Clavicle Hook Locking Plate

Transcription

1 Clavicle Hook Locking Plate

2 Clavicle Hook Locking Plate Clavicle Hook Locking Plate INDEX Indications Patient Position Surgical Technique Step 1 Approach Step 2 Reduction Step 3 Temporary Fixation Step 4 Drilling Step 5 Locking Screw Insertion Step 6 Cortex Screw Insertion Step 7 Final Locking Warning This publication describes the recommended procedures for using Double Engine devices and instruments. It offers guidance that you should pay attention to. But as with any such technical guide, the guide alone does not provide sufficient background for direct use of the instrument set, each surgeon should also consider the particular needs of each patient and make appropriate adjustments when required. Instruction by experienced surgeon is still highly recommended. All non-sterile devices must be cleaned and sterilized before use. Multi-component instruments must be disassembled for cleaning. Please follow the instructions provided in our Reprocessing, Care and Maintenance Guide (RCMG-2012). Please refer to Package Insert for a complete list of potential adverse effects, contraindications, warnings and precautions. The surgeon must discuss all relevant risks, including the finite lifetime of the device, with the patient, when necessary. Caution The implants are designed for temporary fixation of fractured bone fragments until the bone heals. Therefore, if bone does not heal or bone consolidation is delayed or not sufficient, the system may break. Post-operative care under the guidance of the surgeon is also very important and it must be to ensure the promotion of bone consolidation.

3 3 Clavicle Hook Locking Plate Clavicle Hook Locking Plate 4 Surgical Technique Indications - Clavicle fractures - Acromioclavicular joint dislocations Patient Position Place the patient in the beach-chair position with the head tilting away from the affected side. Use sandbag under the thoracic spine to allow the scapula to fall backward, which would facilitate the realignment and reduction of the fracture and assist in regaining length. Please note that excessive extension of the neck should be avoided. STEP 1 APPROACH Expose the delto-trapezoidal fascia by making a transacromial or superior incision and do not hurt the lateral supraclavicular nerves. STEP 2 REDUCTION Guide Wire, φ Reduction Forceps with Points Use guide wire or reduction forceps with points to make reduction and perform temporary fixation. Identify the posterior aspect of the acromioclavicular joint capsule. In order to allow passage of the hook of the plate under the acromion, make a 5mm detachment of the extracapsular fibers of the trapezius from the medial border of the acromion. STEP 3 TEMPORARY FIXATION Guide Wire, φ1.5, length 150mm Drill Sleeve for guide wire, φ1.5 Determine the hook depth and choose the plate. If necessary, bend the plate, avoid contouring the plate excessively. Place the plate and confirm its position under the image intensifier. Temporary fixation could be achieved by guide wire. Insert the guide wire through the drill sleeve in the distal hole to fix the distal part of the plate. Notes: (1) Do not bend or twist the shaft between the holes more than 20. (2) Do not bend the hook more than 10. STEP 4 DRILLING Drill Bit, φ2.8, length 200mm Drill Sleeve, for drill bit, φ2.8 Carefully screw the 2.8 drill sleeve into the threaded hole of the plate. Use a 2.8mm drill bit to predrill the screw hole until it drill through both cortices.

4 5 Clavicle Hook Locking Plate Clavicle Hook Locking Plate 6 Instruments Guide Wire, φ1.5, length 150mm Drill Bit, φ2.8, length 200mm STEP 5 LOCKING SCREW INSERTION Depth Gauge Screwdriver, hexagonal, φ Screw Forceps, self-holding Use the depth gauge to check the length of the screw. And Pick the screw by screw forceps and insert the self-tapping 3.5mm cortex screw using the screwdriver, hexagonal. Note: If a combination of cortex screws and locking screws will be used, cortex screws should be inserted first. STEP 6 CORTEX SCREW INSERTION Drill bit, φ2.5, length 112mm Double Drill Guide, φ2.5/φ3.5 Use the 2.5mm drill bit through the double drill guide to drill. Determine the required length of the cortex screw with the depth gauge. Insert the screws using the hexagonal screwdriver Drill Sleeve for Drill Bits, φ Depth Gauge for Locking Screws Drill Bit, φ2.5, length 112mm Bending Iron, left Tap for Cortex Screws φ3.5 STEP 7 FINAL LOCKING Torque Indicating Screwdriver, 1.5Nm Use torque indicating screwdriver to make a final lock until an audible click is heard, which means the maximum torque value has been reached. And then make a final check to confirm all screws are locked. Note: At least two screws should be inserted in the medial part of the plate so as to achieve a stable fixation, while lateral fragments using one or two screws Torque Indicating Screwdriver, 1.5Nm

5 7 Clavicle Hook Locking Plate Clavicle Hook Locking Plate Screwdriver, hexagonal, φ Screwdriver Shaft, hexagonal, φ Holding Sleeve Bending Iron, right Double Drill Guide, φ2.5/φ Reduction Forceps with Points Extraction Screw for Screws, φ Bone Holding Forceps, self-centering Broken Screw Extractor Periosteal Elevator, round edge T-Handle with Quick Coupling Screw Forceps, self-holding Periosteal Elevator, straight Drill Sleeve, for Guide Wire φ1.5, short Bone Lever, small

6 9 Clavicle Hook Locking Plate Clavicle Hook Locking Plate Bone Lever, large Holding Sleeve for Torque Indicating Screwdriver Instrument Case