What is a trochanteric nail fixation?
The Titanium Trochanteric Fixation Nail (TFN) is intended to treat stable and unstable fractures of the proximal femur including pertrochanteric fractures, intertrochanteric fractures, basal neck fractures, and combinations thereof.
How are intramedullary nails inserted?
Your surgeon will thread a guidewire into the center of the bone. He may need to use a device to make the bone hollow. He will then line up the broken ends of the bone. The nail is then inserted into the hollow part of bone to keep the bones lined up.
What is femoral nail insertion?
An intramedullary nail is a metal rod that is inserted into the medullary cavity of a bone and across the fracture in order to provide a solid support for the fractured bone. Intramedullary nailing is currently considered the “gold standard” for treatment of femoral shaft fractures (Rudloff 2009).
Which position is used for hip fractures and closed femoral nailing?
Patients were positioned on the radiolucent OR table in the supine position. While femoral intramedullary nailing, the fractured extremity usually needs to be positioned in full adduction during surgery for nail entry, reduction, and locking (owing to hardware in the proximal incision).
Is intramedullary nailing percutaneous or open?
Intramedullary nailing has been proven to have biomechanical advantages over the use of a side plate and screw system. Further advantages may be gained with the use of a percutaneous technique, thereby minimizing blood loss, operative time, and overall morbidity.
How do you put intramedullary nail in tibia?
Make sure the nail is properly aimed down the tibia. Remove it and ream to a larger diameter if the nail is still hard to insert. The tip of the nail should be placed deeply in the center of the distal tibia, usually to the level of the physeal scar. Confirm this position with AP and lateral image intensifier views.
What is a femoral nail?
The proximal femoral nail (PFN) is an osteosynthetic implant designed to treat proximal femoral fractures in the trochanter area with a closed intramedullary fixation method.
What is proximal femoral nailing?
What is the purpose of a trochanter roll?
trochanter roll a wedge (usually a rolled towel) placed from the crest of the ilium to midthigh to prevent external rotation of the hip when the patient is in a recumbent position. Use of trochanter roll to prevent external rotation of hip.
What is the trochanteric entry point used for?
The trochanteric entry point is used for proximally curved nails. As a general rule, draping should always be applied up to the pelvic rim, in order to find the correct individual location for the skin incision.
How do you determine the entry point of a trochanteric fracture?
Determination of the entry point The entry point is usually on the lateral aspect of the greater trochanter (see the nailing approach). Make your skin incision in line with the femoral shaft axis and about 5 cm proximal to the tip of the trochanter. Guide-wire insertion
How is unreamed nailing of the greater trochanter diagnosed?
In unreamed nailing, an incorrect entry point may lead to blow out of either the posterior, or anterior wall of the greater trochanter. 2. Skin incision To locate the site of the skin incision, the tip of the greater trochanter and the axis of the femur are marked with the help of the image intensifier and by palpating the trochanter.
How do you find the entry point of a nail?
The soft-tissue track for determination of the entry point should deviate less than 15° from the axis of the femoral shaft in order to avoid any stress on the femoral neck upon insertion of the nail. X-ray showing the correct position of the guide wire.