FH ORTHOPEDICS be POD TYLOS Arthrodese-Nail Посібник - Сторінка 4

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253258

253244

5 - Implantation of the threaded

pin with the motor

253264

6 - Introduction of the cannulated drill

bit – Hollowing the cortical bones

253248

253249

253250

7 - Introduction of the hand reamers

253251

8 – Assembling the TYLOS™

posterior drill guide

It is mounted on the motor and introduced in an ascending, transosseous

manner, controlling its insertion on the image intensifi er (Fig. 5).

It must be positionned exactly in the centre of the tibial pilon, both face on

and in profi le, with the hindfoot in its axis. The choice of introduction point

for the nail must be made very carefully as the nail cannot and must not re-

duce the hindfoot automatically.

The cortical bones are hollowed out (Fig.6) using a cannulated drill bit

253247

253264

253250).

The length of the nail can be read using the graduations on the reamer in posi-

tion, as a projection of the external orifi ce of the retractor (Fig. 7).

At this stage, it is recommended that the threaded tip pin be replaced by a

smooth key wire (ref. 253245). Reaming is performed size for size. It is possible

to use a mechanical reamer in cases of bone resistance or proceed this way if

you are used to.

The nail, the diameter and length aof which were determined previously, is

assembled on the main fi xation nail holder (ref. 253246), to which it is joined

by the M6 connecting screw (ref. 253251).

Depending on whether it is a right (R) or left (L) foot, the notch (R) or (L) in the

holder is placed opposite the arrow marked on the nail. The posterior guide is

joined to the holder by the M5 screw (ref. 253681), using the posterior face of

the nail marked B (back) as the orientation mark.

Before introducing the nail, it is recommended that the leg be raised by

means of a block or a pile of folded sterile drapes so as not to be hindered

by the posterior axis of the main fi xation nail holder. This is introduced on the

foam stem guide (ref. 253245), and crosses the subtalar and talocrural interli-

nes. The nail must be pushed in with the hammer, maintaining the correction

in the axis of the hindfoot, so that its distal extremity, visible on the image

intensifi er, lightly touches the inferior cortical of the calcaneus (Fig. 9).

253246

254596

253681

before inserting the hand reamers (ref. 253248, 253249 and

)

IMPLANTATION OF THE NAIL

254635

9 - Introduction and implantation

of the nail

ref.

(

(Fig. 8)