Sign IM Nail and Interlocking Screw System Technique Manual page 12

Technique for use of SIGN Distractor (for full illustrated version see page 38)
Free up both ends of the fracture fragments
completely. The fracture fragments should be parallel
Fig. 3
when the clamps are applied, figure 3. Once they are
applied, place the clamps through the ends of the
distractor and use the pins to stabilize them.
There is one movable side of the distractor and one
that is immobile. The immobile side of course would
be placed on the fracture fragment that is immobile
such as the proximal fragment of a fractured femur.
Begin ratcheting to distract the fragment. Go slowly
as the quadriceps will be very tight. Stop periodically
to allow the tissues to stretch.
Once the distraction has reached 4 inches, remove the distractor and replace the clamps so that they
are close together. This will put less stress on the
ratchet arm.
Once the clamps have been placed close together,
flex the knee to further stretch the quadriceps
mechanism. Begin the distraction again. If there is
a very tight band in the quadriceps, release it. Be
sure your rotation is proper as you distract the
fragments and they will soon fit together
anatomically, figure 4.
It is important to go slowly so that the tissues can
Fig. 4
stretch.
Please give us feedback about the distractor as the
design is an ongoing innovation.
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