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Hip Preservation Surgery Set. To assistwith periacetabular osteotomy and hipimpingement procedures.

Technique Guide

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Introduction

Surgical Technique

Product Information

Table of Contents

Hip Preservation Surgery Set 2

AO Principles 4

Hip Impingement 5

Periacetabular Osteotomy 7

Instruments 12

Set List 15

Image intensifier control

Synthes

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Hip Preservation Surgery Set. To assist with periacetabular osteotomy and hipimpingement procedures.

2 Synthes Hip Preservation Surgery Set Technique Guide

The Hip Preservation Surgery Set con-tains retractors, osteotomes, chisels,and femoral head templates to assist thesurgeon with periacetabular osteotomyand hip impingement procedures.

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Synthes 3

Osteotomes– Twelve osteotomes– Striking-cap on each osteotome for

improved transfer of force from ham-mer strikes and increased durability

– The working end of each osteotomeis etched in 5 mm increments tohelp the surgeon determine thedepth in the bone

– The distance from the first etchedline to the tip of the blade meas-ures 10 mm, unless it has beensharpened

Aluminum Retractors– Radiolucent properties– Eight aluminum retractors – Lightweight– Also available in stainless steel

Femoral Head Templates– Nine templates with diameters from

42 mm to 58 mm– Femoral head templates are nearly

transparent, to facilitate identifyingpoints of interest in the femoral head

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AO Principles

In 1958, the AO formulated four basic principles, which havebecome the guidelines for internal fixation.1 They are:

Anatomic reductionFracture reduction and fixation to restore anatomical rela-tionships.

Stable fixationStability by fixation or splintage, as the personality of thefracture and the injury requires.

Preservation of blood supplyPreservation of the blood supply to soft tissue and bone bycareful handling.

Early, active mobilizationEarly, active mobilization of the part and patient.


1. M.E. Müller, M. Allgöwer, R. Schneider, and H. Willenegger: Manual of InternalFixation, 3rd Edition. Berlin: Springer-Verlag. 1991.

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Hip Impingement

Synthes 5

1 Patient position

Position the patient laterally.

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2 Hip impingement correction

Instruments

03.100.342– Femoral Head Templates03.100.358 42 mm–58 mm diameters

399.54 Chisel Handle

399.55– Chisel Blades399.58 5 mm, 10 mm, 16 mm, 25 mm widths

399.555– Chisel Blades, long399.585 5 mm, 10 mm, 16 mm, 25 mm widths

Use the femoral head templates to guide the head/neck osteoplasty to restore normal offset and sphericity (wherepossible).

Use the chisel with the appropriate chisel blade to make thenecessary correction.

Hip Impingement


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Periacetabular Osteotomy

Synthes 7

1Patient position

Position the patient supine. Sterile prep and drape the abdomen and ipsilateral hindquarter in a single surgical field.

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2 Ischid osteotomy

Instrument

03.100.038 Curved Pelvic Osteotome, 15 mm bladewidth

or 03.100.039 Curved Pelvic Osteotome, 20 mm blade

width

Through the medial portion of the Smith Peterson approach,place a curved osteotome beneath the cotyloid fossa againstthe ischium.

As the cut progresses from anterior to posterior, drop thehandle of the osteotome to direct the cut above the spine ofthe ischium.



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3 Pubic root osteotomy

Instrument

03.100.300 Straight Pelvic Osteotome, 15 mm bladewidth

or03.100.301 Straight Pelvic Osteotome, 20 mm blade

width

Use a high speed burr to remove the first cortex.

Insert the straight osteotome into the opening, to the cortexprotecting the obturator canal.

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4Posterior column osteotomy

Instrument

03.100.300 Straight Pelvic Osteotome, 15 mm bladewidth

or03.100.301 Straight Pelvic Osteotome, 20 mm blade

width

Alternative instruments

03.100.305 Bayonette Pelvic Osteotome, 15 mm bladewidth

03.100.306 Bayonette Pelvic Osteotome, 20 mm bladewidth

03.100.307 Flag Pelvic Osteotome, 20 mm blade width

Use a high speed burr to initiate the posterior column os-teotomy along a line directed down the quadrilateral surfaceapproximately 1.5 cm anterior to the greater sciatic notch.

Drive the straight osteotome through the bone and through the opening parallel to the greater sciatic notch, to intersectthe first osteotomy.



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Synthes 11

5Iliac osteotomy

Instruments

03.100.302 Angled Pelvic Osteotome, 15 mm bladewidth

or03.100.303 Angled Pelvic Osteotome, 20 mm blade

width

519.170 Saw Blade, 27 mm width, 70 mm length

Alternative instrument

03.100.304 Short Angled Pelvic Osteotome, 15 mmblade width

Cut the iliac wing to intersect the posterior column osteotomy(the third osteotomy) using an oscillating saw. Protect thetensor and gluteals from saw injury by placing a retractoralong the external inominate surface, parallel to the osteotomy path.

Use the angled osteotome at the pelvic brim to ensure thatthe osteotomy is complete.

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Instruments


Malleable Retractors, 330 mm long03.100.015 20 mm wide03.100.016 30 mm wide03.100.017 40 mm wide

Curved Pelvic Osteotomes03.100.038 15 mm blade width 03.100.039 20 mm blade width

03.100.107 Aluminum Blunt Pelvic Retractor

Aluminum Hohmann Retractors 03.100.108 35 mm width03.100.109 18 mm width03.100.110 24 mm width

Aluminum Spoon Retractors03.100.111 medium03.100.112 large

03.100.114 Aluminum Hohmann Retractor, 8 mmshort narrow tip

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Synthes 13

03.100.119 Aluminum Hohmann Retractor, 22 mmwide tip

Straight Pelvic Osteotomes 03.100.300 15 mm blade width 03.100.301 20 mm blade width

Angled Pelvic Osteotomes03.100.302 15 mm blade width 03.100.303 20 mm blade width


Bayonette Pelvic Osteotomes03.100.305 15 mm blade width 03.100.306 20 mm blade width


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Instruments


Femoral Head Templates03.100.342 42 mm diameter03.100.344 44 mm diameter03.100.346 46 mm diameter03.100.348 48 mm diameter03.100.350 50 mm diameter03.100.352 52 mm diameter03.100.354 54 mm diameter03.100.356 56 mm diameter03.100.358 58 mm diameter

399.54 Chisel Handle

Chisel Blades399.55 10 mm width399.56 16 mm width399.57 25 mm width399.58 5 mm width

Chisel Blades, long399.555 10 mm width399.565 16 mm width399.575 25 mm width399.585 5 mm width

Pelvic Osteotomes, 304 mm399.85 15 mm399.86 20 mm

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Hip Preservation Surgery Set (01.100.300)

Synthes 15

Graphic Case60.100.300 Graphic Case, for Hip Preservation

Surgery Set

InstrumentsStraight Pelvic Osteotomes

03.100.300 15 mm blade width


Angled Pelvic Osteotomes




Bayonette Pelvic Osteotomes




Curved Pelvic Osteotomes



Pelvic Osteotomes, 304 mm

399.85 15 mm

399.86 20 mm

Note: For additional information, please refer to package insert. For detailed cleaning and sterilization instructions, please refer tohttp://us.synthes.com/Medical+Community/Cleaning+and+Sterilization.htmor to the below listed inserts, which will be included in the shipping container:– Processing Synthes Reusable Medical Devices—Instruments, Instrument Trays

and Graphic Cases—DJ1305– Processing Non-sterile Synthes Implants—DJ1304

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Hip Preservation Surgery Set (01.100.300)


Instruments continuedFemoral Head Templates

03.100.342 42 mm diameter









Aluminum Spoon Retractors

03.100.111 medium

03.100.112 large

Malleable Retractors, 330 mm long

03.100.015 20 mm wide

03.100.016 30 mm wide

03.100.017 40 mm wide

03.100.107 Aluminum Blunt Pelvic Retractor

Aluminum Hohmann Retractors

03.100.114 8 mm, short narrow tip

03.100.119 22 mm wide tip

03.100.108 35 mm width

03.100.109 18 mm width

03.100.110 24 mm width

399.54 Chisel Handle, synthetic, autoclavable

Chisel Blades

399.55 10 mm width

399.555 10 mm width, long

399.56 16 mm width


399.57 25 mm width


399.58 5 mm width


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Also Available

Synthes

03.100.011 Spoon Retractor, medium, 268 mm

03.100.012 Spoon Retractor, large, 323 mm

Curved Chisel Blades

03.100.116 10 mm

03.100.117 16 mm

03.100.118 25 mm

398.55 Blunt Pelvic Retractor

Hohmann Retractors

399.20 8 mm width, short narrow tip, 220 mm length

399.25 22 mm width, wide tip, 250 mm length

399.26 35 mm width, wide tip, 284 mm length

399.27 18 mm width, long narrow tip, 242 mm

399.28 24 mm width, long wide tip, for hipsurgery, 270 mm length

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Synthes (USA)1302 Wrights Lane EastWest Chester, PA 19380Telephone: (610) 719-5000To order: (800) 523-0322Fax: (610) 251-9056

Synthes (Canada) Ltd.2566 Meadowpine BoulevardMississauga, Ontario L5N 6P9Telephone: (905) 567-0440To order: (800) 668-1119Fax: (905) 567-3185

© 2010 Synthes, Inc. or its affiliates. All rights reserved. Synthes is a trademark of Synthes, Inc. or its affiliates. Printed in U.S.A. 5/10 J9798-A

www.synthes.com

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technique guidesynthes.vo.llnwd.net/o16/llnwmb8/us mobile/synthes north... · 2014. 9. 4. ·...

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