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Simple Free Hand Procedure for Fast Intramedullary Nail Distal Locking: The 45 Degree Technique

February 10, 2018

Contributors: Antonio Cardile, Sr, MD; Roberto Maddalena, DMed; Biagio Moretti, MD; Vito Pesce, MD; Girolamo Picca, MD; Francesco Rifino Sr, MD; Giuseppe Solarino, MD; Antonio Spinarelli, Sr, MD; Giovanni Vicenti Jr, MD; Massimiliano Carrozzo Sr, MD; Massimiliano Carrozzo Sr, MD

The freehand technique is the most widely used method to achieve distal fixation with intramedullary interlocking nails. All of the procedures proposed are based on the need to attain a perfectly round lateral image of the nail holes; usually, many radiographic exposures and a considerable amount of time are necessary for this maneuver. This video explains an already described technique for freehand distal locking that involves the use of two orthogonal radiographic views of the distal nail obtained with the C-arm at an angle of 45° with respect to the long axis of the surgical limb.

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