Surgical technique guide
i. Implants i. Systems 1. Surgical material 2. Surgical approach 3. Application 4. Finishing
Intramedullary Fixation Stabilization of a closed fracture of the Femur with a intramedullary tension screw.
i. Implants Technology The MouseScrew system is an intramedullary lag screw made of medical grade stainless steel (316L). This model available in one standard size and designed to stabilize a closed midshaft fracture of the femur generated by drop weight technique as described by Einhorn et al.. The drive shaft for insertion of the MouseScrew is an integral component of the implant design and shears of when sufficient torque is achieved. A four flanche head remains on the MouseScrew for removal. For a guided application a 0.20 mm guide wire is available which can be inserted to the tip of the MouseScrew.
MouseScrew i. Systems The MouseScrew system can cover simple midshaft fractures.
MouseScrew applied to femur with midshaft fracture
MouseScrew 1. Surgical material Implants: - 1x MouseScrew with front hole RIS.221.100 MouseScrew, length 17.20 mm, with front hole
Implant specific instruments: - 1x 0.20 mm guide wire
RIS.521.100 Guide wire 0.20 mm
Instruments: - 4x hand drills - 1x Accu Pen 3V RIS.390.130 Hand drill RIS.390.200 AccuPen 3V
Consumables: - 1x 0.50 mm centering bit - 1x Vicryl suture 3-0 - Skin glue (Epiglue) / Vicryl suture 5-0 - 1x Ethibond Vicryl suture 6-0
RIS.590.205 centering bit 0.50 mm
MouseScrew 2. Surgical approach Positioning Mouse in dorsal position.
MouseScrew 2. Surgical approach Approach The knee is bent according to illustration.
MouseScrew 2. Surgical approach Approach Longitudinal incision along the medial side of the patella from the distal third of the thigh to the proximal third of the lower leg.
MouseScrew 2. Surgical approach Approach Longitudinal incision along the medial side of the patellar tendon.
MouseScrew 2. Surgical approach Approach Lateral dislocation of the patella to expose the knee joint.
MouseScrew 2. Surgical approach Approach Position of the intercondylary entry point of the femur.
MouseScrew 3. Application Opening of the epycondyle Use the 0.5 mm centring bit to drill a hole into the intercondylar notch. According the illustration start drilling with a 45 째 offset to the axis of the femur and continuously decrease the angle to 0째 offset (parallel with the bone axis). Make sure not to exceed 1.00 mm in depth for the drill hole ! Verify the orientation of the longitudinal axis and keep the centering bit right between the two condyles of the medullary cavity and parallel to the bone axis.
MouseScrew 3. Application Proximal opening of the femur Apply the 0.20 mm guide wire to the 27G needle (length > 19mm) and open the femur at its proximal end. Remove the 27G needle tip and make sure to keep the guide wire in Place. It will stay in the femur until the fracture is initiated ! Accomplishing the fracture Create a defined fracture by using the guillotine.
MouseScrew 3. Application Insertion Connect the MouseScrew to the 0.20 mm guide wire and insert it into the femur under continous pressure und clockwise rotation.
MouseScrew 4. Finishing Wound closure Use Ethibond vicryl suture 6-0 on the patellar tendon and the fascia lata.
MouseScrew 5. Finishing Wound closure Skin suture with Ethibond vicryl suture 6-0. To avoid wound biting it is also possible to use skin glue instead of a suture.
MouseScrew Hazards and legal restrictions Scientific editor: Illustrations: Design and layout: In collaboration with: Hazards
Moritz Klein, Germany; JĂśrg Holstein, Germany Sandra Wissing, Switzerland Romano Matthys, Switzerland University of Saarland, Germany Trauma, Hand and reconstructive Surgery Director: Tim Pohlemann
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Published on Nov 25, 2013