Use of the tibial curved driving piece for AO femoral nail insertion.

The purpose of this article is to demonstrate an improved method of AO femoral nail insertion. The AO/ASIF Universal Femoral Nail (Synthes, Paoli, Pennsylvania) has proven effective in the treatment of femoral shaft fractures. The procedure is sometimes difficult when nailing in the supine position, especially with large or obese patients. The ram device impinges on the flank soft tissue of the patient. By using the curved driving piece (355.16) attached to the femoral set, the ram and the ram rod are brought away from the patient's side, thus allowing a less obstructed nail insertion.