Synthes
5
4
Determine nail diameter
Place the radiographic ruler perpendicular to the femur and
position it over the isthmus to confirm the nail diameter.
Choose the nail diameter with which the transition between
the medullary canal and the cortex is still visible left and right
of the marking.
5
Incision
For 33-A.X and 32-X.X fractures, either make a transligamen-
tar (ligamentum patellae) or a medial parapatellar incision.
For 33-C.X fractures always make a medial parapatellar ap-
proach.
6
The Distal Femoral Nail may be used for either reamed or
unreamed application.
Determine nail entry point and insert guide wire
The entry point for the nail is in the axis of the medullary
canal and in the intercondylar notch, just anterior and lateral
to the femoral attachment of the posterior cruciate ligament.
Insert the Protection Sleeve 17.0/15.0 (357.530) and the Drill
Sleeve (357.531) through the incision to the bone. Insert the
calibrated Guide Wire
3.2 mm (357.129) to a depth of 10
to 15 cm, taking into consideration the 7° to 9° valgus angle
of the anatomic axis of the femur. AP and lateral image inten-
sifier control is mandatory.
Cortex
Cortex
Lateral
Medial
