Name: PIP Joint Arthrodesis With AlloSync™ Bone Dart
Uploaded: 2019-05-03T00:00:00Z
Channel: Arthrex
Description: Eric W. Tan, MD, (Los Angeles, CA) demonstrates a PIP joint arthrodesis using the AlloSync™ bone PIP dart implant.

<p>Eric W. Tan, MD, (Los Angeles, CA) demonstrates a PIP joint arthrodesis using the AlloSync™ bone PIP dart implant.</p>

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VID1-000034-en-US | A | PIP Joint Arthrodesis With AlloSync™ Bone Dart

Eric W. Tan

Human

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

Eine Videoaufnahme einer Operationsanleitung an einem lebenden Patienten oder Patientin in einem Operationssaal oder eine Demonstration an einem Humanpräparat.

Operationstechnikvideos

Surgical Technique Videos

Gravação em vídeo de uma técnica cirúrgica em um paciente em uma sala de cirurgia ou uma demonstração cadavérica.

Vídeos de técnicas cirúrgicas

Grabación en vídeo de una técnica quirúrgica de un paciente en un quirófano o una demostración cadavérica.

Videos de técnicas quirúrgicas

PIP Joint Arthrodesis With AlloSync™ Bone Dart

In this technique video, we're going to demonstrate the Arthrex AlloSync bone dart for the use of Hammertoe correction. So each each AlloSync allograft bone dart will come with an associated kit. The kit will contain the following items. You'll have a K-wires to help guide the drilling. You'll also have drill bits, including a two, five, two, seven, and 3.0mm drill bit. Each of these will be marked to to the necessary length to ensure that you drill to the appropriate depth. We'll also have a profile drill present to allow for additional opening reaming as necessary to help guide the implant in. In this surgical technique video, we will show a dorsal incision a dorsal longitudinal incision centered on the joint. So we'll go ahead and make the incision dorsally centered on the proximal interphalangeal joint. Now we can see we have our joint surfaces exposed. And we're next going to use our micro sagittal saw in order to remove the proximal joint surface as well as the distal joint surface. So we'll resect just proximally to the articular surface. And then we'll make a corresponding cut on the base of the middle phalanx removing that articular surface. This can be done with the saw or can be done with a ranger. So with the articular surfaces resected we can then go ahead and plan for the drill holes. We'll use our guidewire in our kit. We'll go ahead and put it down the center center of our proximal phalanx first, and we can confirm the placement of the guidewire on fluoroscopy. We can see here that we're down the center of the pipe here. So once we're satisfied with the positioning of the guidewire, then we'll go ahead and drill. Depending on the size of the bone and quality of the bone, you can start with either a 2.7mm drill bit or a three millimeter drill bit. In this case, we're going to start with a three millimeters drill bit. As we can see here the drill bit will be marked to 14mm. You want to be careful not to pass a point in this case because the proximal portion of the impact that you want to insert matches that 14mm. If you drill too deep, the implant may subside. And then we'll go ahead and place the guidewire into the middle phalanx next. All right. So we'll go again. Want to be in the center of the middle phalanx on both the AP and the dorsal plantar view here. Essentially, you want to be in the center of the middle phalanx. So in a similar fashion to the proximal phalanx, we are going to use either a 2.5 or a 2.7mm drill bit in order to create a path into the middle phalanx. The drill will also be marked at eight millimeters in order to make sure that you're at the appropriate depth. Again, care. You want to make sure that you don't over drill this or go too deep, because that may lead to displacement of the implant. So prior to final implantation of the implant we do include a profile drill, we'll typically recommend that if you need to help get the implant, especially in the proximal side, you can certainly use this to create a path. So now that we have the surfaces prepared, we're going to go ahead and proceed with inserting of the implant. Again the longer side goes into the proximal end. This is 14mm. The distal side is going to be eight millimeters. And you can see that the the barbs reverse in different directions to allow for capture within the bone. You want to take a coker or some other holding device that you feel comfortable with in order to get a good grip on the implant to give you some force to put it in. And so we'll proceed first with implantation into the proximal phalanx. You may have to regrip it in order to get it down to the appropriate depth there. And you can kind of see that's where the transition begins between the proximal and the distal portion. And then what we're going to do is now distract the joint and then bring the bring the middle phalanx up and over to capture that middle portion of the implant. We'll make sure there's no interposing soft tissue, and we'll put gentle axial load in order to complete the compression across the joint. And we can see there's nice apposition between the bones. And it's pretty compressed there. You can't really pull it apart unless you're going to put a tremendous amount of force here. And we'll check that fluoroscopic as well. So as we can see from the implant, it's well seated within the proximal phalanx as well as the distal phalanx. We have more threads within the proximal phalanx than we do the distal phalanx. There's good compression across the proximal interphalangeal joint from the standpoint of the surgical technique. There are no metal wires or anything that need to be cared for or nothing that needs to be removed. In addition, in any sort of revision situation that you may need, this implant can is something that will integrate within the bone and can be something that can be drilled through just like the normal surrounding bone.

PIP Joint Arthrodesis With AlloSync™ Bone Dart

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