Surgical technique guide  i. Implants  i. Systems 1. Surgical material 2. Surgical approach 3. Application 4. Finishin

Intramedullary Fixation Stabilization of a closed fracture of the Femur with a intramedullary tension screw. i. Implants Technology The MouseScrew system is an intramedullary lag screw made of medical grade stainless steel (316L). This model available in one standard size and designed to stabilize a closed midshaft fracture of the femur generated by drop weight technique as described by Einhorn et al.. The drive shaft for insertion of the MouseScrew is an integral component of the implant design and shears of when sufficient torque is achieved. A four flanche head remains on the MouseScrew for...

MouseScrew i. Systems The MouseScrew system can cover simple midshaft fractures. MouseScrew applied to femur with midshaft fracture

MouseScrew 1. Surgical material Implants: - 1x MouseScrew RIS.221.103 MouseScrew, length 17.20 mm Implant specific instruments: - 1x 0.20/0.35 mm guide tube Instruments: - 2x hand drills - 1x Accu Pen 3V RIS.390.130 Hand drill RIS.390.200 AccuPen 3V Consumables: - 1x 0.50 mm centering bit - 1x Vicryl suture 3-0 - Skin glue (Epiglue) / Vicryl suture 5-0 - 1x Ethibond Vicryl suture 6-0 - 1x 27G needle

MouseScrew 2. Surgical approach Positioning Mouse in dorsal position.

MouseScrew 2. Surgical approach Approach The knee is bent according to illustration.

MouseScrew 2. Surgical approach Approach Longitudinal incision along the medial side of the patella from the distal third of the thigh to the proximal third of the lower leg.

MouseScrew 2. Surgical approach Approach Longitudinal incision along the medial side of the patellar tendon.

MouseScrew 2. Surgical approach Approach Lateral dislocation of the patella to expose the knee joint.

MouseScrew 2. Surgical approach Approach Position of the intercondylary entry point of the femur.

MouseScrew 3. Application Opening of the epycondyle Use the 0.5 mm centring bit to drill a hole into the intercondylar notch. According the illustration start drilling with a 45 ° offset to the axis of the femur and continuously decrease the angle to 0° offset (parallel with the bone axis). Make sure not to exceed 1.00 mm in depth for the drill hole ! Verify the orientation of the longitudinal axis and keep the centering bit right between the two condyles of the medullary cavity and parallel to the bone axis.

MouseScrew 3. Application Proximal opening of the femur Open the proximal end of the femur by the use of a 27G needle (length > 19mm). Remove the 27G needle and insert the guide tube (tappered tip pointing to femur) into the femur and pass it throu the skin in the area of the hip joint. Make sure to keep the guide wire in Place. It will stay in the femur until the fracture is initiated ! Accomplishing the fracture Create a defined fracture by using the guillotine.

MouseScrew 3. Application Insertion Connect the MouseScrew to the 0.20/0.35 mm guide tube and insert it into the femur under continous pressure und clockwise rotation.

MouseScrew 4. Finishing Wound closure Use Ethibond vicryl suture 6-0 on the patellar tendon and the fascia lata.

MouseScrew 5. Finishing Wound closure Skin suture with Ethibond vicryl suture 6-0. To avoid wound biting it is also possible to use skin glue instead of a suture.

MouseScrew Hazards and legal restrictions Scientific editor: Illustrations: Design and layout: In collaboration with: Hazards Moritz Klein, Germany; Jörg Holstein, 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...