Femoral Reconstruction Intramedullary Nail Instrument Set – Cephalomedullary Nailing Orthopedic Set

<p>The Femoral Reconstruction Intramedullary Nail Instrument Set from Peak Surgicals is a 35-piece orthopedic instrument set designed for the complete intraoperative workflow of femoral reconstruction intramedullary nailing — a cephalomedullary nailing technique in which the proximal interlocking screws pass through the nail into the femoral neck and head to simultaneously stabilise the femoral shaft and the proximal femur. The set includes reamers in four diameters (φ10.4mm to φ12.5mm), Kirschner wires and a Wire Depth Gauge for femoral neck targeting, a φ6.0mm tap for cephalomedullary screw thread preparation, a Cannulated Impactor and Extractor, Forcing Cones, and a full assembly of drill sleeves, location forceps, wrenches, and a guide wire, all supplied in a dedicated aluminium box. It is used by orthopedic and trauma surgeons in hospital operating theatres performing peritrochanteric fracture fixation, subtrochanteric fracture fixation, and pathological proximal femoral fracture stabilization worldwide.</p>

<h2>Reconstruction Nailing: Cephalomedullary Fixation of Peritrochanteric and Subtrochanteric Fractures</h2>
<p>A reconstruction intramedullary nail is a cephalomedullary nail — a femoral nail with one or two proximal interlocking holes angled superolaterally to allow lag screws or helical blades to pass through the nail into the femoral neck and head. This design simultaneously provides intramedullary fixation of the femoral shaft and sliding lag screw fixation of the proximal femur at a single implant, making it the implant of choice for unstable intertrochanteric, reverse obliquity, and subtrochanteric femoral fractures — fracture patterns in which a standard femoral shaft nail without cephalomedullary proximal fixation would fail to control the proximal fragment. The reconstruction nail is also used in prophylactic and therapeutic stabilization of pathological fractures where metastatic disease involves both the proximal femur and the femoral shaft, and in revision cases where prior fixation has failed. The instruments in this set are configured specifically for the additional steps that cephalomedullary nailing requires over standard femoral shaft nailing.</p>

<h2>Femoral Neck Targeting Instruments: Kirschner Wires, Wire Depth Gauge, and Tap</h2>
<p>The defining instruments of this reconstruction nail set — absent from the standard femoral shaft nail set — are those required for cephalomedullary proximal screw fixation. The Kirschner Wires (×2) serve as guide wires for the femoral neck screw — after the nail is seated and the proximal targeting arm is in position, a Kirschner wire is drilled through the targeting arm hole, across the nail's proximal interlocking hole, and into the femoral neck and head under biplane fluoroscopic guidance, confirming correct central neck trajectory before the definitive drill and screw are used. The Wire Depth Gauge measures the depth of Kirschner wire penetration in the femoral neck to determine the correct neck screw length. The Tap φ6.0 (item 10) threads the prepared drill hole in the femoral neck cortex to receive the reconstruction nail's cephalomedullary lag screw — a step not present in standard distal locking screw fixation and specific to reconstruction nailing where the proximal screw engages dense femoral neck cortex that requires pre-tapping for accurate screw seating.</p>

<h2>Reaming, Forcing Cone, and Cannulated Impactor Instruments</h2>
<p>The canal preparation component includes four reamers — φ10.4mm, φ11mm, φ12mm, and φ12.5mm — covering the specific femoral canal diameter range used for reconstruction nail sizing, which differs from standard femoral shaft nail reaming ranges. The Forcing Cone components (items 13 and 14) facilitate introduction of the reconstruction nail into the reamed femoral canal — the reconstruction nail's proximal geometry is wider than a standard femoral shaft nail due to the cephalomedullary proximal design, requiring the forcing cone to guide the nail into the canal opening without cortical impingement at the entry point. The Cannulated Impactor and Extractor (item 34) is the dedicated tool for final seating of the reconstruction nail on the guide wire — the cannulated design allows the impactor to advance over the guide rod during nail insertion and provides the extraction function needed if the nail requires removal during the procedure. The T-shaped Handle (item 27), Impactor Handle (item 31), Universal Joint (item 32), Guide Rod (item 21), and Location Handle (item 20) provide the driven connections and leverage for reaming and nail introduction.</p>

<h2>Proximal Targeting and Assembly: Location Stand, Drill Sleeves, and Wrenches</h2>
<p>The proximal targeting assembly for reconstruction nailing is more complex than standard femoral nailing because the proximal targeting arm must position the Kirschner wire and drill at the correct superolateral angle into the femoral neck — typically 130–135° relative to the nail axis — while maintaining rigidity against the rotational forces of drilling in dense femoral neck cortex. The Proximal Location Stand (item 24) and Fixed Connector (item 25) stabilise the targeting arm assembly against the nail. The Drill Bit Sleeve and four additional Drill Bit Sleeves (items 2, 16, 17, 18, 19) provide the soft tissue protection conduits for each drill trajectory used during the procedure. The L-shaped Wrench SW5 (item 22), Limitator Wrench SW3 (item 9), and Open-end Wrench (item 23) tighten the assembly components. The Locking Screwdriver Hex (item 7), Screw Take-off Forcep (item 6), and Hole-open Forcep (item 15) complete the screw fixation toolkit. The Location Forceps (items 1 and 33) provide distal fragment stabilisation during locking. The T-handle Drill Bit φ4.0×220 (item 3) and Drill Bit with Limitator φ4.0×300 (item 4) address the distal locking screw trajectory preparation.</p>

<h2>CE Mark, ISO 13485, and FDA Certification for Orthopedic Instrument Procurement</h2>
<p>The Femoral Reconstruction Intramedullary Nail Instrument Set is manufactured under CE Mark, ISO 13485, and FDA compliant quality standards. ISO 13485 certification confirms Peak Surgicals operates a documented quality management system covering design control, material traceability, and production consistency for orthopedic surgical instruments. CE Mark confirms conformity with European medical device regulations, and FDA compliance supports procurement for US-based hospitals, trauma centers, and orthopedic departments requiring verified regulatory documentation for capital instrument set purchases.</p>

<h2>Product Specifications</h2>
<table>
  <tbody>
    <tr><th>SKU</th><td>— (verify in Shopify admin)</td></tr>
    <tr><th>Product Name</th><td>Femoral Reconstruction Intramedullary Nail Instrument Set</td></tr>
    <tr><th>Price</th><td>$2,365.00 USD</td></tr>
    <tr><th>Total Pieces</th><td>35 instruments + Aluminium Box</td></tr>
    <tr><th>Instrument Category</th><td>Orthopedic — Femoral Reconstruction (Cephalomedullary) Intramedullary Nailing</td></tr>
    <tr><th>Procedure</th><td>Peritrochanteric, subtrochanteric, and pathological femoral fracture fixation by cephalomedullary reconstruction nailing</td></tr>
    <tr><th>Reamer Sizes</th><td>φ10.4mm, φ11mm, φ12mm, φ12.5mm</td></tr>
    <tr><th>Drill Bits</th><td>T-handle φ4.0×220mm; φ4.0×300mm; φ4.0×300mm with Limitator</td></tr>
    <tr><th>Tap</th><td>φ6.0mm (for femoral neck cephalomedullary screw)</td></tr>
    <tr><th>Kirschner Wires</th><td>×2 (femoral neck targeting guide wires)</td></tr>
    <tr><th>Depth Gauges</th><td>Depth Gauge (standard) + Wire Depth Gauge (for femoral neck)</td></tr>
    <tr><th>Key Instruments</th><td>Cannulated Impactor and Extractor, Forcing Cones ×2, Guide Wire, Guide Rod, Proximal Location Stand, Fixed Connector, Location Forceps ×2, Screw Take-off Forcep, Hole-open Forcep, Drill Bit Sleeves ×5, Locking Screwdriver Hex, L-shaped Wrench SW5, Limitator Wrench SW3, Open-end Wrench, T-shaped Handle, Impactor Handle, Location Handle, Universal Joint</td></tr>
    <tr><th>Container</th><td>Aluminium Box (included)</td></tr>
    <tr><th>Certifications</th><td>CE Mark, ISO 13485, FDA</td></tr>
    <tr><th>Warranty</th><td>1 Year</td></tr>
    <tr><th>MOQ</th><td>1 Set</td></tr>
    <tr><th>OEM / Custom Orders</th><td>Available</td></tr>
    <tr><th>After-Sale Service</th><td>Return and Replacement</td></tr>
  </tbody>
</table>

<h2>Frequently Asked Questions</h2>

<p><strong>What is a femoral reconstruction nail and how does it differ from a standard femoral intramedullary nail?</strong><br>
A femoral reconstruction nail is a cephalomedullary nail — a femoral intramedullary nail that incorporates one or two angled proximal interlocking holes that allow lag screws or helical blades to pass through the nail at approximately 130–135° into the femoral neck and head. This design provides simultaneous intramedullary fixation of the femoral shaft and sliding lag screw fixation of the proximal femur from a single device. A standard femoral shaft nail has only transverse proximal interlocking holes that pass through the nail perpendicular to its axis — these holes provide rotational and length stability for shaft fractures but cannot control the proximal femoral fragment in peritrochanteric and subtrochanteric fractures. The reconstruction nail is used specifically when the fracture pattern requires proximal femoral head and neck fixation in addition to shaft stabilization.</p>

<p><strong>What fractures are treated with reconstruction intramedullary nailing?</strong><br>
Femoral reconstruction nailing is indicated for unstable intertrochanteric fractures — particularly reverse obliquity and transverse patterns — where standard dynamic hip screw devices have an unacceptably high failure rate. It is the preferred implant for subtrochanteric femoral fractures, which generate high distracting forces at the fracture site that pull the proximal fragment into flexion, abduction, and external rotation, requiring intramedullary fixation to neutralise these deforming forces. Additional indications include pathological femoral fractures from metastatic bone disease involving the proximal femur and femoral shaft simultaneously — where a reconstruction nail stabilises both the current fracture and protects against impending fracture along the entire nail length — and selected cases involving peritrochanteric fractures with extension into the subtrochanteric region.</p>

<p><strong>Why does this set include Kirschner wires and a Wire Depth Gauge not present in a standard femoral nail set?</strong><br>
The Kirschner wires (×2) in this set are guide wires for the cephalomedullary proximal screw. After the reconstruction nail is seated and the proximal targeting arm is attached, a Kirschner wire is passed through the targeting arm hole at the correct superolateral angle, across the proximal interlocking hole of the nail, and into the femoral neck and head under biplane fluoroscopic control. This confirms central neck trajectory — the Kirschner wire must be positioned centrally in the femoral neck on both anteroposterior and lateral fluoroscopic views before the definitive drill and lag screw are used, because malpositioning of the neck screw is a primary cause of cephalomedullary nail failure. The Wire Depth Gauge measures Kirschner wire penetration depth to determine the correct neck screw length before the definitive screw is selected.</p>

<p><strong>What is the purpose of the Tap φ6.0 in this set?</strong><br>
The Tap φ6.0 (item 10) threads the drill hole prepared in the femoral neck cortex to receive the cephalomedullary lag screw. Femoral neck cortical bone is significantly denser than the femoral shaft diaphyseal cortex — particularly in younger patients where the subchondral bone of the femoral neck is highly compact. Pre-tapping the neck screw hole with the φ6.0 tap allows the lag screw to advance smoothly into the femoral neck and head without generating excessive rotational force on the proximal fragment during screw insertion, reducing the risk of proximal fragment displacement during the final fixation step. This tapping step is specific to reconstruction nailing and is not performed in standard femoral shaft distal locking screw fixation.</p>

<p><strong>What certifications does this set carry?</strong><br>
The Femoral Reconstruction Intramedullary Nail Instrument Set is manufactured under CE Mark, ISO 13485, and FDA compliant quality standards. ISO 13485 certification confirms Peak Surgicals operates a documented quality management system covering design control, material traceability, and manufacturing consistency for orthopedic surgical instruments. CE Mark confirms conformity with European medical device regulations, and FDA compliance supports procurement for US hospitals, trauma centers, and orthopedic departments requiring verified regulatory documentation for capital instrument set purchases.</p>

<p><strong>How does this set differ from the Femur Intramedullary Nail Instrument Set also available from Peak Surgicals?</strong><br>
Both sets are 35-piece femoral intramedullary nail instrument sets at the same price point, but they are configured for different nail designs and different fracture indications. The Femur Intramedullary Nail Instrument Set is designed for standard antegrade femoral shaft nailing — it has reamers 10–13mm, a standard sighting device and bolts for transverse proximal locking, and no femoral neck-specific instruments. The Femoral Reconstruction Intramedullary Nail Instrument Set is configured for cephalomedullary reconstruction nailing — it adds Kirschner wires and a Wire Depth Gauge for femoral neck targeting, a φ6.0 tap for neck screw thread preparation, a Cannulated Impactor and Extractor, Forcing Cones for cephalomedullary nail introduction, a Proximal Location Stand, and reamers in reconstruction nail-specific diameters (φ10.4/11/12/12.5mm). Centres performing both standard shaft nailing and peritrochanteric reconstruction nailing require both sets.</p>