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Gamma3 Long Nail R2.0


Catalog excerpts

Gamma3 Long Nail R2.0 - 1

Operative Technique

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Gamma3 Long Nail R2.0 - 2

Long Nail R1.5 and 2.0 Contributing Surgeons: Prof. Kwok Sui Leung, M.  D. Chairman of Department of Orthopaedics and Traumatology The Chinese University of Hong Kong Prince of Wales Hospital Hong Kong Dr. Gilbert Taglang Head of the Trauma Department Center for Traumatology, Strasbourg France Prof. Dr. med. Volker Bühren Chief of Surgical Services Medical Director of Murnau Trauma Center, Murnau Germany Katsumi Sato M.D.Ph.D. Vice-Director, Chief Surgeon Tohoku University Graduate School of Medicine Tohoku Rosai Hospital, Sendai Japan Christopher T. Born M.D. Professor of Orthopaedic...

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Gamma3 Long Nail R2.0 - 3

Lag Screw and Set Screw Function 6 Distal Locking Screws 7 3. Indications, Precautions & Contraindications 9 Special Techniques for Fracture Reduction 13 Preparation of Medullary Canal 17 Assembly of Targeting Device 23 Lag Screw Positioning using One Shot Device 28 Pre-Drilling the lateral cortex 30 Distal Screw Locking 38 Nail Extension End Caps 43 Post-operative Care and Rehabilitation 43 Dealing with Special Cases 46

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Gamma3 Long Nail R2.0 - 4

The Gamma3 Locking Nail System is based on more than 20 years of Gamma Nail experience. This is the third generation of intramedullary short and long Gamma fixation nails. The Evolution of the successful Trochanteric and Long Gamma Nails as well as the small stature versions followed strictly a step by step improvement based on the clinical experience and outcome from surgeons all over the world. Acknowledgements: Our thanks are due to the many surgeons who supported the develop­ ment of the new Gamma3 System, with their feedback and ideas, during worldwide panel meetings and helped the...

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Gamma3 Long Nail R2.0 - 5

The Gamma3 System Gamma3 Locking Nails come in 3 neckshaft angles of 120, 125 and 130°. • In the following, these Gamma3 Nails are called: Long Nail All nails* use the same Lag Screws, Set Screw, distal Locking Screws and End Caps (see Fig. 1). Technical Specifications: • Material: Titanium alloy with anodized type II surface treatment. • Nail length: 260mm to 480mm, in 20mm increments, shorter or longer nails are available on request • Nail diameter: This nail incorporates several important mechanical design features. The nail is unslotted and cannulated for GuideWire-controlled insertion....

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Gamma3 Long Nail R2.0 - 6

Design Lag Screw and Set Screw Function Technical Specifications Lag Screw diameter: 10.5mm Lag Screw lengths: 70−130mm in 5mm increments Lag Screw design for high load absorption and easy insertion Asymmetrical depth profile to allow the Lag Screw to slide in the lateral direction only (see orange arrow on Fig. 5). Self retaining Set Screw to protect the Lag Screw against rotation and simultaneously allowing sliding of the Lag Screw laterally. Distal Locking Screws Length Definition of the Distal Locking Screw The distal Locking Screw is measured from head to tip (Fig. 6). Dimensions are...

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Gamma3 Long Nail R2.0 - 7

Indications, Precautions & Contraindications Indications The Long Length Gamma3 Nail is intended for fixation of stable and unstable femoral fractures occurring from the base of the femoral neck extending distally to a point approximately 10 cm proximal to the intercondylar notch, including fractures of the basilar neck, intertrochanteric fractures, pertrochanteric fractures, subtrochanteric fractures and femoral shaft fractures. Indications may include fractures from trauma, nonunion, malunion, pathological fractures in both trochanteric and disphyseal areas, impending pathological...

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Gamma3 Long Nail R2.0 - 8

Operative Technique Pre-operative Planning The Gamma3™ Nail with a 125° nail angle may be used in the majority of patients. Where such variations in femoral anatomy require an alternative, the following chapter describes how to select the optimal implant size. Implant Selection X-ray templates are very helpful during preoperative planning. Use the X-ray Template (Fig. 9a for long nails to select the correct implant and the optimal nail angle. This template show the true implant size at a magnification of 10% in anteriorposterior view. The X-rays should be taken at this magnification (10%)...

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Gamma3 Long Nail R2.0 - 9

Operative Technique Patient Positioning The procedure for patient positioning is usually similar to that of a subtrochanteric fracture, however, in fractures that are particularly difficult to reduce, a transcondylar sterile Steinmann pin may be used. The pin is fixed directly to the orthopaedic table by an adaptable stirrup, and traction is applied until anatomical reduction in the A-P view is obtained (Fig. 10). The patient is placed in a supine position on the fracture table and closed reduction of the fracture is recommended (Fig. 11). Traction is applied to the fracture, keeping the...

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Gamma3 Long Nail R2.0 - 10

Operative Technique Fracture Reduction Maintaining traction, the leg is internally rotated 10−15 degrees to complete fracture reduction; the patella should have either a horizontal or slightly inward position (Fig. 12). Position the image intensifier so that anterior-posterior and mediolateral views of the trochanteric region of the affected femur can be easily obtained. This position is best achieved if the image intensifier is positioned so that the axis of rotation of the intensifier is centered on the femoral neck of the affected femur (Fig. 13). The views of the distal femur should...

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Gamma3 Long Nail R2.0 - 11

Operative Technique Fracture Reduction Special Techniques For specific situations, special techniques have been developed for fracture reduction, that are explained below. To counter this misalignment, the trunk is turned to the opposite side and held in position by a thoracic rest or by a large drape. This tightens the gluteus medius muscles and relaxes the psoas, externally rotating the proximal fragment into alignment and exposing the trochanter for easier introduction of the nail. The fractured limb is kept straight, with the knee in flexion (Fig. 14), using the stirrup to avoid...

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Gamma3 Long Nail R2.0 - 12

Operative Technique Incision Incisions may be developed in different manners. Two alternatives will be described below. Alternative 1: The tip of the greater trochanter may be located by palpation (Fig. 16) and a horizontal skin incision of approximately 2−3cm is made from the greater trochanter in the direction of the iliac crest (Fig. 17). In larger patients the incision length may need to be longer, depending on the size of the patient. A small incision is deepened through the fascia lata, splitting the gluteal muscle approximately 1−2cm immediately above the tip of the greater...

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