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FiberWire® und TigerWire®

TigerWire ist Teil der FiberWire®-Produktreihe und besteht aus der gleichen hochstabilen Struktur wie FiberWire. Er enthält zusätzlich einen in den Faden eingearbeiteten schwarzen Markierungsstrang. Im Faden ist dieser Strang als Streifen sichtbar, sodass die Identifikation des Fadens bei Gelenk- und Weichteilrekonstruktionen erleichtert wird. Führende Orthopäden in aller Welt vertrauen bei ihrer Arbeit auf FiberWire, der bereits in über einer Million orthopädischer Eingriffe erfolgreich verwendet wurde.

Hand and Wrist

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Hand, Wrist, and Elbow - Next Generation in Repair and Reconstruction

Steven J. Lee, MD (New York, NY), demonstrates a dorsal reconstruction to treat scapholunate ligament disruption. Dr. Lee displays the 3.5 mm SwiveLock® SL suture anchor and the FiberLoop® suture. The 3.5 mm × 8.5 mm SwiveLock SL is a PEEK suture anchor that allows knotless, lowprofile, and high-strength fixation for reconstructions and other soft-tissue repairs. FiberLoop suture is a continuous loop of FiberWire® suture used for graft preparation in conjunction with the Arthrex SpeedWhip™ technique.
The InternalBrace surgical technique is intended only to augment the primary repair/reconstruction by expanding the area of tissue approximation during the healing period and is not intended as a replacement for the native ligament. The InternalBrace technique is for use during soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation.

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Dorsal Scapholunate Repair Using the InternalBrace™ Ligament Augmentation Procedure

Hi, I'm Stephen Jay Lee from New York Orthopedics. We're going to be talking today about doing a all dorsal scapholunate reconstruction technique. This technique is best utilized for scapholunate ligament tears that involve the dorsal and central interosseous ligament, with hopefully some at least portions of the volar interosseous ligament intact. I'm going to start with the incision. The incision is going to make a little bit of a difference as to whether you're going to take a graft from your incision area. So the graft I typically take would be a intra tendinous graft from the tendon. But you're welcome to take a graft from wherever you want such as palmaris. And if you do that then you probably need to. You can make a small incision than what I'm going to show here. But the incision I'm going to make here is going to be a fairly healthy incision, mostly because of obtaining the graft safely as opposed to exposure for the scapholunate ligament area. The incision is going to be based more or less off of the of the third metacarpal or between third and fourth compartments. And so I'm going to make a nice longitudinal incision here. So normally I do do a pin and a neurectomy. So at this point I'm going to go ahead and open up the fourth compartment. As we know the pin sits on the radial border of the fourth compartment. Normally resect that. And then I will typically go through the interosseous membrane here, find the nerve as well, and perform a neurectomy at the same time. So normally to get exposure to the carpal bones I normally do a inverted T capsulotomy. But you're certainly welcome to do a ligament sparing approach as well. It is important to preserve the blood supply to the scaphoid as best you can, and at the same point, at the same time trying to get his proper exposure to see what you need to see. So the tendon graft that I typically utilize is a intra slip of the ecrb tendon. So I'm going to go ahead and open up the second compartment. As we all know the EPL tendon does come straight across this. So it is important to obviously Not cut the or transect the EPL on the way. When you're getting your tendon graft, it's really important for this graph to be 2.5mm or less in width. If it's any wider than that, you will have trouble getting your graft to sit inside of your pitchfork in the SwiveLock. At this point, I'm going to try to get my graft as much as I can through my open technique, and then once I get to the very proximal part of my incision, I typically will use a tendon stripper to gain the rest of my length. I will need about ten centimeters of length total for this particular reconstruction technique to help tendon graft management, I'm going to go ahead and put FiberLoop two o FiberLoop on the ends of the tendon. This tool FiberLoop is on your kit. I'm going to put the loop right around the clamp, and you're going to go ahead and put the needle in the middle of your tendon. Now you're going to just repeat the same steps. So I've opened the FiberLoop and put the clamp through it, and I'm just going to go ahead and spear this right down the middle. And I'm going to do it one more time. Usually three loops is perfectly fine to get a solid fixation of your tendon graft. Try to get as much as possible open and then I'll use my tendon stripper. And this one looks to be at least ten centimeters, which is great. So your tendon sizers have two holes and your tendon graph does need to fit within hopefully at least a 2.5mm tendon sizer. So went ahead and whipstitch both ends of the tendon graph. It's important to whipstitch both ends actually, because this is going to be how you're going to secure this onto the SwiveLock. So at this point, I'm trying to figure out where I want to put my drill holes for the reconstruction. And I'm going to go ahead and put some joysticks in so I can put these bones together and hold them clamped together while I'm doing my reconstruction. The second joystick is, I typically put somewhere near the waist of the scaphoid. So your kid has 3.045.054 K-wires. And they have laser lines that are that go down to a centimeter. When you put your guide wires in, just make sure that you are going down to or just past the laser line. So just to show you, I made drill holes into the areas in the proximal scaphoid and the lunate to try to recreate the dorsal band of the scapholunate ligament. This last drill hole is going to be in the distal pole of the scaphoid. In order to try to keep the scaphoid from flexing, I'm also going to try to get an idea where my my vector is from my lunate to my scaphoid. The graft, if it's put in certain areas, it might end up in decapitated joint. Okay, at this point, I definitely recommend that we take a fluoro to make sure that we're happy with our drill holes before we actually drill them out. So I want to emphasize that there's two drill bits that are in your kit. There's a silver drill bit and a gold drill bit. The silver one is used. It's a 3.0mm drill bit that's used when you're using the SwiveLock with sutures or SutureTape only. And the 3.5 gold drill bit is when you're using any kind of ReadiGraft. So easy way to remember it is silver for suture and gold for graphs. This being a graph reconstruction, we're going to go ahead and use the gold drill with the blue drill guide. So a couple of things I wanted to show about the SwiveLock. So there's a square tab here, and there's a pear shaped handle or a pear shaped knob. And when you do insert these a few things one, the tendon graph needs to fit completely within the confines of my pitchfork. And so I just want to show here when I put this into bone, this graph is going to slide around my pitchfork. So let's say I had a graph that was too thick and it was being skewered in this manner. It will not slide, and then you will have trouble having this graph slide around your pitchfork. So when you're putting the ReadiGraft on, I'm going to put just the ends of the tendon graft into the forked islet and the two FiberLoop that I've used to secure the tendon graphs. Now I will secure onto the square tab, and you do that for both of them. I'm going to take my SutureTape and put it on my forked islet, and then also secure that onto the slits in my square tab. So the order that we're going to insert the SwiveLock is into the proximal pole of the scaphoid first, and then into the lunate, and then into the distal pole of the scaphoid. I do look to see which side my tendon graft is as compared to where my SwiveLock is. So since I'm going to start it on the proximal pole scaphoid, and this tendon graph is going to make it over to the lunate, I want my tendon graph to be sitting on the ulnar side of my SwiveLock. So just before I'm going to go ahead and put my reconstruction in, I'm going to go ahead and clamp my two joysticks together so that I have my scaffold and lunate tight against each other. I have my SwiveLock with my tendon graft and InternalBrace. I'm going to take my SwiveLock, and I'm going to put some gentle pressure on this thing until I can feel that my anchor body is up against the bone. So it's important not to start screwing this in until I have the anchor body up against the bone. And when I screw this in, I'm going to put some positive forward pressure on the SwiveLock as I'm screwing it down. If you don't do that, the threads may not engage onto the bone. So again, I'm taking note as to the direction that I made my drill hole. I'm holding my square tab here. I'm going to be turning the pair tab pair knob, but as I do so I'm going to push down. At the same time you will feel a few things. One the SwiveLock needs to go until the black line laser line is underneath is at or below the level of the bone. Secondly, if you screw in enough, you will feel a gentle give on your knob, which will let you know that the handle has been disengaged from the from the anchor. So at this point we're going to I can see that my laser line is fully down. I'm going to take my graft and my SutureTape off of my square tab. If you're having some issues getting this off, sometimes it sticks and you can turn your square tab clockwise, clockwise, and it will help you to release the SwiveLock off your anchor. So again, I'm going to take the tendon graft and my SutureTape and do a gentle little twist. It helps to get it into seat into my pitchfork a little bit easier. I need to put forward pressure on my SwiveLock just gentle but firm pressure just to allow my graft to slide around the forked islet. I want to make sure that my SwiveLock is seating fully down onto the bone before I screw it in. So right about here, you can see that my anchor body is up against the bone, and at this point, I'd be happy to go ahead and hold the square and turn the pear. Same thing. This is even more important. I'm putting a fair amount of forward pressure onto my SwiveLock to allow the threads to engage, and this is going to continue on until the laser line is down underneath the bone. And you'll also at the same time feel your SwiveLock give gently as you do that we've now reconstructed the dorsal aspect of the scapholunate ligament with a tendon graft and my SutureTape. And you can see this is pretty robust already. The again, I'm going to go ahead and skewer the tendon graft with the SutureTape somewhere near the bone. I have somebody pushing from under my assistant pushing from underneath the scaphoid tubercle. And I'm going to put some firm but steady pressure on this. Once the anchor body is up against the bone, that's when I can go ahead and secure my SwiveLock by holding the square and turning the pair. And again, forward positive pressure until the anchor body is down. And also you'll feel this. The SwiveLock release. So we've now reconstructed it took our joysticks out. And you can see that when we move this back and forth under fluoro that the two bones stay together. And also on a lateral you can see the lunate in a nice neutral position, but it also seems to move in a nice kinematic and physiological sequence. Once the reconstruction is done, I still put in a K-wires between across the scaphoid capitate joint. So the the the scaphoid capitate wire is going to be distal to the mid axis of my scaphoid, but obviously missing the drill holes that you made for your swivel locks. Protocol is that I put them in a forearm based thumb spica splint, cast for up to about 6 to 8 weeks or so for capitate pin. I leave in for 6 to 8 weeks. If I can keep it in for eight weeks, then I do. After the eight weeks are out, the capitate pin comes out, and at that point they will be justifiably stiff at that point. So they will undergo, on average, 2 to 3 months of hand therapy to regain their range of motion and their strength.

Foot and Ankle

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FiberWire® - Sutura trançada composta

Distal Extremities FiberWire® Braided Composite Suture

Knee

Vet Systems - Large Animal

Shoulder

Vet Systems - Small Animal

FiberWire® Braided Composite Suture

FiberWire® - Confidence after Closure

2-0 FiberWire Suture, 18 in (Blue) w/Tapered Needle, 17.9 mm 3/8 circle, 12/box

2-0 FiberWire-Faden, blau, 46 cm, mit konischer Nadel, 17.9 mm, 3/8Kreis

2-0 FiberWire suture, blue, 46 cm, with tapered needle,17.9 mm, 3/8 circle

FiberWire de calibre #2-0, hilo de sutura de Polyblendtrenzado, azul,co

FIBERWIRE, BRAIDED PB, #2-0 BLUE W/NEEDLE

Sutura de polimistura entrançada FiberWi

FiberWire #2-0, Geflochtener Polyblend Faden, Blau, ohne Nadeln, steril

FiberWire #2-0, Braided Polyblend Suture, Blue

FiberWire de calibre #2-0, hilo de sutura de Polyblendtrenzado, azul

FIBERWIRE, SUTURA PB TRANCADA, TAMANHO 2-0, AZUL

2-0 FiberWire Suture, 18 in (Blue) w/Tapered Needle, 26.5 mm 1/2 circle, 12/box

2-0 FiberWire-Faden, blau, 46 cm, mit konischer Nadel, 26.5 mm, 1/2Kreis

2-0 FiberWire suture, blue, 46 cm, with tapered needle,26.5 mm, 1/2 circle

2-0 BLUE FIBERWIRE W/ 1/2 CIRCLE TAPARED NEEDLE 26.5 X 8.76 MM

3-0 FiberWire, 18" (blue) w/Diamond Point Needle, 26.2 mm 3/8 Circle

FiberWire #3-0, Geflochtener Polyblend Faden, Blau, mit Diamond Point Nadel, 3/8 Kreis, steril

FiberWire #3-0, Braided Polybend Suture, Blue, with Diamond Point Needle

FiberWire de calibre #3-0, hilo de sutura de Polyblendtrenzado, azul,co

FIBERWIRE, #3-0 USP SIZE 1 STRAND BLUE W/TAPER POINT NEEDLE

3-0 FiberWire Suture, 18 in (Blue) w/Tapered Needle, 15 mm 3/8 circle, 12/box

FiberWire #3-0, Geflochtener Polyblend Faden, Blau, mit spitzer Rundnadel, 3/8 Kreis, steril

FiberWire #3-0, Braided Polyblend Suture, Blue, with Tapered Point Needle

3-0 FiberWire, 18" (blue) w/Reverse Cutting Needle, 16.3 mm 3/8 Circle

FiberWire #3-0, Geflochtener Polyblend Faden, Blau, mit Periostnadel, steril

FiberWire #3-0, Braided Polyblend Suture, Blue, with Reverse Cutting Needle

4-0 FiberWire, 18" (blue) w/Diamond Point Needle, 18.7 mm 3/8 Circle

FiberWire #4-0, Geflochtener Polyblend Faden, Blau, mit Diamond PointNadel, 3/8 Kreis, steril

FiberWire #4-0, Braided Polybend Suture, Blue, with Diamond PointNeedle

FiberWire de calibre #4-0, hilo de sutura de Polyblendtrenzado, azul,co

FIBERWIRE 4-0 USP 1 STRAND 18 SUTURE W/DIAMOND POINT NEEDLE

4-0 FiberWire, Suture, 18 in (blue) w/Tapered Needle, 12.3 mm 3/8 Circle, 12/box

FiberWire #4-0, Geflochtener Polyblend Faden, Blau, mit spitzerRundnadel, steril

FiberWire #4-0, Braided Polyblend Suture, Blue, with Tapered PointNeedle

4-0 FiberWire, 18" (blue) w/Reverse Cutting Needle, 11.9 mm 3/8 Circle

FiberWire #4-0, Geflochtener Polyblend Faden, Blau, mit Periostnadel,steril

FiberWire #4-0, Braided Polyblend Suture, Blue, with Reverse CuttingNeedle

4-0 FiberWire Suture, 18 in (White) w/Tapered Point Needle, 12.7 mm 1/2 circle, 12/box

FiberWire #4-0, Geflochtener Polyblend Faden, Weiß, mit spitzer Rundnadel, steril

FiberWire #4-0, Braided Polyblend Suture, White, with Taper Point Needle

FiberWire de calibre #4-0, hilo de sutura de Polyblendtrenzado, blanco,

FiberWire^® und TigerWire^®

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FiberWire® - Sutura trançada composta

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Hand, Wrist, and Elbow - Next Generation in Repair and Reconstruction

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Dorsal Scapholunate Repair Using the InternalBrace™ Ligament Augmentation Procedure

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