7
Reaming
Instruments Used:
1. Bead Tipped Guidewire (20)
2. 14 mm Protection Sleeve (24)
3. Reamer Shaft (29)
4. 10 - 13.5 mm Reamer Heads (10 - 17)
Place the 10 mm Reamer Head onto the Reamer Shaft (A). With the 14 mm Protection Sleeve still
in place against the calcaneus, slide the Reamer assembly over the Bead Tipped Guidewire. Ream
into the tibial medullary canal to the depth recommended for the chosen DynaNail length as determined
from Table 1 (as read off the 14 mm Protection Sleeve (B)). Once the recommended depth is reached,
replace the 10 mm Reamer Head with the 10.5 mm Reamer Head and repeat.
Using fluoroscopy, continue progressively reaming in 0.5 mm increments until cortical contact is made
within the tibia. It is recommended that the final reaming size be 1 - 1.5 mm larger than the selected
implant diameter (Table 2). Use fluoroscopy as necessary to be sure the cortical wall is not compromised.
NOTE: The
he distal end of the DynaNail Implant is larger than the proximal end (12.5 mm), requiring
additional reaming on the distal side through both the calcaneus and talus (refer to Table 2).
Table 1. Recommended Tunnel Depth
Nail Length (mm) Reaming Length (mm)
220 250
260 300
300 325
Table 2. Recommended Tunnel Diameter
Nail
Diameter
16
Proximal End of Nail
Distal End of Nail
To a depth of 75 mm
DynaNail Proximal
Diameter (mm) Reaming
Diameter (mm) DynaNail Distal
Diameter (mm) Reaming
Diameter (mm)
10 mm 10 11 12.5 13.5
12 mm 12 13 12.5 13.5