Gamma3 Trochanteric Nail 180 - Stryker

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Operative Technique Nail Insertion Insert the Gamma3 Nail by hand (Fig. 37) Warning: Even if some resistance is felt during nail insertion, never use high forces and/or a hammer to insert the nail, because these high forces will create stress to both bone and to the nail. It may create micro fractures in the bone or bend the nail, which may lead to a reduced targeting accuracy when drilling. Consider that titanium alloy is a more flexible material than stainless steel. In order to avoid stress in the bone and/or possible bending of the nail shaft, appropriate reaming of the intramedullary canal or respositioning of the proximal entry point may be necessary. The final Nail depth position is monitored with the image intensifier C-arm; the projected axis of the Lag Screw may be projected with a ruler on the monitor screen to ensure that the Lag Screw is placed in the optimal position. Proceed until the axis of the Lag Screw hole (visible as a crescent shape on the screen) is aligned with the lower half of the femoral neck (Fig. 38). The objective of this is to ultimately position the Lag Screw centrally or slightly inferior in femoral head in the frontal plane. Fig. 37 Fig. 38 Fig. 39a Note: Remove Guide Wire for the flexible reamer and nail insertion using Guide Wire Handle. (Fig. 39a). When the Gamma3 Nail has been inserted to its final depth, check the anteversion of the nail. Use of the K-Wire Clip or Closed Tube Clip with K-Wires (Fig. 39); as an alternative also the Gamma3 U-Wire can be used with the K-Wire Clip, Closed Tube Clip or the “One Shot Device” is recommended (see next page). The K-Wire Clip or Closed Tube Clip is mounted into the slots of the Target Arm by pressing the Clip flanges together. Note: Before proceeding ensure that the Nail Holding Screw is still fully tightened. Fig. 39 22
Operative Technique The Lag Screw should be placed in the central position of the femoral head in the lateral view (Fig. 40). Lag Screw Positioning using the One Shot Device The One Shot Device is re commended, for establishing whether the Lag Screw is in the optimum position. This device enables correct positioning of the K-Wire for Lag Screw placement before performing lateral skin incision and opening of the lateral cortex (see Fig. 41−42a). Fig. 40 nail positioned too deep Fig. 41 correct position Fig. 42 nail positioned too high Fig. 41a A / P view Fig. 42a Lateral view 23
Page 1 and 2: Gamma3 Trochanteric Nail 180 Operat
Page 3 and 4: Contents Introduction Design Featur
Page 5 and 6: Features Design Features of the Gam
Page 7 and 8: Implant Features Distal Locking Scr
Page 9 and 10: Implant Features Fig. 7 Indications
Page 11 and 12: Operative Technique Patient Positio
Page 13 and 14: Operative Technique The C-Arm is tu
Page 15 and 16: Operative Technique Alternative 1:
Page 17 and 18: Operative Technique The Trocar is t
Page 19 and 20: Operative Technique Assembly of Tar
Page 21: Operative Technique Before checking
Page 25 and 26: Operative Technique Pre-Drilling th
Page 27 and 28: Operative Technique Lock K-Wire win
Page 29 and 30: Operative Technique Lag Screw Fixat
Page 31 and 32: Operative Technique To verify the c
Page 33 and 34: Operative Technique Distal Screw Lo
Page 35 and 36: Operative Technique End Cap Inserti
Page 37 and 38: Operative Technique Extraction of t
Page 39 and 40: Operative Technique Dealing with Sp
Page 41 and 42: Ordering Information - Instruments
Page 43 and 44: Implants Packaging All implants are
Page 45 and 46: Ordering Information - Implants Tro
Page 47 and 48: Notes 47

Gamma3 Trochanteric Nail 180 - Stryker

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