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

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Move the image intensifier toward the proximal end of thefemur, align the distal end of the ruler with the skin markingand record an AP x-ray of the proximal femur. Check thereduction and read off the required nail length on the ruleras it appears in the x-ray.Notes: It is recommended that the tip of the nail is at least5 cm above the most proximal extension of the fracturezone. Attention must be paid in the area 4 to 6 cm belowthe Lesser Trochanter because of the A. femoralis andthe branches of the N. femoralis. In cases where such longnails (> 320 mm) are used, it is recommended to placethe AP locking as proximal as possible and above the LesserTrochanter.The possibility of dynamisation must also be consideredwhen determining the nail length and a correspondinglyshorter nail should be chosen. The locking screw inthe dynamic locking option can move by up to 5 mm distally.AlternativesDetermine the nail length by the above procedure onthe uninjured leg or before draping (non-sterile) or comparethe length of two identical SynReam reaming rods 2.5 mm (352.032).14 Synthes Expert Retrograde /Antegrade Femoral Nail Technique Guide
Place the radiographic ruler for nail diameters over the femurso that the measuring edge is located over the isthmus.Select the nail diameter shown when the medullary canal /cortex transition is still visible on both sides of the marking(12 mm in this example).If the reamed technique is used, the diameter of the largestmedullary reamer applied must be 0.5 to 1.5 mm larger thanthe nail diameter.4ApproachFor 33-A.X and 32-X.X fractures either make a transligamental(ligamentum patellae) or a parapatellar incision.For 33-C.X fractures either make a medial or a lateralparapatellar approach depending on the type and locationof fracture.Synthes 15
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 and 14: preoperativepostoperativepreoperati
Page 15: 3Measure for length and diameter of
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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