Untitled - Stryker
Untitled - Stryker Untitled - Stryker
Operative Technique Nail Extension End Caps If the proximal end of the nail is completely in the trochanter and cortical bone support is required at the end of the nail, End Caps in size +5mm and +10mm are available and can be assembled to the nail instead of the End Cap size 0. The proximal part of the nail will be elongated by 5mm or 10mm. End Cap (size +10mm) End Cap (size +5mm) The elongation End Caps are assembled using the Strike Plate with the self retaining ring, Spreading Screwdriver or Ball Tip Screwdriver. This can only be done if the Target Device is already removed from the nail. Post-operative Care and Rehabilitation Active and passive mobilization of the lower limbs may be started immediately. The injured limb should be kept elevated. For stable fractures with dynamic locking, full weight-bearing walking may be started immediately. For unstable fractures with static locking, immediate full weight-bearing walking is allowed in fractures with good bone contact. For fractures with poor bone contact due to comminution, partial weightbearing walking is allowed for the first 6 to 8 weeks. Full weight-bearing walking can be commenced when there is a bridging callus formed as evident on the follow up X-Ray. Fig. 65 40
Operative Technique Extraction of the Gamma3 Implants Where implant extraction is indicated, please proceed as follows: Step I (Fig. 66) Remove the distal screw using the 3.5mm Screwdriver after making an incision through the old scar. Step II (Fig. 67) Make a small incision through the old scar below the greater trochanter to expose the outer end of the Lag Screw. remove any bony ingrowth which may be obstructing the outer end or internal thread of the Lag Screw as necessary to enable the Lag Screwdriver to engage fully. Fig. 66 The K-Wire is then introduced via the Lag Screw into the head of the femur. The Lag Screwdriver is passed over the K-Wire, using the Lag Screw Guide Sleeve as a Tissue Protector, and engaged with the distal end of the Lag Screw. Check that ingrowth does not obstruct secure engagement of the Lag Screwdriver, otherwise the Lag Screw or Screwdriver may be damaged and extraction will be much more difficult. Tighten the thumbwheel clockwise. Fig. 67 Step III (Fig. 68) An incision is made over the proximal end of the nail, the proximal End Cap if used is removed using the Ball Tip Screwdriver, Spreading Screwdriver or Strike Plate, and the Set Screwdriver is engaged with the Set Screw. The screw is rotated anticlockwise until it is removed. Note: As the targeting device is not connected to the nail, we recommend using the Straight Set Screwdriver (1320-0210) for better guidance through the soft tissue to get access to the Set Screw. Fig. 68 41
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Operative Technique<br />
Nail Extension End Caps<br />
If the proximal end of the nail is completely<br />
in the trochanter and cortical<br />
bone support is required at the end<br />
of the nail, End Caps in size +5mm<br />
and +10mm are available and can be<br />
assembled to the nail instead of the<br />
End Cap size 0. The proximal part of<br />
the nail will be elongated by 5mm or<br />
10mm.<br />
End Cap (size +10mm)<br />
End Cap (size +5mm)<br />
The elongation End Caps are<br />
assembled using the Strike Plate with<br />
the self retaining ring, Spreading<br />
Screwdriver or Ball Tip Screwdriver.<br />
This can only be done if the Target<br />
Device is already removed from the<br />
nail.<br />
Post-operative Care and Rehabilitation<br />
Active and passive mobilization of<br />
the lower limbs may be started<br />
immediately. The injured limb should<br />
be kept elevated.<br />
For stable fractures with dynamic<br />
locking, full weight-bearing walking<br />
may be started immediately. For<br />
unstable fractures with static locking,<br />
immediate full weight-bearing walking<br />
is allowed in fractures with good bone<br />
contact.<br />
For fractures with poor bone contact<br />
due to comminution, partial weightbearing<br />
walking is allowed for the<br />
first 6 to 8 weeks. Full weight-bearing<br />
walking can be commenced when<br />
there is a bridging callus formed as<br />
evident on the follow up X-Ray.<br />
Fig. 65<br />
40
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