Phoenix Suprapatellar Approach Surgical Technique Addendum

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Phoenix Suprapatellar Approach Surgical Technique Addendum Use this addendum in conjunction with the Phoenix Tibia Surgical Technique, BMET0350.0-GBL Step 5. Opening The Medullary Canal Place the Extended Working Channel Soft Tissue Sleeve (Catalog #SSI000237) and the 11.5 mm One-Step Reamer over the Guide Wire to enlarge the entry site and drill until entering the canal. Alternatively, a Curved Cannulated Awl (Catalog #41026) attached to a Modular T-Handle, Non-Ratcheting (Catalog #29407) can be used to obtain the entrance portal. For protection of the Modular T-Handle, Non-Ratcheting during...

Phoenix Suprapatellar Approach Step 9. Nail Assembly Proximal Targeting Attach the Suprapatellar Driver Handle (Catalog #SSI000229) to the proximal aspect of the tibial nail, ensure the slope is anterior and the three tangs on the underside of the Driver Handle engage with the three slots of the nail. Place the Connecting Bolt (Catalog #41002) into the Driver Nose and proceed to thread into the nail and secure using a 5 mm Connecting Bolt Inserter (Catalog #41003) attached to the Modular T-Handle, Non-Ratcheting (Catalog #29407). Note: To ensure accurate proximal targeting, attach the Tibial...

Step 10. Nail Insertion The tibial nail is inserted manually over the Bead Tip Guide Wire and advanced into the medullary canal. The fracture should be adequately reduced and out to length during insertion of the nail and should be monitored with the image intensifier. The Bead Tip Guide Wire is removed after the nail passes the fracture site. The nail can be countersunk to the level indicated by the groove on the driver nose. Final nail positioning should be checked in both A/P and lateral views to ensure proper alignment. If a Slotted Mallet (Catalog #14-442053) is desired to seat the nail...

Step 12. Targeting Arm Assembly Assemble the Tibial Nail Targeting Arm (Catalog #41000) to the Driver Handle and secure with the Thumb Screw (Catalog #41023).

Step 13a. Proximal Locking – Static Screws Assemble the Trocar (Catalog #41006) to the Drill Sleeve (Catalog #41005) and insert through the Soft Tissue Sleeve (Catalog #41004) through the Static hole (Dynamic Compression Slot) of the Targeting Arm. Advance to the bone to determine and mark the entry point. Remove the Trocar and advance the assembly to the near cortex. Insert the 4.3 mm Calibrated Drill Bit (Catalog #41010) through the Drill Sleeve to perforate the medial cortex, pass through the nail and perforate the lateral cortex. With the Drill Sleeve assembly held firmly against the medial...

Phoenix Suprapatellar Approach Step 13a. Proximal Locking – Static Screws (cont.) The Drill Sleeve is removed and the appropriate 5 mm screw is inserted through the Soft Tissue Sleeve (reference pg. 16 for insertion detail). Ensure position of screw with radiographic visualization. Be sure not to exceed more than 2 mm in the far cortex. If desired, the Static screw can be locked with the reassembled, embedded setscrew/locking mechanism. Insert the Extended 4 mm Hex Driver (Catalog #SSI000234) through the Driver Handle, into the proximal aspect of the nail and turn in a clockwise motion.

Step 13a. Proximal Locking – Static Screws (cont.) An additional screw can be inserted in a similar fashion through the Static hole of the Targeting Arm (reference page 21 of Phoenix Tibia Surgical Technique, BMET0350.0). To remove the targeting assembly, insert the 5 mm Connecting Bolt Inserter through the Driver Handle to engage the connecting bolt and turn counterclockwise to release attachment from the nail. Static Hole Slot

Phoenix Suprapatellar Approach Step 13b. Proximal Locking – Oblique Screws Assemble the Trocar (Catalog #41006) to the Drill Sleeve (Catalog #41005) and insert through the Soft Tissue Sleeve (Catalog #41004) through either the Distal Oblique or the Proximal Oblique hole of the Targeting Arm. Advance to the bone to determine and mark the entry point. Remove the Trocar and advance the assembly to the near cortex. The Drill Sleeve is removed and the appropriate 5 mm screw is inserted through the Soft Tissue Sleeve (reference page 21 of Phoenix Tibia Surgical Technique, BMET0350.0 for insertion details)....

Step 13b. Proximal Locking - Oblique Screws (cont.) When insertion of the proximal oblique screws are completed, insert the Extended 4 mm Hex Driver through the Driver Handle into the proximal aspect of the nail and turn in a clockwise motion to lock the oblique screws with the preassembled, embedded setscrew/ locking mechanism. When complete, remove the hex driver. To remove the targeting assembly, insert the 5 mm Connecting Bolt Inserter through the Driver Handle to engage the connecting bolt and turn counterclockwise to release attachment from the nail.

Phoenix Suprapatellar Approach Step 13c. Proximal Locking – Compression (Optional) The Phoenix Tibial Nail offers a preassembled, embedded setscrew/locking mechanism that can provide up to 5 mm of compression. Note: If compression is desired, first ensure distal locking has been completed. Prior to compressing, remove the sleeve assembly from bone. Assemble the Trocar (Catalog #41006) to the Drill Sleeve (Catalog #41005) and insert through the Soft Tissue Sleeve (Catalog #41004) through the Dynamic hole (Dynamic Compression Slot) of the Targeting Arm. Advance to the bone to determine and mark...