Expert R/AFN Retrograde /Antegrade Femoral Nail. - Osteosyntese

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Retrograde approach –Opening the distal femur1Position patientPosition the patient supine on a radiolucent table.The knee of the injured leg should be flexed 70 to 90º allowingfor correct reduction of the fracture and localisation ofthe nail entry point. A leg roll may be used to allow properreduction and stabilisation of the fracture.Position the image intensifier in such a way that visualisationof the femur including the proximal and distal endsis possible in AP and lateral view.The contralateral leg should be flexed in the hip and inthe knee and rested in an elevated position to enable visualisationby image intensifier.2Reduce fracturePerform closed reduction manually by axial traction underimage intensifier. In case of older fractures, the use ofthe large distractor (394.350) or pinless fixator (186.310) maybe appropriate under certain circumstances.Note: Intra-articular fractures should be stabilised withinterfragmentary screw fixation prior to insertion of the nail.The screws should be positioned to not interfere with thepath of the nail.12 Synthes Expert Retrograde /Antegrade Femoral Nail Technique Guide
3Measure for length and diameter of nailInstruments03.010.020 Radiographic Ruler for ExpertFemoral Nails, length 475 mm03.010.023 Radiographic Ruler for Nail Diametersfor Expert Femoral Nails,length 365 mmThe required nail length must be determined after reductionof the upper leg fracture.Position the image intensifier as for an AP view of the distalfemur. Using long forceps, hold the ruler parallel to thefemur on the lateral side of the upper leg. Position the rulersuch that the distal end is at the desired nail insertion depth.Mark the skin at that site.Synthes 13
Page 3 and 4: Table of ContentsIntroductionFeatur
Page 5 and 6: Synthes 3
Page 7 and 8: Unique distal locking optionsThe un
Page 9 and 10: AO/ASIF principles ofinternal fixat
Page 11 and 12: IndicationsIndications for retrogra
Page 13: preoperativepostoperativepreoperati
Page 17 and 18: Place the radiographic ruler for na
Page 19 and 20: 6Insert guide wire7- 9ºInstruments
Page 21 and 22: 7aOpen medullary canal - drill bitI
Page 23 and 24: Retrograde approach -Reaming (optio
Page 25 and 26: Check that the connecting screw is
Page 27 and 28: The correct insertion depth must be
Page 29 and 30: Retrograde approach -Standard locki
Page 31 and 32: 3Drill and measure for length of lo
Page 33 and 34: 4Insert locking screwInstrument03.0
Page 35 and 36: Retrograde approach -Spiral blade l
Page 37 and 38: 3Insert guide wireInstrument03.010.
Page 39 and 40: 6Insert spiral bladeInstruments03.0
Page 41 and 42: Retrograde approach -End cap insert
Page 43 and 44: 2Align image intensifierCheck the r
Page 45 and 46: Alternative instrument03.010.104 Dr
Page 47 and 48: Alternative instrument03.010.106 Di
Page 49 and 50: Retrograde Approach -Interlocking w
Page 51 and 52: Distal spiral blade lockingInsert s
Page 53 and 54: Final view of implanted Expert Retr
Page 55 and 56: 3Measure for length and diameter of
Page 57 and 58: Place the radiographic ruler for na
Page 59 and 60: 6Insert guide wireInstruments03.010
Page 61 and 62: 7aOpen medullary canal - drill bitI
Page 63 and 64: Antegrade approach -Reaming (option
Page 65 and 66:
The anterior bow of the nail must b
Page 67 and 68:
Alternative instruments03.010.047 C
Page 69 and 70:
Antegrade approach -End cap inserti
Page 71 and 72:
Antegrade approach -Freehand lockin
Page 73 and 74:
2Remove spiral bladeInstruments357.
Page 75 and 76:
4Attach extraction screw and hammer
Page 77 and 78:
ImplantsNailsAll implants are avail
Page 79 and 80:
Expert Retrograde/Antegrade Femoral
Page 81 and 82:
Locking implantsSpiral blades for E
Page 83 and 84:
Locking Screws Stardrive 5.0 mm (l
Page 85 and 86:
InstrumentsStandard instrumentation
Page 87 and 88:
03.010.030 Protection Sleeve 13.0,f
Page 89 and 90:
03.010.070 Trocar 4.0 mm, for No.
Page 91 and 92:
Optional instruments351.050 Tissue
Page 93 and 94:
Vario Case68.003.010 Vario Case for
Page 95 and 96:
Power tools530.010 Power Drive, com
Page 97 and 98:
DFN instrumentation upgrade356.980
Page 100:
Presented by:Ö036.000.519öAAJä03
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Expert R/AFN Retrograde /Antegrade Femoral Nail. - Osteosyntese

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