Técnicas cirugía

External Skeletal Fixation Instructions

External Skeletal Fixation Instructions

External Skeletal Fixation is an effective method of fracture repair in animals, rigidly stabilizing fractures while maintaining a biologic environment for rapid osteosynthesis. Veterinary researchers have defined optimal application techniques. These include using type II fixators with full pins whenever possible (Brinker 1985, Bouvy and Markel 1993), pre-drilling pilot holes (Clary & Roe 1996), and using positive profile threaded pins (Bennet & Egger 1987, Anderson & Mann 1993,1996).

SECUROS Inc., commited to enabling the veterinary surgeon to easily apply science to the art of external fixation, has designed the SECUROS external fixation system. Fixator clamps are not pre-placed on connecting rods, but snapped on wherever you want, even between two installed clamps. Positive profile threaded pins are easily added to type I, II, and III fixator configurations, even at re-check examinations. Pilot holes are drilled using tissue-protecting sleeves. Full and or half pins in type I and type II fixators are accurately placed to either side of the opposite connecting rods. The SECUROS system is interchangeable with medium and small external fixator components.

Biomechanical Testing has shown that the design of the SECUROS external fixator clamp results in greater fixator pin to connecting bar rigidity, reducing pre-mature pin loosening.

It's as easy as 1, 2, 3!

1. Use the SECUROS pin placement device to accurately pre-drill either a 3.2 mm or 2.4mm pilot hole. A fixator pin can be placed to either side of the opposite connecting rod in type II fixators. The depth of the hole can be measured with a standard depth gauge.

 

2. Insert a positive profile fixation pin through the pin placement tool. This aligns the pin with the pilot hole. Either 3.2mm (1/8th inch) or 2.4mm (3/32nd inch) positive profile threaded pins can be used. SECUROS fixation pins have the standard thread characteristics of 4.5mm and 3.5mm orthopedic screws and are self-tapping.

 

3. Snap on the SECUROS fixator clamp by sliding it over the fixation pin and onto the connecting rod. Insert and tighten the clamp bolt. It is ideal to tighten the bolt to 7.34 Nm of torque. SECUROS offers a precision torque wrench for this purpose.

 

ESF PRODUCT INSTRUCTIONS

Applying the SECUROS Fixation Clamp:

  1. After the fixation pin is placed, slide the pin into the appropriate hole on the head component (bullet shaped).
  2. Take the U component and put it together with the head component (keeping the head component on the pin).
  3. Slide the two components down the fixation pin (approaching the fixation bar).
  4. Once the clamp is going over the connecting bar, you will notice that the head component hits the connecting bar not allowing the clamp to go completely over the bar.
  5. At this point, gently use your thumb ( not the one pushing down the clamp) to push the fixation pin away from the clamp. This will allow for the clamp to snap over the fixation bar.
  6. Finger tighten the bolt and then apply two thirds of a turn using the standard wrench.
  7. Construct the rest of the frame in the same manner.
  8. Apply final tightening using the torque wrench.

Using the SECUROS Pin Placement Tool in Type I Configurations:

  1. Apply the most distal and most proximal fixation pins in the standard way.
  2. Connect the connectiing bar to the proximal and distal pins.
  3. Tighten the bolts.
  4. Remove the sliding component of the aiming tool by removing the stainless steel knob.
  5. Put the aiming tool over the connecting rod, making sure that it hits the stainless steel back of the cup shaped component of the through rod (you may have to adjust the stainless steel back by using another connecting bar).
  6. Adjust the aiming tool so that when you drill you will have good bone purchase (you may test this by probing through the aiming tool into the soft tissue using a K-Wire.
  7. Tighten the large knob on the far end of the aiming tool.
  8. Place the drill sleeve through the aiming tool down to the bone surface (you can use a Steinmann Pin to guide the drill guide to the bone).
  9. Make sure that the aiming guide is tight; Drill your fixation pinhole.
  10. Remove the drill sleeve and place the fixation pin through the aiming tool into the drilled hole. Insert pin.
  11. Repeat for all pin locations.

Using the SECUROS Pin Placement Tool in Type II Configurations:

  1. Apply the most distal and most proximal fixation pinsin the standard way.
  2. Connect the connectiing bar to the proximal and distal pins.
  3. Tighten the bolts.
  4. Open the aiming tool as much as possible by loosening the knob and sliding the rail.
  5. Put the aiming tool over the connecting rod, making sure that it hits the stainless steel back of the cup shaped component of the through rod (you may have to adjust the stainless steel back by using another connecting bar).
  6. Slide the rail so that the aiming tool just sits on the opposite connecting bar (IMPORTANT: do not apply a lot of pressure). Adjust the aiming tool so that when you drill you will have good bone purchase (you may test this by probing through the aiming tool into the soft tissue using a K-Wire. You may have to change which side the opposite connecting bar sits in. You can also flip the entire aiming tool so that you are drilling on the opposite side of the connecting bar.
  7. Tighten the large knob on the far end of the aiming tool.
  8. Place the drill sleeve through the aiming tool down to the bone surface (you can use a Steinmann Pin to guide the drill guide to the bone).
  9. Make sure that the aiming guide is tight; Drill your fixation pinhole.
  10. Remove the drill sleeve and place the fixation pin through the aiming tool into the drilled hole. Insert pin.
  11. Repeat for all pin locations.

SECUROS Double Clamp Instructions:
(SECUROS Double Clamps work differently than the KE type double clamps.)

  1. SECUROS double clamps are used with your existing SECUROS clamps.
  2. Take two SECUR-U Clamps and remove the hex head bolt from one and the hex head bolt and head unit from the other.
  3. Place the two clamps so that the smaller holes are face to face.
  4. Place the normal Head unit in one of the larger holes and the double clamp components in the other.

Torque Wrench Instructions:
(Pre-Set for appropriate torque) (Cannot be sterilized!)

  1. Assemble the fixator. Tighten the bolt first by finger and with the standard wrench (two-thirds turn).
  2. Once the fixator is completely assembled use the torque wrench to apply the final tightening.
  3. Place the torque wrench over the bolt head.
  4. Hold torque wrench at the end of the handle.
  5. Turn until you feel a click. (torque wrench clicks when it reaches appropriate torque)
  6. Tighten all bolts.

Using the torque wrench:

  1. Assemble fixator. Tighten the bolts as you go by first finger tightening them and then apply 2/3rds of a turn with a standard wrench. This is close to the recommended torque.
  2. Once the fixator is completely assembled use the torque wrench to apply the final tightening. (non-sterile) place the torque wrench on the bolt head, hold the torque wrench at the end of the handle, tighten until you feel a click, once you feel the click move on to the next clamp and repeat. Once all bolts are tightened you’re done!