Basic technical tips for nailing of trochanteric /IT femur fractures

[@doctorfayazhussain]

loved your videos always. You make complex things very simple and that's the essence of effective teaching

[@asifalam1447]

It's very good video for orthopaedic surgeons. Thank you very much. Instrumental support is important.

[@Justorthothings]

Thanks for your feedback!

[@GHGH-f7p]

Thanks for the immensely informative video on IT fractures . Removing a medial piece of bone is a great point to prevent wedging If somehow wedging infact does happen - 1. it ll not allow to fully compress the fracture ? 2. Do reduction k wire placed anterior need to be removed while tightning the lag screw ? 3 . In wedging the screw length required increase ( more than 95 even in females ) - should be still screw with a long screw to achieve TAD ?

[@Justorthothings]

Thanks for your feedback. 1. Compression may still happen at medial cortex, and fracture may still unite. The issue that will persist will be varus and some shortening, which may be apparent. But wedge effect + distracted fracture and large gap medially may bring a non-union also. 2. If bone is good quality then yes K wire needs to be pulled back, but in osteoporotic, it wont affect much. Usually when we see that compression is not happening, we pull the k wire 3. Yes, TAD is important for screw, it should be within the defined limits of 2.5 cm in AP+Lat view, BUT for blade, it should be kept on higher side to avoid future cut-out, especially in poor bone quality.

[@parkaviyanr6397]

Please do a surgical demonstration video of subtrochanteric fracture fixation in lateral position if possible

[@Justorthothings]

Sure, will add soon

[@navneetrauniyar442]

Putting screw oblique in dynamic hole is also a kind of converting screw to static one…

[@Justorthothings]

Yes, definitely. In most short nails thats the only method of static locking.

[@drkamalkishorjajunda1778]

Very Informative video 👌

[@kanthaswani]

I need contact of person supplying this type of awl

[@Justorthothings]

Hi, we get this kind of awl with Double Medical trochanteric nail, which is similar to synthes/j&j TFN nail. Alternatively, cannulated awls of local companies are also available, which solve the purpose. The design is also similar to the Stryker Awl, Curved 9 mm. I will ask the vendor for the right person to contact and update here.

[@sabdul42]

@@JustorthothingsI had a femur fracture 7 months back and I am still limping. Can you please share me your contact details for consultation? Thank you

[@khadirkhan1044]

​@@Justorthothings sir any update??

[@Justorthothings]

@@khadirkhan1044 See, for the purpose of making medial entry and control guidewire from being angulated, the awl in this link below is sufficient. I have used this, it helps in positioning guidewire correctly without any soft tissue pressure as cannulated part is far from the holding part. Also, since the cannuted part is straight, the direction of guidewire can be better controlled. www.amazon.in/Cannulated-Bone-Awl-Surgical-Instrument/dp/B09W2MK7DP

[@pktrigger2873]

you ever wonder if full blown doctors look at these kind of vids to remind themselves how to do this? lol like a college kid reviewing his classes for a test?