A simplified technique for Zickel nail insertion

The Zickel nail can be inserted without difficulty as follows. The fracture table is set for the supine position and double-leg traction. Adduction of the fractured leg and traction on the opposite abducted leg clear the femur from the iliac wing. With use of the image intensifier for blind insertion of an intramedullary rod, the Zickel nail can be inserted without fracture site exposure. This technique reduces operative time from several hours to 48 minutes +/- 25 minutes and blood loss from several units to 325 cc +/- 150 cc.