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8/14/2019 Interlocking Nails for Femur Tibia and Supra Condylar
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Interlocking Nails
Femur, Tibia and Supracondylar
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2 JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com roup o., . - ma : n o m -group.com - e : www. m -group.com
The femoral, tbial and supracondylar nails in the JMF Nailing system are manufactured from unsloed, cylindrical closed-secton high tensile
strength stainless steel. Superior torsional resistance of this design is an important advantage in comparison with conventonal sloed designs.
A gentle taper at the tp allows easy inserton.
The JMF femur nails feature upward, transverse, downward and miss-the-nail locking optons for ipsilateral fracture configuratons. The same
nails are used for lef and right femora reducing inventory and simplifying handling which are key benefits to operatng surgeons and operatng
room staff.
The JMF tbia nails have proximal locking screws which are oriented at 45 to the long axis of the tbia. These screws are safer to introduce than
conventonal A-P screws and allow excellent purchase in the posterior cortces. All nails are constructed with a reinforced distal locking hole
which is located at the distal tp of the nail. This locking hole allows these nails to be used with more distal fractures when compared with most
systems. Small Diameter Nails Smaller diameter nails (Dia 9 & 10mm) are available for patents with small medullary canals. Modular design
instrumentaton enables the inserton and locking of small diameter nails with the same instruments used for standard diameter nails.
New Generaton Instrumentaton the JMF system features specially designed inserton instrumentaton with polymer shock-absorbing washers
which absorb impacton loads. The instrumentaton is extensively tested for reliability in preventng thread loosening during nail impacton.
Indicatons the JMF femoral locking nail system can be used for a wide range of stable and unstable fracture configuratons including
Proximal and distal fractures
Two part fractures
Segmental fractures Comminuted fractures with or without bone loss
Ipsilateral fractures
Proximal or distal non unions and malunions
Correctve osteotomies
Prophylaxis of pathological fractures
Introducton
Length of proximally enlarged secton of nail (all diameters) 85 mm
Diameter of proximally enlarged secton of nail (9 and 10mm nails) 12 mm
Diameter of proximally enlarged secton of nail (10 and 12mm nails) 14 mm
Distance of transverse locking proximal screw hole from proximal tp of nail 40 mm
Distance of distal tp screw hole from distal tp of nail 5 mm
Radius of curvature 3000 mm
Length of proximally enlarged secton of nail (all diameters) 55 mm
Diameter of proximally enlarged secton of nail (9 and 10mm nails) 12 mm
Diameter of proximally enlarged secton of nail (10 and 12mm nails) 14 mm
Distance offirst proximal screw hole from proximaltp of nail 30 mm
Distance between first two proximal screw holes 10.5 mm
Distance of distal tp screw hole from distal tp of nail 5.0 mm
Locaton of nail bend with reference to proximal nail tp 60mmBend angle (degrees) Dia 9 and 10mm 13
Bend angle (degrees) Dia 11 and 12mm 6
Length of proximally enlarged secton of nail (all diameters) 39 mm
Diameter of proximally enlarged secton of nail (9 and 10mm nails) 14 mm
Diameter of proximally enlarged secton of nail (10 and 12mm nails) 14 mm
Distance offirst distal locking hole from distal nail tp 20 mm
Distance of second distal locking hole from first distal locking hole 10 mm
Distance of most proximal locking hole from proximal nailt
p 15 mmDistance of second proximal locking hole from first 20mm
Locaton of nail bend (distance from distal tp) 45mm
Nail bend angle 8
Femoral Nail
Tibia Nail
Supra-Condylar Nail
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3JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com ., . - - . - . - .
IM Implants
12-1100 FEMORAL NAIL, L.30CM, DIAM. 9MM
12-1101 FEMORAL NAIL, L.32CM, DIAM. 9MM
12-1102 FEMORAL NAIL, L.34CM, DIAM. 9MM
12-1103 FEMORAL NAIL, L.36CM, DIAM. 9MM
12-1104 FEMORAL NAIL, L.38CM, DIAM. 9MM
12-1105 FEMORAL NAIL, L.40CM, DIAM. 9MM
12-1106 FEMORAL NAIL, L.42CM, DIAM. 9MM
12-1107 FEMORAL NAIL, L.44CM, DIAM. 9MM
12-1108 FEMORAL NAIL, L.46CM, DIAM. 9MM
12-1109 FEMORAL NAIL, L.30CM, DIAM. 10MM
12-1110 FEMORAL NAIL, L.32CM, DIAM. 10MM
12-1111 FEMORAL NAIL, L.34CM, DIAM. 10MM
12-1112 FEMORAL NAIL, L.36CM, DIAM. 10MM
12-1113 FEMORAL NAIL, L.38CM, DIAM. 10MM
12-1114 FEMORAL NAIL, L.40CM, DIAM. 10MM
12-1115 FEMORAL NAIL, L.42CM, DIAM. 10MM
12-1116 FEMORAL NAIL, L.44CM, DIAM. 10MM
12-1117 FEMORAL NAIL, L.46CM, DIAM. 10MM
12-1118 FEMORAL NAIL, L.34CM, DIAM. 11MM
12-1119 FEMORAL NAIL, L.36CM, DIAM. 11MM
12-1120 FEMORAL NAIL, L.38CM, DIAM. 11MM
12-1121 FEMORAL NAIL, L.40CM, DIAM. 11MM
12-1122 FEMORAL NAIL, L.42CM, DIAM. 11MM
12-1123 FEMORAL NAIL, L.44CM, DIAM. 11MM
12-1124 FEMORAL NAIL, L.46CM, DIAM. 11MM
12-1125 FEMORAL NAIL, L.34CM,DIAM.12MM
12-1126 FEMORAL NAIL, L.36CM,DIAM.12MM
12-1127 FEMORAL NAIL, L.38CM,DIAM.12MM
12-1128 FEMORAL NAIL, L.40CM,DIAM.12MM12-1129 FEMORAL NAIL, L.42CM,DIAM.12MM
12-1130 FEMORAL NAIL, L.44CM,DIAM.12MM
12-1131 FEMORAL NAIL, L.46CM,DIAM.12MM
12-1132 FEMORAL NAIL, L.34CM,DIAM.13MM
12-1133 FEMORAL NAIL, L.36CM,DIAM.13MM
12-1134 FEMORAL NAIL, L.38CM,DIAM.13MM
12-1135 FEMORAL NAIL, L.40CM,DIAM.13MM
12-1136 FEMORAL NAIL, L.42CM,DIAM.13MM
12-1137 FEMORAL NAIL, L.44CM,DIAM.13MM
12-1138 FEMORAL NAIL, L.46CM,DIAM.13MM
Antegrade Femoral Nail
For reamed and un-reamed inserton
12-1200 SCREW PLUG FOR FEMUR
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4 JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com roup o., . - ma : n o m -group.com - e : www. m -group.com
Locking bolt 5.5mm
for Proximal Femur
12-1300 LOCKING BOLT, L.26MM, DIAM. 5.5MM
12-1301 LOCKING BOLT, L.28MM, DIAM. 5.5MM
12-1302 LOCKING BOLT, L.30MM, DIAM. 5.5MM
12-1303 LOCKING BOLT, L.32MM, DIAM. 5.5MM
12-1304 LOCKING BOLT, L.34MM, DIAM. 5.5MM
12-1305 LOCKING BOLT, L.36MM, DIAM. 5.5MM
12-1306 LOCKING BOLT, L.38MM, DIAM. 5.5MM
12-1307 LOCKING BOLT, L.40MM, DIAM. 5.5MM
12-1308 LOCKING BOLT, L.45MM, DIAM. 5.5MM
12-1309 LOCKING BOLT, L.50MM, DIAM. 5.5MM
12-1310 LOCKING BOLT, L.55MM, DIAM. 5.5MM
12-1311 LOCKING BOLT, L.60MM, DIAM. 5.5MM
12-1312 LOCKING BOLT, L.65MM, DIAM. 5.5MM
12-1313 LOCKING BOLT, L.70MM, DIAM. 5.5MM
12-1314 LOCKING BOLT, L.75MM, DIAM. 5.5MM
12-1315 LOCKING BOLT, L.80MM, DIAM. 5.5MM
12-1316 LOCKING BOLT, L.85MM, DIAM. 5.5MM
12-1317 LOCKING BOLT, L.90MM, DIAM. 5.5MM
12-1318 LOCKING BOLT, L.95MM, DIAM. 5.5MM
12-1319 LOCKING BOLT, L.100MM, DIAM. 5.5MM
Locking bolt 4.5mm
for distal Femur / Proximal tbia / Supra Condylar
12-1350 L.26MM, DIAM. 4.5MM
12-1351 L.28MM, DIAM. 4.5MM
12-1352 L.30MM, DIAM. 4.5MM
12-1353 L.32MM, DIAM. 4.5MM
12-1354 L.34MM, DIAM. 4.5MM
12-1355 L.36MM, DIAM. 4.5MM
12-1356 L.38MM, DIAM. 4.5MM
12-1357 L.40MM, DIAM. 4.5MM
12-1358 L.45MM, DIAM. 4.5MM
12-1359 L.50MM, DIAM. 4.5MM
12-1360 L.55MM, DIAM. 4.5MM
12-1361 L.60MM, DIAM. 4.5MM
12-1362 L.65MM, DIAM. 4.5MM
12-1363 L.70MM, DIAM. 4.5MM
IM Implants
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5JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com ., . - - . - . - .
Tibia Nail
IM Implants
12-1400 TIBIA INTERLOCKING NAIL, L.28,0CM, DIAM. 9MM
12-1401 TIBIA INTERLOCKING NAIL, L.30,0CM, DIAM. 9MM
12-1402 TIBIA INTERLOCKING NAIL, L.31,0CM, DIAM. 9MM
12-1403 TIBIA INTERLOCKING NAIL, L.32,0CM, DIAM. 9MM
12-1404 TIBIA INTERLOCKING NAIL, L.33,0CM, DIAM. 9MM
12-1405 TIBIA INTERLOCKING NAIL, L.34,0CM, DIAM. 9MM
12-1406 TIBIA INTERLOCKING NAIL, L.35,0CM, DIAM. 9MM
12-1407 TIBIA INTERLOCKING NAIL, L.36,0CM, DIAM. 9MM
12-1408 TIBIA INTERLOCKING NAIL, L.38,0CM, DIAM. 9MM
12-1409 TIBIA INTERLOCKING NAIL, L.40,0CM, DIAM. 9MM
12-1410 TIBIA INTERLOCKING NAIL, L.28,0CM, DIAM. 10MM
12-1411 TIBIA INTERLOCKING NAIL, L.30,0CM, DIAM. 10MM
12-1412 TIBIA INTERLOCKING NAIL, L.31,0CM, DIAM. 10MM
12-1413 TIBIA INTERLOCKING NAIL, L.32,0CM, DIAM. 10MM
12-1414 TIBIA INTERLOCKING NAIL, L.33,0CM, DIAM. 10MM
12-1415 TIBIA INTERLOCKING NAIL, L.34,0CM, DIAM. 10MM
12-1416 TIBIA INTERLOCKING NAIL, L.35,0CM, DIAM. 10MM
12-1417 TIBIA INTERLOCKING NAIL, L.36,0CM, DIAM. 10MM
12-1418 TIBIA INTERLOCKING NAIL, L.38,0CM, DIAM. 10MM
12-1419 TIBIA INTERLOCKING NAIL, L.40,0CM, DIAM. 10MM
12-1420 TIBIA INTERLOCKING NAIL, L.28,0CM, DIAM. 10MM
12-1421 TIBIA INTERLOCKING NAIL, L.30.0CM,DIAM. 11MM
12-1422 TIBIA INTERLOCKING NAIL, L.31.0CM,DIAM. 11MM
12-1423 TIBIA INTERLOCKING NAIL, L.32.0CM,DIAM. 11MM
12-1424 TIBIA INTERLOCKING NAIL, L.33.0CM,DIAM. 11MM
12-1425 TIBIA INTERLOCKING NAIL, L.34.0CM,DIAM. 11MM
12-1426 TIBIA INTERLOCKING NAIL, L.35.0CM,DIAM. 11MM
12-1427 TIBIA INTERLOCKING NAIL, L.36.0CM,DIAM. 11MM
12-1428 TIBIA INTERLOCKING NAIL, L.38.0CM,DIAM. 11MM
12-1429 TIBIA INTERLOCKING NAIL, L.40.0CM,DIAM. 11MM12-1430 TIBIA INTERLOCKING NAIL, L.28.0CM,DIAM. 12MM
12-1431 TIBIA INTERLOCKING NAIL, L.30.0CM,DIAM. 12MM
12-1432 TIBIA INTERLOCKING NAIL, L.31.0CM,DIAM. 12MM
12-1433 TIBIA INTERLOCKING NAIL, L.32.0CM,DIAM. 12MM
12-1434 TIBIA INTERLOCKING NAIL, L.33.0CM,DIAM. 12MM
12-1435 TIBIA INTERLOCKING NAIL, L.34.0CM,DIAM. 12MM
12-1436 TIBIA INTERLOCKING NAIL, L.35.0CM,DIAM. 12MM
12-1437 TIBIA INTERLOCKING NAIL, L.36.0CM,DIAM. 12MM
12-1438 TIBIA INTERLOCKING NAIL, L.38.0CM,DIAM. 12MM
12-1439 TIBIA INTERLOCKING NAIL, L.40.0CM,DIAM. 12MM
12-1500 SCREW PLUG FOR TIBIA & SUPRA CONDYLAR
NAIL
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6 JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com roup o., . - ma : n o m -group.com - e : www. m -group.com
IM Implants
Locking bolt 4.5mm for distal tbia / Supra Condylar
12-1501 LOCKING SCREW, L.26MM DIAM 4.5MM
12-1502 LOCKING SCREW, L.28MM DIAM. 4.5MM
12-1503 LOCKING SCREW, L.30MM DIAM. 4.5MM
12-1504 LOCKING SCREW, L.32MM DIAM. 4.5MM
12-1505 LOCKING SCREW, L.34MM DIAM. 4.5MM
12-1506 LOCKING SCREW, L.36MM DIAM. 4.5MM
12-1507 LOCKING SCREW, L.38MM DIAM. 4.5MM
12-1508 LOCKING SCREW, L.40MM DIAM. 4.5MM
12-1509 LOCKING SCREW, L.45MM DIAM. 4.5MM
12-1510 LOCKING SCREW, L.50MM DIAM. 4.5MM
12-1511 LOCKING SCREW, L.55MM DIAM. 4.5MM
12-1512 LOCKING SCREW, L.60MM DIAM. 4.5MM
12-1513 LOCKING SCREW, L.65MM DIAM. 4.5MM
Supra Condylar Nail
12-1600 SUPRA CONDYLAR NAIL, 15CM X DIAM. 11MM
12-1601 SUPRA CONDYLAR NAIL, 20CM X DIAM. 11MM
12-1602 SUPRA CONDYLAR NAIL, 25CM X DIAM. 11MM
12-1603 SUPRA CONDYLAR NAIL, 28CM X DIAM. 11MM
12-1604 SUPRA CONDYLAR NAIL, 30CM X DIAM. 11MM
12-1605 SUPRA CONDYLAR NAIL, 15CM X DIAM. 12MM
12-1606 SUPRA CONDYLAR NAIL, 20CM X DIAM. 12MM
12-1607 SUPRA CONDYLAR NAIL, 25CM X DIAM. 12MM
12-1608 SUPRA CONDYLAR NAIL, 28CM X DIAM. 12MM
12-1609 SUPRA CONDYLAR NAIL, 30CM X DIAM. 12MM
12-1500 SCREW PLUG FOR TIBIA & SUPRA CONDYLARNAIL
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7JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com ., . - - . - . - .
Instruments
IM Instruments
12-1700 SCREWDRIVER HEX. 3,5MM, SELF-HOLDING
12-1701 DIAMOND POINTED AWL
12-1702 STARTER AWL
12-1703 AWL
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8 JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com roup o., . - ma : n o m -group.com - e : www. m -group.com
IM Instruments
12-1704 REDUCTION GUIDE
12-1705 DEPTH GAUGE
12-1706 TWIST DRILL 3,5MM, LENGTH 220MM
12-1707 TWIST DRILL 4,5MM, LENGTH 220MM
12-1708 TWIST DRILL 5,5MM, LENGTH 220MM
12-1709 DRILL GUIDE 3,5MM FOR TIBIA / FEMUR
12-1710 DRILL GUIDE 4,5MM FOR TIBIA / FEMUR
12-1711 DRILL GUIDE 5,5MM FOR TIBIA / FEMUR
12-1712 DRILL SLEEVE ASSEMBLY, LONG, CONDYLAR
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9JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com ., . - - . - . - .
IM Instruments
12-1713 DRILL SLEEVE ASSEMBLY, SHORT, CONDYLAR
12-1714 SUPRA CONDYLAR JIG AND NAIL IMPACTOR
12-1715 FEMUR / TIBIA JIG AND NAIL IMPACTOR
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10 JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com roup o., . - ma : n o m -group.com - e : www. m -group.com
IM Instruments
12-1716 OPEN END WRENCH, SW 10/15
12-1717 IMPACTOR / EXTRACTOR, CANNULATED
12-1718 NAIL EXTRACTION DEVICE
12-1719 GUIDE WIRE HOLDER, SELF LOCKING
12-1720 SKIN PROTECTOR
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11JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com ., . - - . - . - .
IM Instruments
12-1721 GUIDE BUSH
12-1722 TROKAR, RADIOLUCENT
12-1723 HOMING DEVICE, DISTAL FEMUR
12-1724 HOMING DEVICE, DISTAL TIBIA
12-1725 DISTAL AIMING DEVICE
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12 JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com roup o., . - ma : n o m -group.com - e : www. m -group.com
IM Instruments
12-1726 MEDULLARY EXCHANGE TUBE
12-1727 GUIDE ROD F. REAMER,L.900MM,DIAM.4MM
12-1728 GUIDE ROD F. REAMER,L.900MM,DIAM.4MM,
12-1720 SKIN PROTECTOR
12-1729 GUIDE ROD F. REAMER,L.900MM,DIAM.3MM,
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13JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com ., . - - . - . - .
Preparing the Canal and Insertng the Femoral Nail
5 cm An incision of approximately 5 cm is carried outcentered on the tp of the greater trochanter.
Surgical Technique
Technique Femur
Access the medullary canal using the Diamond
Pointed Awl (12-1701). The point of inserton should be in
line with the pyriformis fossa, slightly medial to the tp of the
greater trochanter.
Insert a standard Reaming Guide Wire (or Reducton-cum-
Reaming Guide Wire) using the following steps
Insert the guide wire upto the fracture site
Check fracture reducton using the image intensifier
Insert the wire beyond the fracture site
Insert the wire upto the supracondylar region and check
correct positoning in the center of the femoral canal.
1
2
Proceed to ream the femoral canal using sequental flexible
reamers in steps of 0.5mm. Ensure AP and ML control of the
reamer to avoid eccentric reaming. If comminuton is present,
reaming should be stopped at the fracture site and the reamer
pushed past the fracture site, with the power drill in the off
positon, tll the reamer crosses the site of comminuton. The
last reamer used should be at least 1mm (ideally 1.5 2.0mm)
higher than the planned nail diameter. It may be necessary to
over-ream the proximal part of the canal 2.5 3.0mm higher
than the planned nail diameter to accommodate the proximally
strengthened part of the nail.
3
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Selecton of Nail length
Prior to insertng the nail, the reaming guide wire should be
exchanged for the Nailing guide wire (12-1729) using an Exchange
Sleeve. Select nail length by measuring the length of the nailing
guide wire outside the intramedullary canal (exposed length) from
the point of entry and reducing the same from the total length of
the wire.
Add 5mm to arrive at the length of nail to be used.
Round offthis figure to the next higher nail length available.
In case of highly comminuted fractures, use X-ray measurements of
the contralateral limb to arrive at the nail length to be used.
4
Nail InsertonNail inserton is achieved using the following steps
Disassemble the Driver for Jig Assembly by unthreading
it from the Main Body of the Jig to expose the proximal
end of the Nail Locking Bolt.5
Assemble the selected femur nail with the Femur/Tibia
Jig cum Nail Impactor, complete (12-1715) by aligning
the slots on the nail with the two prongs on the body
of the instrument and tghtening the threads on the
Locking Bolt of the instrument with the internal threads
on the nail.
6
Using the Double Ended Spanner (12-1716), tghten
the Nail Locking Bolt, so that the Femur Nail is securely
fastened.
Important: Excessive force must not be used to tghten
the nail locking bolt. A quarter-turn with the spanner is
normally sufficient to secure the nail following
manual tghtening of the locking bolt.
7
Technique Femur
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15JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com ., . - - . - . - .
Reassemble the Driver for Jig Assembly to the main
body of the instrument.8
Insert the nail over the nailing guide wire and introduce
the nail by hand as far as possible.
Important: While inserton, the tp of the nail may
catch on the medial cortex of the medullary cavity if
the proximal part of the nail is not slightly pushed
in towards the patent. If this happens, it is essental
that hammering is not carried out as a fracture of the
femoral shaf or bending of the nail may result.
9
Reassemble the Driver for Jig Assembly to the main
body of the instrument.10
Use the InLine Impacton/Extracton
Ram (12-1717) to impact the Nail-Jig
assembly for final impacton. If ne-
cessary, the guide wire must be held
to prevent backing out.
Note: Direct hammering on any
part of the Jig assembly should
be avoided at all costs as this will
cause the Jig to distort and destroy
the accuracy of the guiding holes.
Impacton and Extracton should be
carried out only using the
InLine Impacton/Extracton Ram.
11
Technique Femur
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16 JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com roup o., . - ma : n o m -group.com - e : www. m -group.com
Distal Locking with Screws
Distal locking is performed in the conventonal mode with distal screws. The standard free hand technique for distal lockingis recommended.
Distal aiming devices including the Guide Bush (12-1721), Aiming Trocar (12-1722), Homing Device, Femur (12-1723), Homing
Device, Tibia (12-1724) and Distal Aiming Device with Fibre Handle (12-1725) are available in the instrumentaton to assist in
the distal locking process. Different types of distal locking screws are available with the system and are described below:
Locking Screw 4.5mm, self-tapping: This screw requires both cortces to be drilled with a 3.5mm drill bit and over-drilling of
the near cortex with a 4.5mm drill bit. The 4.5mm shaf with distal threads provides higher resistance to shear loading. The
threads on the screw head enable this screw to be securely engaged with the Hex Screwdriver with Sleeve while inserton.
Tibial Locking Screw 4.5mm, self tapping: This screw while designed for the tbia may also be used for distal femoral locking.
Faster inserton is possible as this screw is designed for direct inserton following 3.5mm drilling (both cortces). Inserton is with
a standard Hex Screwdriver (3.5mm a/f).
Proximal Locking
The femur nails allow proximal locking in three configuratons. The steps to be followed to achieve proximal
locking in each of these configuratons are described below.
Engaging the dense trabecular bone of the medial femur, this is the preferred locking opton when allowed by the fracture
configuraton. The additonal benefit of this locking opton is that prox mal locking can be achieved
by slightly extending the main nail inserton incision without creatng a second incision for the proximal lock. Proximal lo-
cking with the 130, downward locking screw is achieved with the following steps:
The 130 Downward Lock
Ensure that the Jig cum Nail Impactor is securely
engaged with the implanted nail and is correctly
oriented with the Locking Arm oriented lateral
to the nail. Extend the nail inserton incision as
necessary to achieve inserton of the Drill Guide
for proximal locking, upto bone.
12
Technique Femur
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17JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com ., . - - . - . - .
Insert the Drill Guide, 3.5mm (12-1709) into the 130, down-
ward locking hole and advance it to bone.13
Drill a 3.5mm hole with the 3.5mm Drill Bit (12-
1706) through the Drill Guide through both cortces.14
Exchange the Drill Guide, 3.5mm with the Drill Gui-
de, 5.5mm (12-1711).15
Drill a 5.5mm hole with the 5.5mm Drill Bit (12-
1708) only through the proximal cortex.16
Technique Femur
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Insert the Depth Gauge (12-1705) to read offthe length of
locking screw required.17
Assemble the Hex Screwdriver with Sleeve (12-1700),
to the selected locking screw by rotatng the Sleeve
clockwise to engage the proximal threads on the locking
screw.
18
Insert the locking screw through the 130, downward guide
hole on the Jig cum Nail Impactor by first advancing it through
the near cortex and the nail hole without rotaton and then
rotatng clockwise to engage the self-tapping distal threads in
the distal cortex.
19
Technique Femur
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The 130 Upward Lock with Miss-a-Nail
The 130 Upward Lock with Miss-a-Nail opt
on is an eff
ect
ve solut
on in cases where a femoral shaf
fracture co-exists with an ipsila-teral intra or extra-capsular fracture of the femoral neck. This locking opton is achieved through the following steps:
Ensure that the Jig cum Nail Impactor is securely engaged with the implanted nail and is correctly oriented with the Locking Arm
oriented lateral to the nail.
Carry out an incision as necessary to achieve inserton of the Drill Guide for proximal locking, upto bone.
Insert the Drill Guide, 3.5mm (12-1709) into the transverse
locking hole and advance it to bone.
Complete the process of creatng the tract for the upward
locking screw and prepare the screw using the same sequence
of steps as described earlier.23
Insert the locking screw through the transverse guide hole onthe Jig cum Nail Impactor by first advancing it through the
near cortex and the nail hole without rotaton and then rota-
tng clockwise to engage the self-tapping distal threads with
the distal cortex.
24
The Miss-a-Nail Screws
Insert the locking screw through the transverse guide hole on the Jig cum Nail Impactor by first advancing it through the
near cortex and the nail hole without rotaton and then rotatng clockwise to engage the self-tapping distal threads with the distal
cortex.
The instrumentaton is designed to allow the placement of two Miss-a-Nail screws anterior to the nail and oriented upwards into the
femoral neck. Proper placement of the nail in the canal verified by image intensifier views to confirm expected placement
Technique Femur
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Positon and lock the Miss-a-Nail aachment on the anterior
surface of the locking arm (Guide Bar).
The Miss-a-Nail holes are positoned to accept two 5.5mm locking
screws placed anterior to the nail.
Use the standard procedure described earlier to place one or two
5.5mm locking screws, as appropriate into the neck of the femur.
25
Finally, the Locking Cap is threaded onto the proximal end of the nail
by engaging the threads of the Cap with the internal threads of the
implanted nail. A standard 3.5 a/f screwdriver is used.
26
Technique Femur
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Preparing the Canal and Insertng the Tibia Nail
A surgical incision of approximately 5 cm vertcally and centrally to thetbial plateau extending distally is carried out. The patellar tendon is either
cut centrally or retracted laterally. Access the diaphyseal canal using the
Diamond Pointed Awl (12-1701). The proximal inserton point
selected should be less than 1 cm distal to the anterior margin of
the tbial plateau. If the inserton point is too distal, damage to posterior
cortcal bone could result.
1
Technique Tibia
Insert a standard Reaming Guide Wire (or Reducton-cum-Reaming
Guide Wire) using the following steps
Insert the guide wire upto the fracture site
Check fracture reducton using the image intensifier
Insert the wire beyond the fracture site
Insert the wire upto the 1 cm proximal to the ankle joint
2
Proceed to ream the tbial canal using sequental flexible
reamers in steps of 0.5mm. Ensure AP and ML control of
the reamer to avoid eccentric reaming. If comminuton is
present, reaming should be stopped at the fracture site andpenetraton contnued with the power drill in the off po-
siton, tll the reamer crosses the site of comminuton. The
last reamer used should be 1.5 2.0mm higher than the
planned nail diameter. It may be necessary to over-ream
the proximal part of the canal (at least the cortcal) 2.5
3.0mm higher
3
Selecton of Nail length
Prior to insertng the nail, the reaming guide wire should
be exchanged for the Nailing guide wire using an Exchange
Sleeve. Tibial nails in the system are available in increments
of 10mm to facilitate easy availability of the closest length
of nail required. Select nail length by measuring the length
of the nailing guide wire outside the intramedullary canal
(exposed length) from the point of entry and reducing the
same from the total length of the wire.
Add 5mm to arrive at the length of nail to be used.
Round offthis figure to the next higher nail length
available.
In case of highly comminuted fractures, use X-ray measure-ments of the contralateral limb to arrive at the nail length
to be used.
4
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Technique Tibia
Nail Inserton (Nail inserton is achieved using the following steps)
Disassemble the Driver for Jig Assembly by
unthreading it from the Main Body of the Jig to
expose the proximal end of the Nail Locking Bolt.5
Assemble the selected tbia nail with the Femur/Tibia Jig
cum Nail Impactor, complete by aligning the slots on the
nail with the two prongs on the body of the instrument
and tghtening the threads on the Locking Bolt of the inst-
rument with the internal threads on the nail.
6
Using the Double Ended Spanner (12-1716), tghten the
Nail Locking Bolt, so that the Tibia Nail is securely faste-
ned. Important: Excessive force must not be used to tgh-
ten the nail locking bolt. A quarter-turn with the spanner
is normally sufficient to secure the nail following manual
tghtening of the locking bolt.
7
Reassemble the Driver for Jig Assembly to the main body
of the instrument.8
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Assemble the Tibial Locking Extension by tghtening the Locking Bolt For Tibial
Locking Extension, first by hand and then using the Double Ended Spanner
(12-1716).9
Insert the nail over the nailing guide wire
and introduce the nail by hand as far as
possible.10
If impacton is necessary to further drive in
the nail, thread the Nail Impacton/Extrac-ton Assembly (12-1717) to the proximal
end (Driver for Jig Assembly) of the Jig.11
Technique Tibia
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Technique Tibia
Use the InLine Impacton/Extracton Ram (12-1717)
to impact the Nail-Jig assembly for final impacton.
If necessary, the guide wire must be held to preventbacking out.
Note: Direct hammering on any part of the Jig assem-
bly should be avoided at all costs as this will cause the
Jig to distort and destroy the accuracy of the guiding
holes. Impacton and Extracton should be carried out
only using the InLine Impacton/Extracton Ram.
12
Image intensifier views may be taken to confirm correcton positoning of the nail.
Distal locking is performed in the conventonal mode with distal screws. The standard free hand technique for distal locking is recom-
mended.
Distal aiming devices including the Guide Bush (12-1721), Aiming Trocar (12-1722), Homing Device, Femur (12-1723), Homing Device,
Tibia (12-1724) and Distal Aiming Device with Fibre Handle (12-1725) are available in the instrumentaton to assist in the distal locking
process. Different types of distal locking screws are available, and are described below:
Locking Screw 4.5mm, self-tapping: This screw requires both cortces to be drilled with a 3.5mm drill bit and over-drilling of the near
cortex with a 4.5mm drill bit. The 4.5mm shaf with distal threads provides higher resistance to shear loading. The threads on the screw
head enable this screw to be securely engaged with the Hex Screwdriver with Sleeve while inserton.
Tibial Locking Screw 4.5mm, self tapping: This screw while designed for the tbia may also be used for distal femoral locking. Faster
inserton is possible as this screw is designed for direct inserton following 3.5mm drilling (both cortces). Inserton is with a standard
Hex Screwdriver (3.5mm a/f).
Distal Locking with screws
Proximal Locking
Proximal locking with tbial nails is achieved with two proximal locking screws oriented at 45to the A-P plane as illustrated.
The 45, orientaton provides two important benefits:
The distal threads of both proximal locking screws engage in the dense postero-medial and
postero-lateral cortces of the tbia. This provides more secure holding when compared with
medio-lateral locking screws
The inclined drilling that is required for placement of these screws is safer as it eliminates
the risk to posterior neurovascular structures associated with antero-posterior drilling for A-P
screws Tibial locking is performed with 4.5mm Tibial Locking Screws with low profile screw
heads. These screws are self-tapping with a core diameter appropriate for direct inserton
following drilling with a 3.5mm drill bit.
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Ensure that the Jig cum Nail Impactor is securely enga-
ged with the implanted nail and is correctly oriented.
Make a small incision as necessary to achieve inserton
of the Drill Guide for proximal locking, into the approp-
riate locking hole, upto bone.
13
Insert the Drill Guide, 3.5mm (12-1709) into the proxi-
malmost locking hole and advance it to bone.14
Drill a 3.5mm hole with the 3.5mm Drill Bit (12-1706)
through both cortces.15
Insert the Depth Gauge (12-1705) to read offthe
length of locking screw required.16
Technique Tibia
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Supracondylar Nailing
The Supracondylar Nail is a non-sloed smooth, cylindrical nail with proximal and distal holes. The 8 angle allows for beer seatng
of the implant within the femoral canal and also allows percutaneous inserton without interfering with the patella or patellar ten-
don. The proximal (inserton) end of the nail features internal threads, which securely couple with the instrumentaton and also allow
engagement of a threaded locking cap.
Point of entry
Technique Supracondylar
The point of entry is located, just anterior to the inserton of the posterior
cruciate ligament. This point is identfied as the co-ordinate at the juncton
of the antero-posterior line drawn through the deepest part of the trochlear
groove and the medio-lateral line connectng the two epicondyles.
Incision
Nailing can be done either through a formal open approach or through a percutaneous approach. For the formal open approach, amedial para-patellar incision is taken and the patella is dislocated laterally.
The percutaneous approach is done through a 2 cm incision distal to the inferior pole of the patella and medial to the patellar
tendon. The infra-patellar fat pad is retracted, a steinman pin is inserted and the point of entry is localized with the help of a C-arm
image intensifier.
Preparing the canal
Make the inital entry with a Diamond Pointed Awl
(12-1701). Take care to ensure that the directon of the
tract is in line with the medullary canal of the femur.1
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Nail inserton
Disassemble the Driver for Jig Assembly, supracondylar
by unthreading it from the main body of the jig to
expose the proximal end of the Nail Locking Bolt.6
Assemble the selected supracondylar nail with theSupracondylar Jig-cum-Nail Impactor (12-1714) by
aligning the slots on the nail with the two prongs on
the body of the instrument and tghtening the threads
on the Locking bolt of the instrument with the internal
threads on the nail. Ensure that the apex of the angle
in the nail faces anterior-wards for correct nail place-
ment.
7
Using the Double Ended Spanner (12-1716), tghten
the Nail Locking Bolt, so that the Supracondylar Nail is
securely fastened.
Important: Excessive force must not be used to tghten
the nail locking bolt. A quarter-turn with the spanner is
normally sufficient to secure the nail following manual
tghtening of the locking bolt.
8
Reassemble the Driver for Jig assembly, supracondylar
to the main body of the instrument.9
Technique Supracondylar
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31JMF (T) Group Co.,Ltd. - Email: info@jmf-group.com - Web: www.jmf-group.com ., . - - . - . - .
Technique Supracondylar
Insert the nail over the nailing guide wire and introdu-
ce the nail by hand as far as possible. If some impac-
ton is found to be necessary, thread the Nail Impac-
ton/Extracton Assembly (12-1717) to the proximal
end (Driver for Jig Assembly) of the Jig.
Note: Direct hammering on any part of the Jig assem-
bly should be avoided at all costs as this will cause the
Jig to distort and destroy the accuracy of the guiding
holes. Impacton and Extracton should be carried out
only using the InLine Impacton/Extracton Ram.
10
The inserton Jig cum nail Impactor exactly matches
the outer diameter of the nail. This allows complete
nail inserton without mechanical impedance. A groove
located on the Jig body enables control of inserton
depth (aligning the groove with the distal artcular
surface of the lateral femoral condyle ensures correct
depth of nail inserton.
11
It is recommended that proximal locking be carried out first and fracture reducton and nail positon confirmed beforecarrying out the distal lock. Proximal locking is carried out using the Drill sleeve assembly, long (12-1712).
The Guide Bar of the Jig cum nail Impactor features four proximal holes. The two most proximal holes are used to lock the
200mm nail. The next two holes are used to lock the 150mm nail.
Use the following steps to carry out proximal locking afer making an appropriate incision
Locking of the supracondylar nail
Insert the Drill sleeve assembly,Long (12-1712) into the
appropriate (more proximal, guide hole on the GuideBar depending on the length of the selected nail).
Tap the Trocar lightly to make an indentaton on the
surface of the bone. This allows beer engagement of
the tp of the drill bit.
Withdraw the Trocar leaving the rest of the assembly
in place.
12
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The Threaded Locking Cap
It is recommended that a threaded locking cap be
screwed in to the distal tp of the nail using a standard
large screwdriver (3.5mm a/f). The locking cap closes
the open end of the nail preventng bony in-growth,
which makes eventual nail removal an easier procedu-
re.
17
Technique Supracondylar
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JMF (T) Group Co.,Ltd.
75/74 Moo 11, Paholyothin Rd.,
Klongnueng, Klongluang,
Pathumthani 12120Thailand
Distributed by :
01-0002
Rev. 1.0.1
Tel.: +66 (0)2 529 64 30
Fax.: +66 (0)2 529 64 31
Email: info@jmf-group.comWeb: www jmf-group com
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