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Coxofemoral Luxation Management Instructions

The following instructions are intended to be used as a quick reference. More detailed information is included with purchase. See also Toggle-Rod Fixation for Management of Coxofemoral Luxation.


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1. Luxate the hip, elevate the femur and rotate it 45 degrees. Debride remnants of the round ligament from the fovea. Place the point of the drill guide in the middle of the fovea. Position the drill sleeve on the lateral aspect of the femur at the base of the greater trochanter. Tighten the sleeve to stabilize the guide. Drill the femoral neck with the 3.2mm drill bit and remove the guide.



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2. Reduce the hip and hold the limb in a normal standing position. This will require that the leg be lifted from the table. Drill through the femoral neck hole and continue through the medial wall of the acetabulum. (If the limb is not lifted, this may damage articular cartiledge and the resulting neutral position of the device will not be optimal.)



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3. Re-dislocate the hip. Thread the nylon through the toggle rod. Load the toggle rod and nylon into the inserter. Roll the "O"-rings over the nylon to help hold the toggle rod in place. Push the toggle rod into the hole in the medial wall of the acetabulum. Push on the plunger to deliver the toggle rod completely through the hole. While Continuing to hold the plunger in place, pull on the nylon to seat the toggle rod. The plunger will prevent the toggle rod from pulling back into the acetabulum. Remove the inserter and plunger. Pull firmly on the nylon to ensure that the toggle is engaged.



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4. Feed the nylon up the hole in the femoral neck and reduce the hip. Pull firmly on the nylon while pushing the femur into the acetabulum. While holding the nylon at the level of the trochanter, manipulate the hip through full flexion and extension. Simulate weight bearing in a normally abducted position. Secure the nylon by tying over a polypropylene button or another toggle rod. Five throws are necessary. If you have the SECUROS Cruciate System you may choose to perform the following steps.



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5. Drill a hole approximately 5-10mm in front of the lateral aspect of the femoral head, perpendicular to the hole drilled in the femoral neck.



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6. Pass one strand of the nylon, that was fed through the femoral neck, through one side of the perpendicular hole. Feed the other strand of the nylon through the other side of the perpendicular hole. Pass the two ends of the nylon through the primary crimp clamp. Apply two secondary crimp clamps to the free ends. Apply the desired tension using the tensioning device.



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7. Crimp the primary crimp clamp and cut off the secondary crimp clamps. Apply three crimps to the primary crimp clamp.