Memento dd by mikeholy


									 MoPyC                                                                MoPyC

       • Modularity: Implant customization                                                                                                                                       MODULAR PYROCARBON RADIAL

                                                                                                                                                                                 HEAD PROSTHESIS
    Height (mm)               9        10                11

   Diameter (mm)             18        20                22

    Height (mm)               5        6,5          8           10

     Angulation              15°       15°         15°          15°

   Diameter (mm)              7         8           9           10

    Height (mm)              40        44          48           50

                         P         M           G           XL

       48 combinations
       • Cementless stem
       • Osteointegration of titanium stem

                                                                                                                          BIOP/PTR/MKT/0193 Ind. D - Non contractual document.
                                                                                        Tornier SAS
                                                                                        Etablissement Bioprofile
      Indications                                                                       Parc d’Activité Polytec                                                                  ELBOW
                                                                                        20, rue des Berges
                                                                                        38024 Grenoble cedex 1 - France
       • Comminuted radial head fractures.
                                                                          0459          Tel.: +33 (0) 4 76 23 94 60
       • Degenerative arthritis of the proximal radio-ulnar joint.                      Fax: +33 (0) 4 76 23 94 61


Memento Mopyc.v4-UK.indd 1                                                                                                                                                                                    12/02/10 17:13

   1      RADIAL H E A D R E S E C T I O N                                             Choice of the neck:                                                                              Orientation adjustment:
                                                                                                                                                                                        Forearm in pronation, correct orientation
                                                                                       use of a heigth gauge:                                                                           of the neck should make the orientation
                                        Arm in pronation, the orientation                                   The height gauge, in association to the                                     tip vertical and perpendicular to the flat
                                        plate is positioned on the radius                                   chosen head, allows choosing the neck                                       of distal radius.
                                        upon the wrist. Thus the cutting                                    size according to the gap to fill in.
                                        guide represents the radius axis.                                   Pay attention to not overstuff the head.
                                        The resection must be sufficient and                                Sizes selection is validated by stability
                                        perpendicular to the radius axis:                                   tests using the trial components.
                                                                                                            A minimum of 3mm piston between radial
                                        • to avoid possible overpressure                                    head and condyle is mandatory.
                                          of the prosthesis on the humerus
                                          condyle.                                                          Orientation of the neck: refer to part 3.
                                        • to allow the good positioning                                                                                          Impaction of the head-neck
                                          of the stem parallel to the radius                                                                                     component into the stem:
                                          axis and a good support of
                                          the stem ring onto the resection             3        P R O S T H E S I S I M P L A NTATION                            Initial locking:
                                          of the diaphysis.                                                                                                      Seat the neck to the stem by applying a force distally while rocking
                                                                                      Stem fixation:                                                             the orientation tip a few degrees. A proper seating of the neck to
                                        Nota Bene:                                                                                                               the stem will make the patient’s hand supine and pronate when gently
                                        Radial head anatomic angulation            tournevis                Impaction of the final stem: Impaction of the        rocking the orientation tip. If rocking the orientation tip does not
                                        will be restored by the neck                                        final stem into the bone shaft with the screw        make the hand rotate, this means that the initial locking has not been
                                        of the prosthesis.                         préhenseur    +          drive and the stem holder.                           completed. If so, perform this whole step again (no locking can be
                                                                                                                                                                 explained by an inappropriate cleaned and dried surfaces).
                                                                                                             Using the stem holder, test rotation stability of
                                                                                                 =          the stem inside the diaphysis. Should stability      Final impaction:
   2     CHOICE O F C O M P O N E N T S                                                                     is insufficient, start expansion of the stem.
                                                                                                            Check regularly stem stability during stem
                                                                                                                                                                 Arm and forearm are firmly maintained by an assistant.
                                                                                                                                                                 With a hammer, give 2 to 3 series of 3 straight hits on the silicon
         SIZES                                                                     préhenseur               expansion process. Stop expansion when               part of the orientation tip.
                                                                                                            stem stability is obtained i.e. the patient’s hand
                                                                                                            supine and pronate when testing stem stability
   H e a d s e l e c tion: compar e                                                                         whith the stem holder.
   w i t h r e s e c ted radial head
   Undersizing is recommended to facilitate
                                                                                                            Visual marking shows steps of expansion:
                                                                                                            =1st red dot (stem holder side):
   annular ligament closure, to increase prosthesis                                                         expansion hasn’t begun yet.
   stability and to decrease pressure on the humeral
   condyle and ulnar sigmoid cavity.                                                                        =Green dot: expansion is on progress
                                                                                                            and must be stopped as soon as stem
                                                                                                            stability is obtained.                               Head/neck assembly control:
                                                                                   Assemblage tête-col
  C h o i c e o f t he stem:                                                                                =2nd red dot (handle side): expansion                Check the correct head / neck assembly applying a manual strength
                                                                                                                                                                 on the head. Vibrations generated by the neck / stem impactions may
                                                                                                            is maximal and screwing must absolutely
  The broaches are available to prepare the radial shaft. Each broach                                       be stopped.                                          disassemble the head from the neck. In case of head disassembly,
  is color-coded, the color corresponding to the trial stem with the same                                                                                        remove the neck from the stem, take the head and the neck off,
  diameter.                                                                                                                                                      clean the surfaces with alcohol, re-assemble the neck with the head
   Nota: Because of its elasticity, definitive stem may enter properly
                                                                                       Neck-head assembly pr epa r a t i o n :                                   according to the technique described, and then impact again the neck
                                                                                                                                                                 into the stem.
   into the diaphysis even when corresponding compactor do not enter                                        A special attention must be paid to the good
   the diaphysis entirely. Always prefer biggest diameter stem so that                                      orientation of the head-neck component.
   constraints will be spread out homogeneously inside the diaphysis.
                                                                                                            Positioning of the neck:                                    For more information refer to the complete
                                                                                                            Forearm in pronation, the thickest side
                                                                                                            of the neck with L letter is positioned
                                                                                                                                                                          surgical technique: BIOP/PTR/MKT/0149
                                                                                                            on the lateral.
                                           In case of small bone shaft the use                              Insert the head side first and then the neck.
                                           of a rasp (diameter 5) is recommended
                                           before the use of the smallest broach                            The tapers of the neck and of the stem must
                                           (diameter 7).                                                    be clean and dry.

Memento Mopyc.v4-UK.indd 2                                                                                                                                                                                                     12/02/10 17:13

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