Simultaneous Use of Cannulated Reamer and Schanz Screw for Closed Intramedullary Femoral Nailing

Table 2

Different technique and devices to assist closed reduction of the fracture during intramedullary nailing.

Sr. No.	Reduction technique	References	Remarks
1	Preoperative skeletal traction	[2, 18, 26]	Key to closed reduction in delayed nailing
2	Traction on fracture table	[17, 22, 23]
3	F-clamp	[19]	Facilitates reduction and reduces exposure of the operator to radiation
4	External supporting device	[20]	Eliminate the deforming forces of thigh muscles and reduces the radiation exposure
5	Strategically placed bumps	[16]
6	Manual traction	[2, 6, 9, 16, 22, 23]	Decreased operative time
7	Femoral distracter	[10]	Useful in nailing without fracture table
8	Steinman pin on a T-clamp inserted percutaneously	[4]
9	Percutaneous Schanz screws	[5, 18]
10	Ball spike pusher	[16]
11	Clamp-assisted reduction	[1]	Advocated clamp-assisted reduction with judicious use of a cerclage cable
12	A small diameter nail in the proximal fragment	[7, 14, 23, 26]	Kuntscher technique
13	8 mm straight reamer into the proximal fragment	[2]
14	Percutaneous cannulated channel reamer over a guide pin	[17]	Significantly decreases the occurrence of malalignment in proximal femoral shaft fractures
15	Small bend at the end of guide wire	[14]	Corrects translation of the distal fragment
16	Intramedullary bone endoscopy	[15]
17	Computerized navigation	[25]	Increases precision in fracture reduction while minimizing fluoroscopic requirements
18	Simultaneous use of cannulated reamer in proximal fragment and Schanz screw in the distal fragment	Present study	Reduces time and radiation exposure for closed reduction