Implants trauma Epiphysis Screw

1. Introduction P. 5 Preface P. 6 Properties P. 7 Indications & Contraindications P. 8 Slipped Capital Femoral Epiphysis (SCFE) 2. Surgical Technique P. 8 Preparation of operation P. 9 Preparation P. 9 Surgical Technique P. 13 Attaching the screw on the other side P. 13 Explantation 3. Information P. 15 Dotize® P. 16 Order list P. 18 Reconditioning Manual

Preface The Epiphysis Screw of ITS. was especially developed for the Slipped Capital Femoral Epiphysis (SCFE) disease. Stabilization using screws is minimally invasive according to today‘s standard. With respect to the blood circulation of the neck of the femur, it is advantageous to use a single central screw, and this reduces the risk of a perforated joint. Such a screw must fulfill two conditions. On the one hand, it has to sufficiently stabilise the epiphysis of the head of the femur to enable at least partial stress. On the other hand, it should hold the epiphysis by means of a short thread...

Properties Properties of the material: • Screw material: TiAl6V4 ELI • Easy removal of the implant after fracture healing • Increased fatigue strength of the implants • Decreased risk of inflammation and allergy • Cannulated Cancellous Tension Screw with constant 10mm thread • Core diameter 5mm • Outer diameter 6.5mm • Lengths: 50 - 120mm in 5mm steps • Cannulation: 3.5mm for D=3.2mm Guide Wire • Selfdrilling & selftapping • Back-tapping flank • Large screw head: WS 10mm, 10mm height • Large countersink head for easy removableness (funnel: D=7.5mm / 30°)

Indications & Contraindications Indications: • The indication for the use of a transcutaneous screw holds for all acute, acute to chronic and chronic loosening of the epiphysis. • Another area of application is the transcutaneous or open screwing of fractures of the femoral head in childhood and other transcutaneous stabilisations by means of screws, where the screws have to be prevented from setting into the bony tissue but percutaneous removal is allowed. Contraindications: • The screw connection of an epiphysiolysis (attachment of a foreign body) in the context of a septic joint inflammation...

Slipped Capital Femoral Epiphysis (SCFE) ECF is a disease of young people and occurs round about sexual maturity. Slippage of the head of the femur occurs on the growth groove. This is really misnamed since it is not the femoral head that moves but rather the metaphysis of the neck of the femur that slips forwards and upwards while the head of the femur is held in the acetabulum by the ligamentum capitis femoris (Fig.1). The problem of this disease is the occurrence of complications such as avascular necrosis or chondrolysis of the head of the femur. Each of these complications can lead to premature...

Preparation • The patient is placed on the extension table and two image intensifiers are arranged in such a way that the proximal end of the femur can be represented in two planes. • The image intensifiers have to be placed in such a way that the X-ray tubes can be positioned respectively above (A-P level) and between the legs (sagittal level) in order to protect the operating team from X-rays as best as possible. • The patient is placed on the extension table with carefully internally rotated leg (neutralising the femoral torsion). • Care must be taken not to force the internal rotation of...

Surgical Technique - Second Step • Under observation from the image intensifiers in the lateral plane, the point at the centre of the neck of the femur in the A-P plane (where the Kirschner’s wire was attached earlier) is determined to allow an additional central attachment to the epiphysis of the head of the femur in the sagittal plane. • The greater the slippage of the head of the femur, the further ventral is the point of entry, and thus the steeper the Kirschner’s wire must be in the lateral plane. • Insertion of the Kirschner’s wire under observation from the image intensifiers (both planes)...

Surgical Technique - Fourth Step • Using the measuring device, the length of the appropriate hollow screw is determined. • It is necessary, however, to take the distance from the joint into account and therefore to choose a screw some 0.5cm longer since the Kirschner Wire stops about 1cm in front of the joint cavity. Surgical Technique - Fifth Step • Screw in the hollow screw above the guide wire under observation from the image intensifiers in both planes. • Care must be taken not to perforate the joint.

Surgical Technique - Sixth Step • Screw out the guide wire • Release the leg • Check mobility using the image intensifiers. • Care must be taken not to perforate the joint! • It is important not to countersink the bolt head into the bone, otherwise the easy percutaneous removeableness will not be able. • Because of the short screw thread you can use the screw as a „dynamic“ one. • This means that you should retighten the screw due to the growth. • For that the head of the screw must stick out from the bone 0.5 - 1cm.

Attaching the screw on the other side • The same procedure as in the steps of the operation, except that the guide wire is inserted parallel to the Kirschner Wire fastened to the skin distal to the Tuberculum inominatum. Explantation • Removal of the epiphysis screw is carried out after closure of the grwoth groove and checked using the image intensifiers and is carried out percutaneously. • A guide wire starting from the scar of the screw attachment is introduced into the funnel shaped screw head of the epiphysis screw and the latter removed by means of the socket wrench, WS 10, L=250mm (561002-250)...

Dotize® Chemical process - anodization in a strong alkaline solution* Dotize Type II anodization • Layer thickness 2000-10 000nm + Film becomes an interstitial part of the titanium + Different colors - Implant surface remains sensitive to: Chipping Peeling Discoloration - No visible cosmetic effect Anodization Type II leads to following benefits* • • • • • • • • Oxygen and silicon absorbing conversion layer Decrease in protein adsorption Closing of micro pores and micro cracks Reduced risk of inflammation and allergy Hardened titanium surface Reduced tendency of cold welding of titanium implants...