- 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)