the fibuLinK system is designed to stabilize a disruption of the ankle
syndismosis while allowing the anatomic motion required during a normal gait
it may be used to treat an isolated syndesmosis disruption or in conjunction
with a fracture repair after the syndesmosis is reduced or
clamped per the surgeon's preference installation begins by inserting a k
wire through the fibula and into the tibia approximately two centimeters
above the plefond once proper placement is verified the
provided step drill is driven over the k wire to drill a three millimeter pilot
hole in the tibia and a four millimeter gliding hole through the fibula
ensure the larger portion of the step drill does not plunge into the tibia
the pre-loaded self-tapping tibia screw is then inserted through the drilled
hole and is threaded into the tibia an increase in torque indicates that the
shoulder of the driver has contacted the lateral tibia cortex
indicating that the screw has been fully inserted
note the indicator on the driver if it remains visible above the fibula
or plate then the standard fibula tensioning cap should be used
if it is below the surface of the fibula or plate then utilize the long
tensioning cap release the green retention suture by
unwinding it from the back of the driver handle
as you remove the driver the green suture will also be removed and the
guide tubes will become accessible the appropriate tensioning cap and knob
are then placed over the guide tubes and a clamp is attached to the silver
portion to prevent its rotation the guide tube is pulled laterally to
bring the external threads of the fibula link into contact with the internal
threads of the tensioning cap clockwise rotation of the tensioning
knob threads the cap onto the link and applies pressure to narrow the
syndismatic gap the mechanical advantage provided by the
link cap interface means that the surgeon will not feel a bite the same
way they will with an orthopedic screw note that an over torque indicator is
built into the knob to prevent construct failure
further tightening or relaxation of the implant can be performed as needed by
rotating the tensioning knob clockwise or counterclockwise
once the surgeon has evaluated the ankle and determined that the procedure is
complete the gold tube can be removed followed by the silver tube and
tensioning knob
to remove the fibulink implant a dedicated instrument kit is available
use the tensioning cap remover to remove the cap
if the link remains in the fibula utilize the link and screw remover which
is the same as the driver in the implant kit to push the link into the base of
the tibia screw once the hexalobe shaped link is engaged
inside the female hexalobe portion of the tibia screw both can be reversed out
of the tibia and fibula in some instances the link may be
removed along with the tensioning cap once removed insert the tibia screw
remover a hexalobe retrieval driver into the tibia screw and reverse thread it
out of the tibia through the initial implant site