Anatomy
What does CMC stand for?
Carpometacarpal
What size SwiveLocks are used in APL Suspensionplasty?
3.5mm DX SwiveLocks
Why are we performing a Suspensionplasty?
Removal of trapezium. (Trapeziectomy )
Drill Size Utilization
(When do you use a 3.0mm, when do you use a 3.5mm?)
3.0mm = All-suture constructs (repairs or IB only)
3.5mm = All graft incorporation (dunking grafts)
What do we have to help with the aiming of the K-wire placement in CMC Mini TR?
C-Ring aiming guide
What bones make up the thumb CMC joint?
Trapezium (wrist carpal bone) and 1st Metacarpal
What suture is used for IB in APL Suspensionplasty?
1.3mm Suturetape
How many CMC joints in a hand?
5 CMC joints
How much graft is dunked in APL Suspensionplasty?
3mm
What can we recommend for helping keep the hand in a relaxed neutral position and thumb in abduction position?
Rolled up blue towel between thumb and palm
Shape of CMC Joint
Biconcave and Biconvex (Saddle shaped)
Does the DX FiberTak in FiberLock CMC come with needles or without needles?
Without
Three types of suspensionplasty
Mini TightRope
APL InternalBrace (APL?)
FiberLock
Which anchor do we drill first in FiberLock CMC?
*In which bone?
DX FiberTak
* Second Metacarpal
Significance of laser lines on FiberLock DX FiberTak guide wire?
Correlates with laser lines on DX FiberTak shaft. Not to mallet into second metacarpal
APL
What size guide wire is used for Mini TightRope CMC?
*What bone do you drill first and what bone second?
1.1mm tapered Kwire
* Base (dorsomedial) of first metacarpal first
* Proximal one third of the second metacarpal
3.5 DX SwiveLock
DX FiberTak
In an APL InternalBrace, what do we recommend doing with the APL graft and InternalBrace before finally fixation?
What can we recommend for drilling trajectory for FiberTak in FiberLock CMC?
Advancing drill sleeve to far cortex
Four proximal carpal row bones
Scaphoid
Triquetrum
Lunate
Pisiform
What two anchors are used in FiberLock CMC?
*What size drills for each?
3.5mm DX SwiveLock (2.7mm, 3.0mm)
DX FiberTak (1.6mm)
What is an LRTI?
*What tendon is used?
*FCR (Flexor Carpi Radialis)
In APL InternalBrace, which anchor do you fixate first and which do you fixate second?
3.5mm DX SwiveLock into 1st metacarpal first
3.5mm DX SwiveLock into 2nd Metacarpal second
In Mini TR CMC, do we recommend passing K-Wire through both 1st and 2nd metacapal and shuttling tightrope or passing k-wire through 1st MC and shuttling and then 2nd MC and shuttling independently?