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PFNA - 1

PFNA. With Augmentation Option. Technique Guide

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PFNA - 2

Introduction PFNA - System Overview 2 Surgical Technique Preoperative Planning 14 Option: PFNA Augmentation 45 Correction of Insertion Depth of PFNA Blade 76

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PFNA - 3

Product Information Augmentation Implants and Instruments Optional: Angular Stable Locking System (ASLS) 104 mage intensifier control This description alone does not provide sufficient background for direct use of the instrument set. Instruction by a surgeon experienced in handling these nstruments is highly recommended Reprocessing, Care and Maintenance of Synthes Instruments For general guidelines, function control and dismantling of multi-part instruments, please contact your local sales representative or refer to: PFNA. With Augmentation Option. Technique Guide Synthes 1

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PFNA - 4

PFNA. Proximal Femoral Nail PFNA Nail The anatomical design guarantees an optimal fit in the femur. The nail design has been well proven in over 450,000 cases performed with the PFN and PFNA. The PFNA has a medial-lateral angle of 6° This allows insertion at the tip of the greater Optimal stress distribution The flexible PFNA tip eases insertion and reduces stress on the bone at the tip of the Several distal locking options Static or dynamic locking can be per- formed via the aiming arm with PFNA standard, small and xs. The PFNA long additionally allows for secondary PFNA long 2 Synthes...

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PFNA - 5

PFNA Nail Product range The PFNA is available in 4 sizes PFNA small, length 200 mm PFNA long, length 300-420 mm, with 20 mm increments, bending PFNA. With Augmentation Option. Technique Guide Synthes 3

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PFNA - 6

PFNA. Proximal Femoral Nail PFNA Blade Rotational and angular stability achieved with one single element Compaction of cancellous bone nserting the PFNA blade compacts the cancellous bone providing additional anchoring, which is especially important Bone structure before insertion of the Bone structure after PFNA blade PFNA blade. insertion - cancellous bone is compacted providing additional anchoring to the PFNA blade Large surface and increasing core diameter guarantee maximum compaction and optimal hold in bone ncreased stability caused by bone compaction around the PFNA blade has been...

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PFNA - 7

PFNA. Instrumentation. Easier guide wire positioning and insertion Correct positioning of the guide wire and finally the PFNA blade in the femoral head is crucial. The guide wire aiming device allows for AP orientation, which permits correction of the nail’s insertion depth prior to guide wire insertion. In the lateral view, rotation of the nail can be adjusted with the two orientation lines in the radiolucent insertion handle for PFNA. Intraoperative compression In good bone quality the new PFNA blades (0X.027.010S – 0X.027.021S and 0X.027.030S – 0X.027.041S) together with the compression...

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PFNA - 8

PFNA. Augmentation. Fractures of the hip are the most common operatively treated fractures of the elderly (over the age of 70). The number of osteoporotic fractures is growing dramatically causing treatment to become an increasingly challenging issue. The PFNA Augmentation offers a unique system of controlled cement augmentation directly through the implant: – Higher number of cycles to cut-out and increased rotational stability in biomechanical testing – Simple and reproducible procedure through standardized surgical technique – Compatible with PFNA instrumentation and implants –...

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PFNA - 9

Cement placement Controlled placement of cement around the implant, through the perforated blade with the side-opening cannula. Traumacem V+ Syringe Kit Traumacem V+ Syringes have wide integrated wings and strong syringe pistons to guarantee excellent force transfer, combined with good tactile feedback. Traumacem V+ Syringe Kit includes a one-way stop-cock for simple, clean and quick filling of the 2 and 1 ml syringes. Traumacem V+ Cement Kit For the best possible visual control during cement application, the Traumacem V+ cement contains 40% zirconium dioxide. A further addition of 15%...

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PFNA - 10

8 Synthes PFNA. With Augmentation Option. Technique Guide

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PFNA - 11

AO Principles In 1958, the AO formulated four basic principles1, 2, which have become the guidelines for internal fixation in general, and intramedullary nailing in particular: Anatomic reduction Before inserting the nail, the reduction can be achieved manually or using a reduction table. A guide wire marks the prescribed path into the medullary canal and secures alignment of the fragments while the cannulated nail is being inserted over the wire. The nail insertion is generally monitored using x-rays. The nail is then locked proximally and distally to the bone fragments in order to hold...

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PFNA - 12

Indications and Contraindications PFNA short (Length 170 mm – 240 mm) Indications – Pertrochanteric fractures (31-A1 and 31-A2) – Intertrochanteric fractures (31-A3) – High subtrochanteric fractures (32-A1) Contraindications – Low subtrochanteric fractures – Femoral shaft fractures – Isolated or combined medial femoral neck fractures PFNA long (Length 300 mm – 420 mm) Indications – Low and extended subtrochanteric fractures – Ipsilateral trochanteric fractures – Combination fractures (in the proximal femur) – Pathological fractures Contraindications – Isolated or combined medial femoral...

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PFNA - 13

PFNA Augmentation Indications – PFNA augmentation is indicated for severe osteoporotic fractures in the proximal femur – The perforated PFNA blade is also indicated without cement augmentation Contraindications – In cases where there is a risk of cement leakage into articular or vascular structures (e.g. via fractures and injuries, which open into the articulation) – Acute traumatic fractures of non-osteoporotic bone For cement related indications and contraindications please consult the “instructions for use” of the “Traumacem V+ Cement Kit”. For contraindications of the “Traumacem V+...

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PFNA - 14

Clinical Cases PFNA 94 years, female 31-A1.1 0 days post-op 14 weeks post-op 11 months post-op 93 years, female, 31-A3.3 4 days post-op 4 weeks post-op 5 months post-op 12 Synthes PFNA. With Augmentation Option. Technique Guide

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