Preparing for nail insertion
Cannulated nails are inserted over appropriate guide wires. No guide wire is used for a solid nail. The ball-tipped, or significantly bent, guide wire used for reaming may be too big to remove through a given cannulated nail. If so, the wire must be replaced before the nail is inserted. A plastic medullary exchange tube is available for exchanging guide wires. Pass the medullary tube over the reaming guide wire and all the way passed the fracture site. Hold it in place while removing the reaming guide wire.