accord线缆系统手术技术

1、Surgical technique completed in conjunction Robert Barrack, St.Louis, Robert Barrack, , Paulare,Surgical technique completed in conjunction Robert Barrack, St.Louis, Robert Barrack, , Paulare, Paulare, NewYork,NewFaresHaddad,London, Michael Huo, Dallas, Michael Ries, San Francisco, Khaled Saleh, Cha

2、rlottesville, FaresHaddad,Michael Huo, Michael Ries, 圣Khaled Saleh, Nota Bene: The technique description herein is made available to the healthcare alto ysis,illustratetheauthorssuggestedtreatmentforplicated he preferredtreatmenttwhichaddressestheneedsoftheThere are two techniques. One technique inv

3、olves the use of cables only, and the second involvestheimplan ionofatrochantericgripwithcables(gripcontainspreassembled此文提及2（钩3The ACCORD Cable System is the result of the most advanced cable technology in orthopaedics. It is an effective, efficient and extensive system.The ACCORD Cable System is e

4、ffective because of ACCORD 线缆系统是骨科领域中最先进线缆技术发The ACCORD Cable System is the result of the most advanced cable technology in orthopaedics. It is an effective, efficient and extensive system.The ACCORD Cable System is effective because of ACCORD 线缆系统是骨科领域中最先进线缆技术发ndflexibilityofthecablesuptofourtimesA

5、CCORD 线缆系统的有效性在于线缆的强度和柔韧度，它的疲4 倍于先前的7x7 结构线缆的fatiguelifeofprevious7x7cabledesignsThe ACCORD Cable System is efficient because it 计。a ed cable to be loosened and retightened deforming the cable something can offer.t no other cable ACCORD 线缆系统高效性在于，它能在不使线缆发The ACCORD Cable System is an extensive syste

6、m it includes cobalt chrome and stainless steel cables, trochanteric t wo sizes and four lengths ACCORD 线缆系统是一套可以广泛应用于临床的系钛制的粗隆钩板，有 2 种尺寸4 种长度，一8a total of eight options and even grip trials. The system includes stainless steel screws and plates for trauma situations.es as well as CableSystem,Smith&

7、Nephew,Inc.,Memphis,TN,OrthopaedicResearchReport,OR- 02-34, May 2002.4ImplantingCablesTechnique This technique can be used, for Cable le, ImplantingCablesTechnique This technique can be used, for Cable le, for attaching femoral strut graft. For this technique, the cable with cl (7134-0007) must be u

8、sed.Step Slide the appropriate Cable Passer under and around the bone. There are three cable passers available: straight, 30offsetandlarge30offset.Step Slip the non-beaded end of the cable through the po ed end of the Cable Passer (Figure 2). Remove the Cable Passer. The cable should now be around t

9、he bone.Figure 1 Step Runthefreeendofthecablethroughthecl a loop (Figure 3)., thus (7134-0007)。Figure2 到对侧穿出。有 3 种线缆导向器可供选择：直型， 将线缆端沿着线缆导向器头端滑入（图2）。（3）Figure 3 5ImplantingCablesOnly Step Reset the er by turning the reset switch (Figure 5). t the locking handle of the is open by turning it counterclo

10、ckwise (Figure 6). Passthe free end of the cable through the er and til the tip of the er isImplantingCablesOnly Step Reset the er by turning the reset switch (Figure 5). t the locking handle of the is open by turning it counterclockwise (Figure 6). Passthe free end of the cable through the er and t

11、il the tip of the er is seated against and there is no slack (Figure Note: If a red band is protruding from the locking handle, Figure 6 erhasnotbeenreset(FigureStep Turnthelockinghandleclockwise(asindicatedbythewordlock on the Tener)untilwelltightenedtogripthecable(Figure9).Figure7 StepApply to the

12、 y the lever on Note:Ifthegauge does not advance with each the er is not the cable sufficiently. Figure 8 Figure 9 the locking handle and continue until the is 顺时针旋转重置开关复位锁紧器（5）。逆时针旋转锁紧把手以确认其处于开启状态的（6）The amount of placed on the cable should be on the patients bone quality and surgical experience of

13、 operative surgeon. However, should not continue to app d if the second red band is visible and protruding from the locking handle (Figure 9).器顶部与夹头紧密接触无间隙（图 7）Note: Due to the design of the ACCORD Cable surgeonsareabletoreceivetactilefeedbacktohelpif the appropriate is being 线缆。（图9） Lever 控制杠ResetS

14、witchGauge Figure 4 压力值取决于患者的骨质本身以及术者的临床经验。当然，若第二条红色标记线凸出锁紧把手，则不应再加压。（9）ACCORD 线缆系统锁紧器的独特设计，术者可Figure5 6Step Before removing the er, tighten the comple y with the 35lb. Torque-Limiting Screwdriver and appropriatescrewdriverbitbyturningclockwise.(Figure10)Piloted Screwdriver 定位起CannulatedNote: Tighte

15、n the screwuntilasingle clickisNote: Do not use Step Before removing the er, tighten the comple y with the 35lb. Torque-Limiting Screwdriver and appropriatescrewdriverbitbyturningclockwise.(Figure10)Piloted Screwdriver 定位起CannulatedNote: Tighten the screwuntilasingle clickisNote: Do not use another

16、torque-limiting screwdriver handle or standard screwdriver handle as this may apply an inappropriate amount of torque to the screw head causing Non-Piloted Non-CannulatedThe screw hex configuration may vary. Therefore, it is mended to use the ACCORD Dual-Ended Driver Bit (7136-0046) with standard he

17、x and pilot hex ensure proper seating of the driver hex end screw. (Figure 10)he You may encounter two screw head hex ACCORD system (Figure 11). Therefore, the instrument set should include one screwdriver bit with each style hex: 35Ib 的限矩型手柄和相应的螺钉起子顺时针旋转完全拧紧锁紧螺钉，然后移除锁紧器（10）。pilot tip ithout. If the

18、 primary screwdriver w/pilot tip (7136-0044) does not he head of the screw,thescrew headmay notbe fullycannulated lottipfromfullyengaging.Ifthisoccurs,thenswitchitthe screwdriver hex bit (7136-To make this procedure faster and easier, you may use the ACCORD Dual-Ended Screw Driver Bit (7136-0046). T

19、his driver hasboththeprimarypilottipandthehexdriverbit.Thedriver allowsyoutouseeitherendbyremovingthebit,turningitdegrees, and engaging the op Handle as needed.Note:TakecarenottostriptheiteheTorque用带有标准内六角和定位内六角ACCORD (7136-0046) 以确保螺钉起子和螺钉相匹配。（CCORD 系统中有两种螺钉内六角的设计（图 11）。因此，任何一套工具均应包括一把起子配两种内六角：定位或不

20、带定位起子。若定位螺钉起子的(736-0044) 与锁紧螺钉不配套，螺钉非中空，定位端不能置入，如果发生此情况，将螺钉起子换(736-0040)。(7136-0046)。screworscrewdrivert the driver bit is fully seated and aligned with screwaxisbefore tighteningtoprevent ofeitherscrew or driver bit. If the screwdriver bit is stripped, and replace new bit. If the screw is stripped

21、ingmaynotbeTorque-LimitingFigure 10 7Implanting Cables Only (continued) 单用线缆技Step ReleasethecablefromtheFlush Cutter 切割Implanting Cables Only (continued) 单用线缆技Step ReleasethecablefromtheFlush Cutter 切割er by loosening the handle (turn counterclockwise). Remove the with the Torque-Limiting Screwdriver

22、 and re-tighten sarywithouttheuseofanyextraStep Use the Flush Cutter to cut the Figure 12 scable(Figure12andNote: In order for the cut to be flush, the cutting side of Flush Cutter must be adjacent to the . e indicated on the instrument by the words cut 注意：ACCORD 线缆系统允许使用限矩起子在锁紧后重使用线缆切割器切断多余的线缆（图12

23、13）Cut eFigure 13 8Implanting a Trochanteric Grip with ThistechniquemaybeusedtoreattachthegreaterTorque-LimitingFor this technique s are built s (7134-0020) should be used.cables lStep Implanting a Trochanteric Grip with ThistechniquemaybeusedtoreattachthegreaterTorque-LimitingFor this technique s a

24、re built s (7134-0020) should be used.cables lStep Use the Trochanteric Grip Trials (Figure 14) to determine size and length grip will modate the femur.Therearetwotrochantersizes:smallandstandard,and there are four lengths: 3-, 5-, 8- and 11-cable grips.These grips range in length from 75 to 255mm f

25、or small grips and 85 to 265mm for standard grips.Figure 14 itioner 把持Step Attach itioner(Figure15)totheTrochantericGriporby placing the foot of itioner over the threaded hole. itioner by screwing the eated, connect othehole.Placethehooksofthegripoverthetrochanter Note: ition the trochanter in place

26、 on the Figure 15 itioner will attach to the trials and grips 16). If desired, the handle of itionercanbesubjectedlight mallet blows in order to sink the hooks of the grip Step ThreePass the non-beaded end of the cable through eitherone of the pair of holes on the cl Trochanteric Grip.builto the(713

27、4-0020)。使用粗隆钩板试模（4）来确定哪个型号的钩板与患者的解剖最匹配。Accod系统的粗隆钩板有两种规格：小号与标准号，四个型号：3-, 5-, 8- 以及11条线缆板Figure 16 小号的长度：75-将板把持器（5）远端置入板的螺孔内并拧紧，使之与粗隆钩板相连。将钩部置于大粗隆上以固定大粗隆使之获得重建。端。9Step Use the Cable Passers to run cable under andaround the femur (Figure 17).Note: The cable must be inserted through the po ed end of t

28、he Cable Passers.Step Runthefreeendofthecab for the clackthroughtheremainingPerform the following steps for ten StepSee Figure 18 for Figure 17 Step Use the Cable Passers to run cable under andaround the femur (Figure 17).Note: The cable must be inserted through the po ed end of the Cable Passers.St

29、ep Runthefreeendofthecab for the clackthroughtheremainingPerform the following steps for ten StepSee Figure 18 for Figure 17 er features. Reset the by turning the reset switch clockwise (Figure 19). t the locking handle of the er is open and counterclockwise (Figure 20). Pass the free end of the thr

30、ough the er and pull til the is seated against the cl (Figure 21).and there is y no Lever 控制杠ResetSwitchNote: If a red band is protruding from the lockinghandle, erhasnotbeenreset.(Figure9,pageStep Turn the locking handle clockwise (as indicated by the Gauge lockonthe Ten (Figure 20).er) until well

31、tightenedto grip the Figure 18 ResetSwitchLockingHandle股骨（端。Figure 19 Figure 20 18 为锁紧器的图解。通过顺时针旋转复位开关重置锁紧器 ( 图 19)。逆时针旋转锁紧把手以确认其于松开状态（20）（图21）（96 页）顺时针旋转锁紧把手（Lock 标记）直到很好的拉紧线缆（20）。Figure 21 Implanting a Trochanteric Grip with Step EightApply to the y pumthe lever onthePiloted Screwdriver 定位起Cannula

32、tedNote:Ifthegauge does not advance with each the er is not the cable sufficiently. the locking handle and continue until the Implanting a Trochanteric Grip with Step EightApply to the y pumthe lever onthePiloted Screwdriver 定位起CannulatedNote:Ifthegauge does not advance with each the er is not the c

33、able sufficiently. the locking handle and continue until the The amount of placed on the cable should be Non-Piloted on the patients bone quality and surgical experience of Non-Cannulatedoperative surgeon. However, should not continue to app d if the second red band is visible and protruding from th

34、elocking handle (Figure 9, page 6).Figure 23 Step Before removing the er, tighten the comple y with the 35lb Torque-Limiting Screwdriver and appropriate screwdriver bit byturning clockwise. (Figure 22)Note: Tighten the screwuntilasingle clickisNote: Do not use another torque-limiting screwdriver han

35、dle or standard screwdriver handle as this may apply an inappropriate amount of torque to the screwhead causing 压力值取决于患者的骨质本身以及术者的临床经验。当然，若第二条红色标记线凸出锁紧把手，则不应再加压。（96 页）The screw hex configuration may vary. Therefore, it is mended to use the ACCORD Dual-Ended Driver Bit (7136-0046) with standard hex a

36、nd pilot hex ensure proper seating of the driver hex end screw. (Figure 22)he You may encounter two screw head hex 35Ib 的限矩型手柄和相应的螺钉起子顺时针旋转完全拧紧锁紧螺钉，然后移除锁紧器（22）。ACCORD system (Figure 23). Therefore, the instrument set should include one screwdriver bit with each style hex: pilot tip ithout. If the pr

37、imary screwdriver w/pilot tip (7136-0044) does not he head of the screw,thescrew headmay notbe fullycannulated lottipfromfullyengaging.Ifthisoccurs,thenswitchitthe screwdriver hex bit (7136-To make this procedure faster and easier, you may use the dual ended hex screwdriver bit (7136-0046). This dri

38、ver has both the primary pilot tip and the hex driver bit. The driver allowsyoutouseeitherendbyremovingthebit,turningit用带有标准内六角和定位内六角ACCORD 双头起 CCORD 系统中有两种螺钉内六角的设计（图 23）。因此，任何一套工具均应包括一把起子配两种内六角：定位或不带定位起子。若定位螺钉起子(736-0044) 定位端不能置入，如果发生此情况，将螺钉起子换(736-0040)。ACCORD双头(7136-0046)。degrees,andengagingtheop

39、 Handle as needed.iteTorque-LimitingFigure 22 Implanting a Trochanteric Grip with Cables Note:Takecarenottostripthescreworscrewdrivert the driver bit is fully seated and aligned with Implanting a Trochanteric Grip with Cables Note:Takecarenottostripthescreworscrewdrivert the driver bit is fully seat

40、ed and aligned with screwaxisbefore tighteningtoprevent ofeitherscrew or driver bit. If the screwdriver bit is stripped, and replace new bit. If the screw is stripped ingmaynotbeStep Releasethecablefromtheer by loosening the handle (turn counterclockwise). Remove the Step Eleven Repeatthisten the Gr

41、ip.ing s for each cable and 注意：ACCORD 线缆系统允许使用限矩起子在锁紧后重Note: The ACCORD Cable System allows you to loosen with the Torque-Limiting Screwdriver and retighten when sary without the use of any extra instruments.Step Use the Flush Cutter to cut the scable(FigureNote: In order for the cut to be flush, th

42、e cutting side of Flush Cutter must be adjacent to the . e indicated on the instrument by the words cut Figure 24 使用线缆切割器切断多余的线缆（24）Cut eACCORD Catalog Information 线缆系统目Instruments 工ACCORD Instrument ACCORD Standard TrochantericGripTrialCat.7136-Cat. 7136-ACCORD Std 85mm ACCORD Std125mm ACCORD Catalog Information 线缆系统目In