Name: Medial Malleolus Fracture Repair Using the Mini Comprehensive Fixation System
Uploaded: 2020-01-23T00:00:00Z
Channel: Arthrex
Description: Eric W. Tan, MD (Los Angeles, CA), uses the Mini Comprehensive Fixation System Y-plate to stabilize a medial malleolus fracture. The Y-design allows the plate to be contoured to the medial malleolus and features variable-angle locking technology with oblong holes for compression.

<p>Eric W. Tan, MD (Los Angeles, CA), uses the Mini Comprehensive Fixation System Y-plate to stabilize a medial malleolus fracture. The Y-design allows the plate to be contoured to the medial malleolus and features variable-angle locking technology with oblong holes for compression.</p>

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VID1-000628-en-US | B | Medial Malleolus Fracture Repair Using the Mini Comprehensive Fixation System

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

Medial Malleolus Fracture Repair Using the Mini Comprehensive Fixation System

So we're going to first see how this plate fits onto the bone. And we can see where we'd like to put it. It's obviously going to be too long. So it's probably going to be about we'd like to have at least three holes proximal to the fracture site. So we're going to cut the plate right where the oblong hole is right here. So once you've cut the plate to the desired length you can take the file here located on the side. And you can actually file the side of the plate so that you don't have any of those rough and sharp edges prior to placing it onto the bone. So now that we have our plate cut to the length, we can then apply it to the bone. And so we'll go ahead and apply it here. And we want to make sure we have three cortices above the fracture site here. We'll hold this in place using one of our tacks. And then we can confirm the placement of the plate onto the bone visually as well as fluoroscopic. With our plate in the appropriate position. We can then start placing the screws. The first screw we like to place is the screw just proximal to the fracture site. And we'll go ahead and we can place our cone here. And again this allows for 15 degrees in all directions for the placement of the screw. And this will traditionally bring just straight across the tibia here. Take our measuring device so we can see on the measuring device. It's actually a matted black so it doesn't reflect as much. And we can see the measurement here more readily at 30mm. Once we have the measurement and chosen the appropriate screw, we do have a holding sleeve for the screw. That helps to prevent any wiggle of the screw or loss of the screw as you take it out and try to apply it. So as we get close to the screw getting into the plate, we can then pull back our holding sleeve. We can take a look at the screw and guide it down to the bone. And then we'll place two additional screws proximally in similar fashion. Again, you can put the screws at a 15 degree arc just depending on where you where you want to put it, using the appropriate sleeve here. And each of these holes do accept both locking and non-locking screws. Perfect. Thank you. So we'll remove this K-wires so we have better access anteriorly to the plate. And then we've taken our measurement and we'll go ahead and take this screw on power. We can see how that helps to bend the plate down to the contour of the medial malleolus. We've got good compression and it fits without being prominent. So we'll place our variable angle guide here. And again we'll want to make sure that we avoid the joint. And again these screws sit well within the plate so you don't have any prominence associated with them as well. So we typically like to create a symmetric construct. We'll have six cortices above. We like to have six cortices below. Certainly you have different holes in these plates. Whether you want to put a screw in the oblong hole or these other locking holes, you can use a locking or non locking screw. So for a locking screw it's the exact same procedure. What we'll do is go ahead and take this variable angle cone wheel plate and place it into the slot. We can then drill just like we did for the non locking screws. And then it uses the exact same holding sleeve. We'll go ahead and place the screw. And again it'll sit well within the plate. It sits flush. There's no prominence of the screw which also prevent irritation as well. Here are all the screws are out of the joint. The plate sits well on the bone. The fracture is well reduced. All the screws are of the appropriate length. And then on the lateral view again we can see that it fits well with on well on the bone and reduces the fracture.

Medial Malleolus Fracture Repair Using the Mini Comprehensive Fixation System

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