I

ntr
oduct
i
ons
I
ndi
cat
i
ons
Per
tr
ochanter
ic,i
nter
tr
ochanteri
cand
hi
ghsubtr
ochanter
icfr
actur
es .

T
abl
eof Feat
ures
Cont
ent
s
PROFI
Nisanunr
eamedti
t
ani
um i
ntr
amedul
arnai
lwhi
ch
i
sdesi
gnedf
orf
emurpr
oxi
malendfr
act
ures
.

Thecannul
atedendcapprotectsthet
opofthenai
land
f
acil
i
tat
estheextr
act
i
onprocedur e.
1 I
ntr
oduct
i
ons The16mm pr ox
imaldi
ameterreducesthebonel
ossto
mini
mum.
I
ndicat
ions
Featur
es Cannul
at
edProximal LagScrews
Ø8.5mm;Self-
Tapping,cancel
loustype,
3 Sur
gical
Techni
que Rotat
i
onals
tabi
li
tyandcompr ession
126ºcol
l
odi
aphysealangle
8 I
ntr
aoperat
i
veCompres
sion
12 Ext
ract
i
onoftheNai
l Anatomic6ºMLSlope
Compat i
bl
ewit
hthefemurpr ox
imal endanatomy
.
I
nst
rument
s Easyenteri
ngwi
thli
t
tlei
ncis
ionfrom thet
rochant
eri
cti
p.
Usi
ngt hesamenai
lforr
ightandl ef
t.
13 I
mplant
s
Cannul
at
edroundgeomet
ry;easyi
nser
ti
onov
ert
he
14 I
nst
rument
s1 gui
dewirebypr
eser
vi
ngthereduct
i
on.
15 I
nst
rument
s2
16 I
nst
rument
s3 Nai
lbodydiamet
er10,11and12mm intramedul
ar
unr
eamednailpl
acement.
Nai
ll
engthchoi
ces:st
andart250mm,short220mm.
Case
17
Radi
ogr
aphi
es Dist
all
ockingopti
ons:s
tat
icand/ordy
namiclocki
ng
Corti
cals
cr ewØ5mm:fi xati
ontothedri
verwit
hunique
18 Li
t
erat
ure headdes
di
recti
i
oni
gn,dr
spr
oppi
ev
ent
ngandadv
ed.
ancementtothewrong

Adis
tals
lott
hatal
l
owsfl
exi
ngandr
educi
ngt
hes
tres
s
f
ocus.

Ti
t
ani
um Mat
eri
al
:hi
ghl
yres
ist
antbi
ocompat
i
blemat
eri
al
.
2
Sur
gical
Techni
que
ThePat ientisplacedtot hetractiont able,i
n
supinepos it
ionandt hehi pwhi chwi llbe
i
ntervenedi nadduct i
on.Ther educt ioni s
control
ledbyt hefl uoroscopy.Af terthe
suit
ablepos iti
onthetrochantericmaj oris
plapedandent eredwi t
ha5cm i ncision
l
ongitudinal
lyfrom thetiptothepr oximal.Iti
s
reachedt otrochantermaj orbyt hei ncisi
onof
thes ki
nands ubcutaneous ,f
aci alataand
parall
eltogluteusmedi usmus clefi ber s
.

10°
-15°

Agui dewi reØ2. 5x600mm i ssentt hrough

Kir
s chnerWi reGui def r
om s li
ghtl
yl ater
alfr
om
thet i
poft het r
ochant ermaj or
,sot hatitison
theneckax i
s.Af t
ers eeingt heguidewi r
ein
themedul l
af r
om bot hpl ansbyt hecont r
olof
fluoros copy,anai lent ryisopenedbya
cannul atedAWLorat r
ochant er
icr eamer
thr
oughas oftti
s suepr ot ect
orov erthegui de
wire.Ther eami ngpr oces siscontinuedunt il
ther eamerr eachest ot hehindrance.The
entrypl aceiswi denedt obes ui
tablet othe
prox i
mal diamet eroft henai l
.

Anat cal 6°
omi
Axi
s

Gui
deWi r
e
Ent
rance

*
Axial
AndAPView
OfTheNai
lEnt
ranc
e

3
Thenaill
engthanddiamet
erisdeter
mined
accordi
ngt ot
hestat
usofthefr
actur
eand
radi
ographicmeasur
ement.Thenail
,i
nthe
appropri
atedi
ameterandi
nlength,i
smounted
toInser
ti
onHandleforPROFIN.

10X220mm

11X220mm

12X220mm

10X250mm

11X250mm

12X250mm
ThePROFI Nnai li
ssentbypus hingorappl yi
ng
rotational f
orces .Wedonots ugges tt heus age
ofthehammer .Ifnecessary,itisgent lytapped
withahammert othePFNI ns ert
ionKnob
whi chi smount edont othePROFI NI ns erti
on
Handl e.As mal l
erdiamet ernai l
mus tbes entif
thenai lcoul
dnotbepl aced.I fitiss ti
llnot
pos sibletos entt henai
l becaus eoft henar r
ow
medul lacavity
,t hemedul l
acav i
tymus tbe
reamedupt o10mm.Thenai lmus tbes ent
untilthet opoft henailreachest hetrochant eri
c
entry.Meanwhi l
eitmus tbecont rol
ledbyt he
fluor os copytobes urethatt hepr oximal screws
woul dfi ndthef emoralneck.

4
 ForthePr oxi
mal scr
ewaPr oxi
malDri
l
l&
ScrewSl eevewi t
hTrocariniti
ssentt
hrough
wit
hs t
apinci
sionuntil
itarr
ivest
othebone.
Topr eventsl
i
pingbackoft heProxi
malDril
l&
ScrewSl eevefrom i
tsplaceaGuideLock i
ng
Deviceisused.

PR
OX
.D
RI
LL
&S
CR
EW
SL
EE
VE

Gui
deLocki
ng
Dev
ice

Thetrocari
st akenout,i
nsteadofitaProxi
mal
Sleev
eK- wir
eGui deisplacedandat hr
eaded
point
edØ2. 5x340mm K- wir
eissentunti
l
subchondralarea.APandl at
eralfl
uoroscopi
c
contr
olisdone.

PR
OX
.D
RI
LL
&S
CR
EW
SL
EE
VE

5
 Theopt i
mal posi
ti
onoft heK- wirewhi chis
dir
ectingt hel owerproximal screwisont he
dist
al halfoft heneckcent erinAPv i
ewandi n
themi ddlel i
neoft heneckax i
si nl
ateral v
iew.
Payat tentiont otheproximal femurant eversi
on
byplaci ngt henailforappropr i
ateplacement .
I
fthepos it
ionoft heK- wir
ei sconvenienta
meas uringi sdonef orthes crewov ert he
K-wire.Ther ealsizeofthes crews houl dbe
10mm l es sthant hemeas urement .

PR
OX
.D
RI
LL
&S
CR
EW
SL
EE
VE

Payat t
entiontot heplacementoft hePr oxi
mal
Dri
ll&Scr ewSl eeve,K-wireGui de,Dril
l Guide
andther elat
edi nstruments,havetot oucht he
bone.Fort hes econds crew( Anti
-r
otations crew)
whichwi l
lbes entt otheneck ,aPr ox
imal Dr il
l&
ScrewSl eevewi thaK- wireguideinitispl aced
tothePr ofinInsertionHandle.
Athreadedpoi ntedØ2. 5x340mm K- wi r
eis
sentthroughittot hefemor alhead.Thepos i
ti
on
i
sappr ovedaf t
ert hecontrolwiththefl uoros copy.

PR
OX
.D
RI
LL
PR &S
OX CR
.D EW
RI SL
LL EE
&S VE
CR
EW
SL
EE
VE

6
 NOTE:Accor dingt othef r
acture,distalor
proxi
mal ofthepr ox i
mal screwcoul dbes ent
first
.Thefi rstscr ews houldbes entwi t
ht he
shortdri
verwhi chi ss peciall
ydes ignedf or
compr essi
on.TheK- wi r
eGui dei stakenout
f
rom thePr oximal Dri
ll&Scr ewSl eeveandt he
proxi
mal cannul ateddr il
lissent.Thegui di ng
waypat hisopenedaccor dingtot he
predeter
mineds crewl ength.Thedr il
li
ng
shouldbedoneundert hecont rolofthe
fluoroscopy.Themeas urementmar kersnut
whichisont hedr il
l,i
sadj ustedt othe
predeter
mineds crewl ength.

Becauseofthes el
f
-tappings pecial
tyoft he
neckscrews(Proxi
mal screw,lags crew),ther
e
i
snoneedf orabonet ap.Ifneces s
ary,for
youngpati
ents’har
dbone,t hreadscanbecut
byatapbeforetheinserti
onoft hes crew.

Owi ngtotheconnect i
ondev icewhi chisinside
ofthes cr
ewdr iver
,theprox i
mal screwistightl
y
securedass hownont hefi gure.Payat t
ention
tomat chthethreadsoft hes crewandt he
dri
ver.
Thepr oximalscrewwhi chi satt
achedt o
theCompr essionWr enchForPr oxi
mal Screw
(
compr essionproximal s
crewdr i
ver
)issent
overtheK- wir
et othefemurhead.

7
I
ntr
aoper
ati
veCompr
ess
ion

I
fther
eisadi s
tracti
on,aft
ers endi
ngthefirs
t
scr
ew,thenutwhi chisont heCompr ess
ion
ScrewDrieri
v sturnedclock wisewi
tha14mm
Wrenchtoaccompl is
hthecompr ess
ionunder
t
hecontrolofthefluoroscopy .

8
I
ntr
aoper
ati
veCompr
ess
ion

Whilethefi r
sts crewi sincompr ess
ion,without
t
akingt hedr i
verof fthes ames t
eps,s ending
t
hes crewaf t
ert hedr i
ll
ingovertheK- wir
e
t
hrought heProx imal Dril
l&ScrewSl eeve,are
f
oll
owedf orthes econds crew(antir
ot at
i
on
scr
ew) .ThisAnt i
-rot
ations cr
ewmus tbes ent
wit
ht hel ongs crewdr i
verunderthecont r
ol of
t
hefl uor oscopy .

Aft
ertheplacementofthepr ox
imalscrewsi
n
ri
ghtposi
ti
on,theScrewDr iv sar
er etakenof
f.
Proxi
malDr i
l
l&ScrewSl eevesandtheK- wi
r
es
areremovedfrom t
heIns er
ti
onHandle.

9
 Accor
dingt
othet
ypeoft
hefr
act
ure,t
hedi
st
al
l
ocki
ngcanbedoneasst
ati
cand/
ordynami
c.

Basedont heus edSt andar dnai l

orShor tnail
,
theSl eeveForCor texScr ewf ordistallocking
andat rocarinit
,i splacedt ot heappr opr i
ate
holeont heinserti
onhandl e.Afterthes k i
n
i
ncision,itisreachedt othebonewi t
habl unt
dissection.Thet rocaristak enoutandt heDr i
l
l
GuideForCor t
exScr ewi spl aced.Thedoubl e
cortexdr il
l
ingisdonewi tht heØ4. 2mm dr i
l
lbit
whichi smount edt othes urgicaldril
l
.

Thescr
ewl
engthi
sdeter
minedaccor
dingt
o
thes
cal
eonthedr
il
lorwi
thadepthgauge.

40 45 50

SLEEVEFORCORTEXSCREW

Thecor ti
calscrewwhichhasas pecial des
igned
holdi
ngendi smount edtotheT -
Handl eScrew
I
ns er
ter.I
tissendasdoublecor t
ext hroughthe
SleeveForCor texScrewunti
lthemar kcomest o
thesleeveend.Accor di
ngtothefracturetype,one
ortwodi stal
locki
ngs cr
ewscanbepl aced.

SLEEVEFORCORTEXSCREW

10
 TheIns
ert
i ei
onHandl ss
epar
atedf
rom t
henai
lwi
t
h
aT-Scr
ewDri
ver
.

Theendcapispl
acedt
otheendofthenai
lwi
t
h
Ø5X180mm s cr
ewdri
vert
iponthedir
ect
i
onof
thenai
lax
is.

Fi
nall
y,thefinalposit
i
onandt helengthofthe
f
ractureandthes cr
ewpos i
ti
ons,iftheyareinthe
scr
ewhol es,arecontrol
l
edwi ththefl uoros
copy .
Aft
ertheconfi r
mat i
onoft hesuit
abil
ity
,theskin
ands ubcut
aneousar eclosedappr opri
atetothe
anat
omy .

11
Nai
lEx
tract
i
on

Fir
stofall,theendcapi sr emov edwiththe
T-ScrewDr iv .Thent
er heIns er
ti
onHandl eis
mount edt othenailendandt heproximal
screwsar es cr
ewedout .Iftherearetwodi st
al
screwsoneoft hem iss crewedoutandt oot her
oneisr eachedwi t
ht het i
ss ueprotectorwit
ha
tr
ocarini t
.Thenwel eav eoneofdi stalscr
ews
toprohibittherot
ati
onoft hePROFI Ndur i
ng
mount i
ngt henailextractor.

Foll
owingtheremov ingoftheInsert
i
onHandle,
theextract
ionrod(NailExtr
actor
)ismountedto
theendoft henail
andt i
ght
enedwi t
ha12mm
wrench.Aftert
hatthel asts
crewiss cr
ewedout
andagent lyhammer i
ngisdonetot henai
l
extr
actorwiththehingeds l
ott
edhammert o
removet henail
.

12
I
nst
rument
s
I
mpl
ant
s

NO CAT
ALOGNO UBBNO DESCRI
PTI
ON QTY
1 80129220010 8699931021349 PROFI
NCANN.( PROX.FEM.INT.NAIL)TIØ10X220MM 1
80129220011 8699931021363 PROFI
NCANN.( PROX.FEM.INT.NAIL)TIØ11X220MM 1
80129220012 8699931021387 PROFI
NCANN.( PROX.FEM.INT.NAIL)TIØ12X220MM 1
80129250010 8699931021356 PROFI
NCANN.( PROX.FEM.INT.NAIL)TIØ10X250MM 1
80129250011 8699931021370 PROFI
NCANN.( PROX.FEM.INT.NAIL)TIØ11X250MM 1
80129250012 8699931021394 PROFI
NCANN.( PROX.FEM.INT.NAIL)TIØ12X250MM 1
2 80221650085 8698673423503 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X65MM 2
80221700085 8698673419544 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X70MM 2
80221750085 8698673419551 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X75MM 2
80221800085 8698673419568 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X80MM 2
80221850085 8698673419575 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X85MM 2
80221900085 8698673419582 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X90MM 2
80221950085 8698673419599 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X95MM 2
80221100085 8698673419605 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X100MM 2
80221050085 8698673419612 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X105MM 2
80221110085 8698673419629 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X110MM 2
80221150085 8698673419636 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X115MM 2
80221120085 8698673419643 PROXI
MALSCREW SELFTCANL TD.TI-Ø8.5X120MM 2
3 80421000006 8698673422551 ENDCUPFORPROFI N 2
4 20124320050 8699931022346 CORTEXSCREW FORNAI LSTIØ5X32MM 2
20124340050 8699931022353 CORTEXSCREW FORNAI LSTIØ5X34MM 2
20124360050 8699931022360 CORTEXSCREW FORNAI LSTIØ5x 36MM 2
20124380050 8699931022377 CORTEXSCREW FORNAI LSTIØ5x 38MM 2
20124400050 8699931022384 CORTEXSCREW FORNAI LSTIØ5x 40MM 2
20124420050 8699931030945 CORTEXSCREW FORNAI LSTIØ5x 42MM 2
20124440050 8699931030952 CORTEXSCREW FORNAI LSTIØ5x 44MM 2
20124460050 8699931030969 CORTEXSCREW FORNAI LSTIØ5x 46MM 2
20124480050 8699931030976 CORTEXSCREW FORNAI LSTIØ5x 48MM 2
5 0605000 8699931028461 PROFI
N(PROX.FEM.INT.NAIL)SCREW BOX 1
6 0605400 8699931028508 PROFI
N(PROX.FEM.I
NT.NAI
L)IMPLANT1. DESIGNTRAY 1

6 4 2 5 3 1
GNTRAY1
NDESI
PROFI

13
I
nst
rume
nts1

NO CAT
ALOGNO UBBNO DESCRI
PTI
ON QTY
7 01193002009 8699931028126 BONEHAMMERMEDI UM 1
8 08040000031 8698673496859 COMPRESSIONWRENCHFORPROX.SCREW 1
9 08040000140 8698673493438 WRENCHFORPROXI MALSCREW 1
10 08040001214 8698673493452 WRENCH12MM- 14MM 1
11 01195001009 8699931028195 HINGEDSLOTTEDHAMMERLARGE 1
12 08061000030 8680858408399 PFNNAILEXTRACTOR 1
13 00250120050 8699931023039 DEPTHGAUGE-PROFI N&A-PFN0-50MM 1
14 00250100010 8699931023015 THANDLESCREW I NSERTER260MM 1
15 0605100 8699931028478 PROFIN(
PROX.FEM.INT.
NAI
L)
INSTRUMENT1.
DESI
GNTRAY 1

15 11 7 10 12 13 8 9 14
GNTRAY2
NDESI
PROFI

14
 I
nst
rume
nts2

NO CAT
ALOGNO UBBNO DESCRI
PTI
ON QTY
16 23412340025 8699931022834 KIRSCHNERWI RETHREADEDPOI NTØ2, 5x340MM 4
17 23410340125 8699931026344 KIRSCHNERWI RETROCARPOI NTØ2, 5x
340MM 4
18 04551000350 8699931030686 K-WIRETUBEØ10XØ8X350MM 2
19 01210030042 8699931030747 GRADUATEDDRI LLBITØ4,2MM x 300MM (PFN) 1
20 23410060025 8699931028744 KIRSCHNERWI RE2.5X600MM 1
21 08201000003 8698673496248 AWL 1
22 02060018050 8680858405886 SCREW DRIVERQUI CKTIPHEGZAGONALØ5. 0X180MM 1
23 00250200001 8699931023046 AWL( PFN) 1
24 02025100500 8699931005172 T-
SCREW DRI VER5MM 1
25 02050101050 8699931029031 QUICKSCREW DRI VERSHAFTWI THSWI VEL5MM HEX.
BIT 1
26 02171000017 8698673440876 REAMERTHANDLE 1
27 08040000085 8698673493704 TAPØ8. 5MM CANNULATEDFORPROXI MALSCREW 1
28 08040000110 8698673494619 PROXIMALCANNULATEDDRI LL 1
29 08040000500 8698673495753 PROFINTROCHANTERI CREAMER 1
30 08300000025 8699931021738 GUIDEWI REPUSHER 1
31 02010101002 8698673493308 SOFTSCREW DRI VERQUICKLARGE 1
32 0605200 8699931028485 PROFIN(PROX.FEM.INT.
NAIL)
I
NSTRUMENT2. DESI
GNTRAY 1

32 24 27 2919 28 30 21 31 22 16 1718 25 23 26
GNTRAY3
NDESI
PROFI

15
I
nst
rume
nts3

NO CAT
ALOGNO UBBNO DESCRI
PTI
ON QTY
33 08040000700 8699931005325 PROX. DRILL&SCR.SLEEVEØ12X9. 5X205MM 2
34 08040000900 8699931022087 PROX. SLEEVEK- WIREGUI DE9.5X2.7X210MM 1
35 08040000800 8698673494602 PROX.SLEEVETROCARØ9. 5X230MM 1
36 00250100602 8699931023022 SLEEVE( A-PFN&PFN)FORCORTEXSCREW OFNAI LS 1
37 08060080220 8699931032253 DISTALTROCAR( A- PFN&PFN)Ø8X220MM 1
38 00250008101 8699931022926 DRILLGUI DE(A-PFN&PFN)FORCORTEXSCREW OFNAI LS 1
39 00250001031 8699931026658 PFNI NSERTIONKNOB 1
40 00250020001 8699931022933 A-PFNSCREW GUI DELOCKI NGDEVI CE 3
41 00250040002 8699931023138 LENGTHMEASURI NGDEVI CE-PROFI N&APFN 1
42 00250200033 8699931030709 PFNTROCHANTERI CSLEEVE 1
43 00260250600 8699931030716 PFNKI RSCHNERWI REGUIDEØ2. 5X600MM 1
44 08080000005 8699931032635 I
NSERTI ONHANDLEFORPROFI N( F
.CARBON) 1
45 0605300 8699931028492 PROFI N(
PROX. FEM.INT.NAI
L)
INSTRUMENT3. DESI
GNTRAY 1
00560270170 8699931010787 CONT AINER560X270X170MM 1

45 34 38 33 35 37 36 39 40 41 42 43 44
GNTRAY4
NDESI
PROFI

16
Cas
eRadi
ogr
aphi
es

17
Li
t
erat
ure

DistalUnlockedProximalFemoralIntr
amedullar
yNai l
ingForInte
rtroc
hante
ricFemurFr
act
ure
s.
Oz kanK,Una yK,De mirc
ayC,Ca ki
rM,Ecevi
zE.
IntOrthop.2009Oct;
33(5):
1397-
400.doi
:10.
1007/s
00264-008-
0673-
1.Epub2008Oct28.
PMCI D: PMC28991
1 1

ProximalFe moralNail
ingWi t
houtAFr ac
tur
eTable .
KorhanOz kan,HakanCift
,KayaAka n,
AdemSa hi
n,EnginEcevi
z,Ende
rUgut
men
EuropeanJournalofOr
thopae
dicSurger
y&Tr a
uma t
ology
April2010,Volume20,Iss
ue3,pp229-231Dat
e:03Se p2009

Treat
me ntOfRe ve
r s
eObl i
queTrochanteri
cFe moralFract
ure
sWi t
hPr oxi
malFemor alNail.
KorhanOzkan,EnginEceviz
,KorayUna y,Leve
ntTasyi
kan,Buda
kAkma n,Abdul
lahEren
IntOr
thop.2011April
;35(4)
:595–598.Publi
shedonl
ine2010March28.doi
:10.
1007/
s00264-010-100
2-z
PMCID:PMC3066315

Eff
ec tOfOs t
e oporosi
sOnCl i
nicalOutc
omesInInt
ert
roc
hant
eri
cHi
pFr
act
ure
sTr
eat
edWi
th
APr oximalFe moralNail.
AkanK,Ci ftH,Oz kanK,Ec e
vizE, Ta
syi
kanL,Er
enA.
J.I
ntMe dRe s.2011;39(
3):
857-65.

I
SO 9001:
2008
I
SO 13485:
2003
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