14 强生带线锚钉在手外科的临床应用.ppt

1 ° 1 ° 手腕部软组织处理- VAPR VAPR 小关节射频刀头 2.3mm x 85mm 腕关节镜下使用 软组织清理 热挛缩 Side Effect Wedge Effect Flexibility of multidirectional access Best geometry for thermal modification Better at ‘sculpting’ Precise removal of targeted tissue Great for central TFCC tears Slightly faster than wedge TFCC- VAPR for 1A Tears Avascular region Debridement is common here Radius Ulna TFCC Triangular FibroCartilage Complex It’s the “meniscus” of the wrist! KEY POINTS PEARLS: Faster than shavers NEED good outflow in small joint Use in ‘spurts’ to avoid overheating Can use trimmed 2.3 suction sheath to improve flow and visualization 强生带线锚钉(Sutue Anchor)在手外科的临床应用 强生(中国)医疗器材 有限公司 DePuy Mitek Q A What? 一种非常小的植入物，通过缝线将软组织和骨重新连接(Reattachment)。 Mechanism? 通过缝针将缝线穿过软组织，并打结将软组织固定于锚钉上，即骨表面。 Material? 不可吸收的钛合金或者高分子聚乙烯; 可吸收性的多聚乳酸。 目前Mitek带线锚钉多用于哪里? 肩关节 肘关节 手和腕关节 膝关节 足和踝关节 颌面部 髋关节 骨盆 ……… 手外科解剖基础 手 腕骨 Palmar (Volar) View Dorsal View Volar Plates Carpal Bones Phalanges Proximal Distal Middle Metacarpals 3rd 2nd 1st Etc.. Radius Ulna 腕骨 Palmar View Dorsal View Triquetrum Scaphoid Lunate Radius Ulna Triquetrum Psisiform Trapezium Capitate Hamate Trapezoid Hamate Capitate Articular Cartilage Remember: SLTPTTCH S L Tq P T Tr C H 手 腕部韧带 Palmar (Volar) View Dorsal View Collateral Ligaments Ulnar Collateral Ligament Skiier’s Thumb Game Keepers Thumb Deep transverse metacarpal Ligaments Dorsal Intercarpal Ligaments Dorsal Radiocarpal Ligament 腕骨间韧带 Palmar View Scaphoid Lunate Triquetrum Inferior View Scaphoid Lunate Triquetrum Scapholunate Ligament- Dorsal 手 腕部肌腱 Palmar View Dorsal View Flexor Tendons FDP Repair (Flexor Digitorum Profundus) Extensor Tendons Boutonniere Deformity Mallet Finger Flexor Pollicis Longus Central Slip Lateral Bands TFCC (三角纤维软骨复合体) Avascular region Debridement is common here Radius Ulna It’s the “meniscus” of the wrist! Trampoline, acts to transmit load to Ulna Skier‘s Thumb- 拇指尺侧副韧带断裂 Repair Using Suture Anchors Method of Ulnar Collateral Li