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What surgical step must occur prior to placing an intramedullary rod?

  1. Drilling

  2. Ream

  3. Incision

  4. Suturing

The correct answer is: Ream

Before placing an intramedullary rod, reaming is a critical surgical step. This process involves using a reamer, which is a specialized instrument designed to enlarge and smooth the intramedullary canal of the bone to accommodate the intramedullary rod. Reaming ensures that the canal is properly sized for the rod, allowing for optimal stability and support within the medullary cavity. This step is crucial as it helps facilitate the insertion of the rod and ensures that the fit is appropriate to minimize the risk of complications, such as improper alignment or fixation failure. In contrast, drilling might be helpful in some contexts but it typically serves different purposes, such as creating holes for screws rather than enlarging the canal. Incision refers to the initial cut made to access the surgical site but does not address the specific preparation of the medullary canal. Suturing comes at the end of the procedure to close the incision and is therefore not relevant to the placement of the intramedullary rod itself.