5
Tylos
TM
POSTERIOR LOCKING
The soft tissue retractor (
ref. 253252
) is assembled in the guide for trans-cal-
caneal screws (ref. 253261), and screwed into the centering guide sleeve (
ref.
253256
). A small posterior skin incision is made to introduce the entire assem-
bly into contact with the bone
(Fig. 10)
.
After withdrawing the soft tissue retractor and distal screw guide, packing
with drill bit M6 (
ref. 253259
) is performed until the nail is blocked. Measured
length A (which corresponds to the measurement of the posterior part of the
screw) will be retained by direct reading on the graduation at the level of the
posterior orifi ce of the centering guide sleeve
(Fig. 11)
.
The drilling sleeve for the 3.5 drill bit (
ref. 253254
) is then assembled in the
centering guide sleeve that remains in place and makes packing the anterior
part of this drill bit possible (
ref. 253257
). The position of the extremity of the
drill bit can be controlled via fl uoroscopy. After installing the blue measure-
ment indicator (
ref. 253635
) on the posterior guide, length B is read directly
(Fig. 12)
in the window designed for this purpose (and which corresponds to
the anterior part of the screw).
It is also possible to use the red measurement indicator (
ref. 255441
) which is
placed on the drill, directly at the level of the graduation desired, and makes
precise drilling possible, as defi ned beforehand.
If the position of the nail does not make it possible to guarantee a minimum
distance of 10 mm between the nail and the anterior cortical of the calcaneus,
length B will be zero and this fi nal step will not be necessary.
Remark :
In case of calcaneal-cuboid arthrodesis, fi xation is possible using
this trans-calcaneal screw, the anterior length of which will then be 20 mm
or more, but after having freshened the interline percutaneously, with fl uo-
roscopic control, and a Wedge 4.1 burr (
ref. 256017
) or, in a more classic
manner, in the open air.
The trans-calcaneal screw will thus have as its defi nitive length the associa-
tion of the measurements of the posterior (A) and anterior (B) portions.
For example, a 10/45 screw corresponds to an anterior portion at the front of the
nail of 10 mm and a posterior portion at the back of 45 mm.
The guide for the drill bit is replaced by that of the screw (
ref. 253261
) so as
to introduce the chosen screw on its screwdriver (
ref. 257381
). The screw will
be tightened until completely blocked
(Fig. 13).
It is recommended that the head of the screw be plugged
by means of a small polyethylene plug, positioned
on the square point.
10 - Implanting the trans-calcaneal screw
11 - Drilling
posterior part A
12 - Drilling
anterior part B
13 – Implantation of the
trans-calcaneal screw
TYLOS™ trans-calcaneal screw
2532261
253252
253256
253259
255441
254635
253257
253254
257381
253261
Содержание be POD TYLOS Arthrodese-Nail
Страница 1: ...FOOT TYLOS A N K L E ARTHRODESIS NAIL...
