6°
5
Identify nail entry point
Instruments
357.392 Drill Sleeve 17.0/3.2, length 161 mm,
for No. 357.410
357.393 Trocar
3.2 mm, length 172 mm,
for No. 357.392
357.399 Guide Wire
3.2 mm, length 400 mm
357.410 Protection Sleeve 22.0/17.0,
for No. 357.394
393.100 Universal Chuck with T-Handle
The entry point for the nail is in line with the medullary canal
in the lateral view. In the AP view, the nail insertion point
is slightly lateral to the tip of the greater trochanter, in the
curved extension of the medullary cavity.
Make a longitudinal incision proximal to the greater
trochanter. Carry the dissection down to the gluteus max-
imus fascia longitudinally in the direction of the wound.
Separate the underlying muscle fibers and palpate the tip of
the greater trochanter. Insert the 22.0 /17.0 protection sleeve,
the 17.0 / 3.2 drill sleeve, and the 3.2 mm trocar assembly
into the incision site and down to the bone. Remove the
trocar.
The lateral angle of the nail is 6°; therefore, the 3.2 mm
guide wire must be inserted at an angle 6° lateral to the
shaft of the femur, and intersect the centerline of the canal,
just distal to the lesser trochanter. The guide wire will be
centered in the canal in the lateral view. The guide wire can
be inserted either manually with the universal chuck with
T-handle or with a power drill.
Axial and AP view
of insertion site
Guide wire
entry path
Anatomic
axis
TFN – Titanium Trochanteric Fixation Nail System
Technique Guide
Synthes
13
