SURGICAL TECHNIQUE M.T.P. arthrodesis Hallu®-Fix system FOREFOOT SOLUTIONS™

HALLU®-FIX The first COMPREHENSIVE system for MTP arthrodesis providing: Hallu®-C plate MTP arthrodesis plate Hallu®-S plate Revision of MTP arthrodesis plate Hallu®-Ream Phalangeal reamers Hallu® Snap-off Snap-off screw Hallu®-Ream Metatarsal reamers Hallux rigidus Severe hallux valgus (Im angle>20° &HV angle> 40°) Deformity from rheumatoid arthritis Post traumatic arthritis Neuromuscular instability Hallu®-S plate (only) : revision of Keller procedure, failed arthroplasty, failed fusion. CONTRAINDICATIONS • Limited skin coverage • Severe osteoporosis • Infection

SURGICAL TECHNIQUE The foot is washed, prepped and draped in the normal sterile fashion. The surgery is done under tourniquet to avoid bleeding. I • INCISION A dorsal longitudinal incision is commonly used. This enables correct exposure of the metatarso-phalangeal joint. The incision is centered just medial to the extensor hallucis longus, and deepened to the joint capsule, through the subcutaneous tissues. The joint capsule is released and retractors are placed to expose the base of the proximal phalanx and metatarsal head. II • PREPARATION OF THE JOINT SURFACES WITH THE HALLU®-REAM SYSTEM The...

Using the Quick coupling device (ref: 129 710ND) the Hallu®-ream reamer is then engaged over the 1.6 mm K-wire, and the metatarsal head is reamed. The 2 in 1 metatarsal reamer is bell shaped to allow barrel reaming and articular preparation in one step. The metatarsal metaphysis is reduced to a cylinder of constant diameter, while the metatarsal head surface is reamed to a convex cup-shaped surface. The metatarsal reamer is removed. The K-wire can be held to elevate the metatarsal head to enable the removal of the bone on the plantar aspect. Excess bone is removed with an osteotome or a rongeur....

Care is taken not to penetrate the interphalangeal joint. Reaming must begin by using the smallest size of phalangeal reamer, size 14 mm; in order to avoid any excessive reaming. The metatarsal head should be protected when reaming. The reamer is placed on the 1.6 mm K-wire, and the surface of the phalanx is reamed, creating a concave cup-shaped surface. If necessary, due to the diameter of the articular surface of the phalanx, superior sizes of the phalangeal reamers can be used until the dimensions match the size used for the metatarsal reamer. When an additional bone graft is required, bone...

The Hallu®-Fix plates both have a 10° lateral angulation (10° valgus) as well as a 10° dorsal flexion. The Hallu®-C plate can be bent by using 2 benders (ref: 129 731ND & 129 732ND), right & left, to match the degree of dorsal flexion required by the case or by the activity of the patient WARNING : • Do not bend the Hallu®-S plate. • The plates should not be bent and rebent again. Once the correct size and type of plate has been chosen, and adequate alignment achieved, a 1 mm K-wire is inserted through the central hole of the plate in the metatarsal head for temporary stabilization. The K-wire...

The screw can be tightened down with the screwdriver from the Hallu®-Fix system. The oblong holes allow for angled and compressive screw fixation. The central K-wire can be removed when solid fixation of the plate is achieved. When all the screws have been inserted on the plate, they are tightened along the dorsal aspect of the plate. Note: a final additional screw can be directed across the plantar aspect of the joint. Closure is then performed in the normal and routine fashion. SURGICAL TECHNIQUE • HALLU®-FIX

Hallu®-S plate Hallu®-C plate Hallu® Snap-off Depth gauge Cannulated screwdriver Plate bender left Plate bender right Drill diam. 1.9 mm Quick coupling

NON-STERILE IMPLANTS FOR SURGERY • SINGLE USE In accordance with EEC directive 93/42 relative to medical devices, this product must be handled and/or implanted by WELL-TRAINED, QUALIFIED PERSONS, AWARE OF THESE DIRECTIONS FOR USE. 1 - Description of the medical devices: The implants - delivered non-sterile - are: - Osteosynthesis plates, existing in different models and sizes - They are made out of Titanium alloy within the frame of the standard ISO 5832-3 and ASTM F136 2 - Indications : Depending on the model, the osteosynthesis plates are indicated for use in fixation of: - Fractures, osteotomies...

HALLU®-SNAP-OFF NON-STERILE IMPLANTS • SINGLE USE In accordance with EEC directive 93/42 relative to medical devices, this product must be handled and/or implanted by WELL-TRAINED, QUALIFIED PERSONS, AWARE OF THESE DIRECTIONS FOR USE. 1 - Description of the medical devices: The implants - delivered non-sterile - are: - osteosynthesis screws, existing in different models, diameters and lengths. They are made out of titanium alloy within the frame of the standard ISO 5832-3 and ASTM F136. 2 - Indications: They are indicated for use in: fixation of arthrodesis, osteotomies or fractures in hand or...

SURGICAL INSTRUMENTS TO BE CONNECTED TO AN ACTIVE DEVICE In accordance with EEC directive 93/42 relative to medical devices, this product must be handled and/or implanted by WELLTRAINED, QUALIFIED PERSONS, AWARE OF THESE DIRECTIONS FOR USE. The following two methods have been validated by the manufacturer and can thus be used: Method: steam Cycle: wrapped gravity Temperature: 132°C Exposure time: 45 minutes Method: steam Cycle: wrapped gravity Temperature: 134°C Exposure time: 18 minutes These instruments are intended for use in surgery, and should be used only for the introduction of associated...

HALLU®-C PLATE • Size 1 • 4 holes • green Size 2 5 holes yellow • Size 3 • 6 holes • blue HALLU® SNAP-OFF Catalog Number Description • Size 1 • 4 holes • green 40 mm • Size 2 5 holes yellow 45 mm • • Size 3 • 6 holes • blue • 50 mm • Left Left Left HALLU®-S PLATE Description Right Right Right Snap-off screw • length 12 mm Snap-off screw • length 14 mm Snap-off screw length 16 mm Snap-off screw • length 18 mm Snap-off screw length 20 mm Snap-off screw length 24 mm Snap-off screw « length 28 mm Snap-off screw • length 12 mm Snap-off screw • length 14 mm Snap-off screw length 16 mm Snap-off...