Group: B. Braun Melsungen
Catalog excerpts
Aesculap® Targon® FN Head Preserving Solution for Medial Femoral Neck Fractures Aesculap Orthopaedics
Open the catalog to page 1Martyn J. Parker, MD, FROS Department of Orthopaedics and Trauma, Peterborough, United Kingdom Hans-Werner Stedtfeld, MD University of Rostock, Germany A fracture of the hip is the most common reason for an elderly patient to be admitted to an acute orthopaedic ward. Half of these fractures are intracapsular. This particular fracture has been termed the “unsolved fracture”, because of this continuing controversy between preserving the femoral head using internal fixation or replacing the head with a prosthesis. Internal fixation is clearly indicated for all undisplaced fractures and for...
Open the catalog to page 2Dynamic with
Open the catalog to page 3z Minimally invasive surgery z Simple surgical technique z Rotationally stable proximal fixation z Solid distal fixation z Early mobilisation z Very promising first clinical results1,2 Implant material: Titanium alloy Ti6Al4V 6.5 mm cancellous screws Sliding capacity within the screw 10 mm minimum sliding capacity Extension to maximum 20 mm slide Femoral Neck Plate z z z z z Anatomically shaped Angled locking side plate Up to 4 proximal screw sites for TeleScrews 130 degree angle for TeleScrews Two distal screw sites Locking Screws z 4.5 mm bicortical screws z Self tapping z Angle-stable...
Open the catalog to page 4z No lateral backing out because of angle stable TeleScrew fixation to the plate. z Controlled TeleScrew sliding prevents cranial migration. z 10 mm standard slide preset. z Adjustable slide to maximum 20 mm. Parker M. Internal fixation for femoral neck fractures – a new dynamic platescrew system. Jatros Orthopädie. 2008; 2:46-8 (article in German). Parker MJ, Stedtfeld HW. Internal fixation of intracapsular hip fractures with a dynamic locking plate: initial experience and results for 83 patients treated with a new implant. Injury. 2010 Apr;41(4):348-51.
Open the catalog to page 5Comparison Targon® FN vs. SHS (Sliding Hip Screw) Measurement of stability of fracture fixation in a simulated lateral femoral neck fracture (osteotomy). Average of Total Movements 16 Results z Targon® FN showing superior rotational stability than SHS3 z Targon® FN with less tilting of the proximal head fragment under cyclic load than SHS 3 Lustenberger A, Bekic J, Ganz R. Rotational instability of trochanteric femoral fractures secured with the dynamic hip screw. A radiologic analysis. Unfallchirurg. 1995 Oct;95(10):514-7. Set-up for biomechanical Targon® FN lab tes
Open the catalog to page 6Finite element analysis of Targon® FN (prototype) in view of testing and improving implant stability stress peaks in plate and sleeves Fatigue strength of Targon® FN in dynamic biomechanical testing Dynamic fatique strength 60
Open the catalog to page 7Advantages of Targon® FN Fixation Rotational Stability The use of two, three or four proximal screws secured laterally to the plate provides a firm fixation on the femoral head with rotational stability. The screw tips can be inserted precisely within the femoral head to enhance hold onto the proximal side of the fracture. Minimally Invasive Operation The alignment jig with the Targon® FN enables fixation to be achieved with minimal exposure of the lateral femoral cortex just below the greater trochanter. The jig guides the drilling for both of the proximal TeleScrews and two distal screws....
Open the catalog to page 8Early Mobilisation After Surgery Because of the improved stability of the fixation most patients should be allowed to mobilise, as soon as able after surgery, with no restriction on hip movements or weight bearing. Routine removal of the implant is not necessary. MRI Compatible The implant is constructed from titanium alloy and should the later fracture healing complications of fracture nonunion or avascular necrosis be suspected, a MRI scan can be undertaken without removal of the implant. Reduced Radiation Exposure Once the alignment jig and plate are in the required position, the...
Open the catalog to page 9Targon® FN Operating Technique Indications for Targon® FN Undisplaced intracapsular fractures: z AO 31B1.1, 31B1.2 and 31B1.3 z Garden classification grades 1 and 2 Undisplaced Intracapsular Fractures All undisplaced (impacted) intracapsular fractures should be considered for internal fixation with the Targon® FN. Conservative treatment of these fractures carries a high risk of fracture displacement and is generally not recommended. Replacement arthroplasty is a more extensive procedure with a higher risk of complications than that of fixation and is therefore inappropriate for this fracture.
Open the catalog to page 10Displaced intracapsular fractures: z z z z AO 31B2.2, 31B2.3 AO 31B3.1, 31B3.2, 31B3.3 Garden classification grades 3 and 4 Pauwels classification type 1-3 Displaced Intracapsular Fractures Any displaced intracapsular fracture in which preservation of the femoral head is felt desirable should be considered for internal fixation with the Targon® FN. This includes younger patients in which preservation of the femoral head is advantageous and those patients in which the more extensive procedure of arthroplasty needs to be avoided. Individual surgeons may also prefer to use the Targon® FN for...
Open the catalog to page 11Targon® FN Operating Technique z Patient Positioning z Preoperative Planning Positioning Avoid sudden or excessive movements when positioning the patient because this might cause a disruption of the blood supply of the femoral head. Fig. 2: Radiograph AP view Fig. 3: Radiograph axial view
Open the catalog to page 12Fracture Reduction Undisplaced fractures and those fractures which are impacted on the AP radiograph and undisplaced on the lateral radiograph (Garden grade 1) require no reduction (Fig. 1). Displaced fractures (Fig. 2) are first reduced by applying gently longitudinally traction with the fracture table, whilst screening on the anterior-posterior (AP) radiograph to reduce the fracture. The aim should be to reduce the fracture to either an anatomical position or a slight valgus position as determined by the alignment of the trabeculae of the femoral head with the shaft of the femur. (Fig. 3...
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