troch nail - Instrumentaria

troch nail
trauma fracture system
since 1896
INSTRUMENTARIA is a company that manufactures medical implants
for traumatology and orthopedics. It was founded in 1896, the year
Henry Ford made the first American car to run on petrol, and the year
of the first electricity flow between the Niagara Falls and Buffalo.
Throughout the years, our products have saved lives and improved
the mobility of many patients, while the company collaborated with
generations of traumatology and orthopedic surgeons who used
our instruments.
Nowadays, INSTRUMENTARIA operates in a new factory using stateof-the-art technology for the development, manufacture and control
of the products, meeting the international quality standards, ISO
9001:2008, ISO 13485:2003 and Directive 92/42/EEC.
Through strategic partnerships, as well as independently collaborating with orthopedic and traumatology surgeons, we manufacture
generic and develop new and innovative implants. Furthermore,
the technology of our instrument sets is always synchronized with
the latest methods and operative techniques around the world. Our
accomplishments and quality are valued by local and international
clients who entrust us with continuous orders.
In five years time, we envision INSTRUMENTARIA as a globally, regionally and locally integrated company with a high level of human
resources and technology. By offering surgeons solutions with both
our standardized and innovative custom made products, we serve
our employees, shareholders and community – local, regional, national and European.
Vladimir Kovačević, M.Sc.
CEO
troch nail
rev. 02, date: 2011-09
INDICATION
›› intertrochanteric fractures
›› pertrochanteric fractures
›› high subtrochanteric fractures
There are two basic components: the troch nail and the lag screw,
effective together in a very wide range of clinical situations and
fracture complexity. Insertion is entirely by closed surgical technique,
minimizing trauma, blood loss and infection potential.
INDIKACIJE
›› intertrohanterni prijelomi
›› pertrohanterni prijelomi
›› visoki subtrohanterni prijelom
Postoje dvije osnovne komponente: trohanterni čavao i vijak za vrat
kojima se zajedno učinkovito rješava velik broj kliničkih situacija i
složenih prijeloma. Postavlja se zatvorenom kirurškom tehnikom, s
minimalnim gubitkom krvi i minimalnom mogućnošću infekcije.
TN
The anatomic design of troch nail is universal for all indicated applications, with a profile specifically designed for trochanteric fractures.
Variations in femoral neck anatomy are accomodated by a range of
angles available for the lag screw entry - 120°, 125°, 130°, 135°. A
single distal locking screw is used to prevent rotation in complex
fractures.
The lag screw, inserted trought small incision with the aid of radiolucent targeting device, incorporates a special sliding lock to provide
dynamic compression with axial stability.
Anatomski oblik trohanternog čavla je univerzalan za sve indicirane
primjene kod trohanternih prijeloma. Kut ulaza vijka za vrat (120°,
125°, 130°, 135°) je prilagođen anatomskim varijacijama vrata bedrene kosti. Distalni vijak se koristi za spriječavanje rotacije kod
složenih prijeloma.
Vijak za vrat, postavljen kroz mali rez uz pomoć Rtg propusne vodilice, omogućuje specijalno zaključavanje klizanja koje osigurava
dinamičku kompresiju s aksialnom stabilnošću.
ordering information
informacije za narudžbu
troch nail L=180 mm // troch femoralni čavao L=180 mm
angle / kut
steel / čelik
titanium / titan
125
07.800-125
07.800T125
130
07.800-130
07.800T130
135
07.800-135
07.800T135
lag screw // vijak za vrat
lenght / dužina (mm)
steel / čelik
titanium / titan
80
86.001-80
86.001T80
85
86.001-85
86.001T85
90
86.001-90
86.001T90
95
86.001-95
86.001T95
100
86.001-100
86.001T100
105
86.001-105
86.001T105
110
86.001-110
86.001T110
115
86.001-115
86.001T115
120
86.001-120
86.001T120
locking screw // vijak za zaključavanje
lenght / dužina (mm)
steel / čelik
titanium / titan
35
86.002-125
86.002T125
cap screw // vijak kapa
steel / čelik
titanium / titan
86.003-125
86.003T125
distal screw ø6.28 mm // vijak distalni ø6.28 mm
lenght / dužina (mm)
steel / čelik
titanium / titan
15
-
86.620T15
20
-
86.620T20
25
86.620-25
86.620T25
30
86.620-30
86.620T30
35
86.620-35
86.620T35
40
86.620-40
86.620T40
45
86.620-45
86.620T45
50
86.620-50
86.620T50
55
86.620-55
86.620T55
60
86.620-60
86.620T60
65
86.620-65
86.620T65
70
86.620-70
86.620T70
75
86.620-75
86.620T75
80
86.620-80
86.620T80
85
86.620-85
86.620T85
90
86.620-90
86.620T90
95
86.620-95
86.620T95
instrument set
komplet instrumenata
13
15
2
22
12
16
20
19
17
14
21
20
24
3
5
6
4
23
9
7
7
11
Instrument sets design have been perfected in the OR and are produced by the state-of-the-art manufacturing process. They guarantee easy use and help surgeon conform to the parameters fixed
during the pre-op planning. Rigorous quality control guarantees full
reliability of the products.
Kompleti instrumenata usavršeni su u operacionim dvoranama i nastali su najsuvremenijim proizvodnim procesom. Jamče jednostavnu
upotrebu kako bi kirurgu omogućili prilagođavanje parametrima
postavljenim tijekom preoperativnog planiranja. Rigorozna provjera
kvalitete jamči potpunu pouzdanost tih proizvoda.
ordering information
informacije za narudžbu
trohalni čavao komplet instrumenata (63.007-01)
troch nail instrument set (63.007-01)
no.
product
code
br.
naziv proizvoda
kataloški br.
1.
curved awl
81.007-01
1.
zakrivljeno šilo
81.007-01
2.
Jacob’s chuck
33.107-02
2.
stezna glava Jacobs
33.107-02
3.
targeting device
88.007-01
3.
vodilica za umetanje čavla
88.007-01
4.
nail holding bolt
86.007-01
4.
vijak probušeni za držanje čavla
86.007-01
5.
socket wrench
74.307-01
5.
zglobni ključ
74.307-01
6.
screwdriver for nail holding
bolt
33.107-01
6.
odvijač za probušeni vijak za držanje
čavla
33.107-01
7.
guide sleeve for lag screw
88.007-05
7.
štitnik mekog tkiva
88.007-05
9.
lag screw guide sleeve
88.007-06
9.
vodilica lag vijka
88.007-06
10.
lag screw awl
81.007-02
10.
šilo lag vijka
81.007-02
11.
K-wire
ø3.2 x 450 mm
28.207-01
11.
Kirschner igla sa navojem na vrhu
ø3.2 x 450 mm
28.207-01
12.
lag screw length gauge
50.307-02
12.
mjerač duljine lag vijka
50.307-02
13.
lag screw step drill
71.307-02
13.
svrdlo za lag vijak
71.307-02
14.
lag screwdriver
33.107-03
14.
odvijač za lag vijak
33.107-03
15.
set screwdriver bit
33.107-04
15.
odvijač za vijak za zaključavanje
33.107-04
16.
distal obturator
51.007-117
16.
distalni opturator
51.007-117
17.
distal tissue protector
88.007-04
17.
distalni štitnik mekog tkiva
88.007-04
18.
distal awl
81.007-03
18.
šilo distalnog vijka
81.007-03
19.
drill guide sleeve for ø5.5 mm
distal drill
88.007-03
19.
vodilica svrdla ø5.5 mm
za distalni vijak
88.007-03
20.
drill bit ø5.5 mm for distal screw
71.307-01
20.
svrdlo ø5.5 mm za distalni vijak
71.307-01
21.
distal screwdriver
33.107-05
21.
odvijač za distalni vijak
33.107-05
22.
distal screw depth measuring gauge
50.307-01
22.
dubinomjer
50.307-01
23.
nail extraction rod
74.007-01
23.
šipka za izvlačenje čavla
74.007-01
24.
final impactor
51.007-116
24.
završni nabijač
51.007-116
25.
instrument case
44.000-500
25.
kutija za instrumentarij
44.000-500
surgical technique
kirurška tehnika
1
2
Modular cavity is opened under Rtg image enhancer using canullary curved punch.
After placing the punch into medullar cavity guide
wire is placed through it into the distal part of
medullar cavity of the femoral bone.
The entering point must be on the top of the big
trochanter, lateral in AP projection and slightly
towards back in LL projection to ensure that the
degree of the nail curving fits to the curving of the
proximal end of the femoral bone.
Medularni kanal otvara se pod Rtg pojačivačem
slike, koristeći kanulirano zakrivljeno šilo.
Točka ulaza mora biti na vrhu velikog trohantera
nešto lateralno u AP projekciji i nešto straga u
LL projekciji, kako bi stupanj zakrivljenosti čavla
odgovarao zakrivljenosti proksimalnog okrajka
natkoljenične kosti.
A flexible drill of 10 mm is placed along the guide
wire and motor bore-machine is used to enlarge
the medullar cavity. Drilling is continued by using
drills of larger diameter by enlarging gradually by
1 mm. Dimension of distal diameter is obtained
by taking away 1 mm of the diameter of the latest
introduced drill which showed the resistance while
introduced. Trochanter region is enlarged using
flexible drills until 17 mm.
Po postavljanju šila u medularni kanal, kroz njega
se postavlja žica vodilica u distalni dio medularnog
kanala natkoljenične kosti.
Po žici vodilici postavlja se fleksibilno svrdlo
10 mm, te se uz pomoć motorne bušilice proširuje
medularni kanal. Nastavlja se razvratnje povećavajući svrdla za po 1 mm. Mjeru za distalni promjer čavla dobijemo tako da od promjera zadnjeg
uvedenog svrdla koje je imalo otpor uvođenju
oduzmemo 1 mm. Trohanternu regiju proširuje
se fleksibilnim svrdlima do 17 mm.
3
4
Selected trochanter anchored nail is mounted on
the guide for introducing nail.
Trochanter nail is introduced along guide wire into
prepared medullar cavity.
Odabrani trohanterni čavao montira se na vodilicu
za uvođenje čavla.
Trohanterni čavao uvodi se po žici vodilici u pripremljeni medularni kanal.
5
Joined protector of the soft tissue and the guide
tube are pushed through the incision and firmly
aligned onto the lateral cortex.
Spojeni štitnik mekog tkiva i cijev vodilice gurnu se
kroz rez i čvrsto prilegnu na lateralni kortikalis.
6
7
Guide of K-wire is placed into the shield of the soft
tissue and through it the K-wire guide of the top
threaded screw for the neck. Check the correctness of positioning in both projections (AP and
LL) using Rtg image enhancer.
After appropriate positioning of the guide wire
is achieved, required length of the screw for the
neck is measured by the screw neck length gauge.
Screw neck length measurer is positioned directly
under Kirschner needle.
U štitnik mekog tkiva pritegnut uz kortikalis
umetne se vodilica za Kirschner-žicu, te kroz nju
Kirschner-žica vodilica vijka za vrat s navojem na
vrhu. Provjeri se ispravnost pozicioniranja u obje
projekcije (AP i LL) Rtg pojačivačem slike.
Nakon postizanja dobrog položaja žice vodilice,
potrebna duljina vijka za vrat mjeri se pomoću
mjerača duljine vijka za vrat. Mjerač duljine vijka
za vrat postavi se izravno pod Kirschner iglu.
8
9
Adjustable spacer on the drill of the neck screw is
placed in the measured cavity on the side towards
the top of the drill. The ring is used for locking of
the spacer into measured position.
The top of the guide wire is partially above the
drill. The appropriate length of the neck screw is
5 mm longer than previously measured by neck
screw length gauge.
Podesivi graničnik na svrdlu vijka za vrat postavi se na izmjerenu dubinu na strani prema vrhu
bušilice. Prsten se koristi za zaključavanje graničnika u izmjerenom položaju.
Vrh žice vodilice lagano strši iz svrdla. Ispravna
dužina vijka za vrat je 5 mm duža nego što je prethodno izmjereno mjeračem dužine vijka za vrat.
10
11
Neck screw of the appropriate length is connected
by the screwdriver for the neck screw and placed
along guide wire.
The locking screw is placed through the opening of
the guide for nail inserting and through the hollow
screw at the proximal end of the nail and firmed
strongly by the screwdriver and angled key and
rescrewed for one half of the round to ensure free
gliding of neck screw. When the locking screw is
in a good position the rotation of the screwdriver
is not possible.
Vijak za vrat odgovarajuće duljine spoji se
odvijačem za vijak za vrat i postavi preko žice
vodilice.
Vijak za zaključavanje se umetne kroz otvor na
vodilici za umetanje čavla i kroz šuplji vijak na
proksimalnom kraju čavla i stegne ga se do
kraja pomoću odvijača i zglobnog ključa te ga se
odvine za jednu polovinu kruga kako bi se osiguralo slobodno klizanje vijka za vrat. Kada je vijak
za zaključavanje dobro postavljen nije moguće
okretanje odvijača za vijak za vrat.
12
13
Guide of the distal screw is placed into distal protector of the soft tissues and pull through the
hole on the guide for placing the nail until lateral
cortex.
Mark is made on the lateral cortex through the
shield of the soft tissue by using distal punch and
slight use of the hammer. Guide of drill of 5.5 mm
diameter is placed for distal screw. Drill of 5.5 mm
is marked of hollow so the needed length of distal
screw could be measured immediately. The distal
screw length needed is measured by the depth
measurer of distal screw.
Vodilicu distalnog vijka umetne se u distalni štitnik mekih tkiva, te se provuku kroz rupu na vodilici
za umetanje čavla do lateralnog kortikalisa.
Distalnim šilom uz blagu upotrebu čekića napravi
se oznaka na lateralnom kortikalisu kroz štitnik
mekog tkiva. Postavi se vodilica svrdla 5.5 mm
promjera za distalni vijak. Svrdlo 5.5 mm ima na
sebi oznake dubine pa se tako može odmah izmjeriti i potrebnu duljinu distalnog vijka. Potrebna
duljina distalnog vijka mjeri se pomoću dubinomjera distalnog vijka.
14
Distal self cutting screw of appropriate (earlier
measured) length is introduced through the distal
protector of the soft tissue and firmed by distal
screwdriver.
The guide for the introduction of the nail is taken
off and screw cap is placed to prevent growth over
the threads of the nail.
Distalni samonarezni vijak odgovarajuće (prethodno izmjerene) duljine se uvodi kroz distalni
štitnik mekog tkiva i pritegne pomoću distalnog
odvijača.
Skida se vodilica za uvođenje čavla i stavlja se
vijak kapica da spriječi prerastanje navoja na samom čavlu.
INSTRUMENTARIA je tvornica za prozvodnju implantata za traumatologiju i ortopediju osnovana 1896. godine, kada je i Henry Ford
konstruirao prvi američki automobil na benzinski pogon, a između
dva grada Niagara Fallsa i Buffala dogodio se prvi prijenos električne
energije.
Tijekom dugogodišnjeg rada, svojim smo proizvodima spasili živote i
pokretljivost mnogih pacijenata, dok smo prisutnošću u operacijskim
dvoranama s instrumentima koje smo proizvodili rasli zajedno s
generacijama traumatologa i ortopeda.
Danas INSTRUMENTARIA djeluje u novoj tvornici, koristi najnovija
tehnološka dostignuća u razvoju, proizvodnji i kontroli proizvoda,
te je u potpunosti svoje poslovanje uskladila sa zahtjevima strogih
međunarodnih normi i standarda ISO 9001:2008, ISO 13485:2003
i Directive 92/42/EEC.
Kroz strateška partnerstva i samostalno, u suradnji s ortopedima
i traumatolozima, proizvodimo generičke, ali razvijamo i nove inovativne implantate, a kroz komplete instrumenata kontinuirano
pratimo najnovije globalno priznate metode i operativne tehnike.
Naša dostignuća i kvalitetu kroz povjerenje i nove narudžbe vrednuju
naši kupci u zemlji, regiji, te na europskim i globalnim tržištima.
INSTRUMENTARIA 2015. godine, kompanija je s visokom razinom
ljudskih resursa i tehnologijama, globalno, regionalno i lokalno integrirana, koja svojim standardnim i inovativnim „custom made“
proizvodima pruža rješenja za izazove s kojima se suočavaju ortopedi
i traumatolozi. Na taj način donosimo korist pacijentima, a isto tako
i zaposlenicima, dioničarima, te lokalnoj, regionalnoj, nacionalnoj
i europskoj zajednici.
mr. sc. Vladimir Kovačević,
CEO
Rimski put 31, 10360 Sesvete, Croatia, Tel: +38515550555, Fax: +38515550550, E-mail: info@instrumentaria.hr
www.instrumentaria.hr