CMC Suspension Using MicroLink™ and CMC Drill Guide - CONMED Animation скачать в хорошем качестве

CMC Suspension Using MicroLink™ and CMC Drill Guide - CONMED Animation

To begin the CMC Suspension procedure, first make a volar incision centered over the Carpometacarpal Joint located along the glabrous skin edge. A second incision is made at the base of the second metacarpal and dissection is made deep to the thenar muscles. The Trapezium Pin, offered in the MicroLink system, is used to assist with trapeziectomy. Use a pin driver to drill the trapezium pin into the center of the trapezium up to the laser line indication of 10-15mm. Next, use the McGlamry Elevator, also offered in the MicroLink system, to scrape soft tissue from the trapezium. Then, use the Trapezium Pin as a joystick to manipulate and remove the trapezium. The extensor tendons should be reflected ulnarly. Next, the MicroLink CMC Drill Guide is used to assist in precise tunnel drilling. The drill guide with paddle can be placed volar to the base of the thumb, with the distal tip of the guide positioned at the metacarpal flare, distal to the middle and index finger articulation. Fluoroscopy can be used to determine correct positioning of the guide. Next, use a Wire Driver to insert the sharp end of the drill into the CMC Drill Guide and drill through all four cortices of the thumb and index finger. Then, pass 2cm of the #2 Hi-Fi suture tail found on the MicroLink All-Suture Button through the nitinol loop found on the end of the Suture Passing Drill. Manually pass the Suture Passing Drill through the second metacarpal tunnel until the drill bit is completely removed and the suture tail has been passed through both the thumb and index metacarpal on the dorsum of the hand. Next, cut the proximal end of the splice found on the suture tail protruding from the ulnar aspect of the index metacarpal. To place the Backstop, pass at least 3cm of each #2 Hi-Fi suture tail through the nitinol loops found on the Backstop Loader. Gently slide the Backstop off the Loader and onto the suture limbs. Slide the Backstop down the suture tails to the skin edge of the index metacarpal. The radiopaque MicroLink All-Suture Button allows for visualization of repair under fluoroscopy. A half-throw can be used to advance the backstop down to the index metacarpal. A minimum of five knots is required to ensure fixation. Suture tails are the cut and the repair is complete.