Synthes The Titanium Femoral Nail System, Technique Manual

Page: 14 / 78

Preoperative Implant Selection
Use the AO Preoperative
Planner rulers to determine
the following measurements:
•
Nail length
•
Nail diameter
•
Spiral Blade angle
(if indicated)
For Spiral Blade
locking procedures
Determine Spiral
Blade angle
Select Spiral Blade angle
based on anatomy and
fracture location.
Ideally, the blade tip should lie
just inferior to the intersection
of the compression and
tension trabeculae in the AP
view of the femoral head, and
the midsection of the blade
should lie in the inferior
aspect of the femoral neck.
Because the trabecular
intersection is the densest
area of bone in the femoral
head, this blade placement
maximizes purchase and
cutout resistance.
The Spiral Blade should be
in the proximal fragment and
should not cross the fracture.
For high subtrochanteric
fractures, a lower angled
Spiral Blade is often needed.
For all locking procedures
Note that all ruler images are enlarged 15% to account
for average radiograph magnification; however, deviations
in magnification levels are common.
When selecting nail diameter, consider anatomic
isthmus diameter, fracture pattern, and postoperative
protocol/expectations.
PREOPERA
T
IVE
IMPLANT
SELECTION
13
Plan for Spiral Blade angle
Example showing ruler placed over the preoperative x-ray.
The 100° angle will place the Spiral Blade inferior to the
trabecular intersection and fully in the proximal fragment.