SURGI^i technique

TABLE OF CONTENTS TALUS OSTEOTOMY GUIDE OVERVIEW. . . . . . . . . . . . . . . 3 CT AND MRI PROTOCOLS . . . . . . . . . . . . . . . . . . . . . . . . . . 4 FINAL DESIGN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 TALUS OSTEOTOMY GUIDE SURGICAL PROCEDURE. . . . . . . . . . . . . . . . . . . . . . . . . . . 6-9 For training and marketing purposes only. EPISURF MEDICAL | TALUS OSTEOTOMY GUIDE

EPISURF TALUS OSTEOTOMY GUIDE OVERVIEW Episurf’s Talus Osteotomy Guide (TOG) is uniquely designed to perfectly fit the patient's distal tibia. This unique placement facilitates the osteotomy of the medial malleolus in preparation of the implantation of the Episealer Talus, or any other surgery where access to the talus bone is required. The guide has two features: • Saw guide facilitates the detachment of the medial malleolus. • Drill hol es give a perfect placement of the fixation holes to re-fixate the medial malleolus to the tibia. Each TOG is designed to fit the patient’s distal tibial anatomy...

CT AND MRI PROTOCOLS The Talus Osteotomy Guide (TOG) is designed based on MRI or CT data. Episurf has developed specific protocols, which need to be installed on a scanner in your radiology department. These protocols are available from your local Episurf representative who will partner with your radiology team to get your scanner validated for the correct sequences. To run the Episurf MRI or CT protocols, no special equipment is needed. For MRI, the scanner must have a magnetic field strength of at least 1.5 T. The individualised TOG is designed using the As an alternative to MRI, a CT scan...

FINAL DESIGN FINAL DESIGN The patient’s CT and/or MR images are used to create a detailed virtual model of the talus and the distal tibia. The 3D visualisation is included in a report together with a suggestion of the design and the position of the TOG. This can be fine-tuned by working with Episurf if adjustment of the design or position is desired. If a TOG is ordered, a Final Design document with be provided togehter with the TOG. The Final Design document is used at the surgery to shows appropriate position of the TOG. The sawing leaves 2 mm of material at the thinnest part, but up to 6,5...

TALUS OSTEOTOMY GUIDE - SURGICAL PROCEDURE CHECKING THE SAWBLADE LENGTH Connect the sawblade to the power tool. Insert the sawblade into the Osteotomy Depth Meter (ODM) until the power tool stops against the ODM. Verify that the tip of the sawblade is visible within the MIN/MAX markings. WARNING! Only use the Talus Osteotomy Guide (TOG) with the specified sawblade dimensions. If another sawblade is used, the TOG must not be used. If the sawblade is too short or too long, the TOG must not be used. PLACING THE TALUS OSTEOTOMY GUIDE (TOG) Make an incision long enough to fully expose the operative...

TALUS OSTEOTOMY GUIDE - SURGICAL PROCEDURE SECURING THE TOG Attach and secure the TOG to the bone by inserting two 2 mm surgical pins in the pin holes on the proximal side of the TOG. Make sure the TOG does not move during fixation. WARNING! Make sure the TOG is securely fastened to the bone. CREATING THE FIXATION HOLES Make sure to use the same drill diameter as specified on the TOG. Attach the designated drill to the power tool. Use the distal guiding holes on the TOG to drill the fixation holes for refixation of the bone fragment after the procedure. PRECAUTION Make sure to use the same drill...

TALUS OSTEOTOMY GUIDE - SURGICAL PROCEDURE SAWING Attach the sawblade to the power tool. Insert the sawblade into the TOG and start sawing. Make sure to keep surrounding tendons away from the sawing field. The TOG will guide the sawing and controls the depth of the cut. Continue sawing until the saw bottoms on the top of the TOG. WARNING! Make sure to use the same sawblade as specified when placing the order. REMOVING THE TOG Remove the surgical pins and the TOG from the surgical field. For training and marketing purposes only. EPISURF MEDICAL | TALUS OSTEOTOMY GUIDE

TALUS OSTEOTOMY GUIDE - SURGICAL PROCEDURE BREAKING OFF THE BONE FRAGMENT Perform the final break-off using an osteotome. FINAL RESULT After the desired procedure has been performed, the fixation holes shall be used for re-fixation of the medial malleolus to tibia. For training and marketing purposes only. EPISURF MEDICAL | TALUS OSTEOTOMY GUIDE

For training and marketing purposes only. EPISURF MEDICAL | TALUS OSTEOTOMY GUIDE

For training and marketing purposes only. EPISURF MEDICAL | TALUS OSTEOTOMY GUIDE

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