|
The Surgical Technologist
|
JANUARY 2015
18
the surgeon may opt to use the cannulated awl to open the
canal. Once the canal is open, the 3.2-mm guidewire will be
removed and the guidewire will be diposed.
Reaming the medullary is optional. Many surgeons opt
to ream when a long nail is used. If the surgeon determines
reaming the canal is necessary, the surgical technologist will
need to load the 2.5-mm ball-tipped reaming rod on the cou-
pler in the power system. The reaming inserts come in 0.5-
mm increments. The surgeon will need to ream to a diameter
1-mm greater than the measured diameter. The reaming rod
may be used as a guide for the nail; the reaming insert will
need to be removed and the guide re-inserted.
This next step will require the cannulated connection
screw, the 5-mm flexible hexagonal screwdriver, the insertion
handle and the 8-mm ball hexagonal screwdriver. The surgi-
cal technologist will load the nail on the insertion handle by
orienting the handle laterally and matching the geometry of
the handle to the nail. For the long nail, the bow of the nail
will need to be aligned with the anterior bow of the femur
and ensured that the left or right nail is being used for the
correct affected limb. The insertion handle is notched to
match a notch on the nail. The surgeon will use the 5-mm
cannulated screw to secure the nail to the insertion handle
and tighten with the ball hexagonal screwdriver. The connect-
ing screw will need to be tight enough to prevent misalign-
ment when inserting the helical blade later in the procedure.
The surgical technologist will hand the insertion handle to
the surgeon, who will then insert the nail into the canal of
the femur. The reaming rod can be used as a guide for the
nail. This is especially useful if the proximal femoral shaft is
also fractured, preventing the nail from exiting the shaft of the
femur laterally. Although short nails do not usually require
malleting or hammering, the surgical technologist will need
to have the mallet ready just in case. Long nails almost always
require malleting or hammering. If needed, there is a driv-
ing cap attachment available in the set for malleting. When
using the mallet, the surgeon will need to carefully monitor
the distal tip of the nail as the nail progresses to ensure it
The Accreditation Review Council on Education in Surgical Technology and Surgical Assisting
(
ARC STSA
) is pleased to announce the launch of our
2015 Scholarship Program
in service to
the Surgical Technology and Surgical Assisting student and educator communities.
Annually, since 2005, the
ARC STSA
Board of Directors has awarded multiple scholarships of
up to
$1,000
in at least two separate categories, Student Scholarship and Educator Scholarship.
In 2015, the
ARC STSA
will award a total of up to
$5,000
in combined scholarships.
All eligible applicants are strongly encouraged to apply before the
February 27th deadline.
For eligibility requirements and to apply visit
arcstsa.org
today!
Scholarship recipients will be announced at the 2015 AST National Conference in
San Antonio, TX and will be posted on our website, arcsta
.org
, by July 3, 2015.
