- Discussion: - 1st guide wire marks femoral anteversion; - 2nd guide wire marks direction of seating chisel and should be driven into the femoral neck parallel to 1st guide wire; - note that because the greater trochanter lies slightly posterior to the femoral neck, the guide wire needs to be placed slightly anterior to the mid-portion of the trochanter so that the guide wire ends up in the mid aspect of the femoral neck; - seating chisel enters femoral neck 1 cm below superior cortex; -
creation of cortical window is made w/ the seating chisel and mallet; - note there is really only one chance to properly oriente this window; - the window needs to be oriented to the long axis of the greater trochanter so that the distal fragment does not become flexed or extended; -
insertion of blade plate: - blade plate is driven flush against lateral cortex; - a single
4.5 cortical screw is inserted into the
calcar; - the second plate hole is left empty in case that the femoral distractor is required to assist w/ indirect reduction (see below);
