AC Joint Separation Repair | Triple Endobutton Construct | NYC Orthopedic Surgeon Dr. Steven Struhl скачать в хорошем качестве

AC Joint Separation Repair | Triple Endobutton Construct | NYC Orthopedic Surgeon Dr. Steven Struhl

NYC Orthopedic Surgeon Dr. Steven Struhl explains the Triple Endobutton Construct which an advanced and effective surgical technique to repair an AC Joint Separation. A 2.4 mm drill hole is made in the midline of the clavicle directly in line with the base of the coracoid, approximately 35 mm from the end of the clavicle. It is important to make sure that the drill hole is aimed to the exact center of the coracoid under direct vision. Then is can be drilled through the coracoid. A second 2.4 mm drill hole is made approximately 15 mm lateral to the initial drill hole for placement of the axial fixation. This drill hole only goes through the clavicle. A 4.5 mm endobutton drill is then used to ream the initial drill hole all the way through the base of the coracoid. A wire loop is then passed through both drill holes and retrieved underneath the coracoid. A folded ultra tape is passed into the loop at the end and pulled out , creating a retrograde passing loop for the implant. The implant is now prepared on the back table. A suture is passed through the near holes of a free endobutton and then tied around the loop so that the loop goes around the button. An ultratape is then passed through the near holes of the endobutton. A rescue suture is then passed in the opposite direction of the far holes so that the button position can be controlled during the passage. All 6 strands of suture not including the rescue stitch are then placed into the passing loop and pulled out of the top side of the clavicle. The 2 ultra tape limbs are then pulled out of the coracoclavicular space with a probe. By pulling on all 6 limbs the endobutton is then passed retrograde through the coracoid and clavicle and then flipped onto the surface of the clavicle completing the fixation. Loop length can be adjusted for by placing a washer or two onto the surface of the clavicle before passage and flipping. The ultra tape limbs are then passed into the second drill hole and tied around the third endobutton. The AC joint internal splint is then completed by passing all 4 limbs of suture from the acromial Qfix anchors into a micro bio raptor and inserting and deploying the anchor. A third Qfix anchor is then drilled into the anterior superior edge of the clavicle just in front of the third endobutton. The CA ligament is then transferred over and the Qfix suture limbs are passed mattress style into the substance of the CA ligament completing the repair. The Triple endobutton construct is now complete. If you have suffered an AC Joint Separation and you are looking for one of the best orthopedic shoulder surgeons to handle your ac joint repair surgery, please call the offices of New York Orthopedic Surgeon, Dr. Steven Struhl at (212) 207-1990 today. AC Joint Separation 136 E 57th St, Suite 1501 New York, NY 10022 (212) 207-1990 311 North St White Plains, NY 10605 (914) 328-4111 https://www.acjointseparation.com