Opening the Medullary Canal

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Opening the Medullary Canal Make a longitudinal incision over the patellar tendon, and retract the tendon laterally. (In some patients, a patellar tendon-splitting technique may be used to access the entry point.) Using the Universal Chuck with T-Handle, insert a 4.0 mm Centering Pin into the entry point. Pass it distally, angled 15° in the sagittal plane to the axis of the tibial shaft, into the proximal aspect of the medullary canal. A sterile nail may be placed against the anterior aspect of the tibial crest to act as a guide to the correct angle of insertion of the centering pin. Verify placement with the image intensifier. Pass the 11.0 mm Cannulated Cutter and Protection Sleeve over the pin. With the Protection Sleeve pressed against the bone, manually rotate the cutter to carve the opening into the medullary canal. Tighten the setscrew at the base of the cutter handle onto the pin, and remove the cannulated cutter, sleeve and centering pin.


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