Interlocking Nails for Femur Tibia and Supra Condylar

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: [email protected] - 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


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




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




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: [email protected] - Web: www.jmf-group.com ., . - - . - . - .

IM Implants

12-1100 FEMORAL NAIL, L.30CM, DIAM. 9MM

























12-1125 FEMORAL NAIL, L.34CM,DIAM.12MM



12-1128 FEMORAL NAIL, L.40CM,DIAM.12MM12-1129 FEMORAL NAIL, L.42CM,DIAM.12MM










Antegrade Femoral Nail

For reamed and un-reamed inserton

12-1200 SCREW PLUG FOR FEMUR


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Locking bolt 5.5mm

for Proximal Femur

12-1300 LOCKING BOLT, L.26MM, 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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Tibia Nail

IM Implants

12-1400 TIBIA INTERLOCKING NAIL, L.28,0CM, DIAM. 9MM





















12-1421 TIBIA INTERLOCKING NAIL, L.30.0CM,DIAM. 11MM








12-1429 TIBIA INTERLOCKING NAIL, L.40.0CM,DIAM. 11MM12-1430 TIBIA INTERLOCKING NAIL, L.28.0CM,DIAM. 12MM










12-1500 SCREW PLUG FOR TIBIA & SUPRA CONDYLAR

NAIL


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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












Supra Condylar Nail

12-1600 SUPRA CONDYLAR NAIL, 15CM X DIAM. 11MM










12-1500 SCREW PLUG FOR TIBIA & SUPRA CONDYLARNAIL


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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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IM Instruments

12-1704 REDUCTION GUIDE

12-1705 DEPTH GAUGE

12-1706 TWIST DRILL 3,5MM, LENGTH 220MM



12-1709 DRILL GUIDE 3,5MM FOR TIBIA / FEMUR



12-1712 DRILL SLEEVE ASSEMBLY, LONG, CONDYLAR


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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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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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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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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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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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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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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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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



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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



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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: [email protected]: www jmf-group com

Documents

Interlocking Nails for Femur Tibia and Supra Condylar