Flexitsystem. - Description Flexitsystem solution - Ancillaries, instruments. Surgical technique for HTO lateral external closing wedge
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1 Surgical technique for HTO lateral external closing wedge - Description solution - Ancillaries, instruments Solution for closing high tibial osteotomy
2 Genu varum: pathology Genu varum is a deformation (orthostatic disorder) of the lower limb, which sits in the knee joint. Knee osteoarthritis is caused by destruction, progressive wear of the cartilage protecting the joint. Genu varum is characterized by osteoarthritis of the medial compartment. Constraints genu varum "Most Frequent Deformation" Constraint on compartment internal
3 Flexitsystem Genu varum: treatment by osteotomy outer closure Benefits: Possible correction in multiple planes Nonunion rare: 1.5 to 3.5% Transposition of the tibial tuberosity can The limits are related to bone mass located above the tibial tuberosity Beyond 15, avoid closing osteotomies Disadvantages: Risk of Common fibular nerve lesions Relaxation of the patellar tendon Relaxation of ELL (External lateral ligament) Fragility - support deferred Effect of exteriorization of the shaft (TKA complicated installation) Syndrome blood changing rooms, rare
4 61,5 mm Anatomical implants dedicated to genu varum pathology Size 1 24 mm 22,5 mm Solution for Closing High Tibial Osteotomy Shape - Stylish Curves protecting soft tissues - Small footprint under the skin - Mini-invasive (small skin cutting approach) - Head-buried - Mono-axial screw-locked system = monobloc system Material - Elasticity of alloy titanium to damp loads (Ta6V-Eli) - Flexibility and fatigue resistance (confirmed by our mechanical tests) - Distribution of axial load, by the plate-screw system and bone hinge Useful Pin locking screws Completely threaded locking screws -1 Size plate - Screwdriver 6-sided standard 3.5 mm - Locking mono-axial fixation - Screw-pin for guidance and fast synthesis/removal Screw orientation (transversal top cross section of tibia)
5 II-3 The range of implants Neosteo The advantages of our system Fully threaded screws: - Respect soft tissue cases double corticotomy (the tip of the screw is rounded) - Wide range of screw length (30-75 mm) Screw heads buried. Curves and rounded shapes, anatomical shape Three support points corresponding to a natural pose, without contouring preoperation. Monobloc system TA6V-Eli, compromise between stiffness and elasticity Remarkable orientation screws, no risk of tearing/pull-out 3 mm thick, compact under the skin Screw locked key: - Smooth part easy to guide into holes. - Double thread screwing fast, only in cortical bone. - Easy to remove Simple lock: - Double threaded nets powerful under the screw head. - Low friction, no cold welding. - Screwing / unscrewing to infinity and beyond! - Good resistance thread, with a maximum torque of 8 Nm
6 II-3 The range of implants Neosteo Common OTV tray (closing and opening osteotomy) Graduated drill bits Direct measurement of the hole depth, related to the length of Neosteo screws. Drill guide Ø4,5mm Short barrels, locking in the plate, light antiheating, chips evacuation. Depth gauge In addition to graduate drills, allows the measurement of the length of the screw implant.
7 II-3 The range of implants Neosteo Common OTV tray Hexagonal screwdriver 3.5mm - Silicone handle, grips firmly with anti-slip gloves. - Important locking torque - Standard for locking screws. HTO closing wedge cutting guide A cutting guide for the tibial and femoral closure. The oscillating saw passes through the angled grooves (blade thickness 1.3 mm max, length 100mm recommended) Ambidextrous instrument (works for left and right tibia) Connects to the Neosteo handle
8 Technique Opératoire Pre-operative In the frontal plane, the angular deformity of the knee is calculated on a single-leg stance radiograph. The surgeon measures the varus on the lower limb X-rays and decides of the angle correction (overall valgus:3 to 6 ) Approach Incision on the outside of the tibial metaphysis, the underside of the bracket and the tibia fibula to the cervix. The common fibular nerve is identified. Release of the patellar tendon on its side and rear. Compliance with meniscal ligaments and patellar fins. Cutting on wires plane Establishment of a pin obliquely upward The wire tip is 15 mm downwards from the joint, and 5mm from the medial cortex Control with an x-ray screening.
9 Technique Opératoire Cutting on wire(s) Choosing the correction angle Osteotomy closing Osteotomy saw guided on wire(s), saving an internal hinge. Put the guide in the first osteotomy cut. Choose the correction and cut with the oscillating saw through the grooves of the closing cutting guide. (Ep.1 blade, 3mm max) Remove the bone wedge without weakening the bone internal hinge, if necessary, with a bone chisel. Close osteotomy.
10 Technique Opératoire Extent and choice of screw length: Position the plate and drill the screw locations through the drilling guide. Measure the bi-cortical depth, select the length and type of the screw (threaded or pin). Lock the screws Apply locking torque using the screwdriver. Tighten strongly. Final X-ray control.
11 Anatomical implants dedicated to a pathology genu varum
12 Anatomical implants dedicated to a pathology genu varum 9 Guide de coupe OTV soustraction - HTO closing wedge cutting guide INS-009 1
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