Guide-wire exchange before insertion of intramedullary nails.
In the past, before a reamed intramedullary nail was inserted, it was mandatory to exchange the beaded-tip reaming guide wire with a smooth-tip wire. This additional step is optional in most new nail designs. Here we describe 2 cases in which not exchanging the wire led to initial wire incarceration and introduced additional steps that had to be taken before locked nailing could be completed. Intramedullary nail designs that avoid extra steps and thereby promote simplicity and reliability of insertion are potentially advantageous to both patient and surgeon. Eliminating the exchange tube and the smooth wire, however, should be approached with caution, as no time may be saved, and the procedure may be made much more difficult technically.
Schaller
Thomas M
TM
Carolinas Medical Center, 1000 Blythe Blvd, MEB 503, Charlotte, NC 28203, USA. tmschaller@gmail.com
Kellam
James
J
D001858:Bone Nails; D004867:Equipment Design; D004869:Equipment Safety; D005264:Femoral Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D012680:Sensitivity and Specificity