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Closed Cephalomedullary Nailing of a Diaphyseal Femur Fracture on a Fracture Table

Michael Weaver, MD
Brigham and Women's Hospital

1. Introduction

2. Positioning on Fracture Table

3. Marking and Incision

4. Insert Nail

  1. Obtain Starting Point for Guidewire
  2. Drill Guidewire
  3. Open Canal
  4. Pass Wire Through Reduced Fracture
  5. Measure and Ream
  6. Insert Nail While Checking Placement

5. Proximal Locking

  1. Drill Guidewire for Locking Bolt
  2. Puncture Iliotibial Band
  3. Measure
  4. Ream Across Femoral Neck
  5. Place Locking Bolt
  6. Engage Locking Mechanism
  7. Check Reduction and Nail Placement

6. Distal Locking

  1. Drill for 1st Distal Locking Screw
  2. Measure
  3. Insert Screw
  4. Drill and Insert 2nd Screw
  5. Final X-ray Check