Master the treatment of femoral shaft refractures, especially in cases of local bone fragility, focusing on early rehabilitation. This training offers a technical immersion in anterograde cephalomedullary intramedullary nail osteosynthesis, emphasizing a minimally invasive approach without the use of a traction table.

Training Focus:

• Treatment of femoral shaft refractures, including in patients with bone fragility.
• Fixation technique with an anterograde cephalomedullary intramedullary nail.
• Minimally invasive approach without a traction table, allowing free limb manipulation.
• Pre-surgical and intra-procedural reduction maneuvers.
• Precise and efficient distal locking.

Detailed Content:

• Planning and Initial Reduction: Learn to perform hip flexion, external rotation, and internal rotation maneuvers to plan reduction before surgical incision, allowing free limb manipulation.
• Access and Precise Guidewire Insertion: Master the creation of the incision for intramedullary nailing and the introduction of the guidewire with a favorable angulation, allowing controlled curvature and ensuring flexibility and control in the initial direction. Verify guidewire introduction in anteroposterior (AP) and lateral views.
• Medullary Canal Opening and Reduction: Learn how to open the medullary canal through a soft tissue protector and introduce the olive-tipped guidewire. Fracture reduction is performed using previously planned maneuvers.
• Optimized Medullary Canal Reaming: Develop the skill of reaming the medullary canal after successful guidewire passage, seeking a reamer size that provides a snug fit for better stability.
• Proximal Fixation with Cephalomedullary Nail: Utilize an 11-millimeter diameter cephalomedullary nail and create a lateral access for sliding screw fixation. Perform synchronized measurement and positioning of the sliding screw, aiming for the center of the femoral head in AP and lateral views, even in diaphyseal fractures.
• High-Precision Distal Locking: Master the distal locking technique using a mini skin portal aligned with the bone tunnel to avoid difficulties with soft tissues. Learn to align the drill bit with the image intensifier, using the first drill bit as a guide for the second, ensuring parallelism and avoiding hole loss due to lower limb manipulations. Understand the importance of precision in the first drilling for quick locking and to avoid inadvertent screw insertion into an incorrect hole.
• Optimized Postoperative Care: Prepare for a minimally invasive surgery that results in comfortable postoperative recovery, allowing full weight-bearing and immediate rehabilitation the day after surgery.

Included Material:

• Complete Technical PDF: Detailed didactic document describing the surgical technique for treating femoral shaft refractures using an anterograde cephalomedullary intramedullary nail. Covers everything from initial planning and patient positioning to reduction steps, instrumentation, and closure.

Enhance your skills in treating femoral shaft fractures. Enroll now and master advanced techniques with an anterograde cephalomedullary intramedullary nail to optimize results and rehabilitation for your patients.