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

1、肘關(guān)節(jié)產(chǎn)品肘關(guān)節(jié)產(chǎn)品 & 手術(shù)技巧手術(shù)技巧誰在做肘關(guān)節(jié)手術(shù)誰在做肘關(guān)節(jié)手術(shù)?l手外科醫(yī)生l上肢外科醫(yī)生l關(guān)節(jié)鏡外科醫(yī)生l 普通骨科醫(yī)生肘關(guān)節(jié)外科手術(shù)肘關(guān)節(jié)外科手術(shù)l遠端二頭肌腱撕裂l肱骨外上髁炎（網(wǎng)球肘）l內(nèi)外側(cè)副韌帶撕裂遠端二頭肌腱撕脫遠端二頭肌腱撕脫 biceps tendon attachment sitedistal biceps attachmentbiceps tendon attachmentdistal biceps tendonbicepsdistal 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網(wǎng)球肘外上髁炎外上髁炎損傷損傷 & 治療治療lecrb橈側(cè)腕

3、短伸肌的小損傷, 非感染性l手術(shù)治療不常用 (報道4-8% 的病例用手術(shù)治療)l外科手術(shù)開放或鏡下松解(shaver or rf)松解，重連接lateral elbow橈骨肱骨外上髁尺骨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個mitek 錨釘 (gii, fastin)重新連接到外上髁內(nèi)側(cè)副韌帶修復(fù)內(nèi)側(cè)副韌帶修復(fù)tommy john surgery (medial ucl)側(cè)副韌帶修復(fù)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”lnamed after the first patient of ulnar collateral replacement surgery.ldoctors name

5、: frank jobelfirst surgery done in 1974when the rupture occurs尺側(cè)副韌帶撕裂相關(guān)問題尺側(cè)副韌帶撕裂相關(guān)問題l過頭投擲運動時缺乏穩(wěn)定性l在做過頭投擲運動時手臂不能用力l過頭投擲運動時不能控制傳統(tǒng)傳統(tǒng)ucl的修復(fù)的修復(fù)l“金標(biāo)準(zhǔn)”l骨隧道技術(shù)l前臂掌長肌腱或跟腱做韌帶移植l尺神經(jīng)轉(zhuǎn)置l移植物8字固定l韌帶端用縫線縫合在一起repair of ucll方法復(fù)雜，費時l可用帶線錨釘固定l簡化手術(shù) &省時l減少骨隧道穿肌腱造成的創(chuàng)傷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