Biomet Multi-Axial Correction (MAC) System Correction Atlas Demonstrated with the XS MAC on a Left Tibia (CORA Centric Approach)
Introduction... Page 1 Indications/ Contraindictions... Page 1 MAC Module Overview... Page 2 Correction Ratios... Page 2 Compression And Distraction Left Tibia... Page 3 Translation Left Tibia... Page 4 Angulation Left Tibia... Page 6 Rotation Left Tibia... Page 8
Introduction The MAC is an intuitive device and has the ability to angulate and translate in the coronal and sagittal planes simultaneously, while also being one of the simplest devices on the market for achieving gradual and/or acute rotation. This guide will pictorially demonstrate how the surgeon and patient can manipulate the MAC device to achieve a desired correction. Indications The Biomet Multi-Axial Correction (MAC) System is an external fixation device intended for use in children and adults in the treatment of bone conditions including leg lengthening, osteotomies, arthrodesis, fracture fixation, and other bone conditions amenable to treatment by use of the external fixation modality. Contraindications Patients with mental or neurologic conditions who are unwilling or incapable of following postoperative care instructions. 1
MAC Module Overview Locking Set Screw Definitively Secure a Dialed Correction Secondary Pivot Capable of 50 of Angulation Primary Pivot Capable of 80 of Angulation Translational Components Allows Translation in the Coronal and Sagittal Planes Simultaneously Correction Ratios: Primary Hinge, Secondary Hinge, and Rotation Rings (Correction involving degrees of correction) ¼ Turn = 1 of correction 1 full wrench revolution = 4 of correction, 1:4 Ratio Rotation Rings Can Achieve up to 150 of Correction Translation Gears and Compression/Distraction Mechanisms (Correction involving millimeters of correction) 1 full wrench revolution = 1.0mm of correction, 1:1 Ratio 2
Compression And Distraction Left Tibia Compression One full wrench revolution = 1.0mm of compression, 1:1 Ratio. Distraction One full wrench revolution = 1.0mm of distraction, 1:1 Ratio. Distraction Compression Distraction Compression 3
Translation - Left Tibia Medial To Lateral Translation One full wrench revolution = 1.0mm of translation, 1:1 Ratio. Lateral To Medial Translation One full wrench revolution = 1.0mm of translation, 1:1 Ratio. 4
Translation - Left Tibia (Continued) Anterior Posterior Translation One full wrench revolution = 1.0mm of translation, 1:1 Ratio. Posterior Anterior Translation One full wrench revolution = 1.0mm of translation, 1:1 Ratio. 5
Angulation Right Tibia Primary Hinge, Valgus Deformity Correction ¼ Turn = 1 of correction 1 full wrench revolution = 4 of correction, 1:4 Ratio. Primary Hinge, Varus Deformity Correction ¼ Turn = 1 of correction 1 full wrench revolution = 4 of correction, 1:4 Ratio. Right Leg Right Leg Lower bone segment moves medially to correct valgus. Lower bone segment moves laterally to correct varus. 6
Secondary Hinge, Correction of Recurvation ¼ Turn = 1 of correction 1 full wrench revolution = 4 of correction, 1:4 Ratio. Secondary Hinge, Correction Of Procurvation ¼ Turn = 1 of correction 1 full wrench revolution = 4 of correction, 1:4 Ratio. Distraction Compression Distraction Compression NOTE: When the fixator is applied to the concave side of the deformity, shortening will occur as a by product. Distraction must also take place to prevent impingement of the two bone segments (see red arrow). Be sure that you have a sufficient amount of travel in the compression/distraction clamp to allow for distraction. NOTE: When the fixator is applied to the convex side of the deformity, lengthening will occur as a by product (sometimes desired). To prevent over-stretching of the soft tissue and neurovascular structures, compression must also take place (see red arrow). Be sure that you have a sufficient amount of travel in the compression/distraction clamp to allow for compression. Utilize the Angulation Rate / Turn Guide for maintenance of 1.0mm / day of length. 7
Rotation Left Tibia External Rotation ¼ Turn = 1 of correction 1 full wrench revolution = 4 of correction, 1:4 Ratio. Internal Rotation ¼ Turn = 1 of correction 1 full wrench revolution = 4 of correction, 1:4 Ratio. 8
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