Description MetaCun TM II and Duo MetaCun TM II are osteosynthesis locking plates for dorsal fixation of mid and hindfoot arthrodesis. Merete® ’s updated system utilizes a novel long-hole compression slot mechanism that compresses the fusion site through the displacement of bone fragments underneath the plate. A DIA 3.0 mm compression screw that glides along a ramp in the distal long-hole slot during insertion causes the fusion site to compress. K-wire hole Compression hole Indications: Painful arthrodesis in mid and hindfoot, post-traumatic deformaties. Intended use: Fusion of mid- and hindfoot...

Surgical Technique Surgical Technique ► Incision Surgeon makes a dorsal 1nc1s1on to gain access to the midfoot after verification, under flouroscope / x-ray of the desired joint(s) for fusion. The surgeon should take care to protect any overlying neurovascular structures. Skin and fatty tissue preparation is performed through a longitudinal (4 cm) incision between the TMT2 Note: The joint surfaces may be located and marked with cannula needles placed under x-ray control. Dorsal incision Joint exposure ► Joint exposture Apply retractors to spread the wound (approx. 5 cm) transversely. Displace...

Surgical Technique ► Osteotomy Perform a sagittal osteotomy and remove arthritic cartilage to release osseous joints. Remove the dissected portion as well as osteophytes or periarticular bone with a rongeur. Position the fragments manually and validate their arrangement. ► Plate selection Surgeon may select MetaCun II plates from 4 different lengths (2-hole) and DuoMetaCun II (Table l) plates from 4 different sizes (4-holes) depending on the midfoot joints to be fused. When selecting the appropriate size, ensure sufficient locking screw hole clearance from the osteotomy to secure the screws in...

Surgical Technique ► Plate placement Place the selected plate across the joint fusion site(s) and fixate the position with K-wires. The surgeon should make both a visual decision of the plate placement and a flouroscopy / x-ray assessment to ensure that the plate placement and size sufficiently bridge the fusion site(s) and prevent the screw fixation to be in or too close to the joints. Temporary fixation with a proximal K-wire (Table 2) is executed first. Position the distal K-wire at the start position of the long-hole slot (most distal position). Olive K-wires may also be used to fixate the...

Surgical Technique Insertion of the proximal locking screw Start by threading the drill guide for a DIA 2.9 mm drill (Ref. FH 10046) in the proximal thread of the plate. Prepare the bone with a DIA.2.9 mm drill (Ref. FH 10009) bicortically. Perforate the plantar cortex. Remove the drill guide. Determine the screw length with the sliding depth gauge (AI00301). Pass the measuring rod through the bone and secure the tip to the plantar cortex before reading the scale on the housing of the depths gauge. For screw length measurements indicated with odd numbers, round to the nearest even number to ensure...

Surgical Technique ► Fusion site compression T he osteotomy surfaces are compressed by displacing the metatarsal bone underneath the plate. Displacement is achieved through the insertion of a headed Merete CS screw into the distal long-hole slot. Position the self-tapping DIA 3.0 mm screw at the distal most position of the compression-hole slot (Position 1 ). The screw glides through the plate in proximal direction while the metatarsal bone is compressed against the fusion site. Insert the screw until the fusion site is compressed sufficiently (Position 2). Inserting the compression screw

Surgical Technique Insertion of t he dist al locking screw Place the drill guide for a DIA.2.9 mm drill (Ref. FHl 0046) in the distal locking hole of the plate. Prepare the bone with a DIA.2.9 mm drill (Ref. FH10009) bicortically. Remove the drill guide. Determine the screw length with the sliding depth gauge (AI003 01) by securing the tip to the plantar surface of the bone while reading the scale. For screw length measurements indicated with odd numbers, round to the nearest even number to ensure bicortical placement of the locking screw. Insert the distal locking screw with the hexalobe (Tl...

Ordering Information Ordering Information ► Implants MetaCun ™ II 29

Ordering Information

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Ordering Information

Distributed by: Merete Technologies Inc. (MTI) One Lincoln Centre l 8Wl 40 Butterfield Road Oakbrook Terrace, IL 6018 l Phone: 630-869-1091 Fax: 630-445-1752 E-Mail: [email protected] www.mereteUSA.com Manufactured by: Merete GmbH