Surgical Technique Femur Nail Ins Hilden

ARZZT Techniques Surgical Technique Femur Nail Intramedullary locked nail to screw for femur fractures Introduction Implant design Preoperative planning Patient position Surgical approach Nail placement in the instrumental set Nail insertion Distal and proximal locking Postsurgical care This guide is made to expose the recommended techniques and applications for femur ARZZT intramedullary nail by orthopedics trauma surgeons in the treatment of fractures. The recommendations on its use does not seek to interfere whit the surgeon´s experience and each patient own needs, following basic rules for...

ARZZT Techniques Surgical Technique for Femur Nail Introduction One of this implant favorite utilization features is the distal locking security, since inside the technique use, practical and simple, a constant symmetry is maintained between instrumental set and implant, saving surgical time and reducing the use of images intensifier. These innovations result in the surgical procedure success, diminishing considerably locking time for patient´s benefit since ischemia short time reduces deep veined thrombosis risk, of infection by the minimum approaches that are carried out, patient´s fast recovery...

Preoperative planning Nail diameter and length can be established by means of the healthy extremity X-ray, keeping in mind a 10 to 15% magnification. Some surgeons use an image intensifier superimposing the nail to the affected extremity to establish its length and to obtain a sure distance without affecting the knee and hip articulation. Another method is to measure from the greater femoral trochanter tip to the knee joint line, subtracting 8 cm. When operating very narrow bones the smallest diameter nail is suggested as chosen by the surgeon; and depending fractures comminution and stability...

Direct vision surgical approach: Make an incision in the lateral side middle line with post lateral approach depending fracture height, dissect by planes following the intramuscular septum up to the femur, retracting soft tissues in anterior direction to minimize quadriceps damage, after exposing the fracture, pull and pull out the distal fragment, rhyme the fragment one millimeter greater than the nail chosen by the Orthopedic Surgeon, make the same procedure in the proximal fragment. Insert the guide through the shaft to proximal, cross the trochanter until it is subcutaneous, flex the hip...

Nail placement in the instrumental set The nail must be installed and calibrated prior to use inside the femur to corroborate bolts free passage and exact symmetry. 1.- Place the nail in the insertion handle coinciding with notches fixing it with the clamp screw. 2.- Hold the nail on the insertion handle with the fixing screw and tighten the nail, assisting whit a Allen wrench for leverage, entering it through the locking nut holes. 3.- Place the guide according to nail length coinciding the grip handle arrows with the guide arrows.

4.- Secure the guide pressing with a Allen wrench the locking nut 5.- Place the second guide depending which leg is being operated, right or left, following the arrow in the guide. 6.- Tighten two number 2 screws always matching arrow with arrow according correct nail length.

7.- Place the distal target device tightening it with a number 3 screw. 8.- Place the distal target device tightening it with a number 3 screw. 9.- Place the distal target device tightening it with a number 3 screw.

10.- Place the sleeve and distal drill sleeve and verified a 3.6 mm drill bit goes through the holes without trouble. 11.- Insert the sleeve and drill sleeve in the proximal holes and verified likewise the drill bit goes through the proximal holes without trouble.

Nail insertion Verifying the system is properly calibrated; proceed to insert the nail in the femur. Remove the guides when it is completely inserted in the piriformis or digital fossa, previous placement the impacting handle and with soft hits insert the nail, everything with an image intensifier vision, then place the guides. Distal and proximal locking Place distal guide, place guide sleeve and perform a skin incision in the thigh anterior side, it is in blunt form dissected, insert the drill sleeve up to the femur anterior cortical with trocar help, insert the 5.2 mm drill bit up to the nail,...

15.- se retira el sistema y se coloca el tornillo de oclusión en la parte proximal del clavo, se sutura por planos o solo con nylon la piel, de acuerdo a las preferencias del Cirujano Ortopedista, se colocan apósitos y vendaje elástico, se retira de la mesa de fractura. Postsurgical care Must be place a elastic bandage from foot up to tight nearest origin, inguinal region, keeping the extremity elevated, the patient can perform free tolerance flexion/extension, each orthopedic surgeon may choose how analgesics and antibiotics are prescribed. Walking and support will be decided by each surgeon,...