The Pros and Cons of the FIBULINK Technique
The FIBULINK fixation technique avoids disruption of the medial soft tissue, improving procedural efficiency and minimizing interference with medial malleolar screws. As a result, only one lateral incision, with no interruption of medial soft tissue delivers fixation. This innovative procedure is a proven, minimally invasive option for tibial fractures. The following article focuses on the pros and cons of the technique.
Polhemus System Fibulink Technique
FIBULINK is a novel syndesmosis repair system. Developed by DePuy Synthes after acquiring FIBULINK technology from Akros Medical, this system has a short, high-strength suture bridge that eliminates the need for syndesmotic screws and allows surgeons to fine-tune tension during the procedure. Using this system, the surgeon can tighten or reverse the suture tension, which improves the final gap between the tibia and fibula.
FIBULINK Implants Technique
A newly developed technique for repairing fibula fractures called FIBULINK implants offers many advantages. Stainless steel or titanium manufactures FIBULINK implants and is provided in single-use kits. The implant system combines flexible fixation and an easy-to-use technique. This technique eliminates the need for a medial incision and provides superior biomechanical performance and 71 percent less elongation than other fusion techniques. A FIBULINK implant is compatible with any plate with a hole of 4 mm. If the corresponding screw hole size is 4mm, a FIBULINK implant uses any plate.
FIBULINK syndesmosis repair system designs to restore ankle physiologic motion following traumatic injury to the syndesmosis. Developed by Akros Medical Inc., which was acquired by DePuy Synthes last year, the system includes a high-strength suture bridge. This feature eliminates the risk of broken syndesmosis screws, which can lead to additional complications. Also, the system allows surgeons to adjust the final gap between the fibula and the tibia.
The implantation tool positions the first anchor 12 in the fibula 4 through the hole in the tibia 2. After positioning the anchor, it retracts the device. The tether 16 attaches to the first anchor 12. The tether extends through the hole in the fibula. The deployment component 232 extends from the tether. Then, the surgeon inserts the second anchor. Using a procedure similar to the fibula implant technique treats Fibula 4 fractures.
FIBULINK Distal Fibula Plate
The FIBULINK distal fibula plating technique involves placing an implant through the bone in a targeted area. Stainless steel or titanium makes this device and comes in single-use kits. It is compatible with all DePuy Synthes distal fibula plates and any plate hole that accepts a 4 mm non-locking cortex screw. A special drill bit places this implant.
The FIBULINK Syndesmosis Repair System and Arthrex Syndesmosis TightRope(r) XP Implant System made a comparison during bench testings. Eight samples in each group are cyclically loads from 20 N to 113 N for 300,000 cycles. The cyclic loading was repeated and displacements in the load direction were measured. A static load-to-failure test was then performed to determine the fixation strength of the implant. The fixation strength was defined as the load at two millimeters of fibula displacement. A fibula displacement difference of 2 mm or more is considered pathological.
The FIBULINK distal fibula anchor system consists of a first anchor 12 and a second anchor 14. Both of these anchors have a threaded component that attaches to an externally threaded anchor. The second anchor 14 threads coupled to the base component 16B. The anchors are then coupled together with a suture. The FIBULINK distal fibula plate technique comprises two anchors: an externally threaded anchor 12 and an internally threaded anchor 14. The first anchor 12 is threaded onto the tether by a circular screw, and the second anchor 14 is fixed to the lateral face of fibula 4. The second anchored 14 is then coupled to the base component 16B by a looped suture.
FIBULINK Tibial Screw
FIBULINK is a new tibial fixation system for traumatic syndesmosis injuries that allows for the reestablishment of physiologic motion. Developed by Akros Medical Inc., this device was recently acquired by DePuy Synthes. Unlike conventional implants, the FIBULINK system has a short, high-strength suture bridge that eliminates the risk of a broken syndesmosis screw. The company claims that the FIBULINK system is the only flexible syndesmosis repair system that allows surgeons to optimize the final gap between the tibia and fibula.
To achieve the desired results, the Fibula Link transfixes to the tibia using seven screws. The tibia fixes the tibia using a second tibial screw, called a “countersink” screw. The bridge makes 4 mm of #1 Ultra High Molecular Weight Polyethylene and is provided in single-use kits. The fibula tensing cap pre-attaches the Tensioning Knob, while the Tibia Screwdriver preloads the self-tapping Tibia Screw.
The first anchor 12 has threads that are similar to standard metallic bone screws. The implantation tool engages the tibia via the annular space between the major and minor diameters. The tibia screw inserts until it is flush with the lateral cortex of the tibia. The internal or external oblique imaging confirms the insertion depth. This procedure repeats as needed if the patient experiences complications.
FIBULINK Distal Fibula Screw
The FIBULINK Distal Fibula Screw Technique standard procedure uses to stabilize the distal fibula. The single-use kit provides screws made from titanium or stainless steel. These implants are compatible with all DePuy Synthes distal fibula plates. They accept a four-millimeter non-locking cortex screw. The surgeon can cinch down the screws in order to optimize the tensioning of the implant.
The FIBULINK Syndesmosis Repair System combines the benefits of suture fixation with the flexibility of screws. The system is the first adjustable syndesmosis repair system that allows for precise anatomical fixation. It addresses limitations associated with previous suture button constructs, allowing surgeons to customize fixation. The implant is available in titanium and stainless steel and used in combination with a fibula plate. The FIBULINK Implant accepts a 4-mm non-locking cortex screw.
The Suture Bridge transfers tension from the Fibula Link to the Tibia Screw. The Suture Bridge makes four mm of #1 Ultra High Molecular Weight Polyethylene. The Tibia Screw serves as an anchor in the tibia. Sutures included a single-use kit. The Fibula Tensioning Cap pre-attaches to the Tensioning Knob. The Tibia Screwdriver has a self-tapping tip.
Arthrex Syndesmosis TightRope(r) XP Implant System
Designed to eliminate the need for a medial incision, the FIBULINK Syndesmosis Repair System delivers fixation through a single lateral incision. The FIBULINK technique combines a flexible fixation system and single-use, single-incision surgical kits to provide fixation during the healing process.
The FIBULINK Syndesmosis Repair System combines a suture button with a special delivery mechanism to make it easy to insert and remove. Syndesmosis repair in patients who have ankle fractures uses this system and repairs isolated syndesmosis injuries. This minimally invasive technique allows surgeons to implant two or more implants at the same time. The implant is available in titanium and stainless steel.
The FIBULINK Syndesmosis Repair System design restores the ankle motion following trauma to the talus and fibula. DePuy Synthes acquired the technology from Akros Medical Inc. Injuries to the syndesmosis occur when the talus pushes externally against the fibula. Most patients require surgical repair to restore the ankle’s motion. Approximately thirteen to fifty percent of ankle fractures and one-eighth of all ankle sprains are due to syndesmosis injury.
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