Driving innovation with the latest technological products and procedures to treat a variety of hand and wrist conditions.

The Hand/Wrist InternalBrace Ligament Augmentation Convenience Kit incorporates SutureTape for greater strength at time zero than a traditional repair, allowing patients to begin rehab sooner and return to activity faster.1 Applications include CMC suspensionplasty, MCP volar plate capsulodesis, scapholunate reconstruction, and thumb UCL and RCL repair.
The InternalBrace Ligament Augmentation Convenience Kit contains the necessary instrumentation to perform a 2-anchor repair. For scapholunate reconstructions, an additional anchor or tenodesis screw can be used to supplement the kit.
Reference
1. Shin SS, van Eck CF, Uquillas C. Suture tape augmentation of the thumb ulnar collateral ligament repair: a biomechanical study. J Hand Surg. 2018;43(9): 868.e1–868.e6. doi:<a href="https://doi.org/10.1016/j.jhsa.2018.02.002">10.1016/j.jhsa.2018.02.002</a>.

Hand/Wrist InternalBrace™ Ligament Augmentation Repair

The FiberLock™ suspension system is a single-incision suture suspensionplasty using the latest in anchor and suture technology. A FiberTak® all-suture anchor provides cortical fixation on the far cortex of the 2nd metacarpal. The 1st metacarpal is suspended from the 2nd using the FiberTak anchor SutureTape, which is then secured into a knotless DX SwiveLock® SL anchor in the 1st metacarpal.
Specialized instrumentation allows for precise drilling and insertion of the FiberTak anchor through the same standard incision made for trapeziectomy. All contents are conveniently packed in a single-use system kit.

FiberLock™ CMC Suspensionplasty

The Mini TightRope technique provides a unique method for stabilization of the thumb metacarpal following trapezial resection or removal for the treatment of CMC arthritis. The Mini TightRope technique can also be used as an adjunct and stabilizer in CMC instability and in the case of revision with proximal migration after tendon reconstruction. The Mini TightRope technique supports and maintains the thumb and index metacarpals in proper relationship, while allowing for healing and scar tissue formation in the trapezial space. The construct consists of 2 strands of #2 FiberWire® suture, which are fixed with 2 oblong stainless steel buttons for cortical fixation. For more specific information about the Mini TightRope CMC fixation technique, please see the Mini TightRope CMC surgical technique guide.

Mini TightRope® CMC Technique

The Titanium Wrist Plating System is designed for fixation of intra-articular and extra-articular fractures, osteotomies, and nonunions and malunions of the distal radius. The titanium volar plates are available in a wide array of sizes (narrow, standard, and wide) and in multiple shaft lengths. A variety of screw fixation options, aiming guides, and instrumentation allows for customization according to surgeon preference and fracture complexity. The Titanium Wrist Plating System is designed to provide the answer to your distal fixation repairs. 

 
Advantage
 
Anatomic: Plates are developed to fit the anatomy and contours of the distal radius for a low-profile repair and anatomic reduction of the fracture. 

 
Comprehensive: In addition to a comprehensive plate selection, multiple screw options are available, including fixed angle locking, variable angle locking, and non-locking screws. 

 
Options: Fracture patterns create unique challenges and the variety of fixation options included provides multiple solutions for even the most complex fracture patterns. 

 
Straightforward Instrumentation: Separated into individual caddies, the instrumentation for the 2.4 mm and 3.5 mm screws is easy to identify. The screws sit in a graduated tray to ensure that proper screw length is given to the surgeon, reducing the time needed to measure screws by hand.

Titanium Wrist Plating System

The Titanium Wrist Plating System Technique is designed for fixation of intra-articular and extra-articular fractures, osteotomies, as well as nonunions and malunions of the distal radius. The titanium volar plates are available in a wide array of sizes (narrow, standard, and wide) and in multiple shaft lengths. A variety of screw fixation options, aiming guides, and instrumentation allows for customization according to surgeon preference and complexity of the fracture. The Titanium Wrist Plating System is developed to provide the answer to your distal fixation repairs. Advantages Anatomic Plates are developed to fit the anatomy and contours of the distal radius for a low-profile repair and anatomic reduction of the fracture. Comprehensive In addition to a comprehensive plate selection, multiple screw options are available including fixed angle locking, variable angle locking, and nonlocking screws. Options Fracture patterns create unique challenges and the variety of fixation options included allow multiple solutions for even the most complex fracture patterns. Straightforward Instrumentation Separated into individual caddies, the instrumentation for the 2.4 mm and 3.5 mm screws are easy to identify. The screws sit in a graduated tray to ensure the proper screw length is selected, reducing the time needed to measure screws by hand.

Titanium Wrist Plating System Technique

The Arthrex Mini Comprehensive Fixation System (Mini CFS) is designed to be a comprehensive solution for Mini fragment fixation and fusion needs. Multiple modules within the system offer 1.0 mm screws, 1.4 mm plates/screws, 1.6 mm plates/screws, 2.0 mm plates/screws, and 2.4 mm plates/screws along with associated instrumentation.
Each module offers an array of plate options and sizes with VAL capabilities in every plate family down to the smallest 1.4 mm plate size. Hexalobe drive shafts in every plate/screw module ensure excellent torque transfer and overall screw control.1
Reference
1. Arthrex, Inc. Data on file (APT-04343B, APT-03842C, APT-04100, APT-0384B). Naples, FL; 2018-2019

Mini Comprehensive Fixation System

Hand and Wrist

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Dorsal reconstruction of the scapholunate ligament with the 3.5 mm DX SwiveLock SL anchor is indicated for dynamic and static scapholunate instability where there is inadequate ligament to repair, the carpal cartilage is preserved (no arthrosis) and the carpus is reducible. The reconstruction is achieved by utilizing a strong anchor construct that incorporates a combination of a biologic tendon graft reconstruction into bony tunnels with static suture reinforcement with InternalBrace™ ligament augmentation. Together, this construct supports the connection of and between the bones so that graft incorporation can take place.

DX SwiveLock® SL Anchor for Scapholunate Ligament Repair

Carpal Instability

Carpal instability can range from a partial ligament tear to a complex dissociation pattern. Arthrex has developed specific procedures to address this type of wrist instability primarily related to the Scapholunate Ligament and the Lunotriquetral Ligament.

Primary (B)

The surgeon introduces the device into the carpal tunnel through a single limited incision in the wrist flexor crease. Viewing the deep side of the transverse carpal ligament (flexor retinaculum) under direct visualization at the tip of the instrument, the surgeon elevates the blade to cut the ligament as the instrument is withdrawn. The Centerline technique incorporates improved safety features compared to other ECTR devices that have been used for over 20 years and eliminates rotational movements while offering superior visualization. The thumb trigger pull is synergistic, increasing steadiness and facilitating control. The Centerline endoscopic carpal tunnel release system attaches to a standard video camera and light source.

Centerline™ Endoscopic Carpal Tunnel Release Technique

Carpal Tunnel

The Centerline Carpal Tunnel Release System is indicated for patients diagnosed with carpal tunnel syndrome. Clinical data* supports an earlier return to normal activities of up to 50% when using an endoscopic approach over open procedures for carpal tunnel release. The Centerline System raises the bar for endoscopic carpal tunnel procedures by increasing safety, visualization, ergonomics and reducing the possibility of mechanical failures. *data on file

After removal or resection of the trapezium the FCR tendon is routed through the base of the 1st metacarpal via a pre drilled and sized hole. The Arthrex QuickPass Tendon Shuttle is used to help facilitate passage of the tendon through the drill tunnel. Once passed the graft is tensioned to obtain appropriate suspension and a 4 x10 or 4.75 x 15 tenodesis screw is advanced to lock the graft into position. The remaining tendon tails can be cut flush or interposed into the joint space if desired.

Ligament Reconstruction - Tendon Interposition

CMC Arthritis

Thumb basilar arthritis is a debilitating condition often accompanied by subluxation of the metacarpal and concomitant attenuation of the ligamentous stabilizers of the carpometacarpal (CMC) joint. Arthrex offers multiple techniques to treat arthritis pain and restore the stability of the CMC joint.

Various methods and suture patterns are described for repairing flexor / extensor tendons and their use varies by the surgeon’s preference. FiberWire’s superior strength and reliability makes FiberWire an ideal choice when performing a Suture Flexor/Extensor Repair. FiberWire is constructed of a multi-stranded, long chain, ultra-high molecular weight polyethylene (UHMWPE) core with a braided jacket of polyester and UHMWPE. This combination provides a high strength, soft suture with abrasion resistance that virtually eliminates suture breakage during knot tying and is found to be five times more abrasion resistant than standard polyester sutures.

FiberWire® Suture Flexor/Extensor Repair

Flexor/Extensor TendonLaceration

Flexor/Extensor Tendon Lacerations can be repaired using Arthrex FiberLoop® used in any one of these surgical procedures including Flexor Tendon Repair, Extensor Tendon Repair, and most other soft tissue and tendon repairs in the hand and wrist.

The titanium Compression FT (fully threaded) screws come in 2.5 Micro, 3.5 Mini, and 4.0 Standard. The variable-stepped thread pitch headless design reduces the risk of profile complications, provides compression, and allows for simplified insertion. Surgeons can now achieve zero-profile, stable fixation.

Compression FT ScrewsTechnique

The Arthrex Mini Comprehensive Fixation System (Mini CFS) is a complete solution for mini fragment fixation and fusion needs. Multiple modules within the system offer 1.0 mm screws, 1.4 mm plates/screws, 1.6 mm plates/screws, 2.0 mm plates/screws, and 2.4 mm plates/screws along with associated instrumentation.
Each module offers an array of plate options and sizes with VAL capabilities in every plate family down to the smallest 1.4 mm plate size. Hexalobe drive shafts in every plate/screw module ensure excellent torque transfer and overall screw control.
Intramedullary fracture fixation is also an option with our longer length headless compression FT screws offered in the 2.0 mm and 2.4 mm modules giving surgeons a minimally invasive option to treat metacarpal and phalangeal fractures.

Mini Fragment Plating Technique

Fracture Management

Arthrex offers a multitude of options and advancements to help surgeons treat these fractures. Our products are developed with the most up to date technology and material choices to help treat your patients better. For more information about Arthrex innovations in fracture management, please learn more about our hand/wrist fracture repair using Bio-Compression Screws, class='small-caps'&gt;Trim-It Pins and the QuickFix™ Cannulated Screw System.

Osteoarthritis

Interphalangeal fusions using Arthrex class='small-caps'&gt;Trim-It Drill Pins, Bio-Compression Screws, or the QuickFix Cannulated Screw System is an effect procedure used to treat osteoarthritis in the hand and wrist. class='small-caps'&gt;Trim-It Pins class='small-caps'&gt;Trim-It Pins provide the ability to fuse the joint and eliminate the need for hardware removal traditionally associated with k-wire placement. See also, class='small-caps'&gt;Trim-It Screw System. Bio-Compression Screws For complications such as hardware prominence and post-operative imaging, the Bio-Compression Screw is an excellent solution for fusions associated with osteoarthritis. QuickFix™ Cannulated Screw System The QuickFix Cannulated Screw System is ideal for joint fusions, and provides compression across the joint surface for reliable fusion results.

Arthrex introduces an all-arthroscopic, knotless technique to repair peripheral ulnar tears of the articular disk. The advantage of this technique is that it repairs both superficial and deep layers (ligamentum subcrunetum) of the articular disk back-to-bone at their anatomic insertion. In addition, using a knotless technique decreases potential soft tissue irritation from suture knots. The use of FiberWire suture allows for permanent suture fixation of the articular disk as compared to absorbable suture. The featured TFCC Instrument Kit significantly simplifies the arthroscopic procedure.

Arthroscopic Knotless TFCC Repair Back to Bone

The Arthrex Micro SutureLassos were designed to facilitate repair of the TFCC, whether the dorsal or palmar capsular ligament portion is torn. Each Micro SutureLasso has a 20-gauge tip designed to be less traumatic to the TFCC and surrounding ligament during passing. Both inside/out and outside/in techniques can be used, as well as a double needle technique. Use of the Micro SutureLassos will facilitate the repair by increasing the control and speed with which the suture can be passed when compared with previously described techniques. For detailed information about the Arthroscopic TFCC Repair Technique, visit our resources section.

Arthroscopic TFCC Repair

The Ulnar Head Wafer procedure is used to eliminate further impingement of the distal ulna against the lunate. This impingement is commonly associated with central TFCC tears. Arthrex has developed extremely efficient, small size burrs (round and oval) to resect the few millimeters needed from the ulnar head.

Ulnar Head Wafer Excision

TFCC Tears

Triangular Fibrocartilage Complex (TFCC) injury is an increasingly recognized problem that can significantly affect wrist function, even for activities of daily living. Diagnosis and treatment of ulnar-sided wrist pain has improved with advances in technology in imaging and arthroscopy. Several techniques have been described for arthroscopic repair of the TFCC. Arthrex provides solutions for capsular repair of the superficial TFCC as well as superficial and deep tears back to bone.

Using #2-0 or #0 suture the torn ulnar collateral ligament of the thumb is sutured. The 2.5 mm PushLock® uses a PEEK eyelet to place the sutures at the bottom of a drill hole, allowing the surgeon to tension precisely by hand and lock the sutures in place by impacting the tak portion of the anchor. Both the high strength radiolucent PEEK and the absorbable PLLA 2.5 mm PushLock optimize tissue tension and fixation without knot tying. The final repair is tensioned to the surgeon's preference and remains completely knotless allowing for less irritation with minimal overlying soft tissue. For more information on this surgical technique, please see the resources section.

2.5 mm PushLock® Thumb Collateral Ligament Repair

A K-wire pre-drill is used to create a bone socket for the anchor. The anchor is screwed into the bone socket until the anchor is fully seated. The anchor handle is removed exposing two FiberWire sutures and diamond point needles. The needles are advanced through the soft tissue to accomplish the desired stitch. Once completed the needles are removed and the sutures are tied using the surgeons preferred sliding or static knot.

Corkscrew® Thumb Collateral Ligament Repair

Ulnar collateral ligament (UCL) tears of the thumb are common injuries. When the tear results in pain and instability, surgical repair offers a predictably successful outcome. Augmenting the reconstruction with SutureTape to create an InternalBrace™ ligament augmentation results in a strong construct that allows for early motion and limited postoperative immobilization.1
1. De Giacomo et al. Tech Hand Up Extrem Surg. 2017;21(4):164-166. doi:10.1097/BTH.0000000000000173.

DX SwiveLock® SL Anchor Thumb Collateral Ligament Reconstruction

Utilizing a drill or punch, a bone socket is created for the anchor. The drill or punch is removed and the implant is inserted through into the bone socket. The anchor is gently impacted until it is fully seated. The anchor handle is removed exposing the 2 FiberWire sutures and tapered needles. The needles are advanced through the soft tissue to accomplish the desired stitch. Once the sutures are passed, the needles are removed and the sutures are tied using the surgeon's preferred sliding or static knot.

SutureTak® Thumb Collateral Ligament Repair

InternalBrace™ ligament augmentation used with tenodesis screws or SwiveLock® anchors allows earlier joint motion and faster return to activity.1 The 2.5 mm × 6 mm and 3 mm × 8 mm tenodesis screws can be used in conjunction with SutureTape to reconstruct and augment the thumb UCL ligament.
Reference
1. Shin SS, van Eck CF, Uquillas C. Suture tape augmentation of the thumb ulnar collateral ligament repair: a biomechanical study. J Hand Surg Am. 2018;43(9):868.e1-868.e6. doi:10.1016/j.jhsa.2018.02.002.

Thumb Collateral Ligament Reconstruction With Tenodesis Screws and InternalBrace™ Ligament Augmentation

UCL and RCL Tears of the Thumb

Arthrex has developed the Thumb Metacarpophalangeal (MCP) Joint Ulnar Collateral Ligament (UCL) Repair using either a 2.5 mm PushLock® Knotless Suture Anchor, a Micro/Mini BioComposite SutureTak®, a Micro/Mini FT Corkscrew® or FASTak™ anchors. Reconstruction of a chronic tear is achieved by utilizing two 3 mm x 8 mm Bio-Tenodesis™ Screw.

Hand and Wrist

Hand/Wrist InternalBrace™ Ligament Augmentation Repair

Carpal Instability

Carpal Tunnel

CMC Arthritis

Flexor/Extensor Tendon Laceration

Fracture Management

Osteoarthritis

TFCC Tears

UCL and RCL Tears of the Thumb

Disclaimers

Disclaimers

What's New in Hand and Wrist

Hand and Wrist

Hand/Wrist InternalBrace™ Ligament Augmentation Repair

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CMC Arthritischevron_right

Flexor/Extensor Tendon Lacerationchevron_right

Fracture Managementchevron_right

Osteoarthritischevron_right

TFCC Tearschevron_right

UCL and RCL Tears of the Thumbchevron_right

Disclaimers

Disclaimers

What's New in Hand and Wrist

Carpal Instability

Carpal Tunnel

CMC Arthritis

Flexor/Extensor Tendon Laceration

Fracture Management

Osteoarthritis

TFCC Tears

UCL and RCL Tears of the Thumb