fixation options with P28 (R3FLEX, R3ACT, 3.5mm Static Locking Screws) to accommodate surgeon preference and patient need Proximal wings expand nail diameter up to 1 mm on either side (2mm total) to prevent rotation and potential fracture collapse – may be retracted to accommodate removal Entry k-wire guide to help optimize the start point and subsequent nail placement Opening reamer contains notches for syndesmotic fixation and hash marks for countersinking depth Solid and cannulated options available for reaming Curved reamer guide to help centralize pilot hole proximal reamer into shaft of fibula Outrigger k-wire hole to show distal tip of the nail in the fibula Outrigger options to apply traction and hold rotation after nail insertion Multiple nail cap sizes to add nail length if syndesmotic fixation requires countersinking Includes both easy outs as well as a removal hook pin to facilitate efficient removals. Indications Fixation of fibular fractures and osteotomies Approach Patient positioning is per surgeon preference: supine with an ipsilateral bump, lateral, decubitus, or prone Make a 1.5-2 cm vertical incision centered over the distal end of fibula; extending slightly proximal and distal to the tip Once past the tip, perform tissue dissection to expose the distal end of the fibula Nail Size Offerings Fibular Nail Length Options x Fibular Nail Diameter Options Ø2.8 mm Ø3.4 mm Ø4.0 mm Ø5.5 mm 130 mm • • • • 180 mm • • • • 270 mm • • Ø2.8 mm x 130 mm Fibula Nail Ø5.5 mm x 180 mm Fibula Nail Ø3.4 mm x 270 mm Fibula Nail Distal and Proximal Locking 2.7 mm screws that interlock with the nail to secure the distal segment of the fibula with the nail Proximal wings expand nail diameter up to 1 mm on either side (2mm total) to prevent rotation and potential fracture collapse – may be retracted to accommodate removal Screws Phantom Fibula Nail P28 Syndesmotic Options 3.5mm Screw R3ACT Syndesmotic Screw R3FLEX Stabilization System