5
Chapter 3
Surgical Technique
Once adjustments are made to best fit patient anatomy, the bolts should
be tightened with the 10mm wrench, locking the frame/boot position.
Subsequently, the surgeon is ready to insert the 2mm Titanium Nitride (TiN)
Tip Wires (#EF002400) across the foot to eventually achieve transosseous
compression of the arthrodesis sites. The 2mm Titanium Nitride (TiN) Tip Wires
(#EF002450) with olive and SIDEKICK® FREEDOM™ 1.8mm wires (#RR18400 and
#RR180400) are also available for use with the system.
When placing transosseous wires, they can be inserted directly through the skin
in a percutaneous manner. When using an olive (stopper) wire, a small 3mm
incision is made in the skin to allow the olive to rest directly against the bone.
Wires are inserted under power, and it is recommended to use a start/stop
technique to minimize potential thermal damage. Once the wire is through both
cortices, the wire can be tapped through the skin on the opposite side manually,
or advanced using the oscillating feature of the hand-held power equipment.
Tapping the wire manually or oscillating the wire may help prevent “wrapping”
soft tissue as the wire penetrates the soft tissue. When placing any percutaneous
fixation, be mindful of anatomic safe zones. If a wire causes tension or tenting of
the skin, this tension should be released with a small incision. Utilization of the
fluoroscope may be helpful in determining the exact anatomic position.
The boot position of the fixator can be adjusted. Loosen the four vertical
adjustment locking bolts, the two carbon fiber reinforced composite rod clamp
bolts, and the two carbon fiber reinforced composite rod connector bolts using
the 10mm wrench (RR301090B SIDEKICK® SLOTTED WRENCH 10mm or the
RR3010 WRENCH 10mm) prior to adjusting the height of the boot assembly.
Once loosened, the boot assembly can be adjusted up or down by sliding the
boot assembly on the carbon fiber reinforced rods.
Wrench 10mm
RR3010
SIDEKICK® Slotted Wrench 10mm
RR301090B