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Anything which will facilitate the accurate and fast placing of the initial guide-wire for a Smith-Petersen nail is surely a boon, especially in poorrisk patients. For some time, it has been my custom to insert a Michel clip, after reduction and skin preparation, over the midpoint of the head of the femur.
This point is located by palpating the femoral artery where it crosses the inguinal ligament, then moving vertically down for 1 in. and laterally for 0.5 in. Two additional clips are inserted, 0.5 in. medially and laterally to the first respectively. Ordinarily, a check x-ray is then done to ascertain the accuracy of the reduction. If it is satisfactory, the usual lateral incision and insertion of the initial guide-wire follows. The clips, plainly visible on the film, afford a target toward which to aim the drilled wire.
Frequently, the first guide-wire is not found in optimum position by
Holzwarth FK. TIMESAVING AID IN HIP-PINNING. JAMA. 1958;167(8):992. doi:10.1001/jama.1958.72990250017009e
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