Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用課件

1、肘關(guān)節(jié)產(chǎn)品 & 手術(shù)技巧Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用1肘關(guān)節(jié)產(chǎn)品 & 手術(shù)技巧Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用1誰在做肘關(guān)節(jié)手術(shù)?手外科醫(yī)生上肢外科醫(yī)生關(guān)節(jié)鏡外科醫(yī)生 普通骨科醫(yī)生Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用2誰在做肘關(guān)節(jié)手術(shù)?手外科醫(yī)生Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用2肘關(guān)節(jié)外科手術(shù)遠端二頭肌腱撕裂肱骨外上髁炎（網(wǎng)球肘）內(nèi)外側(cè)副韌帶撕裂Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用3肘關(guān)節(jié)外科手術(shù)遠端二頭肌腱撕裂Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用遠端二頭肌腱撕脫 Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用4遠端二頭肌腱撕脫 Mitek肘關(guān)節(jié)產(chǎn)品及Biceps Tendon Attachment SiteDistal Bic

2、eps AttachmentMitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用5Biceps Tendon Attachment SiteDBiceps Tendon AttachmentDistal Biceps TendonBicepsMitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用6Biceps Tendon AttachmentDistalDistal Biceps Tendon Rupture肱骨內(nèi)側(cè)髁尺骨莖突撕裂的二頭肌腱常見于中年男性的dominant手Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用7Distal Biceps Tendon Rupture肱骨Biceps Tendon Reattachment2 Incision

3、Technique Drill HolesMitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用8Biceps Tendon Reattachment2 IBiceps Tendon ReattachmentSingle Incision Suture AnchorsMitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用9Biceps Tendon ReattachmentSinSuture Anchor Technique1 incisionLess risk of infection & less scarringNo risk of bone tunnel breakageEasier to perform, saves OR tim

4、e. Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用10Suture Anchor Technique1 incisJHS- May 2003Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用11JHS- May 2003Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用11肱骨外上髁炎網(wǎng)球肘Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用12肱骨外上髁炎網(wǎng)球肘Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用12外上髁炎損傷 & 治療ECRB橈側(cè)腕短伸肌的小損傷, 非感染性手術(shù)治療不常用 (報道4-8% 的病例用手術(shù)治療)外科手術(shù)開放或鏡下松解(shaver or RF)松解，重連接Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用13外上髁炎損傷 & 治療ECRB橈側(cè)腕短伸肌的小損傷, 非感Later

5、al Elbow橈骨肱骨外上髁尺骨Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用14Lateral Elbow橈骨肱骨外上髁尺骨Mitek肘關(guān)節(jié)Location of ECRBECRL橈側(cè)腕長伸肌ECRB 橈側(cè)腕短伸肌ECU Extensor Carpi Ulnaris尺側(cè)腕伸肌Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用15Location of ECRBECRLECRB ECRB Location ContinuedMitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用16ECRB Location ContinuedMitek肘關(guān)Mitek Technique Brochure (Dr. Lorenzo Walker Cat # 90009

6、1)找到ECRB松解ECRBResect Lateral Epicondyle & expose raw cancellous surfaceMobilize Extensor Origin用2個Mitek 錨釘 (GII, Fastin)重新連接到外上髁Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用17Mitek Technique Brochure (Dr.內(nèi)側(cè)副韌帶修復(fù)Tommy John Surgery (Medial UCL)Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用18內(nèi)側(cè)副韌帶修復(fù)Tommy John Surgery (Med側(cè)副韌帶修復(fù)Medial UCL Complex斜束前束后束Mitek肘關(guān)節(jié)產(chǎn)品及

7、手術(shù)應(yīng)用19側(cè)副韌帶修復(fù)Medial UCL Complex斜束前束后束Medial UCL: Anterior BandA Pitchers Injury“Tommy John Surgery”Named after the first patient of ulnar collateral replacement surgery.Doctors name: Frank JobeFirst surgery done in 1974Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用20Medial UCL: Anterior BandA PiWhen the Rupture OccursLate-cockingA

8、ccelerationMitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用21When the Rupture OccursLate-co尺側(cè)副韌帶撕裂相關(guān)問題過頭投擲運動時缺乏穩(wěn)定性在做過頭投擲運動時手臂不能用力過頭投擲運動時不能控制Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用22尺側(cè)副韌帶撕裂相關(guān)問題過頭投擲運動時缺乏穩(wěn)定性Mitek肘關(guān)傳統(tǒng)UCL的修復(fù)“金標(biāo)準(zhǔn)”骨隧道技術(shù)前臂掌長肌腱或跟腱做韌帶移植尺神經(jīng)轉(zhuǎn)置移植物8字固定韌帶端用縫線縫合在一起Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用23傳統(tǒng)UCL的修復(fù)“金標(biāo)準(zhǔn)”Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用23Repair of UCL方法復(fù)雜，費時可用帶線錨釘固定簡化手術(shù) &省時減少骨隧道穿肌腱

9、造成的創(chuàng)傷Mitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用24Repair of UCL方法復(fù)雜，費時Mitek肘關(guān)節(jié)產(chǎn)品Anchors for the ElbowMitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用25Anchors for the ElbowMitek肘關(guān)節(jié)產(chǎn) Anchor Body:2.4 x 8.8mmArc Range:7.8mmDrill 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 w

10、ith Nitinol ArcsPullout lbs.: 25 lbsIndications:Foot: Lateral & medial ankle instability, Mid-foot reconstruction, Hallux Valgus & Achillies tendon repairElbow:Tennis Elbow, Biceps TendonHand: Thumb UCL and ScapholunateGII AnchorMitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用26 Anchor Body:2.4 x 8.8mmGII Anchor Body:4.1 x 6.0 mm D

11、rill 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: Achilles tendon repair, Lateral stabilization, Medial stabilization at the medial talus sitePanalok AnchorMitek肘關(guān)節(jié)產(chǎn)品及手術(shù)應(yīng)用27Anchor Body:4.1 x 6.0 mm PanAnchor 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 t