OSTEOSINTEZA RESORBABILA PLACI SI PINI
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1 OSTEOSINTEZA RESORBABILA PLACI SI PINI
2 PLACI - INDICATII Fractura de maleola peroniera Fracturi de antebrat Chirurgia antepiciorului Fixare de grefe osoase / substituenti Fixare cominutii
3 CARACTERISTICI SI AVANTAJ E CARACTERISTICI Posibilitatea de a personaliza placile Placile pot fi taiate la forma si dimensiunea necesare AVANTAJE Pot fi folosite in cele mai dificile situatii anatomice Inventar redus de implanturi (patru coduri pentru placi, patru coduri pentru suruburi) Suruburile pot fi taiate la lungimea dorita Montaj low profile Risc scazut de a irita tesuturile Suruburi poliaxiale Suruburile se zavorasc in placa Pozitia suruburilor si directia lor pot fi hotarate in functie de necesitati Risc scazut de desurubare Permite taierea capetelor suruburilor montaj low profile Radiotransparente Permit vizualizarea completa a focarului de
4 IMPLANTURI Plates Screws Ref. No. Description Ref. No. Description FRF x65 mm straight plate FRF x40 mm screw FRF x100 mm straight plate FRF x23 mm screw (2 pcs) FRF x65 mm concave plate FRF x18 mm screw FRF x100 mm concave plate FRF x40 mm screw
5 INS-9088 Drill guide 2.5/2.8/3.1 mm INSTRUMENTAR Ref. No. Description INS-9024 Plate bending pliers INS mm drill bit with 32 mm stop (AO) INS mm drill bit with 42 mm stop (AO-bayonet) INS mm bone tap with 42 mm stop (AO-bayonet) INS mm bone tap with 42 mm stop (AO-bayonet) INS-9085 Countersink 2.5/2.8/3.1 mm, (AO-bayonet) INS-9087 K-wire 1.6 mm, 2 pack
6 ACCESORII ACC-9810 Inion Thermo+ water bath (230 V) ACC-9802 Inion Thermo drape (5 sterile drapes/package)
7 UTILIZAREA BAII DE TERMOFORMARE Open the sterile drape peel pouch and unfold the sterile drape onto a sterile table. The scrub nurse places both hands inside the sterile drape pouch while the circulating assistant inserts the water bath against the drape s closed end. The sterile drape pouch is turned inside out. The opening of the sterile pouch remains around the power cable.
8 UTILIZAREA BAII DE TERMOFORMARE The water bath is now ready to be placed on a sterile table close to the operating surgeon. Pour sterile water or saline into the bath. Fill the bath just over half full. Remember to ensure that this amount of fluid is in the bath during the procedure. Once more ensure there is no air between the bath and the sterile drape. Once fluid is in the bath, plug the cable in. After placing the draped water bath on the sterile table, make a depression into which sterlile water or saline can be poured. Ensure that the drape lines the bottom of the water bath and that no air is left between the drape and the water bath basin. This is important to ensure correct temperature of the sterlie fluid during procedure. The water bath can now be switched on.
9 PREGATIREA PLACII Implantul poate fi scos din ambalaj in momentul finalizarii reducerii / osteotomiei Placa este pregatita pentru modelare prin introducerea in baia de termoformare Inion Thermo+ TM pentru aproximativ 1 minut. Astfel placa devine
10 MODELAREA PLACII Placa este taiata la forma si dimensiunile necesare cu o foarfeca Va fi introdusa apoi in baia de termoformare pentru aprox 15 sec. Va deveni astfel maleabila si va putea fi modelata cu usurinta in functie de anatomia zonei de aplicare Pentru 10 sec. se va putea indoi usor, dar forma ii va putea fi modificata si in urmatoarele 15 min. cu ajutorul bacurilor
11 GAURIRE SI TARODARE Gaurirea se poate face sub un unghi de maxim 30 de grade fara a influenta stabilitatea montajului Diametrul tarodului este egal cu cel al surubului Tarodarea creaza filet si in placa si in os, determinand zavorarea surubului in placa Inainte de introducerea surubului gaura filetata trebuie spalata cu ser
12 INSERTIA SURUBURILOR SI SECTIONAREA CAPETELOR ACESTORA Suruburile nu trebuiesc stranse la maximum pentru ca sa li se poata ulterior inlatura capetele Stabilitatea montajului nu este influentata de inlaturarea capetelor suruburilor. Acest lucru insa reduce riscul de iritatie a tesuturilor si deci si reactiile inflamatorii locale Taierea capetelor Capetele suruburilor inainte de inlaturare
13 OSTEOSINTEZA RESORBABILA Inion OTPS TM Pin System PINI RESORBABILI
14 PINI - INDICATII Alinierea si fixarea fracturilor, osteotomiilor, artrodezelor sau a grefelor osoase in prezenta imobilizarilor suplimentare necesare (alte fixari rigide, gips) Fracturi la nivelul piciorului sau osteotomii (de ex. in tratamentul hallux valgus-ului) Fracturi si osteotomii la nivelul mainii si pumnului Fracturi de cap radial Fracturi de condili humerali
15 PINI - AVANTAJ E Nu migreaza la exterior Risc mai mic de infectii Mai confortabil pentru pacienti Material cu siguranta biodegradabil Nu au fost raportate reactii tisulare generate de aceste produse Mai mult de de implantari pana in prezent Produsele au fost introduse pe piata de mai mult de 5 ani Introducere facila, materialul este indeajuns de rezistent
16 REZISTENTA VS. BROSELE METALICE S-au efectuat teste biomecanice pentru a evalua comparativ pinii Inion OTPS cu brosele Kirschner pe un model de osteotomie Chevron Fixarea cu brose K s-a dovedit a fi cu 16 Newtoni mai ferma decat cea cu pini Inion OTPS, dar fara diferente clinice semnificative 16N este echivalent cu 1.6kg Rezistenta biomecanica a pinilor Inion OTPS este deci clinic Data echivalenta on file at Inion cu cea a fixarii cu brose K Maximum fixation failure force (N) plantar face proximal end Metal K-wire distal end dorsal face Inion OTPS Pin
17 KITURI SI PINI DISPONIBILI INDIVIDUAL Inion OTPS Pin kits Single-packed pins 3 x 1.5 or 2.0 mm pins (50 mm in length) 2 x K-wires PIN-1550: 1.5 x 50 mm PIN-2050: 2.0 x 50 mm 1 x Cannula 1 x Introducer 1 x Depth gauge Pn kit reference numbers PCK mm pin kit PCK mm pin kit
18 IMPLANTARE 1. Reducerea fracturii / osteotomiei 2. Introducerea a doua brose K Inion pentru a fixa fragmentele 3. Inlaturarea uneia dintre cele doua brose si masurarea canalului 4. Selectarea unui pin de acelasi diametru ca si brosa si scurtarea acestuia cu foarfeca la nevoie 5. Inlocuirea pe rand a tuturor broselor K cu pini 6. Inchiderea placii si imobilizare
19 OSTEOSINTEZA RESORBABILA PLACI SI PINI
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