i. Implants i. Models1. Surgical material2. Surgical approach3. Application4. Osteotomy 5. Finishing

MouseFixSurgical technique guide

Internal fixaton SystemStabilisation of osteotomies with a conventional bridging osteosynthesis or by inter frag-mentary compression. Possible size of osteotomy 0.25 mm to 3.50 mm.

i. ImplantsTechnology The MouseFix system is a locked internal fixator made of pure Titanium (TiCp). For this model a rigid and a flexible design are available. The rigid one is offered in two different sizes. A standard size for osteotomies of 0.25 - 1.75 mm and an extra large (XL) model for osteotomies of up to 3.50 mm.Similar MouseFix plates are available for the distal metaphysis of the femur. The MouseFix Screw is made out of TAN and comes in a uniform length of 2.00 mm. The screw driver for insertion of the screws is an integral component of the screw design and shears of when sufficient torque is achieved. A four flanche head remains on the screw-head to remove the screw after use. For the application of the plates various Drill- and Saw guides are available.

iRIS.401.110 MouseFix Plate 4 hole, rigide

RIS.401.100 MouseFix Screw, length 2.00 mm

RIS.401.111 MouseFix Plate 3 hole, metaphyseal flexible

RIS.401.120 MouseFix Plate 4 hole, flexible

RIS.401.130 MouseFix Plate 6 hole, XL

RIS.401.111 MouseFix Plate 3 hole, metaphyseal rigide

MouseFix

The MouseFix system can cover single cut osteotomies up to large bone defects or flexible fixation technology. The plates available can be used within the diaphysis and the metaphysis of the femur. On the right all available MouseFix plates are shown applied to the femur of a mouse.

i. SystemsRIS.401.110 MouseFix Plate 4 hole, rigide

RIS.401.120 MouseFix Plate 4 hole, flexible

RIS.401.130 MouseFix Plate 6 hole, XL

RIS.401.111 MouseFix Plate 3 hole, metaphyseal flexible

RIS.401.111 MouseFix Plate 3 hole, metaphyseal rigide

MouseFix

Implants:- 1x 4 hole plate rigid - 4x MouseFix screws with a length of 2.0 mm

1. Surgical material

Implant specific instruments:- 1x MouseFix Drill-& Saw guide

Instruments:- 4x hand drills - 1x Accu Pen 3V

Consumables:- 1x 0.30 mm Drill bit- 1x 0.22 mm Gigly wire saw, 0.50 m- 1x Square box wrench 0.50 mm- 1x Vicryl suture 3-0 - Skin glue (Epiglue) / Vicryl suture 5-0 - 1x Ethibond Vicryl suture 6-0

RIS.401.110 MouseFix Plate 4 hole, rigide RIS.401.100 MouseFix Screw, length 2.00 mm

RIS.390.130 Hand drill

RIS.390.200 AccuPen 3V

RIS.590.100 Gigly wire saw 0.22 mm

RIS.590.200 Drill Bit 0.30 mm

RIS.590.111 Square box wrench 0.5 mm

RIS.301.100 MouseFix Drill-& Saw guide, rigid

MouseFix

Positioning

Mouse in prone position.

2. Surgical approach

MouseFix

Approach

Longitudinal incision along the femur from the hip joint to the knee.

2. Surgical approach

MouseFix

Approach

Longitudinal incision of the fascia lata.

2. Surgical approach

MouseFix

Approach

M. vastus lateralis and M. biceps femoris

are split and M. tensor fasciae latae is lifted to expose the full length of the femur preserving the sciatic nerve.

2. Surgical approach

MouseFix

Approach

Circular preparation of the femur at the transition from the middle third to the distal third.

2. Surgical approach

MouseFix

Application of the Gigly wire saw

Put the wire saw closely around the bone in in medio-lateral orientation

Preparation of the hardware

Insert the screws into the holders of the hand drill no more than 1-2 mm deep. Make sure to knot the suture at one end.

3. Application

MouseFix

Detail:Drill-& Saw guide with plate inserted.

Fixation of the MouseFix Drill- & Saw guide Plate positioning in the MouseFixDrill- & Saw guide

Position the plate upside down in the MouseFix Drill- & Saw guide with the con-cave bottom surface showing towards you.

Attach the fixation suture to the Drill- and Saw guide securing the plate onto it.

Put the device on the prepared femur in anterolateral direction by externally rotating the femur.

Fix the tool by wrapping the suture around the bone and the device.

Gauge the Drill- and Saw guide.

3. Application

MouseFix

Preparation for drilling and screwing

By applying the first screw the alignment of the plate is determined. Therefore it is important to position the plate parallel to the femur.

Adjust the orientation of the longitudinal axis so that the plate is reclined anterolater-ally and parallel to the bone.

Retain rotation of the bone to ensure the stability of the plate.

3. Application

MouseFix

4. ApplicationDrilling and insertion of the screws

Carefully use the forceps to connect the drilling and sawing guide to the femur.

Drill the first hole (1) distally to the planned fracture gap and insert the screw.

Shear off the drive shaft.

MouseFix

3. ApplicationSequence of screw placement

Drill the hole for the second screw (2) proximally to the planned osteotomy and insert the screw.

The third (3) and the last screw (4) should be placed in the order shown in the illustration.

Make sure to insert the last screw without shearing off the pin to provide additional stability during sawing.

4 1 2 3

MouseFix

4. OsteotomyAccomplishing the osteotomy

Remove the suture lying around the femur.

Create a defined fracture gap by using the Gigly saw (sufficient irrigation !).

To avoid damage of the soft tissue cut the saw wire close to the bone on one side after completing the osteotomy.

MouseFix

5. FinishingWound closure

Lift the M. quadriceps loosely over the plate.

Close the fascia lata with Ethibond vicryl suture 6-0.

Skin suture with Ethibond vicryl suture 6-0.

To avoid wound biting it is also possible to use skin glue instead of a suture.

MouseFix

Hazards and legal restrictionsScientific editor: Tina Histing, GermanyIllustrations: Sandra Wissing, SwitzerlandDesign and layout: Romano Matthys, Switzerland In collaboration with: University of Saarland, Germany Trauma, Hand and reconstructive Surgery Director: Tim PohlemannHazards Great care has been taken to maintain the accuracy of the information contained in this publication. However, the publisher, and/or the distributor, and/or the editors, and/or the authors cannot be held responsible for errors or any consequences arising from the use of the information contained in this publication. Contributions published under the name of individual authors are state-ments and opinions solely of said authors and not of the publisher, and/or the distribu-tor, and/or the RISystem Group. The products, procedures, and therapies described in this work are hazardous and are therefore only to be applied by certified and traine medical professionals in environments specially designed for such procedures.

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No suggested test or procedure should be carried out unless, in the user‘s professional judgment, its risk is justified. Whoever applies products, procedures, and therapies shown or described in this work will do this at their own risk. Because of rapid advances in the medical sciences, RISystem recommends that independent verification of diagnosis, therapies, drugs, dosages, and operation methods should be made before any action is taken. Although all advertising material which may be inserted into the work is expected to conform to ethical (medical) standards, inclusion in this publication does not constitute a guarantee or endorsement by the publisher regarding quality or value of such product or of the claims made of it by its manufacturer.

MouseFix