Unsuccessful Use of Syringe as a Drill Sleeve

We read with interest the documented Technical Tip with regards the use of a modified syringe as a drill sleeve for the femoral intramedullary reamer. We agree that the cobra plate is often cumbersome and requires an assistant to keep it in the correct place. However, when we followed the authors' advice, we came across a major problem that led us to discard the syringe. The reamer shaft needs to be longer than the sum of the length of the femur and the length of the syringe. Considering that the reamer is often pushed up to the hilt at the greater trochanter, that leaves no space for a circumferential drill sleeve. The cobra plate design is effective because it is not circumferential and so the reamer can slide past utilising its full length. We tried to reduce the length of the syringe but that just reduced its effectiveness in protecting the soft tissues. Therefore, we had to remove the syringe to ream to the correct depth.