MAAG screws with a diameter 8.0are particularly recommended for a fracture of the neck of the femur. For a correct application insert guide wires 4,280,000 with the aid of the instrument 4280005 anchored to the bone surface as shown in the adjacent figure. Perform a radioscopic check after partial insertion of the first thread and then proceed with the full insertion up to the cortical wall.
Insert the remaining wires, trying to occupy the greatest distance possible dependent on the size of the femoral neck. In case you want to use the washers take into account their circumference (see diagram) for the distance between the screws.
Fit the the caliber 4,280,003 along the guidewires previously entered to find the length of the wire embedded in the bone tissue. Then choose the most appropriate screws. For each length, there are two types characterized by threads of 16mm and 32mm. Choose the screw based on the location of the fracture. For a correct application thread must be completely contained in the distal portion of the line of fracture. For the choice you need to use the pre-operative radiographs and possible intraoperative radiographs.
Insert the helical drill 4,500,002 and with the aid of a medical dril, drill the holes along the guide wire. The hole created is Ø5.0 diameter, equal to that of the cylindrical portion. If the bone tissue is not very consistent it is possible to avoid drilling in the distal zone to increase thread tightness. In this phase of the intervention you can optionally use the canullated burr 4,800,001 to countersink hemispheric head of the screw into the cortical bone. Do not use this tool in conjunction with the use of washers.
Insert the preselected cannulated screws using screwdriver 4,800,004 screwing until complete adherence to the head of the cortical bone. Carefully continue screwing up to reduction of the fracture. After checking positioning of the screws radiographically, extract the guidewires.
In the figure on the right you can see the three screws fully inserted. The higher screws seem to overlap because they are on two different levels.
In addition you can load the devices with a curative substance such as platelet gel to speed up the process of fracture healing. To do this, select the injection cannula based on the length of the screw and prepare the syringe 5.12S.001.The hospital is responsible for the substance injected, for more information please refer to the instruction sheet for use of the product.
Draw the substance and attach the cannula to the syringe using the luer-lock. Insert the cannula inside the screw and turn it until it seats in the hexagon socket of the screw. In this way the alignment between the holes of the cannula and the screw is assured. Proceed with the injection dividing the gel between the three screws. Remember to always align the cannula with the screws.