Mitek肘关节产品及手术应用课件

1、肘关节产品 & 手术技巧Mitek肘关节产品及手术应用1肘关节产品 & 手术技巧Mitek肘关节产品及手术应用1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Mitek肘关节产品及手术应用2谁在做肘关节手术?手外科医生Mitek肘关节产品及手术应用2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Mitek肘关节产品及手术应用3肘关节外科手术远端二头肌腱撕裂Mitek肘关节产品及手术应用远端二头肌腱撕脱 Mitek肘关节产品及手术应用4远端二头肌腱撕脱 Mitek肘关节产品及Biceps Tendon Attachment SiteDistal Bic

2、eps AttachmentMitek肘关节产品及手术应用5Biceps Tendon Attachment SiteDBiceps Tendon AttachmentDistal Biceps TendonBicepsMitek肘关节产品及手术应用6Biceps Tendon AttachmentDistalDistal 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的dominant手Mitek肘关节产品及手术应用7Distal Biceps Tendon Rupture肱骨Biceps Tendon Reattachment2 Incision

3、Technique Drill HolesMitek肘关节产品及手术应用8Biceps Tendon Reattachment2 IBiceps Tendon ReattachmentSingle Incision Suture AnchorsMitek肘关节产品及手术应用9Biceps Tendon ReattachmentSinSuture Anchor Technique1 incisionLess risk of infection & less scarringNo risk of bone tunnel breakageEasier to perform, saves OR tim

4、e. Mitek肘关节产品及手术应用10Suture Anchor Technique1 incisJHS- May 2003Mitek肘关节产品及手术应用11JHS- May 2003Mitek肘关节产品及手术应用11肱骨外上髁炎网球肘Mitek肘关节产品及手术应用12肱骨外上髁炎网球肘Mitek肘关节产品及手术应用12外上髁炎损伤 & 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Mitek肘关节产品及手术应用13外上髁炎损伤 & 治疗ECRB桡侧腕短伸肌的小损伤, 非感Later

5、al Elbow桡骨肱骨外上髁尺骨Mitek肘关节产品及手术应用14Lateral Elbow桡骨肱骨外上髁尺骨Mitek肘关节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Mitek肘关节产品及手术应用15Location of ECRBECRLECRB ECRB Location ContinuedMitek肘关节产品及手术应用16ECRB Location ContinuedMitek肘关Mitek Technique Brochure (Dr. Lorenzo Walker Cat # 90009

6、1)找到ECRB松解ECRBResect Lateral Epicondyle & expose raw cancellous surfaceMobilize Extensor Origin用2个Mitek 锚钉 (GII, Fastin)重新连接到外上髁Mitek肘关节产品及手术应用17Mitek Technique Brochure (Dr.内侧副韧带修复Tommy John Surgery (Medial UCL)Mitek肘关节产品及手术应用18内侧副韧带修复Tommy John Surgery (Med侧副韧带修复Medial UCL Complex斜束前束后束Mitek肘关节产品及

7、手术应用19侧副韧带修复Medial UCL Complex斜束前束后束Medial UCL: Anterior BandA Pitchers Injury“Tommy John Surgery”Named after the first patient of ulnar collateral replacement surgery.Doctors name: Frank JobeFirst surgery done in 1974Mitek肘关节产品及手术应用20Medial UCL: Anterior BandA PiWhen the Rupture OccursLate-cockingA

8、ccelerationMitek肘关节产品及手术应用21When the Rupture OccursLate-co尺侧副韧带撕裂相关问题过头投掷运动时缺乏稳定性在做过头投掷运动时手臂不能用力过头投掷运动时不能控制Mitek肘关节产品及手术应用22尺侧副韧带撕裂相关问题过头投掷运动时缺乏稳定性Mitek肘关传统UCL的修复“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Mitek肘关节产品及手术应用23传统UCL的修复“金标准”Mitek肘关节产品及手术应用23Repair 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

9、造成的创伤Mitek肘关节产品及手术应用24Repair of UCL方法复杂，费时Mitek肘关节产品Anchors for the ElbowMitek肘关节产品及手术应用25Anchors for the ElbowMitek肘关节产 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 NeedleAnchor Material:Titanium body w

10、ith 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 AnchorMitek肘关节产品及手术应用26 Anchor Body:2.4 x 8.8mmGII Anchor Body:4.1 x 6.0 mm D

11、rill 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 AnchorMitek肘关节产品及手术应用27Anchor Body:4.1 x 6.0 mm PanAnchor 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 t