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Technique of Blade Plate Insertion

- 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)