Covision surgical intramedullary nail

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INTRAMEDULLARY NAIL SYSTEM

FEMUR INTRAMEDULLARY NAIL SURGICAL TECHNIQUE

Can be used for fractures in the shaded area

Fractures situated in the shaded area can be treated with Covision’s Reamed and Unreamed Femoral Interlocking Nail.

1

For reamed and unreamed femur surgery there is a requirment an incision which is made from proximal to greater trochanter approximetly 6-8 cm(Figure 2).
Figure 2

FEMORAL PREPRATION Curved aw1is introduced to trochanteric fossa and makes an opening directly at the midplane of the femur. Proximal is larged to 13,5 mm diameter for reamed and unreamed nails. Skin protector is used at the reaming (Figure 3).

Figure 3

INSERTION OF GUIDE ROD INTO I-M CANAL To assist the reaming technique, 3 mm Guide rods are available, simple fractureswill utilize the Straight Guide Rod while more severely displaced fractures may require the use of the Curved Guide Rod, Guide rod can be inserted to level of the fracture by using THandle (Figure 4).

Figure 4

2

NAIL LENGTH GAUGE Two different methods can be used to determine the appropriate nail length.

A) Position the Nail Length Gauge anterior to the femur with its distal endcentered in the distal epiphysis, read from image intensifier the correct nail length (Figure 5).

Figure 5

B) With the distal end of the Guide Rod centered in the distal epiphysis, overlap a second Guide Rod to the portion of the reduction Guide Rod extending proximally from the femoral entry portal. Subtract the length of the overlapped Guide Rods from 900 mm to determine the nail length (Figure6).

Figure 6

REAMING THE I-M CANAL Advance the Guide Rod until it is centered in the distal fragment 1 cm. Using the Flexible Reamers over the Guide Rod, ream the entire femur until the desired diameter has been achieved (Figure 7).

Figure 7

3

Select a nail 1 mm smaller then final reamer used. Never insert a nail that has a larger diameter than the last reamer used. Introduce themedullary Exchange Tube over the Reamer Guide Rod, Remove the Curved Guide Rod and insert the Straight Guide Rod (Figure 8).

Figure 8

NAIL INSERTION Attach the selected nail to the proximal Drill Guide with the Hexagonal Bolt and tighten with an Open End Wrench. Attach the Supine Driver to Femoral Drill Guide and tighten (Figure 9).

Figure 9

Insert the nail by tapping the slotted hammer(Figure 10).

Figure 10

4

PROXIMAL SCREW INSERTION Insert the 8.0 mm Cannulated Aligment Rod through superior hole in the Femoral Proximal Drill Guide and make a skin incision tip determine the proper location of the incision. Advance the 8.0 mm Cannulated Aligment Rod until to bone and insert the 4.8 mm Drill Sleeve into it, insert the Trocar Guide Pin into 4.8 mm Drill Sleeve. (Figure11).
Figure 11

Remove the Trocar Guide Pin and Drill the two holes by using Femoral Drill (Figure 12).

Figure 12

Be sure that screw length gauge is against to cortex and make screw length measurement (Figure 12).
Figure 13

5

Attach the selected screw to screw driver and insert the selected screw through to Drill Sleeve. Repeat the procedure for the second Proximal Screw (Figure14).
Figure 14

6

TIBIA INTRAMEDULLARY NAIL SURGICAL TECHNIQUE

Can be used for fractures in the shaded area

Fractures situated in the shaded area can be treated with Covision’s Reamed and Unreamed Tibial Interlocking Nail.

7

STARTING SURGICAL OPERATION In order to find Tibial Medullary Canal, use curved Awl. Ream the proximal fragment of the tibia to 12 mm diameter using theSkin Protector while reaming (Figure 2).
Figure 2

INSERTION OF GUIDE ROD INTO I-M CANAL To assist the reaming technique, 3 mm Guide rods are available, simple fractures will utilize the Straight Guide Rod while more severely displaced fractures may require the use of the Curved Guide Rod, Guide rod can be inserted to level of the fracture by using T-Handle. (Figure 3)

Figure 3

REAMING THE...
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