{"product_id":"patella-case-2-cannulated-screws-cerclage","title":"PATELLA [Case 2] · Cannulated Screws + Cerclage","description":"\u003cp\u003eDisplaced patellar fractures associated with joint stiffness, preexisting deformity, and poor bone quality represent a significant technical challenge, particularly in achieving and maintaining reduction.\u003c\/p\u003e\n\u003cp\u003eThis training presents, in 4K video under a surgical perspective, a systematized approach to patellar osteosynthesis using cannulated screws associated with cerclage, focused on restoration of the extensor mechanism even in highly complex scenarios.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eTraining Focus\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003eOsteosynthesis of displaced patellar fractures\u003c\/li\u003e\n\u003cli\u003eDifficult reduction in a knee with flexion stiffness\u003c\/li\u003e\n\u003cli\u003eUse of cannulated screws associated with cerclage\u003c\/li\u003e\n\u003cli\u003eStrategies for associated longitudinal fractures\u003c\/li\u003e\n\u003cli\u003ePreservation of the extensor mechanism\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003e\u003cstrong\u003eDetailed Content\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003ePrecise Anatomic Planning:\u003c\/strong\u003e Careful identification of fracture lines, bony interdigitations, and areas of greater bone mass to safely define implant positioning.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eSelective Periosteal Dissection:\u003c\/strong\u003e Technique limited to the fracture line, preserving bone vascularity and favoring consolidation.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eProgressive Reduction in High-Tension Situations:\u003c\/strong\u003e Manual and clamp-assisted strategies to overcome muscular contractures and joint stiffness without generating secondary fractures.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eStrategic Use of Temporary Crossed Wires:\u003c\/strong\u003e Maintenance of reduction in scenarios where immediate definitive fixation is not possible.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eOptimized Sequence of Cannulated Screws:\u003c\/strong\u003e Homogeneous compression through alternating tightening and prevention of opening of longitudinal fracture lines.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eManagement of Associated Longitudinal Fractures:\u003c\/strong\u003e Complementary fixation with transverse screws for structural protection of the patella.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eGuided Cerclage Closely Applied to Bone:\u003c\/strong\u003e Technique of passage through the cannulated screws, avoiding interposition of soft tissues.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eControlled Knot Tying and Knot Positioning:\u003c\/strong\u003e Strategies to minimize anterior prominence and reduce the future need for implant removal.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eFunctional Preservation of the Extensor Mechanism:\u003c\/strong\u003e Planned longitudinal incisions in the quadriceps tendon to accommodate the cerclage without functional impairment.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eIntraoperative Technical Analysis:\u003c\/strong\u003e Detailed commentary on surgical decisions, encountered difficulties, and adopted solutions.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003e\u003cstrong\u003eIncluded Material\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDetailed PDF:\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eTechnical document with a structured summary of the step-by-step surgical procedure, biomechanical principles of patellar osteosynthesis, indications for the implants used, strategies for difficult reduction, prevention of complications, and critical points for preservation of the extensor mechanism.\u003c\/p\u003e\n\u003cp\u003eEnhance your decision-making and execution in complex patellar fractures. Enroll and incorporate a systematized technical approach into your surgical practice.\u003c\/p\u003e\n\u003cp\u003e\u003c!-- notionvc: db2f077e-f248-41b9-90ee-1e339930c9d4 --\u003e\u003c\/p\u003e","brand":"Dr Savio Chami","offers":[{"title":"Default Title","offer_id":43320157634621,"sku":null,"price":30.0,"currency_code":"BRL","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0641\/3664\/2621\/files\/PATELACase2_ParafusosCanulados_Cerclagem.webp?v=1783098784","url":"https:\/\/www.surgie.com\/ja\/products\/patella-case-2-cannulated-screws-cerclage","provider":"Surgie","version":"1.0","type":"link"}