Calcaneus StepPlate. Surgical Technique. Calcaneus StepPlate
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1 Calcaneus StepPlate Surgical Technique Calcaneus StepPlate
2 Medializing Calcaneal Osteotomy (MCO) with Calcaneus StepPlate 1 2 Perform an incision on the lateral side of the calcaneus. An L -shaped incision is recommended to avoid overlapping of the plate and to ensure optimal scar tissue healing. Dissect soft tissue and expose the calcaneus. 3 4 Use the sawing jig to indicate size and contour of the plate. The handle should point to the heel tip in order to perform an appropriate cut (35-45 ). Fix the sawing jig by securing the pins with a mallet. Remove the mating part of the template when desired position is met.
3 5 6 Use a saw blade (min. length 50 mm) and saw along the template through the calcaneus. Hohmann Retractors help to protect blood vessels or nerves on the medial side. Use a chisel to brake the medial cortex completely. Remove the sawing jig. The holes of the pins should be maintained as they indicate the best position for the plate. Insert K-Wires into these holes and place the plate with preassembled drill guides over the K-Wires on the calcaneus. 7 8 Remove one K-Wire and drill the hole for the first locking screw using the 2.5 mm drill bit, noting the depth from the laser marking. Remove the drill guide and insert a 3.5 mm locking screw. Remove the second K-Wire, drill and measure the length for the next locking screw. Remove the second drill guide and insert a 3.5 mm locking screw.
4 Surgical Technique 9 10 Thread the drill guides into the remaining locking holes and use them to medialize the calcaneus. The S-shaped retractor can be used to facilitate further displacement. While maintaining the displacement, place the compression screw drill guide in a flat angle into the compression hole and drill using the 2.5 mm drill bit Measure the compression screw length using the depth gauge and insert the screw. While tightening down the screw, interfragmentary compression is achieved between the two fragments by a circular shift of the posterior calcaneus fragment. Respect the subtalar joint: It is important that the compression screw does not penetrate the subtalar joint.
5 Surgical Technique Drill the holes for the locking screws through the drill guide. Measure the screw length and insert the screws. Final plate placement. Lateralizing Calcaneal Osteotomy (LCO) with Calcaneus StepPlate With the Calcaneus StepPlate you can also perform a lateral sliding osteotomy. The surgical technique for this procedure is basically the same, only the sawing jig and the plate have to be rotated for 180. After the osteotomy cut has been performed, fix the plate with two locking screws on the anterior part of the calcaneus. Pull the loose part of the calcaneus towards the plate. While maintaining the displacement drill with the 2.5mm drill through the compression drill guide. Place the compression screw in order to achieve interfragmentary compression. Drill the holes for the locking screws through the drill guide, measure the screw length and insert screws. The osteotomy is fixed.
6 Ordering Information Plates and Screws Calcaneus Step Plate, 5 mm step AR Calcaneus Step Plate, 7.5 mm step AR Calcaneus Step Plate, 10 mm step AR Locking Screw, Titanium, 3.5 x 24 mm to 38 mm AR-8935L-24 to 38 Compression Screw, Titanium, 4 x 28 mm to 44 mm AR to 44 Instruments Saw Template AR-8949ST Handle for Triangular Augmentation Cage AR-14520H Hohmann Retractor AR Drill/Depth Guide Recessed AR-8950GL Drill Guide for compression hole AR-8949DG Retractor for Calcaneus Step Plate, L-Shaped AR-8949RL Retractor for Calcaneus Step Plate, S-Shaped AR-8949RS 2.5 mm Drill Bit AR K-Wire 2.4 mm, 200 mm Length AR-8967K Depth Measuring Device AR-4166 Driver Handle, AO cannulated AR-13221AOC Hexalobe Driver AR-8941DH This description of technique is provided as an educational tool and clinical aid to assist properly licensed medical professionals in the usage of specific Arthrex products. As part of this professional usage, the medical professional must use their professional judgment in making any final determinations in product usage and technique. In doing so, the medical professional should rely on their own training and experience and should conduct a thorough review of pertinent medical literature and the product s Directions For Use. 2013, Arthrex Medizinische Instrumente GmbH. All rights reserved. LT EN_B
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