S2 Femoral Nail Compression Operative Technique - Stryker

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Introduction & Features Instrument Features The major advantage of the instrument system is a breakthrough in the integration of the instrument platform which can be used not only for the complete S2 Nailing System, but will be the platform for all future Stryker Trauma nailing systems, reducing complexity and inventory. The instrument platform offers advanced precision and usability, and features ergonomically styled targeting devices. In addition to the advanced precision and usability, the instruments are number coded to indicate the step during the surgical procedure in which the instrument is used. Step Number Opening 1 Reduction 2 Nail Introduction 3 Guided Locking 4 Freehand Locking 5 The S2 Distal Targeting Device offers the competitive advantage of: • Minimizing fluoroscopy time • Helping to avoid misdrilling • Reducing the operative time. For detailed information about the Distal Targeting Device please refer to the S2 Distal Targeting Device – Operative Technique, REF B1000012. References 1. T.e. Richardson, M. Voor, D. Seligson, Fracture Site Compression and Motion with Three Types of Intramedullary Fixation of the Femur, Osteosynthese International (1998), 6: 261-264. 2. Hutson et al., Mechanical Failures of Intramedullary Tibial Nails Applied without Reaming, Clin. Orthop. (1995), 315 : 129-137. 3. M.E. MULLER, et al.,Manual of Internal Fixation, Springer-Verlag, Berlin, 1991. 4. O. Gonschorek, G.o. Hofmann, V. Bühren, Interlocking Compression Nailing: a Report on 402 Applications. Arch. Orthop. Trauma Surg (1998), 117: 430-437. Drills Drills feature color coded rings: 4.2mm = Green For 5.0mm Fully Threaded Locking Screws and for the second cortex when using 5.0mm Partially Threaded Locking Screws (Shaft Screws). 5.0mm = Black For the first cortex when using 5.0mm Shaft Screws. Unique to the S2 Nailing System is a special Distal Targeting Device designed for Distal Guided Locking Technique. 6
Indications & Relative Contraindications Indications Relative Contraindications The S2 Femoral Nail, Compression is indicated for: • Open and closed shaft fractures • Segmental fractures • Comminuted fractures with or without bone loss • Fractures proximal to a total knee arthroplasty • Pathologic and impending pathologic fractures • Tumor resections • Non-unions • Pseudarthrosis • Mal-unions • Corrective osteotomies The physician‘s education, training and professional judgement must be relied upon to choose the most appropriate device and treatment. Conditions presenting an increased risk of failure include: • Any active or suspected latent infection or marked local inflammation in or about the affected area. • Compromised vascularity that would inhibit adequate blood supply to the fracture or the operative site. • Bone stock compromised by disease, infection or prior implantation that can not provide adequate support and/or fixation of the devices. • Material sensitivity, documented or suspected. • Obesity. An overweight or obese patient can produce loads on the implant that can lead to failure of the fixation of the device or to failure of the device itself. • Patients having inadequate tissue coverage over the operative site. • Implant utilization that would interfere with anatomical • • structures or physiological performance. Any mental or neuromuscular disorder which would create an unaccep table risk of fixation failure or complications in postoperative care. Other medical or surgical conditions which would preclude the potential benefit of surgery. Antegrade Pre-operative Planning An X-Ray Template, Femur, Compression (1806-8007) is available for pre-operative planning (Fig. 1). Thorough evaluation of pre-operative radiographs of the affected extremity is critical. Careful radiographic examination of the trochanteric region and intercondylar regions can prevent intra-operative complications. The proper nail length, after locking, should extend from the Tip of the Greater Trochanter to the Epiphyseal Scar. This allows the surgeon to consider the apposition/compression feature of the S2 Femoral Nail, Compression, knowing that up to 10mm of active apposition/compression is possible, prior to determining the final length of the implant. If dynamization or apposition/compression is planned, the nail should be at least 10mm shorter. Note: Check with local representative regarding availability of nail sizes. 7 Fig. 1
Page 1 and 2: S2 Femoral Nail Compression Operati
Page 3 and 4: Contents Page 1. Introduction & Fea
Page 5: Introduction & Features S2 Femoral
Page 9 and 10: Operative Technique Patient Positio
Page 11 and 12: Operative Technique Entry Point The
Page 13 and 14: Operative Technique Nail Selection
Page 15 and 16: Operative Technique The Slotted Ham
Page 17 and 18: Operative Technique Note: The Targe
Page 19 and 20: Operative Technique When the Drill
Page 21 and 22: Operative Technique End Cap Inserti
Page 23 and 24: Operative Technique The Long Tissue
Page 25 and 26: Operative Technique Nail Removal Na
Page 27 and 28: Ordering Information - Implants 5mm
Page 29 and 30: Ordering Information - Instruments
Page 31 and 32: Ordering Information - Instruments

S2 Femoral Nail Compression Operative Technique - Stryker

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