WISHBONE MEDICAL MEMORY STAPLE SYSTEM SURGICAL TECHNIQUE
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WISHBONE MEDICAL MEMORY STAPLE SYSTEM SURGICAL TECHNIQUE

The WishBone Medical Memory Staple is a form of fixation for arthrodesis, osteotomy and fracture fixation.1, 2 Made from Nitinol memory alloy, the Memory Staple is fully activated at 98.6°F (37°C), patient body temperature.* OPEN STATE Body Heat Activated for Continuous Compression Available in 22 sizes, a wide selection makes the Memory Staple ideal for most applications in the foot, ankle, hand and wrist. LOW PROFILE DESIGN Only the bridge portion of the Memory Staple stays above the bone, maintaining a low profile. CONTINUOUS COMPRESSION Manufactured from Nitinol, the staple will begin...

IMPLANT SPECIFICATIONS Standard Legs Standard leg staples are utilized when a flush surface exists while the offset staples offer different leg lengths to accommodate uneven bone surfaces. Bridge Width WIRE SIZE Offset Legs Leg Length A Wire Size Bridge Width BRIDGE WIDTH WIRE SIZE WISHBONE MEDICAL MEMORY STAPLE SYSTEM SURGICAL TECHNIQUE

INSTRUMENT SPECIFICATIONS All instruments provided are reusable and can be found in cases and trays. Adjustable Drill Guide An adjustable drill guide (ref 17681) is included in the instrument kit (ref 17707). The drill guide accommodates every staple size. Set the adjustable drill guide by pulling down on the set pin (green arrow), with the set pin pulled down slide the top guide bar (blue arrow) until the desired staple bridge width shows in the engraving window. WISHBONE MEDICAL MEMORY STAPLE SYSTEM SURGICAL TECHNIQUE

INSTRUMENT SPECIFICATIONS (CONT.) Single Hole Drill Guide One single hole drill guide (ref 17656) and three angled drill guides (ref 17648/17649/17650) offer additional options during limited exposure procedures. Drill Bits Ø1.4mm,1.8mm, 2.4mm, 3.0mm color coded drill bits are included in the instrument tray. The drill bits feature etched lines that indicate drill depth. Note: Etched lines only correlate with the adjustable drill guide and single hole drill guide. Instrument Kit Instrument kit (ref 17707) includes all of the necessary instruments for implantation of any staple size....

HANDLING INSTRUCTIONS It is important to always handle the staple with hemostats, never by hand as this may result in premature activation. The instrument kit includes specially designed hemostats to securely handle all sizes of the Memory Staple. WISHBONE MEDICAL MEMORY STAPLE SYSTEM SURGICAL TECHNIQUE

COMMON PROCEDURES Foot and Ankle 1. 2. Lesser PIPJ Fusion: 7x5, 9x7 Austin, Youngswick, Reverdin Bunionectomies: 11x10, 13x10, 11x15x13 Base Wedge Osteotomies: 11x10,13x10,15x12, 18x18x15 Lapidus Procedure (Dorsal): 20x20,18x18x15 Lapidus Procedure (Medial): 15x12 Calcaneal Cuboid Fusion: 15x12, 18x18x15, 20x20 WISHBONE MEDICAL MEMORY STAPLE SYSTEM SURGICAL TECHNIQUE

INDICATIONS & CONTRAINDICATIONS Hand and foot bone fragment and osteotomy fixation and joint arthrodesis of the hand and foot bones. Comminuted bone surface which would militate against staple placement. Pathologic conditions of bone such as osteopenia which would impair the ability to securely fix the staple. Foreign body sensitivity to metals including nickel. Where material sensitivity is suspected, appropriate tests should be made prior to implantation. • Immobilization in addition to this internal fixation • Inspect the sterile blisters used for the implants prior to until bone healing...

SURGICAL TECHNIQUE Determine Staple Size Prepare the surgical site and determine optimal staple size. Note: The adjustable drill guide can act as a sizer when determining the correct staple size (fig 1). Drill Distal Hole Utilizing a provided drill guide, drill the distal hole (fig 2). Pin Insertion Insert the provided anchor pin in the distal hole to maintain position; drill the proximal hole (fig 3). WISHBONE MEDICAL MEMORY STAPLE SYSTEM SURGICAL TECHNIQUE

SURGICAL TECHNIQUE (CONT.) Insert Staple Utilizing a pair of hemostats, place the staple into the pre-drilled holes (fig 4). Caution: It is important that the staple is always handled with hemostats, never by hand, as this may result in premature activation. Ensure Insertion Use the appropriate size staple punch to ensure the staple is fully inserted and seated against the bone (fig 5). Staple Compression After insertion, the staple should sit flush against the bone (fig 6). Staple compression will occur at body temperature, but may be hastened by irrigation with saline 98°F (37°C) to 100°F...

ORDER INFORMATION: IMPLANTS Standard Legs Bridge Width Wire Size Color Code Offset Legs Bridge Width Color Code WISHBONE MEDICAL MEMORY STAPLE SYSTEM Wire Size SURGICAL TECHNIQUE

ORDER INFORMATION: INSTRUMENTS MEMORY STAPLE COMPLETE KIT ANGLED STAPLE PUNCH LARGE STAPLE PUNCH SMALL STAPLE PUNCH LARGE STAPLE CLAMP SM STAPLE 4 3/4 BULLDOG HEMOSTAT DRILL GUIDE ADJUSTABLE DRILL GUIDE SINGLE HOLE MEMORY STAPLE INSTRUMENT TRAY WISHBONE MEDICAL MEMORY STAPLE SYSTEM SURGICAL TECHNIQUE

REFERENCES 1. T.J. Chang and B.D. Overley, “An In Vitro Comparative Study of Screw and Nitinol Staple Compression: A Model Showing Active ‘Dynamic’ Compression,” Presented at the American College of Foot & Ankle Surgeons 65th Annual Scientific Conference, Orlando, FL, March 2007. 2. Farr, D., Karim, A., Lutz, M. et al. A biomechanical comparison of shape memory compression staples and mechanical compression staples: compression or distraction?. Knee Surg Sports Traumatol Arthrosc 18, 212–217 (2010). https://doi.org/10.1007/s00167-009-0887-9 WISHBONE MEDICAL MEMORY STAPLE SYSTEM SURGICAL...

100 Capital Drive Warsaw, IN 46582 +1-574-306-4006 WishBoneMedical.com All trademarks herein are the property of WishBone Medical, Inc. or its subsidiaries unless otherwise indicated. This material is intended for the sole use and benefit of Health Care Professionals and the WishBone Medical Sales Force. It is not to be redistributed, duplicated or disclosed without the express written consent of WishBone Medical. All WishBone Medical Memory Staples are only available as single-use, sterile packed devices. Always confirm product expiration date prior to use. For product information,...