Endovis B.A.
32Pages

Operative technique Intramedullary Nail Lateral proximal femur fractures fissazione ESTERNA INTERNAL INTERNA EXTERNAL fixation INTERNAL fixation LIMB reconstruction fissatori IBRIDI ricostruzione legamentosa fissatori ARTICOLATI HYBRID fixators Essential moves in Trauma ligaments reconstruction ARTICULATED fixators

Citieffe thanks Dr. Vincenzo Caiaffa, Ospedale di Venere, Carbonara di Bari (Italy) Dr. Mario Manca, Ospedale Versilia, Lido di Camaiore (LU - Italy) for their collaboration in the development of this operative technique. This operative technique is intended for orthopaedic surgeons and describes the standard procedure suggested by the manufacturer. Surgeons should however decide on the best approach to be followed depending on their clinical judgment and the patient’s needs. Before use please read the instruction booklet enclosed in the packaging.

Operative technique - Endovis B.A. Basic instrument 8 Indications 10 Patient positioning and incision 11 Operative technique. Standard nail 12 Medium and long nail instrument 18 Operative technique. Medium nail 20 Operative technique. Long nail 24 Ordering information 29

Operative technique - Endovis B.A. Product description Standard nail - One size Indicated for the treatment of lateral proximal femur fractures Slot for end cap and nail removal 2 holes for cephalic screws Neck-shaft angle: 130° Distal diameter: 10 mm Metaphyseal angle: 5° Hole: static locking Distal slotted section: 30 mm

Essential moves in Trauma Product description Medium nail - One size Indicated for the treatment of subtrochanteric fractures with diaphyseal extension Slot for end cap and nail removal 2 holes for cephalic screws Neck-shaft angle: 130° Distal diameter: 10 mm Metaphyseal angle: 5° Hole: static locking Slot: dynamic locking Distal slotted section: 20 mm

Operative technique - Endovis B.A. Product description Long nail - 6 lengths (3 right and 3 left) Indicated for the treatment of lateral proximal femur fractures associated with diaphyseal fractures Slot for end cap and nail removal 2 holes for cephalic screws Neck-shaft angle: 130° Length: 320 - 360 - 400 mm Right and left Anatomical curvature: 10° Distal diameter: 10 mm Metaphyseal angle: 5° Hole: static locking Slot: dynamic locking Distal slotted section: 20 mm

Essential moves in Trauma Product description Cephalic screw - 9 lengths Screwdriver retention system Double pitch thread Lengths from 70 to 110 mm (5 mm in steps) Thread diameter: 6.5 mm self-tapping Threaded portion hydroxyapatite coated Cortical screw - 11 lengths Screwdriver retention system Thread diameter: 7.6mm for angular stability Thread diameter: 5 mm self-tapping Lengths from 30 to 80 mm (5 mm in steps)

Operative technique - Endovis B.A. Basic instrument Code Description Qt. EBA-0010 Tissue protection sleeve 1 EBA-0030 Chuck for 02.5-3 mm guide wires 1 EBA-0035 05/7.5 mm cephalic drill solid 1

EBA-0060 Screw length ruler 1 EBA-0131 Standard Endovis B.A. nail guide 1 EBA-0250 Endovis B.A. standard instrument tray, empty TK87170-2F-YE Sterilization box 580x270x110 mm, empty

Operative technique - Endovis B.A. Indications Standard nail Fixation of lateral proximal femur fractures with extension inferior at 1 centimeter of small trochanter: 31A1 pertrochanteric simple fracture 31A2 pertrochanteric multi-fragment fracture 31A3 intra-subtrochanteric fracture (AO classification) Medium nail The device has been designed to treat 31A3.3 fractures (AO classification). This nail is designed for less complex fractures, which need more distal locking. Long nail Fixation of lateral proximal femur fractures associated with diaphyseal fractures: 31A1, 31A2, 31A3 associated...

Essential moves in Trauma Patient positioning and incision Figure 4 Patient positioning The patient is positioned with the controlateral hip and knee flexed at 90 degrees (to facilitate use of the image intensifier). The trunk should be turned 20-30 degrees towards the healthy limb. The fracture should be reduced in the best possible way, with moderate traction against a well padded perineal post. Some posterior support may be useful to reduce the fracture in the lateral view. Incision Skin incision should be about 4 cm extending proximally from the apex of the greater trochanter.

Operative technique - Endovis B.A. Standard nail. Proximal Locking Guide wire insertion Fix the ø3x750 mm guide wire on the chuck by manually tightening the ring nut. Under image intensifier control penetrate the apex of the greater trochanter using the cannulated awl, and insert the guide wire down to the condyles. Remove the cannulated awl, and insert the soft tissue protection sleeve with the trochanteric reamer over the guide wire, up to the mechanical stop. Remove the trochanteric reamer and soft tissue protection sleeve leaving the guide wire in situ. INSTRUMENTS REQUIRED EBA-0010...

Essential moves in Trauma Standard nail. Proximal Locking Nail insertion Attach the nail to the metal part of the nail guide, tightening the screw with the hexagonal T-wrench. Introduce the nail over the guide wire, which is removed when the nail has passed the fracture. Attach the radiolucent part with the locking knob, only when the optimal nail position has been reached. Locking knob Guide wire insertion in the distal cephalic hole Insert the cannula with the trocar into the most distal cephalic hole of the guide until it touches the cortex. Insert the graduated wire on the chuck for at...

Operative technique - Endovis B.A. Standard nail. Proximal Locking Cephalic screw insertion Prepare the track for the proximal cephalic screw: if the bone is hard, use the cephalic drill inserted in the cannula until the stop. Screw insertion with screwdriver Fix a cephalic screw of a length 10 mm less than read on the graduated wire to the hexagonal screwdriver by turning the knob clockwise. This screw will be inserted in the proximal cephalic hole of the wire guide. There is an hexagonal socket in the knob of the screwdriver to insert the T-wrench in case of excessive tightening of the...