Zimmer Biomet Zimmer Natural Nail, Manual

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15 | Zimmer Natural Nail – Cephalomedullary Asia Nail Surgical Technique
Figure 17
Lag Screw Placement (cont.)
If it is desired to utilize an antirotation pin to assist
in stabilizing the femoral head during lag screw
insertion, a 3.0 mm pin can be placed into the
femoral neck and head using a double cannula. Use
the smaller sleeve of the double cannula to place
this pin at this time. The pin is passed so that it does
not penetrate the femoral cortex in the femoral
head or neck.
Note: Place the 3.2 mm pin prior to the anti-
rotation pin to reduce mistargeting. Position the
antirotation pin slightly proximal to the center-line
of the femoral neck (Figure 17 and 18).
Alternatively, the pin can be placed using a freehand
technique anterior to the nail and into the femoral
neck and head.
2,3
Further, antirotation pins can be placed along
the nail. Insert the antirotation pin sleeve into the
corresponding hole of the targeting guide. Both
sleeve and hole are color coded blue (Figure 19).
Technique Tip: Due to the shape of the femoral
bone, predrilling is recommended to reduce the
risk of skiving. Use the antirotation drill 3.0 mm to
perforate the near cortex.
Warning:
Insert antirotation pins anterior to the
nail. Inserting them posterior to the nail may
cause damage to the neurovascular structures.
Figure 19
Figure 18