Easy insertion of the gamma nail's end cap

Instrumentation for the Gamma 3 Trochanteric Nail 180 (Stryker, UK) facilitates a minimally invasive approach. However, insertion of the end cap can be difficult through a small incision. The end cap can fall off the screwdriver and is sometimes lost in the soft tissues for some minutes. We have found that by re-inserting the ball-tipped wire into the top of the nail, the end cap can be easily threaded over the wire and pushed down to engage the nail. It is then screwed home. This simple technique, which is not previously reported,¹ avoids multiple insertion attempts and saves operative time.

Figure 1.

Secure insertion of the end cap over the guide wire.