Friday, August 14, 2009

New Surgery 08 18 2009

Clavicle Hook Plate 

Technique Guide 

Original Instruments and Implants of the Association 

for the Study of Internal Fixation—AO/ASIF

Overview 

The Clavicle Hook Plate provides a single solution for 

fixation of both lateral clavicle fractures and 

acromioclavicular joint injuries. This plate and screw 

construct allows early rotational mobility of the shoulder. 

Indications 

The Clavicle Hook Plate is 

indicated for: 

•Lateral clavicle fractures 

•Dislocations of the 

acromioclavicular joint 

Lateral clavicle fracture 

Dislocation of the acromioclavicular joint

Clavicle Hook Plates 

Features 

•Dynamic compression screw holes accept 

3.5 mm cortex and 4.0 mm cancellous 

bone screws 

•Compatible with the 3.5 mm DCP®Drill Guide 

[322.32] or the 3.5 mm Universal Drill Guide 

[323.36] 

•Anterolateral screw hole provides additional options 

for screw fixation in the lateral clavicle 

•Hook provides additional support to both lateral 

clavicle fractures and acromioclavicular 

joint dislocations 

•Plates available with 6 or 8 holes 

•15 mm and 18 mm hook depths 

accommodate patient anatomy 

•Precontoured in left and right plates 

•Available in commercially pure (CP) titanium or 

316L stainless steel 

•Offset hook design to avoid insertion of 

hook into acromioclavicular ligament 

241.064 

441.067 

1

Surgical Technique 

2 

Lateral Clavicle Fractures 

Incision 

Through a standard surgical incision, taking care 

not to disrupt the surrounding soft tissues, expose 

the outermost part of the clavicle, the fracture site, 

and the acromioclavicular joint. 

Insertion 

Perform temporary fixation of the fracture using 

Kirschner wires or bone holding forceps. Dissect 

the soft tissue, posterior to the acromioclavicular 

joint, to prepare a path for the insertion of the 

hook. Using the plate with 15mm hook depth, pass 

the hook under the acromion. Place the shaft of the 

plate onto the superior aspect of the clavicle. If 

there is difficulty lowering the plate shaft onto the 

clavicle, then the plate with 18 mm hook depth 

should be used. Once the plate shaft is placed on 

the clavicle, the end of the hook should be in 

contact with the underside of the acromion. 

Confirm that the correct anatomic alignment of the 

clavicle and acromion has been restored without 

impingement of the rotator cuff. Also before 

fixation, use the c-arm to verify that full shoulder 

motion, particularly in abduction and external 

rotation, can be achieved without impingement of 

the humeral head on the hook. 

Fixation 

One or two screws (either 3.5 mm cortex or 

4.0mm cancellous bone screws) can be placed in 

the lateral plate holes. The position and angulation 

of the screws depends on the fracture configuration. 

The 3.5 mm cortex screws placed in the medial 

plate holes can be positioned eccentrically 

depending on the fracture configuration, to provide 

dynamic compression of the fracture fragments. 

1

3 

Incision 

Through a standard surgical incision, taking care 

not to disrupt the soft tissues, expose the acromio- 

clavicular joint and the lateral shaft of the clavicle. 

Insertion 

Push down on the clavicle to reduce the dislocation 

of the acromioclavicular joint and provide 

temporary fixation using Kirschner wires. Dissect 

the soft tissue, posterior to the acromioclavicular 

joint, to prepare a path for the insertion of the 

hook. Perform any ligament or capsule repairs. 

Using the plate with 15 mm hook depth, pass the 

hook under the acromion. Place the plate on the 

superior aspect of the clavicle and confirm that the 

correct anatomic alignment of the clavicle and 

acromion has been restored. If the realignment 

appears to be overcorrected, use the plate with 

18mm hook depth. Before fixation use the c-arm 

to verify that full shoulder motion, particularly in 

abduction and external rotation, can be achieved 

without impingement of the humeral head on 

the hook. 

Fixation 

If sutures are used to repair the ligaments, the 

sutures can be passed through the lateral hole(s) 

of the plate and tied under tension to provide 

additional stability to the acromioclavicular joint. 

Place 3.5 mm cortex or 4.0 mm cancellous bone 

screws in the medial plate holes. Tighten the 

screws, ensuring that the acromioclavicular joint is 

reduced and stable. 

Dislocation of the Acromioclavicular Joint

4 

3.5 mm Clavicle Hook Plates 

RIGHT LEFT HOLES HOOK DEPTH MATERIAL 

241.062 241.063 6 15 mm Stainless Steel 

241.064 241.065 6 18 mm Stainless Steel 

241.066 241.067 8 15 mm Stainless Steel 

241.068 241.069 8 18 mm Stainless Steel 

RIGHT LEFT HOLES HOOK DEPTH MATERIAL 

441.062 441.063 6 15 mm Titanium 

441.064 441.065 6 18 mm Titanium 

441.066 441.067 8 15 mm Titanium 

441.068 441.069 8 18 mm Titanium 

Removal of the Implant 

Caution 

It is recommended that the Clavicle Hook Plate be 

removed after healing to prevent potential irritation 

of the acromion or impingement of the rotator cuff. 

241.064 

441.067

Sunday, May 17, 2009

Joaquin Graduates!








Today our little Joaquin graduated from puppy school... He really surprised us and was actually quite a good little student!

Sunday, April 26, 2009

Still waiting to hear from Republic Services....

It's been just over a week and I still haven't heard back from Republic Services... Please keep your fingers crossed for me..... I miss all of you and Arizona!

Sunday, April 19, 2009

Latest obsession.....

I figure that if I get this job in Phoenix, which I think looks pretty good, I should have a fancy new car to drive to my fancy new position.... Don't you think? Should a Safety Auditor be driving a Scion? I think not! Please help me convince Porter of this....

Thursday, April 16, 2009

In Phoenix


I am in Phoenix this morning for a safety seminar. Why this is what I choose to do with my time off from work, is really beyond me. Other than it's free OSHA certification and I am trying to beef up my resume. Speaking of which... I have an interview with Republic Services this afternoon. They are the second largest waste management (I can already hear the Tony Soprano jokes) in the country. I guess I am partial to # 2 since leaving Big Brown...
Wish me luck!

Thursday, April 02, 2009

Little Mini Cooper S




I have been dreaming about a little Mini Cooper lately. I went and drove one this afternoon... I think I am in love....

Tuesday, March 17, 2009

I changed the settings....

Now anyone can post an comment.. Please keep it clean... That means you Mr. Brenton.

Monday, March 16, 2009

I am back in Palm Springs!

I got back this afternoon.. Sorry I didn't get to see many of you. But the good news is that I GOT THE HOUSE RENTED!!!

Monday, March 09, 2009

I'll Be home this weekend...!






Let's see who actually reads this.....
I will be home to hopefully rent our house out..
If you know anybody looking for a cute house... Let us know!

Thursday, February 26, 2009

Coffee in Idyllwild


Cafe Aroma
54750 North Circl Dr
Idyllwild, CA 92549 Map

(951) 659-5212

Monday, February 23, 2009

Leonard Knight's Salvation Mountain



This place is realy interesting... Just about 45 minutes from our house in case you are planning on a visit sometime....Porter and I got to met Leonard, he even gave us a personal tour of his mountain!

Salvation Mountain is located in the lower desert of Southern California in Imperial County just east of the Salton Sea and about a hour and a half from Palm Springs.
Salvation Mountain is Leonard's tribute to God and his gift to the world with its simple yet powerful message: "God Is Love." Leonard's passion has lovingly created this brilliant "outsider art " masterpiece resplendent with not only biblical and religious scripture such as the Lord's Prayer, John 3:16, and the Sinner's Prayer, but also including flowers, trees, waterfalls, suns, bluebirds, and many other fascinating and colorful objects. Salvation Mountain must be seen to be fully appreciated as those who have made the journey will attest. Its 50 foot height and 150 foot breadth is made totally of local adobe clay and donated paint and is truly unique in the United States and probably the world. From its Sea of Galilee at the bottom, to the big red heart in the middle, to the cross at the very top, the reoccurring theme of "Love" is everywhere at Salvation Mountain.

Sunday, February 22, 2009

New Espresso Machine


I finally got a nice espresso machine- from my wonderful Husband for Valentine's day...
I love coffee. I truly believe it is the nectar of the God's.
I got a Saeco Incanto Deluxe. It is classified a a super-automatic espresso machine. All you do is push a button. It grinds, tamps and dispenses the beautiful espresso...

Tuesday, February 17, 2009

Jury Duty


I am at Jury Duty today.. I have been here since 8 am.. It's almost 3 pm.. This is so boring.....

Monday, February 16, 2009

Coachella Fest is coming Soon!

We live about 4 miles from the festival and would welcome any of our friends to stay with us....


Here's the full line up as it stands right now.
FRIDAY APRIL 17:
Paul McCartney, Morrissey, Franz Ferdinand, Leonard Cohen, Conor Oberst and the Mystic Valley Band, Beirut, The Black Keys, Girl Talk, Silversun Pickups, The Ting Tings, The Crystal Method, Ghostland Observatory, Crystal Castles, The Airborne Toxic Event, We Are Scientists, N.A.S.A., Patton & Rahzel, M. Ward, The Presets, The Hold Steady, A Place to Bury Strangers, Felix da Housecat, Buraka Som Sistema, Ryan Bingham, Bajofondo, Peanut Butter Wolf, Noah & the Whale, White Lies, The Bug, Alberta Cross, Los Campesinos!, Craze & Klever, Molotov, Switch, Gui Boratto, Steve Aoki, The Aggrolites, People Under the Stairs, The Courteeners, Cage the Elephant, Dear and the Headlights.

SATURDAY, APRIL 18:
The Killers, Amy Winehouse, Thievery Corporation, TV on the Radio, Band of Horses, Fleet Foxes, MSTRKRFT, Michael Franti & Spearhead, Atmosphere, Mastodon, TRAV$DJ-AM, Henry Rollins, Crookers, Turbonegro, Hercules and Love Affair, Superchunk, Glasvegas, Dr. Dog, Drive-By Truckers, Booker T & the DBT's, Amanda Palmer, The Bloody Beetroots, Surkin, Para One (Live), Calexico, Liars, Bob Mould Band, Zane Lowe, Electric Touch, Blitzen Trapper, James Morrison, Drop the Lime, Glass Candy, Thenewno2, Gang Gang Dance, Billy Talent, Ida Maria, Ariel Pink's Haunted Graffiti, Zizek, Cloud Cult, Tinariwen.

SUNDAY, APRIL 19:
The Cure, My Bloody Valentine, Yeah Yeah Yeahs, Throbbing Gristle, Lupe Fiasco, Paul Weller, Peter Bjorn and John, X, Antony & the Johnsons, Roni Size, Public Enemy, Jenny Lewis, Groove Armada, Paolo Nutini, Christopher Lawrence, Lykke Li, The Kills, Okkervil River, M.A.N.D.Y., Clipse, Sebastien Tellier, Fucked Up, Perry Farrell, The Horrors, Late of the Pier, K'naan, Junior Boys, Brian Jonestown Massacre, Supermayer, No Age, Vivian Girls, Shepard Faire Themselves, Gaslight Anthem, The Knux, Mexican Institute of Sound, The Night Marchers, Marshall Barnes.

Joaquin the monster





I am attaching some pictures of our new puppy Joaquin (the dog) for those who haven't seen him. He is a monster.....

I'm gonna give this a try...

I enjoy reading the three blogs I follow regularly so much... I will give this a go...
Things in Palm SPrings are going well... Porter and I both miss Arizona and of course our friends.... We are seriously thinking of moving back to either Tucson or Phoenix. Only Phoenix because it is a much stronger job market... So if any of you know anyone looking to either support us, or anyone looking for a GREAT SAFETY MANAGER- Please let me know...

Thursday, January 22, 2009

Wedding photos for those who haven't seen any...







I am attaching a few of our wedding photos for those who may npt have seen any...