Business Overview 2006 - Synthes

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Product Highlights. Trauma Trauma. RIA – Reamer-Irrigator-Aspirator Intramedullary nailing is one of the most successful treatment methods in trauma. This method requires the expansion of the bone’s medullary canal by means of reaming. With RIA, Synthes provides a device which makes the reaming procedure easier, faster and safer. As an added benefit, RIA can be used for harvesting autologous bone. Presently fractures of the long bones, particularly the femur and tibia, are routinely treated by placing an intramedullary nail into the bone’s medullary canal. The implant serves as a substitute load-bearing column until healing occurs. Since the introduction of this technique by Gerhard Küntscher in the 1940s, it has evolved to become one of the most successful treatment methods in orthopedic trauma surgery. Intramedullary nailing allows the quick remobilization of the patient. This is important in avoiding the serious complications that were common with the conservative management of fractures by means of traction and prolonged bed rest. Preparing the bone for implantation However, despite the undoubted benefits of the procedure, a risk of complications remains. The center of long bones is filled with fat which can be displaced into the venous system when the nail is placed into the canal. This problem can be compounded if the intramedullary space needs to be increased in diameter to accommodate a larger, stronger nail than could be placed in the patient’s natural canal. In order to create a greater diameter inside the bone, the surgeon introduces drills of increasing size until the canal has been expanded sufficiently. This process is known as reaming. Reaming produces pressure which forces marrow fat into the vascular system. In most cases the consequent embolic debris is tolerated, but it is known, on occasion, to provoke respiratory and cerebral complications with adverse consequences ranging from mild lung problems to, in extreme instances, death. The risk of such complications is increased in polytrauma patients needing placement of multiple nails, or patients with cancer who need a nail to prevent a tumor-weakened bone from fracturing. create a slurry of cut particles, and then vacuum it away. And, unlike the inefficient original reaming systems, RIA increases the diameter in one pass down the bone instead of requiring time-consuming multiple passes and numerous exchanges of cutting heads. This saves costly operating room time and provides an easier technique. And because the cutting surfaces are constantly cooled by irrigation, the complication of thermal damage to the bone is avoided. New method for bone harvesting Being able to enter the canal of the bone safely, without the risk of complications, has resulted in an entirely novel application for RIA. Often bone needs to be transplanted from one area, most commonly the pelvis or iliac crest, to a place where bone is missing or will not heal. This is known as autograft. Unfortunately, in some cases the amount of bone needed for transplanting is not available from the usual harvest sites. This presents a treatment quandary: how to find the extra bone needed? RIA provides an answer by unlocking an entirely new source of autograft – the rich reamings of the bone marrow from the femur or tibia. With RIA Synthes has once again proven its dedication to developing solutions to important clinical problems. The pursuit of better treatments is a sustaining mission and one that constantly yields new opportunities. RIA is poised to open new areas of discovery that result from this philosophy. But that is another story – one of many which will undoubtedly result from this truly unique product. Risks eliminated with RIA Synthes has long been in pursuit of a solution to this complex but important clinical dilemma. With RIA, the Reamer-Irrigator-Aspirator, Synthes presents a new reaming device which allows surgeons to increase the canal diameter of the bone without creating pressure, thereby eliminating the risk of embolization. RIA creates a negative pressure within the bone, enabling surgeons simultaneously to ream, 20
Synthes. Annual Report 2006 Patient story | The young man was a belt-restrained back-seat passenger involved in a motor vehicle accident. He sustained life-threatening injuries which included fractures of femurs, a tibia and a forearm. Surgeons at the University of Florida/Jacksonville routinely use RIA and it was ideally suited for management of this severely injured patient. Now, seven months after the injury, his fractures are healed and he has recovered. Pre-operative Post-operative 21
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Business Overview 2006 - Synthes

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