University:
Michigan State University
Course:
MED 492 | Basics and Methods in Biomedical Research
Academic year:

2021
Views:

180

Pages:

3
Author:

Alexa Livingston

Preparation 1. Position Patient Place the patient in a supine position on the operating table. Position the image intensiﬁer to enable visualization of the proximal femur in both the AP and lateral planes. (1) 6 1 Instrument 357.399* or 356.830* Guide Wire B 3.2 mm, length 400 mm Guide Wire B 3.2 mm, for PFNA Blade Before Reduction 2. Reduce Fracture Check the reduction in two planes under image intensiﬁer control. If the reduction is insufﬁcient consider open reduction. Insert an unused wire as an antirotation wire in the superior/anterior part of the femoral neck to prevent any inadvertent rotation of the femoral head. Notes: • An inappropriate position of the antirotation wire may interfere with the proper placement of the implant. • The antirotation wire can be placed percutaneous or through the lateral incision. Temp. Fixation Reduce the fracture by means of gentle traction/flexion, adduction/abduction and internal rotation (about 15°, so the femoral neck is parallel to the operating table). After Reduction Note: Proper reduction of the fracture is crucial for good bone healing and function as well as reduction of complications. Precaution: Monitor the position of the wire during insertion and confirm the final position using the image intensifier. Over inserting guide wires could lead to damage to vital organs. * Available non-sterile and sterile packed. Add “S” to the article number to order sterile products. 7 Preparation 3. Approach Make a straight lateral skin incision of approximately 6 cm in length, starting 2 to 3 cm proximal to the center of the femoral neck axis. (1) Access and expose the lateral femoral surface accordingly for satisfactory hardware placement. Option: In obese patients, consider making a second incision during locking screw insertion. The second incision needs to be at the entry point of the protection sleeve, proximal to the main incision (see step Locking Screw Insertion for additional information on attaching the protection sleeve). 8