Surgical technique guide  i. Implants  i. Models 1. Surgical material 2. Surgical approach 3. Application 4. Osteotomy 5. Finishin

Internal fixaton System Stabilisation of osteotomies with a conventional bridging osteosynthesis or by inter fragmentary compression. Possible size of osteotomy 0.25 mm to 3.50 mm. Technology The MouseFix system is a locked internal fixator made of pure Titanium (TiCp). For this model a rigid and a flexible design are available. The rigid one is offered in two different sizes. A standard size for osteotomies of 0.25 - 1.75 mm and an extra large (XL) model for osteotomies of up to 3.50 mm. Similar MouseFix plates are available for the distal metaphysis of the femur. The MouseFix Screw is made...

MouseFix i. Systems The MouseFix system can cover single cut osteotomies up to large bone defects or flexible fixation technology. The plates available can be used within the diaphysis and the metaphysis of the femur. On the right all available MouseFix plates are shown applied to the femur of a mouse. RIS.401.110 MouseFix Plate 4 hole, rigide RIS.401.120 MouseFix Plate 4 hole, flexible RIS.401.130 MouseFix Plate 6 hole, XL RIS.401.111 MouseFix Plate 3 hole, metaphyseal rigide RIS.401.111 MouseFix Plate 3 hole, metaphyseal flexible

MouseFix 1. Surgical material Implants: - 1x 4 hole plate rigid - 4x MouseFix screws with a length of 2.0 mm RIS.401.110 MouseFix Plate 4 hole, rigide RIS.401.100 MouseFix Screw, length 2.00 mm Implant specific instruments: - 1x MouseFix Drill-& Saw guide RIS.301.100 MouseFix Drill-& Saw guide, rigid Instruments: - 4x hand drills - 1x Accu Pen 3V RIS.390.130 Hand drill RIS.390.200 AccuPen 3V Consumables: - 1x 0.30 mm Drill bit - 1x 0.22 mm Gigly wire saw, 0.50 m - 1x Square box wrench 0.50 mm - 1x Vicryl suture 3-0 - Skin glue (Epiglue) / Vicryl suture 5-0 - 1x Ethibond Vicryl suture 6-0

MouseFix 2. Surgical approach Positioning Mouse in prone position.

MouseFix 2. Surgical approach Approach Longitudinal incision along the femur from the hip joint to the knee.

MouseFix 2. Surgical approach Approach Longitudinal incision of the fascia lata.

MouseFix 2. Surgical approach Approach M. vastus lateralis and M. biceps femoris are split and M. tensor fasciae latae is lifted to expose the full length of the femur preserving the sciatic nerve.

MouseFix 2. Surgical approach Approach Circular preparation of the femur at the transition from the middle third to the distal third.

MouseFix 3. Application Application of the Gigly wire saw Put the wire saw closely around the bone in in medio-lateral orientation Preparation of the hardware Insert the screws into the holders of the hand drill no more than 1-2 mm deep. Make sure to knot the suture at one end.

Drill-& Saw guide with plate inserted. Fixation of the MouseFix Drill- & Saw guide Plate positioning in the MouseFixDrill- & Saw guide Position the plate upside down in the MouseFix Drill- & Saw guide with the concave bottom surface showing towards you. Attach the fixation suture to the Drill- and Saw guide securing the plate onto it. Put the device on the prepared femur in anterolateral direction by externally rotating the femur. Fix the tool by wrapping the suture around the bone and the device. Gauge the Drill- and Saw guide.

MouseFix 3. Application Preparation for drilling and screwing By applying the first screw the alignment of the plate is determined. Therefore it is important to position the plate parallel to the femur. Adjust the orientation of the longitudinal axis so that the plate is reclined anterolaterally and parallel to the bone. Retain rotation of the bone to ensure the stability of the plate.

MouseFix 4. Application Drilling and insertion of the screws Carefully use the forceps to connect the drilling and sawing guide to the femur. Drill the first hole (1) distally to the planned fracture gap and insert the screw. Shear off the drive shaft.

3. Application Sequence of screw placement Drill the hole for the second screw (2) proximally to the planned osteotomy and insert the screw. The third (3) and the last screw (4) should be placed in the order shown in the illustration. Make sure to insert the last screw without shearing off the pin to provide additional stability during sawing.

MouseFix 4. Osteotomy Accomplishing the osteotomy Remove the suture lying around the femur. Create a defined fracture gap by using the Gigly saw (sufficient irrigation !). To avoid damage of the soft tissue cut the saw wire close to the bone on one side after completing the osteotomy.

MouseFix 5. Finishing Wound closure Lift the M. quadriceps loosely over the plate. Close the fascia lata with Ethibond vicryl suture 6-0. Skin suture with Ethibond vicryl suture 6-0. To avoid wound biting it is also possible to use skin glue instead of a suture.

MouseFix Hazards and legal restrictions Scientific editor: Illustrations: Design and layout: In collaboration with: Hazards Tina Histing, Germany Sandra Wissing, Switzerland Romano Matthys, Switzerland University of Saarland, Germany Trauma, Hand and reconstructive Surgery Director: Tim Pohlemann Great care has been taken to maintain the accuracy of the information contained in this publication. However, the publisher, and/or the distributor, and/or the editors, and/or the authors cannot be held responsible for errors or any consequences arising from the use of the information contained in this...