Name: Akin Osteotomy Using the DynaNite® Nitinol Staple
Uploaded: 2017-12-18T00:00:00Z
Channel: Arthrex
Description: Thomas G. Harris, MD, (Pasadena, CA) performs an Akin osteotomy on the hallux valgus using a DynaNite ® Nitinol staple.

<p>Thomas G. Harris, MD, (Pasadena, CA) performs an Akin osteotomy on the hallux valgus using a DynaNite<sup>®</sup> Nitinol staple.</p>

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VPT1-00950-EN | B | Akin Osteotomy Using the DynaNite® Nitinol Staple

Thomas G. Harris

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Akin Osteotomy Using the DynaNite® Nitinol Staple

This is the medial aspect of the of the great toe. And we'll be fixing this with a DynaNite staple. So important parts about the Aiken is just want to make sure before you make your cut that you're pretty well centered on the bone. There is some soft tissue here and the plantar aspects that can throw you off a little bit. And dorsally here, a little bit more bone than you sometimes would expect. So there's some bone dorsally there. And then we're going to free this up. One other little tip is just to make sure that your cuts distal enough so that you're not going to make this in any way Intra-articular. Sometimes we'll place a K-wires for our proposed site of osteotomy. So to make sure that we're extra articular, but you definitely want to be distal enough so we can get good fixation in bone that is not too close to the joint. Typically this cut, you want to make it along the long axis of the proximal phalanx there. And I don't remove too much bone. Maybe two 2 or 3mm is all. So I'm just feeling the other cortex but not going through. And then I'll make my other cut diagonally, coming back at that about 2 or 3mm. You can always take more. You can always take more if you need to. And then what I'll do is if you like our overall alignment here, then we'll switch to this K-wires and just perforate that lateral cortex to kind of grain, stick this osteotomy, make a few passes. It definitely weakens the cortex and still allows it to dorsally and bring it together. So it came together okay. There. And then you want to have some sort of temporary fixation however you like to do it across this area. Now we're going to fix this with one of our newer staples. And the nice part about this staple is that it comes pre-fixed. So it's on it's on the application on the Applier as, as it comes out of the bag. The other thing that's nice about this is if it were to fall, it is something that we can reload onto here. So this can tighten or loosen it. So there we can see it spreading the tines apart as we turn this. And then if we need to loosen it a little bit to reapply it or to get it on there, we can do that. This actually fits into it like that. So it's actually you can just make sure that once our holes are drawn and made, then we can just follow it through with our staple. So it really fits in nicely there. So we'll make our drill holes here. There are some pins I'll also show you that we can put in here once the drills are made. So the laser lines you can see on there too. First laser lines used for this smaller staple. So something like that. And then if you want to, you can put a pin in at this point to help hold your position. Not mandatory since we have it held with the wire already. If you just want to make sure it doesn't rotate on you or anything like that, then that pin can be applied there. And then likewise we'll drill this to the first laser line as well. And the pins can be placed or not. And then these are nice pins. You have a nice firm grip to them. You can see it like that. It's not just your standard pin and it's smooth not threaded. And so then we just apply the staple here into the holes that we've made already there and kind of follow it through like that. We can see it in yeah, we can even push it and get it started just a little bit. Or if you don't like it, we can always turn it a little bit, but it's already going in there just fine. And then if you needed to impact it into place a little bit then you can. So perfect. Good. Then we undo this for it to come out, comes out like so, and then we use the rest of the impactor to impact it into place, which comes with the the kit as well. It's nicely threaded there so it fits into the staple. So we line that into the staple like so. And then that could just be impacted into place. Good pretty flush there. We can remove our temporary fixation. And so there is the staple in place there with good fixation if needed. Some of that bone that you took off can be used as crushed up and put on bone graft if needed around this area, but it looks like we have pretty good fixation into. Here as well. And the staple is very low profile. Now this staple that we utilized was nine by seven. Seems to be a nice size for the Aiken. If you had a bigger foot and you wanted to use something that was a little bit offset, you could use this. So in the situation where the staple does come off or it becomes unattached for any reason or just disassembled from the applicator, then it can be easily placed back on it and then hold it there, and then just start spinning this and you can see it's kind of got a good grasp on it there. And then as we keep doing that, it just widens it out into the place that you want it. So now you can see that's maybe even a little too much. So we can back off just a little bit there. And that's completely in its relaxed state where it wants to be. And this is where we have it distracted when you want to apply it. So it has that nice compression to it once the night null is engaged. But it does come out of the package loaded like this. So you're all set to go.

Akin Osteotomy Using the DynaNite® Nitinol Staple

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Fuß & Sprunggelenk

Akin-Osteotomie

Operationsverfahren

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DynaNite®-Nitinolklammer

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