CHARNLEY Wires. Surgical Techniques

Transcription

1 CHARNLEY Wires Surgical Techniques

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3 BACKGROUND CHARNLEY Trochanteric Wires are indicated for use in re-attachment of the greater trochanter following a trochanteric osteotomy. The use of a double wire and two single wires is required with this technique to ensure adequate fixation. CHARNLEY Wires Surgical Technique DePuy Synthes 1

4 Step 1: The drill is centered in the middle of the lateral surface of the femur, inferior to the osteotomy and directed towards the medullary cavity under direct vision. Step 2: The vertical double wire is inserted. Step 3: The medial drill is sited about 1cm from the cut edges of the femur as shown in the figure. Step 4: The single wire (45cm) is passed through the drill holes with a pair of wire holding forceps. 2 DePuy Synthes CHARNLEY Wires Surgical Technique

5 Step 5: The medial wire is displaced laterally within the medullary cavity using the stem of the final prosthesis held in the prosthesis holder. This will ensure that the wire will not impede the stem cementing process. Step 6: The lateral drill should be directed parallel with the direction of the previous medial drill so that both drills on the posterior surface of the femur are about the same distance apart at the points of entry on the anterior surface. The lateral drill does not transfix the medullary cavity. Step 7: The lateral wire is inserted. Step 8: Before introducing the cement, the double wire should be arranged to emerge from the medullary cavity posterior to the anticipated femoral prosthesis position. CHARNLEY Wires Surgical Technique DePuy Synthes 3

6 SURGICAL TECHNIQUE Step 9: After cementing the stem, and allowing for the cement to cure, a large awl is used to make a track in the bone at the central superior border of the greater trochanter. A quarter circle wire passer is passed in the same track. Step 10: The two ends of the double wire are pushed, side by side, into the hollow end of the wire passer and directed from deep to the superficial through the track. Step 11: The trochanter is rotated so that the aponeurotic fibres lie in line with the corresponding fibres of the vastus lateralis aponeurosis on the femur. It is temporarily pegged in position by driving the awl through the trochanter into the cancellous bone of the femur. Step 12: The loop is turned horizontal and the two ends of the double wire are threaded through the wire loop in opposite directions. Check to make sure the double wires are crossing the middle of the trochanter for optimal fixation. Apply the wire tightener and tighten these wires. 4 DePuy Synthes CHARNLEY Wires Surgical Technique

7 Step 13: The punch and mallet should be used to impact the length of the double wire and then the wires retightened. Step 14: The medial and lateral wires are then positioned in a cruciate pattern over the double wire. The wires should be twisted sequentially, cut off and impacted into the surface of the femur. Product Codes: CHARNLEY WIRE SINGLE 18 SWG 316L PK CHARNLEY WIRE DOUBLE 18 SWG 316L PK CHARNLEY WIRE DOUBLE 19 SWG ORT 90 PK CHARNLEY WIRE DOUBLE 18 SWG ORT 90 PK CHARNLEY WIRE SINGLE 19 SWG ORT 90 PK CHARNLEY WIRE SINGLE 18 SWG ORT 90 PK 10 CHARNLEY Wires Surgical Technique DePuy Synthes 5

8 References: *With permission of Springer Science+Business Media all figures taken from: Title: Low Friction Arthroplasty of the Hip 1979, pp Chapter: Technique of Low Friction Arthroplasty of the Hip Author: Professor Sir John Charnley C.B.E., F.R.S., F.R.C.S., F.A.C.S Springer-Verlag Berlin Heidelberg This publication is not intended for distribution in the USA. The third-party trademarks used herein are trademarks of their respective owners. Johnson & Johnson Medical Limited PO BOX 1988, Simpson Parkway, Livingston, West Lothian, EH54 0AB, United Kingdom. Incorporated and registered in Scotland under company number SC DePuy Orthopaedics, Inc. 700 Orthopaedic Drive Warsaw, IN USA Tel: +1 (800) Fax: +1 (574) DePuy International Ltd St Anthony s Road Leeds LS11 8DT England Tel: +44 (0) DePuy (Ireland) Loughbeg Ringaskiddy Co. Cork Ireland Tel: Fax: depuysynthes.com DePuy Synthes All rights reserved. DSEM/JRC/0615/0312(1) Issued: 11/17