3
Identify insertion point
Instrument
03.306.009 2.5 mm K-Wire Insertion Handle
Make an incision at the intersection between the extension
of the line of the femoral axis over the tip of the greater
trochanter, and a vertical line from the anterior superior iliac
spine in the dorsal direction.
If orientation is difficult, use an image intensifier.
The surface reference point of the outer side of the ilium
changes at the level of the sacroiliac joints. In emergency
situations, the resulting “fossa” can be used as a relatively
secure point of reference aid. For secure anchoring, the
pelvic C-clamp must be placed at the level of the sacroiliac
joints. Palpation with a blunt instrument, such as the K-wire
insertion handle, allows easy identification of this site, even
with severe soft-tissue swelling.
Warnings:
– If the nails are placed too ventrally to the correct insertion
point, there is a risk of perforation of the ilium, which can
result in organ injury.
– Placement of the pins in an excessively dorsal position may
result in injury to gluteal nerves and vessels.
– Inserting the nail too distally endangers the sciatic nerve
and the gluteal vessels in the sciatic notch. Malpositioning
of the nail in osteoporotic bone, combined with excessive
compression, can result in unwanted nail penetration.
Identify Insertion Point
8 DePuy Synthes Pelvic C-Clamp II Surgical Technique
