Synthes The Titanium Femoral Nail System, Technique Manual

Page: 27 / 78

With the insertion handle
in place, take an AP image
intensification view of the
proximal femur. Note the
position of the proximal nail
end in relation to the tip of the
greater trochanter. The nail
end should be apparent due
to the difference in nail and
insertion handle diameters.
26
Standard Locking
(continued)
Note position of proximal nail end
Example showing indication for the
green 10 mm extension end cap
Lock distally
For distal locking techniques, see pages 64– 65.
Place the green end cap
6
5
If the nail end is level with the
tip of the greater trochanter,
select the green 12 mm end
cap with 0 mm extension.
If the proximal nail end is
distal to the tip of the greater
trochanter, and the surgeon
chooses to extend nail length,
note the position of the
insertion handle barrel in
relation to the tip of the greater
trochanter on the image.
•
If the indented ring is at the
tip of the greater trochanter,
use the green 12 mm end
cap with 10 mm extension.
•
If the base of the flare is
at the tip of the greater
trochanter, use the green
12 mm end cap with
20 mm extension.
If the nail end isn’t visible,
remove the aiming arm, place
a 3.2 mm guide wire through
the hole in the insertion
handle, and note wire
position radiograph-
ically. This is the
level of the proxi-
mal nail end.
The etched line
on the insertion
handle is also
at the level of
the proximal
nail end.