Mitek肘关节产品及手术应用

1、肘关节产品肘关节产品 & 手术技巧手术技巧谁在做肘关节手术谁在做肘关节手术?l手外科医生l上肢外科医生l关节镜外科医生l 普通骨科医生肘关节外科手术肘关节外科手术l远端二头肌腱撕裂l肱骨外上髁炎（网球肘）l内外侧副韧带撕裂远端二头肌腱撕脱远端二头肌腱撕脱 biceps tendon attachment sitedistal biceps attachmentbiceps tendon attachmentdistal biceps tendonbicepsdistal biceps tendon rupture肱骨内侧髁尺骨茎突撕裂的二头肌腱常见于中年男性的dominant手biceps t

2、endon reattachment2 incision technique drill holesbiceps tendon reattachmentsingle incision suture anchorssuture anchor techniquel1 incisionless risk of infection & less scarringlno risk of bone tunnel breakageleasier to perform, saves or time. jhs- may 2003肱骨外上髁炎肱骨外上髁炎网球肘外上髁炎外上髁炎损伤损伤 & 治疗治疗lecrb桡侧腕

3、短伸肌的小损伤, 非感染性l手术治疗不常用 (报道4-8% 的病例用手术治疗)l外科手术开放或镜下松解(shaver or rf)松解，重连接lateral elbow桡骨肱骨外上髁尺骨location of ecrbecrl桡侧腕长伸肌ecrb 桡侧腕短伸肌ecu extensor carpi ulnaris尺侧腕伸肌ecrb location continuedmitek technique brochure (dr. lorenzo walker cat # 900091)l找到ecrbl松解ecrblresect lateral epicondyle & expose raw canc

4、ellous surfacelmobilize extensor originl用2个mitek 锚钉 (gii, fastin)重新连接到外上髁内侧副韧带修复内侧副韧带修复tommy john surgery (medial ucl)侧副韧带修复侧副韧带修复medial ucl complex斜束前束后束medial ucl: anterior banda pitchers injury“tommy john surgery”lnamed after the first patient of ulnar collateral replacement surgery.ldoctors name

5、: frank jobelfirst surgery done in 1974when the rupture occurs尺侧副韧带撕裂相关问题尺侧副韧带撕裂相关问题l过头投掷运动时缺乏稳定性l在做过头投掷运动时手臂不能用力l过头投掷运动时不能控制传统传统ucl的修复的修复l“金标准”l骨隧道技术l前臂掌长肌腱或跟腱做韧带移植l尺神经转置l移植物8字固定l韧带端用缝线缝合在一起repair of ucll方法复杂，费时l可用带线锚钉固定l简化手术 &省时l减少骨隧道穿肌腱造成的创伤anchors for the elbow anchor body:2.4 x 8.8mmarc range:7

6、.8mmdrill hole size:2.4 x 14.2mm suture:#2 ethibond & cp-2 reverse cut needle#2 panacryl & cp-2 reverse cut needleanchor material:titanium body with nitinol arcspullout lbs.: 25 lbsindications:foot: lateral & medial ankle instability, mid-foot reconstruction, hallux valgus & achillies tendon repaire

7、lbow: tennis elbow, biceps tendonhand: thumb ucl and scapholunategii anchoranchor body:4.1 x 6.0 mm drill hole size:3.5 x 18 mm suture:#2 ethibond & cp-2 reverse cut needle#2 panacryl & cp-2 reverse cut needleanchor material:plapullout lbs.: 35 lbsindications:elbow: biceps tendon reattachmentankle:

8、achilles tendon repair, lateral stabilization, medial stabilization at the medial talus sitepanalok anchoranchor body:3.0 x 8.4 mm4.0 x 9.7 mmsuture:#2 ethibond (no needles)drill bit:self drillinganchor material:titaniumpullout lbs.:33.5 lbs (for 3.0mm), 61 lbs (4.0mm)indications:foot: midfoot reconstruction, medial or lateral instability, achilles tendon, hallux v