伽玛钉手术操作演示.ppt

伽玛钉手术操作演示 欢迎关注德迈医械 伽玛钉 伽玛钉器械箱１ 伽玛钉器械箱２ Positioning on the extension table Upper body inclined 10° - 15° to the opposite side The C-arm is positioned on the healthy side Closed reduction attempt under image intensifier controlin two planes After sterile painting and draping, 5-8 cm skin incision 3 cm above the tip of the trochanter Split the fascia Blunt splitting of gluteus medius in the line of its fibres Find the tip of the trochanter Introduce the nail (colour code red ) The nail entry point is directly at the level of the tip of the trochanter ap and in the extension of the medullary space axially. The ?2.5 mm K-wire can be inserted up to 15 cm into the femur by hand or with the motor 6° - 8° lateral to the shaft axis. Image intensifier control in both planes is obligatory After removing the drill chuck, attach the protection sleeve Open the medullary space with the cannulated medullary drill as far as the given drill stop Remove the drill sleeve and K-wire The nail size is determined during operative planning or intraoperatively The selected nail is attached firmly to theinsertion handle by the instrument nurse. To do this, the connecting screw is tightened with theopen-end wrench or socket wrench The modular part for proximal locking ( 130° ) is also coupled The insertion handle with coupled nail is passedto the surgeon The nail is inserted under pressure using slight rotating movements under image intensifer control If necessary the impaction adapter for hammer assistancecan be attached The depth of impaction is checked with the image intensifier.The nail position can be estimated with the image intensifierby placing a K-wire over the insertion handle in the directionof the carrier screw. ?Insertion of the carrier screw (colour code yellow ) After the optimal nail position has been obtained, a ? 2.5 mm K-wire for the carrier screw is inserted with drill sleeve through the insertion handle. To prevent the K-wire from drif