Shaft Reaming; Implant Selection - Zimmer Biomet Zimmer Natural Nail Manual

Shaft Reaming

Reaming should be performed through the entry
cannula. To reduce risk of enlarging the entry hole
laterally push the entry cannula medially. Start with
a small reamer, and increase the diameter of the
reamer by 0.5 - 1.0 mm depending on the amount
of resistance felt while reaming (Figure 8). When
cortical chatter occurs, stop reaming. Choose a nail
that is 1.5, 1.7 or 2.0 mm smaller than the last reamer
used. If an Asia nail is to be used, it is only necessary
to ream the proximal 18 cm of the canal. If a long
nail is planned, ream the full length of the canal. The
guide wire pusher can help prevent the ball tip guide
wire from coming out of the femur during reaming.
Note:
If the guide wire becomes lodged within
the reamer, use the guide wire pusher to push
the guide wire back into the intramedullary canal.
Zimmer Natural Nail – Cephalomedullary Asia Nail Surgical Technique
9 |
Figure 8

Implant Selection

The diameter and length of the nail have already
been determined (using nail length gauge and last
size of reamer utilized). Visualizing the reduced
femur and/or the contralateral femur, determine
which CCD angle is appropriate for the patient.
Technique Tip: Lateral starting point pushes the
lag screw tip to superior part of the femoral head.
In that case an Asia Nail with less CCD angle is
advantageous.