2.4mm中空螺钉

2.4mmand3.0mmHeadlessCompressionScrews.Forfixationofsmallbonesandsmallbonefragments.TechniqueGuideIntroductionSurgicalTechniqueProductInformationTableofContents2.4mmand3.0mmHeadlessCompressionScrew2TechniqueOverview4AOPrinciples5Indications6ScaphoidFixation7FirstMetatarsalOsteotomy14ScrewRemoval20Implants21Instruments25SetLists28ImageintensifiercontrolSynthes2Synthes2.4mmand3.0mmHeadlessCompressionScrewsTechniqueGuideThe2.4mmSelf-drilling,Self-tapping,CannulatedHeadlessCompressionScrewT8StarDriverecess3.1mmcorticalthread(doublethread*)2.0mmshaft2.4mmcancellousthread(singlethread*)Implantquality316LstainlesssteelTitaniumalloyTi-6Al-7NbShortthread1.1mmguidewireSelf-drillingandself-tappingflutesSelf-drillingandself-tappingflutesLongthread*Threadsareofequallead(i.e.theyadvancethesamedistanceforeachrevolution)Synthes3The3.0mmSelf-drilling,Self-tapping,CannulatedHeadlessCompressionScrewT8StarDriverecess*Threadsareofequallead(i.e.theyadvancethesamedistanceforeachrevolution)3.5mmcorticalthread(doublethread*)2.0mmshaft3.0mmcancellousthread(singlethread*)Implantquality316LstainlesssteelTitaniumalloyTi-6Al-7NbShortthread1.1mmguidewireSelf-drillingandself-tappingflutesSelf-drillingandself-tappingflutesLongthread4Synthes2.4mmand3.0mmHeadlessCompressionScrewsTechniqueGuideTechniqueOverview1InsertscrewThreadtheheadoftheheadlesscompressionscrewintothetipofthecompressionsleeve.Insertthescrewintotheboneusingthecompressionsleeveconstruct.2CompressThetipofthecompressionsleeveactsasaconventionallagscrewhead.Whenthetipofthecompressionsleevecontactsthebone,thefracturegapisclosedandcompressedaswithalagscrew.3CountersinkFollowingcompressionofthefracture,holdthecompressionsleevestationaryandusethescrewdrivertoadvancethescrewheadintothebone.Synthes5In1958,theAOformulatedfourbasicprinciples,whichhavebecometheguidelinesforinternalfixation.1Thoseprinciplesasappliedtothe2.4mmand3.0mmHeadlessCompressionScrewsare:AnatomicreductionAguidewiremarkstheprescribedpathforthecannulatedheadlesscompressionscrewandsecuresthealignmentofthefragmentswhilethescrewisbeinginserted.Thecannulatedheadlesscompressionscrewisinsertedoverthewireandtightenedtofurthercompressthefragmentsandholdthereduction.StablefixationRegardlessofthesizeofthefracturegap,cannulatedheadlesscompressionscrewsprovideinterfragmentarycompressionandabsolutestability.Furthermore,theinstrumentationallowsthesurgeontodirectlycontroltheamountofcompression.Thescrewsareavailableindifferentthreadlengths,allowingthesurgeontooptimizepurchaseinthefarfragmentformaximumcompressionandstability.PreservationofbloodsupplyTheuseofsmalldiameterguidewiresallowspreciseplacementofthecannulatedheadlesscompressionscrewsthroughsmallincisions.Thistechniqueminimizesdisruptionofsofttissueandpreservesvascularbloodflowforbonehealing.Early,activemobilizationCannulatedheadlesscompressionscrews,combinedwithAOtechnique,providestablefracturefixationwithminimaltraumatovascularsupply.Thishelpstocreateanimprovedenvironmentforbonehealing,acceleratingthepatient’sreturntopreviousmobilityandfunction.AOPrinciples1.M.E.Müller,M.Allgöwer,R.Schneider,andH.Willenegger.AOManualofInternalFixation,3rdEdition.Berlin:Springer-Verlag.1991.6Synthes2.4mmand3.0mmHeadlessCompressionScrewsTechniqueGuideSynthes2.4mmHeadlessCompressionScrewsareindicatedforfixationoffracturesandnonunionsofsmallbonesandsmallbonearthrodeses,includingscaphoidfractures;intra-articularfracturesofthetarsals,metatarsals,carpalsandmetacarpals;bunionectomiesandosteotomies;arthrodesesofsmalljoints(e.g.phalanges);fracturesofthepatella,ulnaandradialstyloid.Synthes3.0mmHeadlessCompressionScrewsareintendedforfixationofintra-articularandextra-articularfracturesandnonunionsofsmallbonesandsmallbonefragments;arthrodesesofsmalljoints;bunionectomiesandosteotomies,includingscaphoidandothercarpalbones,metacarpals,tarsals,metatarsals,patella,ulnarstyloid,capitellum,radialheadandradialstyloid.IndicationsScaphoidnonunionScaphoidfractureCarpalfusionDIPfusionCalcanealandtalarfracturesBunionectomyToefusionRadialstyloidfractureSynthes7Thissurgicaltechniquedescribesavolarapproachprocedure.Dependingonthetypeandlocationofthefracture,adorsalapproachtothescaphoidmaybepreferred.Thesamesurgicalstepsapply.1InsertguidewireInstruments292.622,1.1mmGuideWire(threadedornonthreaded)292.623312.1512.0mm/1.1mmDoubleDrillSleeveReducefragmentswitha1.1mmguidewireandthe2.0mm/1.1mmdoubledrillsleeveusingimageintensification.Insertthewirefromdistal-radialtoproximal-ulnaruntilthetipisanchoredintothefarcortex.Ensuretheguidewireliesalongthecentralaxisofthescaphoidinthefrontalandsagittalplanes.Note:Usingapen-styleratherthanapistol-gripdriveunitmayfacilitatetheinsertionofthe1.1mmguidewire.Inserttheguidewirein10mmto15mmincrementstominimizethepossibilityofbendingthewire.ScaphoidFixation8Synthes2.4mmand3.0mmHeadlessCompressionScrewsTechniqueGuideScaphoidFixationcontinued2Drilltrapezium(optional)Instruments03.226.0034.8mmCannulatedTrapeziumDrill03.226.0054.8mmTrapeziumDrillSleeve311.43Handle,withquickcouplingIfthefootprocess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