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Femoral shaft – Antegrade nailing – Guide wire insertion

Guide wire insertion

A guide wire is advanced into the distal main fragment until it is about 5 mm proximal to the intercondylar notch. It is important that the guide wire be centered to prevent eccentric reaming and subsequent malposition of the nail, which can result in varus/valgus/antecurvatum/retrocurvatum malalignment.

Unreamed nailing does not require a guide wire. When unreamed nailing is performed, the nail is used as a reduction tool.