Product information
Surgical Technique for NITINOL
intramedullary reamers
AS Medizintechnik GmbH
•
0483
Sattlerstrasse 15, 78532 Tuttlingen, Germany
•
Tel 07461/966326
•
Fax 07461/9663288
Reduction
The reductdion can be proceeded after determination and opening the medullary canal (see surgical standard techniques
for corresponding interlocking nail implant systems). The reduction could be proceed with the reamer guide rod with
ball tip Ø 2.4 mm x 900 mm, the reamer guide rod with ball tip should be passed the fracture inside of the bones cavity
advanced reaming, this process of reduction should be required under using image – X Ray control.
During reaming the reamer guide rod should be place inside of the medullary cavity.
Note
As each manipulation in the fat-filled medullary cavity causes an intramedullary pressure increase by using not recommended intramedullry reduction instruments, this is not allowed and prohibited.
Medullary reaming
The keyless chuck with T-handle should be used to insert and push the reaming guide rod Ø 2.4 mm x 900 mm into the
medullary cavity for reduction and flexible reamer process.
Important
The reamer guide rod is already in the medullary cavity – canal, if the reduction has been achieved. In the sclerotic medullary canals, the reaming rod cannot pass the fracture zone. Start by opening these sclerotic zones with the hand reamer
Ø 6.0 mm, Ø 7.0 mm and Ø 8.0mm hand reamers. After opening with the hand reamers the reamer guide rod now could
be pushed into the medullary cavity. Use the image X-Ray control to check the correct central position of the reamer
guide rod in two plans.
For the initial reaming, the Nitinol reamer Shaft with AO-Connection is usually connected with the Reamer Head
Ø 8.5 mm.
Important
This connection is only a primary connection. Always ream over the reaming guide rod to ensure a secure connection!
Necessary equipment for flexible reaming should be available in the surgical theatre, battery, electric or air drive motor
with a large AO-coupling-connector (cannulated minimum Ø 3.0 mm) should be available for flexible reaming process.
Do not rotate the reamer head when inserting it over the reamer guide rod into the medullary canal. The tissue.skin
protector protects the soft tissues during reaming. Use the highest speed and slight but uniform force to advance the
reamer head in the medullary canal. Move the reaming shaft backwards and forwards but just in right clockwise rotation
to remove the bone chips from the reamer head. This prevents jamming of reaming head in the medullary cavity. Right
clockwise rotation is required, don’t change the clockwise rotation during reaming process to left clockwise rotation.
Caution:
During reaming the reamer guide rod should be keep from a assistant with the keyless chuck or a holding forceps in
position.
After full-length reaming of the medullary cavity, withdraw the reaming shaft until the entire reamer head is visible. To
prevent a loss of reduction, the assistant should be grasp the reaming rod at the canal entry point and hold the rod in
place using the keyless chuck or a holding forceps.
If a reamer head gets jammed while reaming, disconnected the attachment for medullary reaming. Mount the keyless
chuck or the holding forceps onto the reaming rod (in the countersinking). Light hammer blows on the keyless chuck or
the holding forceps allow drawing the jammed reamer head from the medullary canal using the reamer guide rod. As
an alternative, release the reamer head by turning the shaft backwards. For the next reaming steps proceed in the same
steps as from the beginning, connect the next larger reamer head with the reamer shaft over the reamer guide rod into
the medullary cavity. Reaming to the desired diameter, is usually done in 0.5 mm increments over the precalculated and
selected interlocking nail distal shaft diameter.
Important
The subsequent surgical steps are carried out according to corresponding surgical technique of the implant system used.
In cannulated intramedullary nails, the nail cannot insert directly over the reamer guide rod, after finishing the reaming
Revision status: A
Constructed / revised: 03.12.2013
PI_Flexible NITINOL Markraumbohrer Technik_EN_A
Constructed by: ns
Page 1 of 2
Product information
Surgical Technique for NITINOL
intramedullary reamers
AS Medizintechnik GmbH
•
0483
Sattlerstrasse 15, 78532 Tuttlingen, Germany
•
Tel 07461/966326
•
Fax 07461/9663288
process, withdraw the reamer shaft with the reamer head but keep the reamer guid rod in position and insert over the
reamer guide rod the intramedullary exchange tube, remove the reamer guide rod and replace it with the selected necessary intramedullry nail guide rod (should be usually a guide rod without a ball or olive tip).
After replacing the guide rod remove the intramedullary exchange tube and insert your selected intramedullary nail over
the nail guide rod, after nail insertion should be required to remove the nail guide rod!
AS MEDIZINTECHNIK GMBH DOES NOT ACCEPT RESPONSIBILITY IF THIS CUSTOMER INFORMATION HAS BEEN
VIOLATED PROVABLY.
Revision status: A
Constructed / revised: 03.12.2013
PI_Flexible NITINOL Markraumbohrer Technik_EN_A
Constructed by: ns
Page 2 of 2