INSERTER* / HOLDER PREP FOR TRIALS
Insert the Internal Holder through the base of the External Holder Fig. A.
Fig. B Then attach the Trial Implant to the end of the External Holder by aligning the pins of the Holder to the holes of the Trial Implant. The flat sides of the Trial Implant and the Inserter handle are aligned.
Fig. C Next screw the Internal Holder through the External Holder into the Trial Implant and tighten.
The first Trial Implant is placed over the Guide-wire and seated in the sinus tarsi. Hindfoot mobility is assessed and the size may be adjusted accordingly. Correct position of the Trial Implant may be verified by fluoroscopy. It is recommended to advance the leading edge of the Trial Implant close to but not past the talonavicular bisection on the AP view. The corresponding flat surfaces of the Trial and Inserter handle are aligned parallel to the lateral talar process which is an approximate 45° angle to the fibula and the plantar aspect of the foot on the lateral view
The Trial Implant is removed leaving the Guide-wire in place.
INSERTER PREPARATION FOR IMPLANT
As with the trial, theImplant is fixed to the External Holder Fig. D.
Fig. E Then tightened onto the Internal Holder by turning the bottom knob to engage the Implant.
The Inserter is used to “press fit” the Implant in the correct position with a pushing motion. “Do not screw Implant into place.” X-ray markers at each end of the Implant help achieve the adequate depth with fluoroscopy visualization. The corresponding flat surfaces of the Implant and Inserter handle are aligned parallel to the lateral talar process which is an approximate 45° angle to the fibula and the plantar aspect of the foot on the lateral view.
Unscrew the Internal Holder to release the Implant and push with finger pressure to remove the Holder from the Implant.
Hind-foot mobility is assessed to verify adequate correction. The wound should be closed according to surgeon preference.