2
Identifying nail insertion point
Required instrument
Guide Handle, for Kirschner Wire
2.5 mm
03.306.009
Make an incision at the intersection between the extension of
the line of the femoral axis over the tip of the greater
trochanter, and a vertical line from the anterior superior iliac
spine in the dorsal direction (see illustration).
If orientation is difficult, use an image intensifier.
The surface reference point of the outer side of the ilium changes
at the level of the sacroiliac joints. In emergency situations, the
resulting “fossa” can be used as a relatively secure point of refer-
ence aid. For secure anchoring, the Pelvic C-Clamp must be
placed at the level of the sacroiliac joints. Palpation with a blunt
instrument, such as the Guide Handle for Kirschner Wire, allows
for easy identification of this site, even with severe soft-tissue
swelling.
Note:
If the nails are placed too ventrally to the correct insertion
point, there is a risk of perforation of the ilium, which can result
in organ injury.
Placement of the pins in an excessively dorsal position may result
in injury to gluteal nerves and vessels.
Inserting the nail too distally endangers the sciatic nerve and the
gluteal vessels in the sciatic notch. Malpositioning of the nail in
osteoporotic bone, combined with excessive compression, can
result in unwanted nail penetration.
8
Synthes
Pelvic C-Clamp
Technique Guide
