1、肘关节产品肘关节产品&手术技巧手术技巧Mitek肘关节产品及手术应用1谁在做肘关节手术谁在做肘关节手术?l手外科医生l上肢外科医生l关节镜外科医生l 普通骨科医生Mitek肘关节产品及手术应用2肘关节外科手术肘关节外科手术l远端二头肌腱撕裂l肱骨外上髁炎（网球肘）l内外侧副韧带撕裂Mitek肘关节产品及手术应用3远端二头肌腱撕脱远端二头肌腱撕脱 Mitek肘关节产品及手术应用4Biceps Tendon Attachment SiteDistal Biceps AttachmentMitek肘关节产品及手术应用5Biceps Tendon AttachmentDistal Biceps Ten
2、donBicepsMitek肘关节产品及手术应用6Distal Biceps Tendon Rupture肱骨内侧髁尺骨茎突撕裂的二头肌腱常见于中年男性的dominant手Mitek肘关节产品及手术应用7Biceps Tendon Reattachment2 Incision Technique Drill HolesMitek肘关节产品及手术应用8Biceps Tendon ReattachmentSingle Incision Suture AnchorsMitek肘关节产品及手术应用9Suture Anchor Techniquel1 incisionLess risk of infec
3、tion&less scarringlNo risk of bone tunnel breakagelEasier to perform,saves OR time.Mitek肘关节产品及手术应用10JHS-May 2003Mitek肘关节产品及手术应用11肱骨外上髁炎肱骨外上髁炎l网球肘Mitek肘关节产品及手术应用12外上髁炎外上髁炎损伤损伤&治疗治疗lECRB桡侧腕短伸肌的小损伤,非感染性l手术治疗不常用(报道4-8%的病例用手术治疗)l外科手术开放或镜下松解(shaver or RF)松解，重连接Mitek肘关节产品及手术应用13Lateral Elbow桡骨肱骨外上髁尺骨Mitek肘
4、关节产品及手术应用14Location of ECRBECRL桡侧腕长伸肌ECRB 桡侧腕短伸肌ECU Extensor Carpi Ulnaris尺侧腕伸肌Mitek肘关节产品及手术应用15ECRB Location ContinuedMitek肘关节产品及手术应用16Mitek Technique Brochure(Dr.Lorenzo Walker Cat#900091)l找到ECRBl松解ECRBlResect Lateral Epicondyle&expose raw cancellous surfacelMobilize Extensor Originl用2个Mitek 锚钉(GI
5、I,Fastin)重新连接到外上髁Mitek肘关节产品及手术应用17内侧副韧带修复内侧副韧带修复lTommy John Surgery(Medial UCL)Mitek肘关节产品及手术应用18侧副韧带修复侧副韧带修复Medial UCL Complex斜束前束后束Mitek肘关节产品及手术应用19Medial UCL:Anterior BandA Pitchers Injury“Tommy John Surgery”lNamed after the first patient of ulnar collateral replacement surgery.lDoctors name:Frank
6、 JobelFirst surgery done in 1974Mitek肘关节产品及手术应用20When the Rupture OccursMitek肘关节产品及手术应用21尺侧副韧带撕裂相关问题尺侧副韧带撕裂相关问题l过头投掷运动时缺乏稳定性l在做过头投掷运动时手臂不能用力l过头投掷运动时不能控制Mitek肘关节产品及手术应用22传统传统UCL的修复的修复l“金标准”l骨隧道技术l前臂掌长肌腱或跟腱做韧带移植l尺神经转置l移植物8字固定l韧带端用缝线缝合在一起Mitek肘关节产品及手术应用23Repair of UCLl方法复杂，费时l可用带线锚钉固定l简化手术&省时l减少骨隧道穿肌腱造
7、成的创伤Mitek肘关节产品及手术应用24Anchors for the ElbowMitek肘关节产品及手术应用25 Anchor Body:2.4 x 8.8mmArc Range:7.8mmDrill 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&media
8、l ankle instability,Mid-foot reconstruction,Hallux Valgus&Achillies tendon repairElbow:Tennis Elbow,Biceps TendonHand:Thumb UCL and ScapholunateGII AnchorMitek肘关节产品及手术应用26Anchor 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 Needl
9、eAnchor Material:PLAPullout lbs.:35 lbsIndications:Elbow:Biceps tendon reattachmentAnkle:Achilles tendon repair,Lateral stabilization,Medial stabilization at the medial talus sitePanalok AnchorMitek肘关节产品及手术应用27Anchor Body:3.0 x 8.4 mm4.0 x 9.7 mmSuture:#2 Ethibond(no needles)Drill bit:Self drillingA
10、nchor Material:TitaniumPullout lbs.:33.5 lbs(for 3.0mm),61 lbs(4.0mm)Indications:Foot:Midfoot reconstruction,Medial or lateral instability,Achilles tendon,Hallux valgus.Elbow:Tennis elbow,Biceps tendonHand:Scapholunate ligament,Ulnar or radial collateral ligament Fastin 3.0 or 4.0 AnchorMitek肘关节产品及手术应用28
