• T2 Supracondylar Nailing System Operative technique
  • 2 Supracondylar Nailing System

    Prof. Dr. med. Volker Bühren Chief of Surgical Services Medical Director of Murnau Trauma Center Murnau Germany Dean C. Maar, M.D. Methodist Hospital − Indianapolis Indianapolis Indiana USA James Maxey, M.D. Clinical Assistant Professor University of Illinois College of Medicine Peoria, IL USA This publication sets forth detailed recommend procedures for using Stryker Osteosynthesis devices and instruments. It offers steering that you should heed, but, as with any such technical guide, each surgeon must consider the finical needs of each patient and make appropriate adjustments when and a required. A workshop education is required prior to first surgery. All non-sterile devices must be cleaned and sterilized before use. Follow the instructions provided in our reprocessing scout ( L24002000 ). Multi-component instruments must be disassembled for cleanse. Please refer to the match assembly/ dismantling instructions. examine box cut-in ( L22000007 ) for a complete list of electric potential adverse effects, contraindications, warnings and precautions. The surgeon must discuss all relevant risks, including the finite life of the device, with the affected role, when necessary. warn : All bone screws referenced in this document here are not approved for screw attachment or fixation to the back tooth elements ( pedicles ) of the cervical, thoracic or lumbar spur. Contributing Surgeons

  • 3 Contents page 1. introduction 4 Implant Features 4 Technical Details 5 instrument Features 6 Target Device Features 6 2. Technical Details 8 Locking Options 8 3. Indications, Precautions & Contraindications 9 Indications 9 Precautions 9 relative Contraindications 9 4. Pre-operative Plannning 10 5. running technique 11 Patient Positioning 11 incision 11 entry point 12 Reamed Technique 14 Nail Selection 15 Nail Insertion 16 Guided Distal Locking Mode 17 Proximal Locking – amply Threaded Screw 17 Proximal Locking – Condyle Screw 20 Oblique Locking – fully Threaded Screw 22 Distal Locking – fully Threaded or Condyle Screw 24 Freehand Proximal Locking 25 Guided Proximal Locking T2 SCN Short adaptation 26 end Cap Insertion 27 Nail Removal 28 Ordering Information – Implants 29 Ordering Information – Instruments 31
  • 4 Over the past respective decades ante- degree femoral nail has become the treatment of option for most femoral shaft fractures. recently, retrograde femoral complete has increased in popularity, expanding the use of intramedullary nails. Complicated multiple injury injuries, ipsilateral femoral neck and quill fractures, associated pelvic and acetabular fractures, ipsilateral femoral and tibial shot fractures, supracondylar and intercondylar fractures, may be better managed by utilizing retrograde femoral nailing techniques. In addition to the T2 Femoral Nailing System, Stryker developed the T2 Supracondylar Nail ( SCN ) for the discussion of complex distal femoral fractures. The T2 Supracondylar Nailing System offers the advantages of a singular lock shape and targeting concept, allowing superior fixation in the distal femur, using the already established T2 instrumental role platform and locking screws. plant Features The T2 SCN System is the realization of superior biomechanical intramedullary stabilization using humble quality, strong and cannulate implants for home arrested development of the femur. According to the fracture type, the system offers the option of a static lock mode with 3 plane fixation. The design of the T2 SCN System is universal for left and right indications. Two implant versions are available : short version : • Proximal Targeting via Target Device long version : • Proximal Locking via Freehand Locking Nails : T2 SCN Short version Length : 170 & 200mm T2 SCN Long version Length : 240−440mm in 20mm increments initiation SCN end cap : One end cap for all T2 SCN is available to lock the most distal Locking Screw in ordain to avoid lateral movement of the breeze through and to prevent bony ingrowth. This feature creates a situate angle between the nail and Locking Screw. common 5mm cortical screws simplify the surgical operation and promote a minimally invasive approach. fully Threaded Screws are available for standard lock procedures. particular Condyle Screws with adjustable screw heads for better burst are designed to fix fragments in the condyle sphere. They provide compres- israel of intracondylar fractures and increased stability in distal fracture fragment. All implants of the T2 SCN System are made of Type II anodized titanium admixture ( Ti6Al4V ) for enhanced biomechanical and biomedical performance .
  • 5 introduction Technical Details Nails Diameter 9−14mm Short Version 170 & 200mm long version 240−440mm end Caps M/L View A/P View M/L View A/P View 5.0mm in full Threaded Locking Screws L = 25−120mm 5.0mm Condyle Screws L = 40−120mm

    0mm 15mm 20mm 40mm 0mm 6mm 14mm 42mm Bend 4° 21mm 32mm note : Screw length is measured from top of pass to point. Condyle Nut

  • 6 The major advantage of the instrument system is a breakthrough in the consolidation of the instrumental role platform which can be used not only for the accomplished T2 Nailing System, including the T2 SCN System, but will be the platform for all future Stryker nailing systems, reducing complexity and inventory. The legal document platform features ergonomically styled targeting devices, and provides promote preciseness while maintaining relief of use. symbol coding on the instruments indicates the type of procedure and must not be blend. symbol = long instruments Drills Drills feature a tinge coded ring : 4.2mm = Green For Fully Threaded Screws 5.0mm 5.0mm = Black For Condyle Screws The Targeting Arm for the T2 SCN is designed with one locking hole for all locking screws to be placed in the distal femur ( Fig. 1 ). These are the locking holes in the distal femur : 1. proximal Transverse Distal Condylar Locking 2. Oblique Condylar Locking 3. Oblique Condylar Locking 4. distal Transverse Distal Condylar Locking The Targeting Arm can be rotated and axially moved along the Nail Adapter. The Locking Window, together with the match positions on the Targeting Arm indicates the appropriate lock status. After the ask lock position is reached, the Targeting Arm is locked by tightening the ovolo screw. eminence : To avoid mis-drilling the Targeting Arm can be locked in the consecrated situation only. An extra target Device for the T2 SCN Short interpretation is available for the proximal lock options : The identify of this Target Device is : Targeting Arm Proximal, SCN ( Fig. 2 ). After the compulsory lock placement is reached, the Targeting Arm is locked by tightening the finger fuck. The Targeting Arm Proximal, SCN, is designed to provide guided proximal locking for the T2 SCN Short version 170 & 200mm. introduction legal document Features Target Device Features ( Targeting Arm, SCN ) Target Device Features Target Device Features ( Targeting Arm Proximal, SCN )
  • 7 Nail Adapter, SCN ( 1806-3301 ) proximal Transverse Distal Condylar Locking Oblique Condylar Locking Oblique Condylar Locking distal Transverse Distal Condylar Locking Nail Holding Screw, SCN ( 1806-3307 ) Targeting Arm, SCN ( 1806-3302 ) target Hole Safety Clip Thumb Screw Locking Window 1 2 3 4 Targeting Arm Proximal, SCN ( 1806-3305 ) Fig. 1 Fig. 2 initiation
  • T2 SCN Short Nail 8 Fig. 5 Proximal Locking Options T2 SCN Long translation When treating distal fractures, two A/P screws should be used in static position when potential ( Fig. 3 ). proximal interlock may be done in either static or dynamic modality depend- ing on surgeon preference. These holes are targeted freehand. Proximal Locking Options T2 SCN Short version When treating distal fractures, two M/L locking screws should be used when potential ( Fig. 4 ). Both screws can be placed directly through the Targeting Arm Proximal, SCN. Distal Locking Options T2 SCN Short and Long adaptation The unlike distal screw positions for both T2 SCN versions are ( sequence of recommend interpolation, Fig. 5 ) : Technical Details Fig. 4 T2 SCN Long Nail Fig. 3 Locking Options cross Screw : condyle Screw or Fully Threaded Screw 4 Oblique Screw : in full Threaded Locking Screw 3 Oblique Screw : in full Threaded Locking Screw 2 cross Screw : condyle Screw or Fully Threaded Screw


  • 9 The T2 SCN System is indicated

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