Open Proximal Femur
10
Synthes
Titanium Trochanteric Fixation Nail System—Screw Option Technique Guide
5
Identify nail entry point
Instruments
357.392 17.0 mm/3.2 mm Wire Guide
357.393 3.2 mm Trocar
357.399 3.2 mm Guide Wire, 400 mm
357.410 22.0 mm/17.0 mm Protection Sleeve
393.10 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 maximus fascia longi-
tudinally in the direction of the wound. Separate the underlying
muscle fibers and palpate the tip of the greater trochanter.
Insert the 22.0 mm/17.0 mm protection sleeve, the 17.0 mm/
3.2 mm wire guide, 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
6°
Anatomic
axis
Guide wire
entry path
