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                                                                                  315InDternntal EFiqxuaitpiomnent & Instrumentation www.vetinst.com
HIF - Humeral Intracondylar Fissure (IOHC)
Humeral intracondylar fissure (HIF) is most commonly seen in English Springer Spaniels, and occasionally other breeds.The condition is characterised by a fissure in the centre of the humeral condyle, which has been hypothesised to be either failure of the ossification centres to fuse, or a stress fracture. Reported healing rates for the fissure vary, with techniques that employ bone grafting appearing to be superior in this regard.
Humeral Intracondylar Repair System (HIRS)
The HIRS was developed by Ben Walton and John Innes, in partnership with the Veterinary Tissue Bank, to optimise healing and minimise complications for cases of HIF and humeral condylar fractures. Specifically, to allow application of DBM putty to the site of the fissure, to provide compression (improving stability), to ensure bone-holding either side of the fissure (to minimise the risk of screw loosening), and to be low-profile (headless) to minimise soft-tissue irritation.
The screw is titanium alloy, self-tapping, headless, and self-compressing. The drill-bit is designed to drill a hole of varying diameter; simplifying the procedure and creating a void around the central section that is packed with DBM putty.
• The screw is driven until it is tight, creating compression at the fissure site
• A surgical demonstration video is available at https://youtu.be/nMhBNBPadXs
Surgeons can contact Ben Walton (ben.walton@cvsvets.com) or John Innes (john.innes@cvsvets.com) for advice or to provide feedback on the HIRS.
 Shaft Screws
4.5mm Shaft Screws for HIF
                                                                                                                                                                                                            Surgical Planning
Accurate placement is key to success with this implant. Ben Walton has created a video describing planning of the transcondylar tunnel, and how to execute this plan during surgery.
It is available to view at https://youtu.be/GHH9Mm7Umy8
Surgical Technique Summary
• A 2.0mm pilot hole is drilled across the humeral condyle.
• The developers advise medial and lateral approaches are made to the humeral epicondyles, and the entry-exit points of the transcondylar tunnel are marked.
• A 2.0mm pilot hole is drilled using an aiming device, and measured for depth.
• The HIRS stepped drill bit is used to prepare the hole for the implant, using the laser-etched depth markers as guides, and drilling in a medial-to-lateral direction.
• The HIRS implant is placed in the tunnel, and the trans-thread is engaged.
• DBM putty is injected around the screw, using a 16g IV catheter or needle.
Titanium Titanium
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HIRS - HUMERAL INTRACONDYLAR REPAIR SYSTEM
HIRSSC32 HIRSDRILL H090102 S090102S SDH3500 ADJDG2035
HIRS Screw 32mm Long Titanium HIRS Step Drill
2.0mm (Pilot) Drill Round Shank 2.0mm (Pilot) Drill AO Quick Release 3.5mm Hex Screwdriver
Adjustable Drill Guide for 2.0/2.5/3.5mm Drills
Please note a chuck with minimum capacity 6mm will be required.
              Please note that a tap is required for the shaft screws. It is also recommended that an insert sleeve is used to centre the pilot hole in the far condyle.
4.5MM SHAFT SCREWS EQUIPMENT
N45
CN45-A COU4565QR COU4565T-A DRILLSTOP SDH3500 H090105S S090105S H090108S S090108S TS00045 ADJDG45
4.5mm Cortical Nut Stainless Steel Non Sterile 4.5mm Cortical Nut UHMPWE - Sterile
Quick Release Countersink for 4.5/6.5 Screws AO Fit T Bar Countersink for 4.5/6.5 Screws
Drill Stop Set in Stainless Case
3.5mm Hex Screwdriver for 4.5/5.5/6.5mm Screws 3.2mm (Pilot) Drill Round Shank
3.2mm (Pilot) Drill AO Quick Release
4.5mm (Clearance) Drill Round Shank
4.5mm (Clearance) Drill AO Quick Release
4.5mm Cortical Tap Quick Release - Handle required Adjustable Drill Guide for 4.5mm Drills
Thanks to Andy Moores
 LABEL DESCRIPTION: MATERIAL:
union in the proximal
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90-<150mm 31-<90mm 7-<31mm 0-<7mm
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± 0.5mm ± 0.3mm ± 0.2mm ± 0.1mm ± 1°
NAME DATE 08/08/2015
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GENERAL TOLERANCES
SHSC4532 SHSC4534 SHSC4536 SHSC4538 SHSC4540 SHSC4542 SHSC4544 SHSC4534TI SHSC4536TI
Shaft Screw 32mm Shaft Screw 34mm Shaft Screw 36mm Shaft Screw 38mm Shaft Screw 40mm Shaft Screw 42mm Shaft Screw 44mm Shaft Screw 34mm Shaft Screw 36mm
Material Hardness:
DR'N CHK'D APPV'D Weight:
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SHEET 2 OF 2
8 week follow-up of a
Springer Spaniel with
HIF showing bony
We offer a range of 4.5mm shaft screws specifically designed to be used as trans-condylar stabilising screws. Note that the 4.5mm shaft screws are significantly stronger than a standard 4.5mm cortical screw.
Humeral Intercondylar Fissure screw 32mm
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