Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated Surgical Technique Cannulated Femoral Interlocking Nail Solid Femoral Interlocking Nail Intramedullary Nail System Femur Nail Kit Code 08040001

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com ► Preparing the Nail and Instruments 8 ► Solid Nail Technique 13 ► Distal and Proximal Blocking 14 ► Cannulated Nail Technique 16 Intramedullary Nail System

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com This guide is designed to demonstrate the recommended techniques and applications for the use of the ARZZT intramedullary nail for femurs, meant for orthopedic traumatologists in the treatment of fractures. The recommendations for their use do not presume to interfere with the surgeon’s experience, nor the particular needs of each patient, and follow the basic norms for the treatment of fractures through intramedullary fixation with the biomechanical principle of internal splints or tutors. Intramedullary...

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com Introduction The treatment of diaphyseal femoral fractures is currently based on closed- focus intramedullary nailing by virtue of its biological and biomechanical advantages. The solid nails—drilled or not drilled—act as internal splints, serving as “bridge nails” between the proximal fragments, with both their distal and proximal locking being essential due to the fact that all efforts are transmitted and supported via the locking screws. In cases of simple transverse fractures and short oblique fractures...

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com Implant Design ARZZT solid and cannulated intramedullary nails for the femur are made with a titanium 6AI4V alloy, with two distal orifices for fixed locking and two for proximal locking (one fixed and one dynamic), in which one places locking screws with conical heads to achieve greater fastening in the cortex. They have been designed for use in diaphyseal fractures with simple, complex or comminuted fragments up to 5 cm proximal to the distal metaphysis of the femur. The solid nail is available in...

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com Pre-operative Planning The diameter and longitude of the nail are determined based on the measurement of the X-rays of the healthy extremity, taking into account the image magnification standards (which vary between 10 and 15%). Some surgeons use the image intensifier, superimposing the nail over the affected extremity in order to establish the longitude and to obtain a safe distance without affecting the articulation of the knee and hip. Another method is measuring from the point of the great trochanter...

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com Patient Positioning The femoral fracture can be reduced in an open or closed manner, with the latter being the preferred method, placing the patient in a supine position on a fracture reduction table or a radiolucent surgical table. In order to allow for better access for the surgical approach, the trunk is inclined toward the side opposite the fracture at 25 degrees. With the trunk fixed, the healthy pelvic extremity is placed in a leg support with hip abduction to allow the image intensifier to have...

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com Preparing the nail and Instruments The nail must be assembled and calibrated before it is used inside the femur in order to allow for the free passage of the screws and to create exact symmetry. 1.Position the nail in the insertion handle, ensuring that the grooves line up when fixing it with the nail connector. 2.Fasten the nail in the insertion handle with the nail connector and firmly tighten the handle using the Lhandled hexagon key (Allen), introducing it into the handle’s orifices. Intramedullary...

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com 3.Position the proximal arm in accordance with the longitude of the nail, lining up the arrows of the insertion handle with those of the proximal arm. 4.Secure the proximal arm by tightening the handle with the L-handled hexagon key (Allen). 5. Position the second module (aiming arm) depending on the leg to be operated on (left or right), following the direction of the arrow on the module. 6. Tighten the two no. 2 screws while taking into account the longitude of the nail arrow by arrow. 7. Position...

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com 7. Position the aiming arm in order to insert the Thandled feeler gauge, tightening it with fastening screw no. 3. 8. Position the internal sheath (drill bit guide) for the 5.2 mm bit, which must touch the distal groove. Intramedullary Nail System 10

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com 9. Remove the internal sheath (drill bit guide) and position the feeler gauge, affixing and fastening it to the module with the different spacers (to lock it in), depending on the diameter of the nail. 10. Position the external sheaths (for tissue protection) and internal sheaths (distal drill bit guides) through the distal arm and verify that the 4 mm bit passes through the orifices without any problem. Intramedullary Nail System 11

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com 11. Introduce the external sheaths (for tissue protection) and the internal sheaths (distal drill bit guides) into the proximal orifices, and verify that the bit passes through the proximal orifices without any problem. Intramedullary Nail System 12

Intramedullary locked Nailing With Screws for Femoral Fractures Solid/Cannulated www.arzzt.com Antegrade Surigcal Technique for the Arzzt Solid Femoral Nail Once the patient is on the operating table, with the fracture reduction closed, the image intensifier in position, following asepsis and antisepsis the surgical area is delimited with drapes, and the surgeon proceeds to perform a proximal cutaneous incision (10–15 cm), with respect to the great trochanter (3 cm in longitude), and to palpate the tip of the great trochanter through the gluteal musculature. The point of entry must be aligned...