强生带线锚钉在手外科的临床应用

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1、强生带线锚钉(SutueAnchor)在手外科的临床应用强生(中国)医疗器材有限公司DePuyMitekQ&AWhat?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)ViewDorsalVie

2、wVolarPlatesCarpalBonesPhalangesProximalDistalMiddleMetacarpals3rd2nd1stEtc..RadiusUlna腕骨PalmarViewDorsalViewTriquetrumScaphoidLunateRadiusUlnaTriquetrumPsisiformTrapeziumCapitateHamateTrapezoidHamateCapitateArticularCartilageRemember:SLTPTTCHSLTqPTTrCH手&腕部韧带Pa

3、lmar(Volar)ViewDorsalViewCollateralLigamentsUlnarCollateralLigamentSkiier’sThumbGameKeepersThumbDeeptransversemetacarpalLigamentsDorsalIntercarpalLigamentsDorsalRadiocarpalLigament腕骨间韧带PalmarViewScaphoidLunateTriquetrumInferiorViewScaphoidLunateTriquetrumScapho

4、lunateLigament-Dorsal手&腕部肌腱PalmarViewDorsalViewFlexorTendonsFDPRepair(FlexorDigitorumProfundus)ExtensorTendonsBoutonniereDeformityMalletFingerFlexorPollicisLongusCentralSlipLateralBandsTFCC(三角纤维软骨复合体)AvascularregionDebridementiscommonhereRadiusUlnaIt’sthe“menis

5、cus”ofthewrist!Trampoline,actstotransmitloadtoUlnaSkier‘sThumb-拇指尺侧副韧带断裂RepairUsingSutureAnchorsMethodofUlnarCollateralLigamentInjuryGoldStandardofRepairMostCommonUseofAnchorsinHand!!!指深屈肌腱(akaJerseyFingerorFDP)RepairUsingSutureAnchorsFlexorDigitorumProfundusGo

6、ldStandardRepairAnchors…MicroMiniRecommendedFlexorTendonJHS,May2001Compares,2Micro,1MiniandPulloutButtonMaxpassiverehabforcesat11N(2.0lbs)Maxactivemotionat19N(4.3lbs)Compare4.3toouranchorstrengths!43.344.669.9(N)15.7lbsButtonMini2Micro指伸肌腱–锤状指MalletFingerRepair

7、usingSutureAnchor指伸肌腱–Boutonniere（钮扣指）BoutonniereDeformityRepairoptionusingSutureAnchors指伸肌腱-SwanNeck（鹅颈畸形）SwanNeckDeformityArepairoptionusingSutureAnchors腕部舟月韧带ScaphoLunaterepairusingSutureanchorsLunateScaphoidRadius手外科常用的带线锚钉锚钉尺寸:1.6x2.7mm钻孔尺寸:1.3mmx5.0mm(inc

8、ludedinpackage)缝线:3/0Ethibond&V-4TapercutNeedle4/0Ethibond&C-1TaperpointNeedle4/0Ethibond&P-3PrecisionPointNeedle锚钉材料:PLA(tintedblueforvisualization)回拉力lbs.:~8.5lbs.inhand(1