Zimmer Biomet Zimmer Natural Nail, Руководство пользователя

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11 | Zimmer Natural Nail – Cephalomedullary Asia Nail Surgical Technique
Figure 12
Nail Assembly and Insertion (cont.)
Lay the guide attached to the nail over the femur.
Confirm that the bow of the nail is anterior similar to
the bow of the femur. Confirm also that the lag screw
hole in the nail is oriented to guide a lag screw into
the femoral head. Care must be taken to ensure that
the correct nail is selected and that it is assembled
correctly to the guide. If this is not the case, loosen
and reattach the nail appropriately or choose the
correct nail and attach it to the guide.
Warning: Use a lag screw cannula and the lag
screw reamer or a cannula, drill sleeve and drill
to verify that the guide will target all required
holes in the nail correctly. Hole indicators can be
placed in static (ST) and dynamic (DY) holes of
the targeting guide and in holes for CCD angles
that will not be used to avoid the accidental use
of those holes during the surgery. Use a push-and-
twist motion when inserting the hole indicators to
help ensure that they stay in place.
Warning:
The targeting guide Asia is designed
to target the transverse distal static (ST) and
dynamic (DY) holes in Asia nails. As the guide is
designed to work with both left and right ST and
DY holes, care must be taken to ensure that the
correct ST/DY holes will be used for the surgery
(use the left holes when using a left nail, and vice
versa). The holes that will be used to place screws
into the distal portion of Asia nails are on the
anterior side of the guide when the patient is in a
supine position.
The targeting guide Asia has a built in locking
mechanism for the lag screw cannula. To lock, the
knob at the end of the guide has to be turned until
the cannula is fixed.
Insert the nail over the guide wire with the arm of
the guide facing anteriorly.
As the nail passes through the canal, it will naturally
turn approximately 90° until the anterior bow of the
nail is in line with the bow of the femur (Figure 12).
Monitor the progression of the nail down the canal
using the C-arm, especially as the nail is passing
through or near the fracture site.
Caution: Do not pry excessively on the targeting
guide as damage may result.