Surgical technique for subtrochanteric fracture of femur. Despite this change, the authors have noticed that there are times when anterior breaches or. Gamma3 trochanteric nail 180 cambridge orthopaedics. Overcoming anterior breaches in the distal femur during. In addition, ifn alpha2b eye drops were applied in the treatment group 4 times a day for 3 months. This ensures that the extensor tendon is protected during drill and pin insertion. Make sure that the fragment control clip is positioned in close contact to. Results in the literature on the time and radiation doses of distal locking screw of femoral nails.
Introduction introduction our thanks are due to the many sur. New technique for c1c2 fixation surgical neurology. Strykers learn was created in 2014 as a support initiative provide educational grants to perioperative nurses. With more than 630 images, stepbystep instructions to numerous surgical procedures, and standardized and systemic presentation of materials in the chapters, it is a welcome guide to learning numerous tasks and acquiring important skills in surgical critical care. Surgical technology program 6 objectives at completion of the surgical technology program, the graduate shall, at the level of an advanced. Zimmer natural nail system cephalomedullary nail surgical technique standard. Supplementary information about the surgical techniques brochure and video and products are available on request. During this period, modifications of design and instrumentation have occurred to combat the intra and postoperative complications that were associated with the use of early designs. Surgical technique preparing the patient place the patient in a direct lateral decubitus position on the operating room table to ensure suitable visualization of the trajectory of the retraction through the soft tissue.
At stryker learn, we are deeply committed to improving patient outcomes. Gamma3 ublade lag screw assembled and spreaded gamma3 ublade lag screw end cap fig. Overcoming anterior breaches in the distal femur during long. Stable fixation of these fractures can be obtained using a special intramedullary nail known as the gamma nail.
Pdf evaluation of surgical gamma probes for sentinel node. Straight limited use in oral surgery or curved figure 3. Surgical technique guide the latency period is the time period between the initial surgery when the distraction device is placed and when the distraction begins. This surgical technique is written from the trochanteric antegrade nail tan perspective. If miniopen modified wiltse rod placement is desired, make a 3. This device permits immediate full weightbearing 1 3. Surgical needles are designed to lead suture material through tissue with minimal injury. Atlas of surgical techniques in trauma edited by demetrios. Gamma nail is a cephalomedullary implant that was developed for the treatment of pertrochanteric hip fractures and has been successfully used for over 20 years. Improved lag screw positioning in the treatment of proximal femur. Biomet sports medicine, as the manufacturer of this device, does not practice medicine and does not recommend this or any other surgical technique for use on a specific patient. This manual is discribing the surgical technique using a gamma3. Placement of the external distal targeting device on the classic proximal nail device of the gamma long nail. Surgical technique guide select plate select the appropriately sized plate.
Timberline mpf lateral systemsurgical technique guide 9 step 3 the timberline retractor is utilized to create the desired exposure for implanting the timberline mpf implant. After the routine midline approach, the inferior facet of c2 was docked, and drilling was performed through the c1c2 facet joint to the level of the anterior arch of c1 under fluoroscopy, within the lateral mass of c1. Computer assisted surgery, lag screw placement, proximal. Right tibial tubercle traction was performed and sustained for 3 days up to surgery. As principle radiosterilization utilizes ionizing radiation and is a terminal sterilization method. Sep 23, 2019 imhs cp clinically proven intramedullary hip screw surgical technique. Correlate the knowledge of anatomy, physiology, pathophysiology, and microbiology to the roles and responsibilities of a surgical technologist. Surgical principles fractures of the neck of the femur and of the trochanteric region are typical injuries of the elderly. Stereotactic radiosurgery of the surgical resection cavity. The volumes of normal brain receiving 4 and 12 gy were higher, and increased more.
Operative technique 10 preoperative planning 10 implant selection 10. Each cadaveric specimen had a trochanteric 125 degree gamma3 nail. Accolade ii femoral hip system surgical technique previously lsp76 hipaccolade ii. Ptn insertion there is no need to exchange the guide wire prior to nail insertion. Although gamma irradiation has been used for many years in sterilization process, electron beam ebeam sterilization. The bipass pushers are sterilized by exposure to a minimum dose of 25 kgy of gamma radiation. The biomet peritrochanteric nail is inserted over the guide wire and into the medullary canal, by hand.
External distal targeting device for safe insertion of distal locking screws when performing long gamma nail. Nevertheless, they offer the same biomechanical strength and cutout resistance as the well established trochanteric and long gamma nails. Refer to the timberline surgical technique guide for instructions on using the timberline retractor figures 4a, b, c. Gamma3 distal targeting system reduce the or time to a minimum1 with the aid of using the stateoftheart instrumentation and an optimized surgical technique. The technique description herein is made available to the healthcare professional to illustrate the. Accolade surgical protocol previously lasst adm x3 mobile bearing hip system surgical protocol for us previously lsp64 hiprestoration adm. The gamma3 ublade lag screw system gamma3 ublade fig.
Then, follow the operative technique until distal screw locking. Plate sizes are shown on the superior blocking slide. The patients case history was assessed and physical examination was undertaken in the emergency room. A pocket manual, we are very pleased to add three new chapters. Features 5 design features of the gamma3 system 5 lag screw and set screw function 6 distal locking screws 7 gamma3 system benefits 8 3. By supporting the or with access to the latest technologies, training and innovations, we aim to be the leader in providing resources to empower and advance your. All intertrochanteric fractures were classified before surgery by attending physicians, according to aoota classification for the choice of the fixation method. Risk factors for cutout failure of gamma3 nails in treating unstable. Surgical technique continued incision and entry point assemble the honeycomb 71674075, entry handle 71674092 and entry tube 71674060. This manual is discribing the surgical technique using a gamma3 trochanteric nail 180. Classification of surgical needles according to eye. The aim of this study is to present the surgical technique of minimally invasive fixation of trochanteric fractures with the use of gamma 3 nail and report our results after two years of clinical use. Operative technique patient positioning the procedure for patient positioning is usually similar to that of a subtrochanteric fracture, however, in fractures that are.
The instructions for the gamma3 rc lag screw operative technique should not interfere with or replace any chapters in the gamma3 operative technique except for those detailing lag screw insertion and fixation. Proximal femoral nail antirotation surgical technique depuy synthes 11 2 confirm nail length and diameter instrument 309. The duration of the latency period is to be determined by the surgeon. Make a 23cm oblique incision directly over the fracture site along langers lines.
The gamma3 180 are designed to offer the same biomechanical strength and cutout resistance as the trochanteric and long gamma nails. An adequate incision is made along the palpable edge of the index metacarpal to expose the metacarpal surface. A snap is felt, if the fragment control clip is placed correctly onto the lag screw guide sleeve. Image intensifier control warning more information. Surgical technique the surgeon should be fully familiar with the surgical technique. Gamma 3 strykerhowmedica nail is the latest evolution of gamma device and offers its use in stable and unstable fractures with a miniincision. A 3 4cm midline incision is made followed by a medial parapatellar capsular incision to expose the intercondylar notch. Patient positioned with operative extremity adducted for intramedullary nailing. Minimally invasive treatment of trochanteric fractures with. Minimally invasive treatment of trochanteric fractures. The pieces will lock in place securely at either 0 or 180. Pdf gamma nails have been used extensively for the treatment of proximal femoral fractures.
If desired, tilt the pelvis away from the spine to better expose operative disc space. Imhs cp clinically proven intramedullary hip screw surgical technique pdf. This brochure is presented to demonstrate the surgical technique utilized by scott kuiper, m. The bare sclera technique was performed on both groups by the same surgeon doctor hang li from beijing tongren hospital.
Using the gamma3 distal targeting system is recommended when distal locking screws are required for the gamma3 long nail system. Zimmer natural nail system cephalomedullary nail surgical. It is important to perform distal targeting device calibration prior to the nail insertion. Gamma3 nail 180 the anatomical shape of the nail is universal for all indications involving. Long nail all nails use the same lag screws, set screw, distal locking screws and end caps see fig. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Guidelines for surgical procedures university of california. Perioperative view of the angle of the fluoroscope in relation to the leg, a surgical field is created. If percutaneous rod placement is desired, make a skin incision 2. Interferon alpha2b eye drops prevent recurrence of pterygium.
Imhs cp clinically proven intramedullary hip screw surgical technique. Gamma3 nail 180 all nails use the same lag screws, set screw, distal locking screws and end caps see fig. Pdf evaluation of surgical gamma probes for sentinel. Interferon alpha2b eye drops prevent recurrence of. Lat e n c y pe r i o d use of the osteomed logic mandibular distractor system is. Refer to page 16 implants for plate and screw sizes. Surgical technique metacarpal pin placement pins with a 15mm thread length are provided for use in the metacarpal. Surgical technique ch 6874 castel san pietro switzerland. Position the carm for an ap view of the proximal femur. Gamma3 ublade lag screw in the gamma3 trochanteric nail 180 fig. After treatment with the bare sclera technique, levofloxacin and 0. In the following, the trochanteric nail 180 is called. The lag screw shape has been improved, especially in the area of the. Distal screw locking of the trochanteric gamma3 nail.
Free hand technique 40 end cap insertion 42 nail extension end caps 43 postoperative care and rehabilitation 43 extraction of the gamma3 implants 44 dealing with special cases 46 packaging 47 references49 contents 3. Gamma3 ublade lag screw disassembled 3 the standard gamma nail. Gamma3 long nail gamma3 lag screw distal locking screws 120 125 gamma3 end cap gamma3 locking nails come in 3 neckshaft angles of 120, 125 and. Correlate the knowledge of anatomy, physiology, pathophysiology, and microbiology to the roles. Pdf we have retrospectively analysed 439 peritrochanteric hip fractures treated in our institution using the gamma nail, with. Laboratory indexes of this patient were all in the normal range. Careful preoperative planning, documented by xrays, is essential. Position plate use the plate holder to position the plate into the operative site for placement and sizing verification.