Operatieverslag scaphoidfractuur Headless Compression Screw (HCS) – SynthesIndicatie: Gedisloceerde scaphoidfractuur met comminutie rechts, Herbert B5
Verslag:
Time Out Procedure. Kefzol 1000mg iv. Axillair blok. Patiënt in rugligging met rechter arm in 90 graden. Huiddessinfectie middels Chloorhexidine 0,5% in alcohol 70% met Magenta. Volaire benadering. Reductie van fragmenten met 1.1mm K-draad via een separate incisie. Insertie van K-draad van distaal-radiaal naar proximaal-ulnair, waarbij de tip in de cortex van het proximale fragment komt. K-draad ligt in de centrale as van het scaphoid in zowel frontale en sagittale vlak, radiologisch gecontroleerd. Voorboren met 2.0mm Double Drill Sleeve. Meten over de K-draad. Plaatsen van 3.0mm Headless Compression Screw (HCS) – Synthes - 24mm in lengte over de K-draad. Aandraaien van HCS met T8 Stardrive Screwdriver. Reductie van fractuurgap. Aangedraaid tot rode markering. Verwijderen van K-draad. Radiologische controle met fractuur en HCS. Huid wordt gehecht met Flexocrin 3.0. Sign out procedure. 5cc bloedverlies.
Post-operatieve conclusie: Gedisloceerde scaphoidfractuur met comminutie rechts waarvoor 3.0mm Headless Compression Screw - 24mm (HCS) – Synthes
Nabehandeling:
- Oefenstabiel
- Niet belast voor 6 weken
- Over 2 weken policontrole voor hechtingen verwijderen en oefeninstructies herhalen
- Over 6 weken policontrole met X-controle
Headless Compression Screw (HCS)
2.4 mm Headless Compression Screws, short thread
Shaft thread (T) approximatly 20% of screw length (L)
|
| Stainless Steel |
Titanium |
Lengte (mm) |
Thread lengte (mm) |
| 02.226.209 |
04.226.209 |
9 |
4 |
| 02.226.210 |
04.226.210 |
10 |
4 |
| 02.226.211 |
04.226.211 |
11 |
4 |
| 02.226.212 |
04.226.212 |
12 |
4 |
| 02.226.213 |
04.226.213 |
13 |
4 |
| 02.226.214 |
04.226.214 |
14 |
4 |
| 02.226.215 |
04.226.215 |
15 |
4 |
| 02.226.216 |
04.226.216 |
16 |
4 |
| 02.226.217 |
04.226.217 |
17 |
4 |
| 02.226.218 |
04.226.218 |
18 |
4 |
| 02.226.219 |
04.226.219 |
19 |
4 |
| 02.226.220 |
04.226.220 |
20 |
4 |
| 02.226.221 |
04.226.221 |
21 |
4 |
| 02.226.222 |
04.226.222 |
22 |
4 |
| 02.226.223 |
04.226.223 |
23 |
4 |
| 02.226.224 |
04.226.224 |
24 |
5 |
| 02.226.225 |
04.226.225 |
25 |
5 |
| 02.226.226 |
04.226.226 |
26 |
5 |
| 02.226.227 |
04.226.227 |
27 |
6 |
| 02.226.228 |
04.226.228 |
28 |
6 |
| 02.226.229 |
04.226.229 |
29 |
6 |
| 02.226.230 |
04.226.230 |
30 |
7 |
| 02.226.232 |
04.226.232 |
32 |
7 |
| 02.226.234 |
04.226.234 |
34 |
8 |
| 02.226.236 |
04.226.236 |
36 |
9 |
| 02.226.238 |
04.226.238 |
38 |
9 |
| 02.226.240 |
04.226.240 |
40 |
10 |
2.4 mm Headless Compression Screws, long thread
Shaft thread (T) approximatly 40% of screw length (L)
|
| Stainless Steel |
Titanium |
Lengte (mm) |
Thread lengte (mm) |
| 02.226.317 |
04.226.317 |
17 |
6 |
| 02.226.318 |
04.226.318 |
18 |
6 |
| 02.226.319 |
04.226.319 |
19 |
7 |
| 02.226.320 |
04.226.320 |
20 |
7 |
| 02.226.321 |
04.226.321 |
21 |
8 |
| 02.226.322 |
04.226.322 |
22 |
8 |
| 02.226.323 |
04.226.323 |
23 |
8 |
| 02.226.324 |
04.226.324 |
24 |
8 |
| 02.226.325 |
04.226.325 |
25 |
8 |
| 02.226.326 |
04.226.326 |
26 |
10 |
| 02.226.327 |
04.226.327 |
27 |
10 |
| 02.226.328 |
04.226.328 |
28 |
10 |
| 02.226.329 |
04.226.329 |
29 |
10 |
| 02.226.330 |
04.226.330 |
30 |
12 |
| 02.226.332 |
04.226.332 |
32 |
12 |
| 02.226.334 |
04.226.334 |
34 |
14 |
| 02.226.336 |
04.226.336 |
36 |
14 |
| 02.226.338 |
04.226.338 |
38 |
16 |
| 02.226.340 |
04.226.340 |
40 |
16 |
3.0 mm Headless Compression Screws, short thread
Shaft thread (T) approximatly 20% of screw length (L)
|
| Stainless Steel |
Titanium |
Lengte (mm) |
Thread lengte (mm) |
| 02.226.010 |
04.226.010 |
10 |
4 |
| 02.226.011 |
04.226.011 |
11 |
4 |
| 02.226.012 |
04.226.012 |
12 |
4 |
| 02.226.013 |
04.226.013 |
13 |
4 |
| 02.226.014 |
04.226.014 |
14 |
4 |
| 02.226.015 |
04.226.015 |
15 |
4 |
| 02.226.016 |
04.226.016 |
16 |
4 |
| 02.226.017 |
04.226.017 |
17 |
4 |
| 02.226.018 |
04.226.018 |
18 |
4 |
| 02.226.019 |
04.226.019 |
19 |
4 |
| 02.226.020 |
04.226.020 |
20 |
4 |
| 02.226.021 |
04.226.021 |
21 |
4 |
| 02.226.022 |
04.226.022 |
22 |
4 |
| 02.226.023 |
04.226.023 |
23 |
4 |
| 02.226.024 |
04.226.024 |
24 |
5 |
| 02.226.025 |
04.226.025 |
25 |
5 |
| 02.226.026 |
04.226.026 |
26 |
5 |
| 02.226.027 |
04.226.027 |
27 |
6 |
| 02.226.028 |
04.226.028 |
28 |
6 |
| 02.226.029 |
04.226.029 |
29 |
6 |
| 02.226.030 |
04.226.030 |
30 |
7 |
| 02.226.032 |
04.226.032 |
32 |
7 |
| 02.226.034 |
04.226.034 |
34 |
8 |
| 02.226.036 |
04.226.036 |
36 |
9 |
| 02.226.038 |
04.226.038 |
38 |
9 |
| 02.226.040 |
04.226.040 |
40 |
10 |
3.0 mm Headless Compression Screws, long thread
Shaft thread (T) approximatly 40% of screw length (L)
|
| Stainless Steel |
Titanium |
Lengte (mm) |
Thread lengte (mm) |
| 02.226.116 |
04.226.116 |
16 |
5 |
| 02.226.117 |
04.226.117 |
17 |
6 |
| 02.226.118 |
04.226.118 |
18 |
6 |
| 02.226.119 |
04.226.119 |
19 |
7 |
| 02.226.120 |
04.226.120 |
20 |
7 |
| 02.226.121 |
04.226.121 |
21 |
8 |
| 02.226.122 |
04.226.122 |
22 |
8 |
| 02.226.123 |
04.226.123 |
23 |
8 |
| 02.226.124 |
04.226.124 |
24 |
8 |
| 02.226.125 |
04.226.125 |
25 |
8 |
| 02.226.126 |
04.226.126 |
26 |
10 |
| 02.226.127 |
04.226.127 |
27 |
10 |
| 02.226.128 |
04.226.128 |
28 |
10 |
| 02.226.129 |
04.226.129 |
29 |
10 |
| 02.226.130 |
04.226.130 |
30 |
12 |
| 02.226.132 |
04.226.132 |
32 |
12 |
| 02.226.134 |
04.226.134 |
34 |
14 |
| 02.226.136 |
04.226.136 |
36 |
14 |
| 02.226.138 |
04.226.138 |
38 |
16 |
| 02.226.140 |
04.226.140 |
40 |
16 |
Merk:
- Depuy-Synthes
2.4 mm Headless Compression Screws, short thread
Shaft thread (T) approximatly 20% of screw length (L)
2.4 mm Headless Compression Screws, long thread
Shaft thread (T) approximatly 40% of screw length (L)
3.0 mm Headless Compression Screws, short thread Shaft thread (T) approximatly 20% of screw length
3.0 mm Headless Compression Screws, long thread
Shaft thread (T) approximatly 40% of screw length (L)
Complicaties
- - Wondinfectie
- - Nabloeding
- - Uitbreken osteosynthese materiaal
- - Pijnklachten en/of functieverlies ondanks geslaagde procedure
- - Pseudoartrose
- - Osteonecrose
- - Secundaire artrose
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