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Gamma3 Trochanteric Nail 180 - Stryker

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Operative Technique<br />

Dealing with Special Cases<br />

In the case of a comminuted fracture,<br />

there is a tendency for the fracture to<br />

become displaced posteriorly, making<br />

it difficult to place the K-Wire into the<br />

center of the neck and head. This can<br />

be solved by lifting the nail insertion<br />

Targeting Device (Fig. 71).<br />

Alternatively, an assistant can lift up<br />

the greater trochanter manually or<br />

with a reduction spoon; or support it<br />

with a sandbag. This will maintain<br />

the neck and the femur in almost the<br />

same axis, facilitating passage of the<br />

K-Wire through the center of the neck<br />

and head.<br />

Fig. 71<br />

The position should then be checked<br />

in both the anterior-posterior<br />

and lateral views using the image<br />

intensifier.<br />

39

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