SWANSON Titanium Great Toe Surgical Technique ? SOSTL002
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SWANSON Titanium Great Toe Implant

S WA N S O N titanium GREAT TOE IMPLANT surgical technique presented by ALFRED B. SWANSON, MD, FACS, GRAND RAPIDS, MICHIGAN.

titanium GREAT TOE IMPLANT general PRECAUTIONS as described by Alfred B. Swanson, M.D. The potential for complications or adverse reactions with any implant can be minimized, by following the instructions for use provided in product literature. It is the responsibility of each surgeon using implants to consider the clinical and medical status of each patient and to be knowledgeable about all aspects of implant procedures and the potential complications that may occur. The benefit derived from implant surgery may not meet the patient's expectations or may deteriorate with time, necessitating...

Abnormal force loading and subsequent wear may be caused by: · Uncorrected instability · Oversized implant · Inadequate soft tissue support · Implant mal-position · Excessive motion · Uncorrected or recurrent deformity · Patient misuse or over activity · Intra-operative fixation Some preventive measures to consider when minimizing the potential for complications: · Follow guidelines for indications and contraindications provided above · Identify prior pathology · Stabilize collapse deformities · Bone graft pre-existing cysts · Use a properly sized implant WARNING | Avoid flawing implant...

potential COMPLICATIONS An implant site may become infected, painful, swollen or inflamed. The status of the adjacent bone and soft tissue may be inadequate to support the implant or may deteriorate with time resulting in instability, deformity or both. Excessively mobile joints are generally less stable and an implant alone cannot provide long-term stability in a joint which lacks functional stability; complications necessitating revision surgeries are more frequent in unstable joints. specific COMPLICATIONS In any surgical procedure, the potential of complications exists. The risks and...

clinical ADVANTAGES general INDICATIONS specific INDICATIONS general CONTRAINDICATIONS requirements. · Improves toe dynamics: provides stability, mobility, pain relief, and maintains toe length. The increased flexion power of the great toe assists in normal gait pattern. · Provides a smooth articular surface for the first metatarsal head. · Acts as a space filler: maintains joint space and allows capsule/ligament reconstruction to correct the deformities. · Fixation in the intramedullary canal is not necessary. Any joint implant arthroplasty requires consideration of the following general...

specific CONTRAINDICATIONS · Severe hallux valgus as seen in rheumatoid arthritis, in older patients, or following a Mayo-type resection · Severe valgus deformity FIGURE 1A | Preoperative x-ray showing degenerative joint changes of the first metatarsal phalangeal joint in a 49 year-old woman. She presented with decreased motion of first MTP joint with pain on walking short distances. FIGURE 1B | Postoperative x-ray showing a well tolerated single stem titanium great toe implant replacing the base of the proximal phalanx. Patient has pain free functional motion and a good cosmetic result....

A slightly curved longitudinal skin incision is made along the dorsomedial aspect of the metatarsophalangeal joint. Care must be taken to avoid injury to the small dorsal sensory nerves and veins in the area. The fascia and the medial joint capsule are incised medial to the extensor hallucis longus tendon to prepare a capsuloligamentous flap for later closure and correction of deformity. The flap is usually proximally based on the metatarsal and it is reflected for later resuture. If a bursa is present, it is excised and the metatarsophalangeal joint opened. BONE PREPARATION The proximal...

SOFT TISSUE RELEASE, REEFING AND CLOSURE Complete correction of the deformity may require release of the lateral capsule and incision of the attachments of the adductor muscle to the basal phalanx. The short flexor attachments to the proximal phalanx should be reattached if released during the bone resection. Rerouting or lengthening of the long extensor tendon may also be necessary. It is often necessary to cut the short extensor tendon and lengthen the long extensor tendon in a manner similar to a Z-plasty. A loose and unrestricted passive range of motion of the joint must be obtained...

SWANSON TITANIUM GREAT TOE IMPLANT The Swanson Titanium Great Toe Implant has been sterilized and packaged as follows: Quantity Description Catalog Number 1 sizing set One each, Sizes 0,1, 2, 483-3000 color black (non-sterile) TYPICAL DIMENSIONS (millimeters)

HANDLING AND STERILIZATION The Swanson Titanium Great Toe Implant has been sterilized and should be considered sterile unless the package has been opened or damaged. Remove from package, using accepted sterile technique, only after the correct size has been determined. Always handle the product with powder-free gloves, and avoid contact with hard objects that may damage the product. Handling of the implant should be done with blunt instruments to avoid surface trauma or contamination with foreign bodies. Rinse the implant thoroughly with sterile saline solution before insertion. The sizing...

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