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7Reaming

Femoral shaft – Antegrade nailing – conversion from external fixator to intermedullary nail

Special situation: conversion from an external fixator to an intramedullary nail

Because the external fixator is still in place, the Schanz screws must be partially withdrawn to allow the guide wire, the reamers, and later the nail, to pass through. The external fixator is held in place by monocortical purchase to assure that the fracture remains stable. The external fixator also acts as a joystick for the reduction.