Gamma nail fixation

Part of the trochanteric fracture of the femoral subtrochanteric fracture, fracture under the small trochanter, type 5 according to Seinsheimer classification, type I fracture without displacement or displacement <2mm, type II and IIa transverse fracture, IIb screw fracture Small trochanter in the proximal fracture block, IIc spiral fracture small trochanter in the distal fracture block, type III 3 fractures, small trochanter falling down or trochanteric lateral cortical bone with triangular bones, type IV comminuted fracture, not small Rough, V-shaped trochanter and intertrochanteric fracture, up to the large trochanter, Russell and Taylor classification, IA fracture from the small trochanter, upward oblique to the large trochanter, IB fracture line with A + small trochanter Separation, IIA fracture line from the small trochanter down to the large trochanteric fossa, IIB and IIA + small trochanter fracture and separation. This type of internal fixation is developed on the basis of the intramedullary interlocking intramedullary nail and the lag screw parallel to the axis of the femoral neck, so that the femoral shaft and the head and neck are connected in the marrow, forming the name of the Arabic letter Gamma. The arm has short arm and small bending moment, meets the requirements of mechanics, and has strong anti-shrinkage and strong rotating force. It is especially suitable for various types of intertrochanteric and intertrochanteric and comminuted fractures. The nail internal fixation includes one intramedullary nail, one compression (tension) screw, one fixation screw for preventing rotation, and two distal locking nails. The intramedullary nail and the compression nail that intersects it are hollow and can be placed through the guide needle. Treatment of diseases: intertrochanteric fractures preoperative preparation General anesthesia or epidural anesthesia is used depending on the patient's condition. Because of the majority of elderly patients, general anesthesia is safer. The patient is lying on his lower limb traction operating table. Adjust the position of the C-arm X-ray machine. Lower extremity abduction, neutral traction, fluoroscopy to see the fracture reduction. Surgical procedure 1. Incision from the proximal end of the large trochanter, revealing the top of the large trochanter through the fascia and abductor muscle. The needle is inserted at the intersection of the first 1/3 and the last 2/3. First puncture the medullary cavity with a prismatic cone and place the guide pin. The pulp is reamed along the guide needle with the medullary cavity. 2. Insert the gamma nail until the central axis of the lag screw hole is located at the lower third of the femoral neck. After drilling the compression screw guide pin through the concentric circular needle positioner and reaming, screw the lag screw under the cartilage of the femoral head, and then tighten the fixation nail. 3. If the fracture is unstable, the distal femur is comminuted, separated, or the diameter of the intramedullary needle and the medullary cavity are large, the distal locking nail is performed. Also insert the sleeve first, hollow the hole, and screw in the self-tapping screws. 4. Finally sew the incision.

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