Catalog excerpts
Operative Technique
Open the catalog to page 1Trochanteric Nail 170 & 180 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 Assist. Prof. Gilbert Taglang, M. D. Department of Traumatology University Hospital, 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 This publication sets forth detailed...
Open the catalog to page 2Lag Screw and Set Screw Function 6 Distal Locking Screws 6 3. Indications, Precautions & Contraindications 7 Preparation of Medullary Canal 13 Assembly of Targeting Device 19 Lag Screw Positioning using One Shot Device 24 Pre-Drilling the lateral cortex 26 Distal Screw Locking 34 Nail Extension End Caps 37 Post-operative Care and Rehabilitation 37 Dealing with Special Cases 40
Open the catalog to page 3The Gamma3 Locking Nail System was developed based on more than 20 years of Gamma Nail experience. This is the third generation of Gamma intramedullary short and long fixation nails. The Gamma3 Lockin was developed based o 15 years of Gamma N This is the third gener intramedullary short nails. The evolution of the successful Trochanteric and Long Gamma Nails as well as the Asia Pacific and Japanese versions followed strictly a step-by-step enhancement based on the clinical experience and outcome from surgeons all over the world. The evolution of the s Trochanteric and Lon as well as the...
Open the catalog to page 4Design The Gamma3 System Gamma3 Locking Nails come in 3 neckshaft angles of 120, 125 and 130°. Technical Specifications: All nails* use the same Lag Screws, Set Screw, distal Locking Screws and End Caps (see Fig. 1). Titanium alloy with anodized type II surface treatment. • Nail length: The anatomical shape of the nail is universal for all indications involving the treatment of trochanteric fractures. The nail is cannulated for Guide-Wirecontrolled insertion. A range of three different neck-shaft angles are available for Lag Screw entry to accommodate variations in femoral neck anatomy. A...
Open the catalog to page 5Design 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. 4). Self retaining Set Screw to protect the Lag Screw against rotation and simultaneously allowing sliding of the Lag Screw laterally. Distal Locking Screws Lag Screw Stabilization System Length Definition of the Distal Locking Screw The distal Locking Screw is measured from head to...
Open the catalog to page 6Indications, Precautions & Contraindications Indications The indications for the Gamma3 Nail 170 and 180 are the same of those for the Gamma Trochanteric Locking Nail (Fig. 7). • Intertrochanteric fractures • Pertrochanteric fractures • Nonunion and malunion Stryker Osteosynthesis systems have not been evaluated for safety and use in MR environment and have not been tested for heating or migration in the MR environment, unless specified otherwise in the product labeling or respective operative technique. Contraindications Contraindications are medial neck fractures and sub-trochanteric...
Open the catalog to page 7Operative 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 optimum implant size. Implant Selection X-Ray templates are very helpful during pre-operative planning. Use the X-Ray Templates for short and long nails to select the correct implant and the optimal nail angle. These templates show the true implant size at a magnification of 15 % in anterior-posterior view. The X-Rays should be taken at this magnification...
Open the catalog to page 8Operative Technique Patient Positioning The patient is placed in a supine position on the fracture table and closed reduction of the fracture is recommended. Reduction should be achieved as anatomically as possible. If this is not achievable in a closed procedure, open reduction may be necessary. Traction is applied to the fracture, keeping the leg straight. The unaffected leg is abducted as far as possible to make room for the image intensifier (Fig. 10). Maintaining traction, the leg is internally rotated 10–15 degrees to complete fracture reduction; the patella should have an either...
Open the catalog to page 9Operative 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. 13) and a horizontal skin incision of approximately 2−3cm is made from the greater trochanter in the direction of the iliac crest (Fig. 14). In larger patients the incision length may need to be longer, depending on BMI 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 trochanter,...
Open the catalog to page 10Operative Technique The C-Arm is turned approx 90° to provide an A/P image of the tip of the trochanter using the metal rod as shown in Figure 17 and 17a. A vertical line is drawn onto the skin (Fig. 18). The intersection of the lines indicates the position for the entry point of the nail. This is usually the anterior third of the tip of the greater trochanter as shown in Fig. 19. The skin incision is made cranially to the indicated intersection, following the sagittal line in cranial direction. The distance between the intersection and the starting point for the incision differs, depending...
Open the catalog to page 11Operative Technique Incision Using a finger, the tip of the trochanter should be felt easily (Fig. 21). Entry Point The correct entry point is located at the junction of the anterior third and posterior two-thirds of the tip of the greater trochanter and on the tip itself (Fig. 22). The medullary canal has to be opened under image intensification. The use of the cannulated Curved Awl (Fig. 23) is recommended if conventional reaming or the One Step Conical Reamer will be used to prepare the canal for the nail. Caution: During opening the entry point with the Awl, dense cortex may block the...
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