Neon Proximal Femoral Nail Surgical Technique

Special thanks to Contributing Surgeons, Yalkin £AMURCU, MD, Department of Orthopedics and Traumatology Medical Faculty of Erzincan University Erzincan, Turkey Mehmet Cenk Canku§, MD, FEBOT Department of Orthopedics and Traumatology Medical Faculty of Sanko University Gaziantep, Turkey

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TABLE OF CONTENTS Neon Proximal Femoral Nail SURGICAL TECHNIQUE NAIL REMOVAL

Claw Technology Dunitech leads innovational systems and aims to supply options for the surgeons to excel at their expertise. Claws Six retractable Claws are designed to penetrate the cortex and provide exceptional axial and rotational stability. are a novelty solution on distal locking systems designed to support the orthopedic trauma community. Claws are titanium pins that act as anchors to provide a stable fixation, as well as other superior operative parameters. Claws are made from titanium and mechanically deploy from within the nail. Claws penetrate through the cancellous bone and anchor...

Lag Screw with Claw Technology 3x More Rotational Stability reliably retractable! All Claws were successfully retracted after every test. Conventional systems are subjected to screw breakage, screw headwear and drill bit breakage that may prevent the nail to be removed. Dunitech Claws are deployed within the nails from precise holes in a tight fit, preventing empty spaces for bone ingrowth. Virtually no cut-out Four retractable Claws anchor the lag screw into the dense cortical bone of the femoral head-neck junction for Rotational Stability superior control. Peak Compressive Forces Cumulative...

NEON KEY FIGURES • Proximal Diameter: 15.5 mm • Distal Diameter: 11 mm • Distal Claws Maximum Span: 38 mm • Medial-Lateral Angle: 4° • End Cap Length: 0 mm, 5 mm and 10 mm • Fully Cannulated Body: Compatible with guide wire • Lag Screw Locking System: Set Screw integrated into the nail. Designed for fixed or sliding configuration while preventing rotation. • Lag Screw Angle: 120°, 125° and 130° • Material: Titanium alloy with anodized type II surface treatment. NEON SHORT FIGURES • Length: 220 mm NEON LONG FIGURES • Length: 300 mm to 420 mm in 20 mm increments • Anteversion: 10° • Curvature Radius:...

1. Patient Positioning and Fracture Reduction INSTRUMENTS FOR ACCESSING THE CANAL AND PROXIMAL REAMING ● Place the patient in the supine or lateral decubitus position according to surgeon preference on a fracture or other radiolucent table. ● Apply traction to the affected leg and place it in slight adduction to ease access to the greater trochanter and intramedullary canal. Alternatively, the torso can be abducted 10-15° towards the unaffected leg. The unaffected leg should be placed in a leg holder or extended away from the affected leg (Fig-1 and Fig-2). Position the image intensifier as to...

4. Proximal Reaming INSTRUMENTS: Option 1: Trocar Tip Guide Wire INSTRUMENTS: V Trocar Tip Guide Wire 3 mm x 600 mm (N01-0250) • Advance the 3 mm Trocar Tip Guide Wire through the entry point and into the proximal femur with the help of a powered driver (Fig-5). • The wire should be centered in the canal on the lateral view and intersect the center of the canal just beyond the lesser trochanter on the AP view. • Withdraw and reposition the wire as necessary. Option 2: Entry Awl and Trocar Tip Guide Wire INSTRUMENTS: V Entry Awl (N01-0040) s/ Trocar Tip Guide Wire 3 mm x 600 mm (N01-0250) • Insert...

INSTRUMENTS FOR DETERMINING NAIL LENGTH AND DISTAL REAMING INSTRUMENTS: Dunitech Intramedullary Reamer Set (INST-01-002) Neon Radiographic Claw Template (N02-0080) Guide Wire Pusher (N01-0060) ● Confirm that the fracture reduction has been maintained. Starting from 8.5 mm Reamer Cutter Head, ream until the Guide Wire Pusher (N01-0060) desired depth with steady pressure (Fig-11). By each pass, increase the diameter of the Reamer Cutter Head in 0.5 mm increments. Use the Guide Wire Pusher to keep the guide wire in place. If the sheath comes out with the reamer, insert it back before starting the...

INSTRUMENTS FOR TARGET GUIDE ASSEMBLY AND NAIL INSERTION 7. Assembling the Target Guide INSTRUMENTS: Guide Arm (N02-0050) Guide Handle (N02-0060) Handle-Arm Connector Screw (N02-0200) 7 mm Hex Driver (N01-0030) Guide Arm Lock (N02-0180) ● Mate the Guide Arm to the Guide Handle and use the 7 mm Hex Driver to tighten the HandleArm Connector Screw (Fig-13). Ensure that the connection is tight before proceeding. ● Insert the Guide Arm Lock into the bottom of the Guide Arm Lock (N02-0180) Handle-Nail Connector Screw (N02-0070) Guide Arm and engage the screw. Do not tighten at this moment. 8. Attaching...

INSTRUMENTS FOR DRILLING FOR LAG SCREW INSTRUMENTS: Impactor (N01-0070) Lag Guide Pin Obturator (N02-0190) Note: 4 If the Guide Wire Sheath has not been removed, it has to be removed in before the insertion of the nail (Fig-12). 4 If a traditional ball tip guide wire was used, it must be exchanged for a smooth guide wire. The tip of traditional ball tip guide wires won’t pass through the nail. Lag Screw Guide Pin Ruler (N02-0140) ● Assemble the impactor into the Guide Handle. Pass the nail over the guide wire, through the incision and into the bone. Hold the targeting arm vertically as you enter...

10. Preparing for Guide Pin Placement ● Set the nail in its final orientation with the help of the image intensifier in the lateral view. Arrange the image intensifier for a true lateral position. The Guide Arm should perfectly overlap the nail and femoral head, as seen in Fig-22a. If the Guide Arm is lateral to the nail and/or femoral head, reorient the nail, so they overlap. 7 mm Hex Driver (N01-0030) – Optional ● Set the nail in its final depth with the help of the image intensifier in the AP view. The projected axis of the lag screw should be slightly inferior to the axis of the femoral neck...