10. FIXATION OF TIBIO-FIBULAR SYNDESMOSIS
with ActivaScrew™ 4.5 mm or ActivaScrew™ 4.0 mm Cannulated (Length 60 - 90mm)
After fixation of concomitant fractures of fibula and tibia, fibula is firmly placed into the fibular notch of the tibia to regain the normal anatomy of the ankle mortise. While holding the fibula in place, a hole is drilled through the four cortices in slightly anteriorly inclined direction. The screw hole is tapped and a full threaded screw is inserted until the distal tip of the screw can be palpated through the tissues of the medial aspect of the tibia. Screw head and excess screw can be cut off flush along the bone surface. Cutting with hot loop increases the holding power due the small head formation.
With Plate Fixation:The syndesmosis screw can be placed through a hole of a fixation plate (ActivaScrew™ 4.0 mm cannulated is also compatible with most of the modern locking plates due to its smaller outer diameter). |
Optional Technique with two ActivaScrew™ implants:If the technique of two screws is applied, sufficient holding power is gained by fixation through three cortices. Also in this case the head and the excess screw can be cut off after insertion of the screw. |
|
|
|
Benefits using ActivaScrew™ in fixation of tibio-fibular syndesmosis
-
Avoidance of routine metal screw removal
-
No need to worry about the screw breakage like with metal screws
-
In case of non-cannulated ActivaScrewTM no extra instrumentation is needed due to AO-compatibility
-
ActivaScrew 4.0 mm cannulated compatibility with most of the modern locking plates
9. FIXATION OF TIBIO-FIBULAR SYNDESMOSIS with ActivaScrewTM 4.5 mm or ActivaScrewTM 4.0 mm Cannulated (Length 70 mm)
After fixation of concomitant fractures of fibula and tibia, fibula is firmly placed into the fibular notch of the tibia to regain the normal anatomy of the ankle mortise. While holding the fibula in place, a hole is drilled through the four cortices in slightly anteriorly inclined direction. The screw hole is tapped and a full threaded screw
is inserted until the distal tip of the screw can be palpated through the tissues of the medial aspect of the tibia. Screw head and excess screw is cut off flush with the bone surface. Cutting with hot loop increases the holding power due the small head formation. The syndesmosis screw can be placed through a hole of a fixation plate. If two screw technique is applied, sufficient holding power is gained by fixation through three cortices. Also in this case the head and the excess screw can be cut off after insertion of the screw.
Benefits using ActivaScrewTM in fixation of tibio-fibular syndesmosis
- Avoidance of routine metal screw removal
- No need to worry about the screw breakage like with metal screws
- In case of non-cannulated ActivaScrewTM no extra instrumentation is needed due to AO-compatibility
- ActivaScrew 4.0 mm cannulated can be used also with some of the modern locking plates due to it’s smaller outer diameter