Three weeks prior to her last admission, she complains of recurrent right thigh pain for which epidural analgesics were administered for presumed radiculopathy, however preliminary x-rays and even MRI of the thigh were also taken in view of her primary complaint regarding her right thigh. At the same time she was put on fosamax for osteoporosis.Ĭase provided by Merng Koon Wong, Singapore, Singapore The patient underwent left L5S1 minimally invasive TLIF with pedicle screws 2 years ago for left lumbar 5th radiculopathy. Dynamic strength of the Expert A2FN is about 30% above that of the AFN.Ĭase 2: A 76-year-old female underwent right total knee replacement 5 years ago and left total knee replacement 4.5 years ago The nail is cannulated and available in a left and right version.ĭynamic 4-point bending test of Expert A2FN and AFN according to ASTM showed that the stress curve of the Expert A2FN is about 5% superior to that of the AFN. The nail comes in diameters of 914 mm and in lengths of 280460 mm. A special guide wire with hook engages with the end cap to facilitate a secured way through soft tissue. The end cap has a longer unthreaded part for easier insertion. The locking options are identical to the AFN except for an additional anteromedial (25) locking hole for more axial stability. The entry point is at the greater trochanter (5) as this approach is preferred in Asia. Optimum positioning of the recon screws has been accounted for and the length of the proximal end of the nail has been decreased to negate protrusion in the shorter patients. In the proximal region of the nail, the relationship between the locking elements and the proximal nail end has been decreased to negate protrusion in the small stature/Asian patient. The A2FN has accommodated all these different aspects.
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