Simultaneous Use of Cannulated Reamer and Schanz Screw for Closed Intramedullary Femoral Nailing
Figure 1
Surgical technique: (a) Insertion of the guide wire in the proximal fragment. (b) Insertion of the cannulated reamer over guide wire. (c) The cannulated reamer over the guide wire is used as intramedullary joystick to control the proximal fragment as visualized under image intensifier. (d) Instruments used to insert percutaneous Schanz screw to aid fracture reduction (i) T handle, (ii) Drill sleeve, (iii) 4.5 mm cortical Schanz screw (iv) 3.2 mm drill bit. (e) Insertion of the Drill sleeve up to the bone. (f) T handle with Schanz screw inserted in the lateral cortex of the distal fragment. (g) The surgeon controls the distal fragment with the Schanz screw and the proximal fragment with the help of cannulated reamer to achieve fracture reduction. (h) Insertion of the guide wire through the cannulated reamer into the distal fragment. The arrow depicts the Schanz screw in the distal fragment. (i) The Schanz screw is inserted in the intermediate fragment in segmental diaphyseal fractures (Type C2 fractures).
