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Operative Hip Arthroscopy - part 6

Các Distractor Hip trên bàn OSI Jackson. Lưu ý cánh tay C-IS Mang Bên dưới bàn. Chân của bệnh nhân có thể được định vị ở góc độ khác nhau của luân chuyển, uốn, gia hạn, vụ bắt cóc, và sự diển dẩn. Một Tensiometer readout kỹ thuật số IS sử dụng để giám sát các lực kéo | CHAPTER 9 THE LATERAL APPROACH 133 FIGURE 9.7. The OSI Hip distractor on the Jackson table. Note the C-arm is brought beneath the table. The patient s leg can be positioned in varying angles of rotation flexion extension abduction and adduction. A digital readout tensiometer is used to monitor the traction. The peroneal post has more than 9 cm of padding. FIGURE 9.8. Patient is lying on a fluoroscopic table in the Innomed hip distractor. Note there is no tensiometer and the leg cannot be flexed or extended once positioned however rotation is possible. FIGURE 9.9. The Glick Hip Set Stryker . Note the long arthroscope as well as long instruments and sheaths. 1 34 THOMAS G. SAMPSON FIGURE 9.10. Slotted cannula allowing introduction of curved instruments into the hip joint. FIGURE 9.11. Dyonics system of sheaths that fit a standard Dyonics arthroscope. Additional instruments are a 14-gauge intracath no. 11 blade slotted cannula switching sticks and Nitanol wire as well as a syringe with marcaine and epinephrine. FIGURE 9.12. Operating room layout. Note the patient is in an OSI distractor and the surgeon and technician are anterior to the patient with the assistant posterior. The C-arm lies between the surgeon and the technician. A Mayo stand lies above the patient for organization of the cords coming from the tower which is opposite the surgeon. The anesthesiologist is above the head and out of the way. CHAPTER 9 THE LATERAL APPROACH 135 B FIGURE 9.13. A The patient is lying in a lateral decubitus position with the peroneal post in place. Note the posterior lumbosacral support preventing rollback on the peroneal post. B Anterior view of the peroneal post with adequate padding. Note there is adequate space beneath the post not compressing on the downside leg and offsetting the post toward the operating leg taking pressure off the pudental nerve. force which is entered in the record with the vital signs. Once the intraarticular portion of the surgery is finished all the