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8Choice of implant

Nail length

Variations in surgical preferences exist with regard to the optimal length of a retrograde nail for treatment of a distal femoral fracture.

Determine nail length using a guide wire
If reaming was performed, the maximal length of the nail is determined by comparing a second identical length guide wire to the one that has been inserted. The correct placement of the tip of the guide wire in the proximal canal should be assessed using an image intensifier. A second guide wire must be positioned in contact with the articular surface of the distal femur. This must also be verified by image intensifier.

It is desirable to use the longest nail possible in the femur to prevent latent risk of periimplant fractures.