Mitek肘关节产品及手术应用PPT课件

1、谁在做肘关节手术谁在做肘关节手术? 手外科医生 上肢外科医生 关节镜外科医生 普通骨科医生第1页/共28页肘关节外科手术肘关节外科手术 远端二头肌腱撕裂 肱骨外上髁炎（网球肘） 内外侧副韧带撕裂第2页/共28页远端二头肌腱撕脱远端二头肌腱撕脱 第3页/共28页Biceps Tendon Attachment SiteDistal Biceps Attachment第4页/共28页Biceps Tendon AttachmentDistal Biceps TendonBiceps第5页/共28页Distal Biceps Tendon Rupture肱骨内侧髁尺骨茎突撕裂的二头肌腱常见于中年男性

2、的dominant手第6页/共28页Biceps Tendon Reattachment2 Incision Technique Drill Holes第7页/共28页Biceps Tendon ReattachmentSingle Incision Suture Anchors第8页/共28页Suture Anchor Technique 1 incisionLess risk of infection & less scarring No risk of bone tunnel breakage Easier to perform, saves OR time. 第9页/共28页JHS-

3、May 2003第10页/共28页肱骨外上髁炎肱骨外上髁炎网球肘第11页/共28页外上髁炎外上髁炎损伤损伤 & 治疗治疗 ECRB桡侧腕短伸肌的小损伤, 非感染性 手术治疗不常用 (报道4-8% 的病例用手术治疗) 外科手术 开放或镜下松解(shaver or RF) 松解，重连接第12页/共28页Lateral Elbow桡骨肱骨外上髁尺骨第13页/共28页Location of ECRBECRL桡侧腕长伸肌ECRB 桡侧腕短伸肌ECU Extensor Carpi Ulnaris尺侧腕伸肌第14页/共28页ECRB Location Continued第15页/共28页Mitek Tech

4、nique Brochure (Dr. Lorenzo Walker Cat # 900091)l找到ECRBl松解ECRBlResect Lateral Epicondyle & expose raw cancellous surfacelMobilize Extensor Originl用2个Mitek 锚钉 (GII, Fastin)重新连接到外上髁第16页/共28页内侧副韧带修复内侧副韧带修复Tommy John Surgery (Medial UCL)第17页/共28页侧副韧带修复侧副韧带修复Medial UCL Complex斜束前束后束第18页/共28页Medial UCL: A

5、nterior BandA Pitchers Injury“Tommy John Surgery”lNamed after the first patient of ulnar collateral replacement surgery.lDoctors name: Frank JobelFirst surgery done in 1974第19页/共28页When the Rupture Occurs第20页/共28页尺侧副韧带撕裂相关问题尺侧副韧带撕裂相关问题l过头投掷运动时缺乏稳定性l在做过头投掷运动时手臂不能用力l过头投掷运动时不能控制第21页/共28页传统传统UCL的修复的修复 “

6、金标准” 骨隧道技术 前臂掌长肌腱或跟腱做韧带移植 尺神经转置 移植物8字固定 韧带端用缝线缝合在一起第22页/共28页Repair of UCL 方法复杂，费时 可用带线锚钉固定 简化手术 &省时 减少骨隧道穿肌腱造成的创伤第23页/共28页Anchors for the Elbow第24页/共28页 Anchor Body:2.4 x 8.8mmArc Range:7.8mmDrill Hole Size:2.4 x 14.2mm Suture:#2 Ethibond & CP-2 Reverse Cut Needle#2 Panacryl & CP-2 Reverse Cut Needl

7、eAnchor Material:Titanium body with Nitinol ArcsPullout lbs.: 25 lbsIndications:Foot: Lateral & medial ankle instability, Mid-foot reconstruction, Hallux Valgus & Achillies tendon repairElbow: Tennis Elbow, Biceps TendonHand: Thumb UCL and ScapholunateGII Anchor第25页/共28页Anchor Body:4.1 x 6.0 mm Dril

8、l Hole Size:3.5 x 18 mm Suture:#2 Ethibond & CP-2 Reverse Cut Needle#2 Panacryl & CP-2 Reverse Cut NeedleAnchor Material:PLAPullout lbs.: 35 lbsIndications:Elbow: Biceps tendon reattachmentAnkle: Achilles tendon repair, Lateral stabilization, Medial stabilization at the medial talus sitePanalok Anchor第26页/共28页Anchor Body:3.0 x 8.4 mm4.0 x 9.7 mmSuture:#2 Ethibond (no needles)Drill bit:Self drillingAnchor Material:TitaniumPullout lbs.:33.5 lbs (for 3.0mm), 61 lbs (4.0mm)Indications:Foot: Midfoot reconstruction, Medial or lateral instability, Achilles tendon, Hallux valgus.Elbow: