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Closed Cephalomedullary Nailing of Subtrochanteric Hip Fracture

Michael Weaver, MD
Brigham and Women's Hospital

1. Exposure and Reduction

  1. Lateral Incision Over Trochanter
  2. Provisional Wire Fixation

2. Proximal Fixation

  1. Insert Guidewire for Drill
  2. Drill Through Proximal Cortex
  3. Ream Medullary Canal
  4. Insert Nail
  5. Attach Aiming Arm
  6. Insert Lateral Guidewire for Drill
  7. Drill Through Lateral Cortex
  8. Insert Spiral Blade
  9. Engage Locking Mechanism
  10. Adjust as Needed

3. Distal Fixation

  1. Align Drill with Distal Nail
  2. Drill Through Cortex
  3. Insert Distal Screw
  4. Repeat for 2nd Screw