Documente Academic
Documente Profesional
Documente Cultură
C M F S U R G E R Y: S t o r i e s f r o m t h e O . R .
Evas rib.
On the potentials of
craniomaxillofacial surgery*.
Legend tells us that woman was created from the rib of man. However we may view this story
from the Book of Genesis, modern medicine offers applications pointing in this direction. Man
sometimes functions as his own spare parts warehouse such as for the transfer of muscle or
fatty tissue to another part of the body or the use of bones as transplants. The body does not
reject its own endogenic substances, and this is why autologous bone replacement is preferable
to autogenous transplanting from one person to another or, for that matter, to xenogenic trans-
fer from animals. However, bone also has the ability to form callus the prerequisite for grow-
ing back together in the event of a fracture. This property is the basis of distraction, a method
that has led to outstanding results in CMF surgery over the last 20 years, such as in the case of
the girl well simply call Eva instead of her real name.
va is four years old. Since her birth she supplier of distractors, notably with regard to the
had only half a mandible a congenital second generation of distractors, initiated at the
deformity. The rest of the jaw was simply University Hospital of Zurich back in 1999. To this
missing. Until now she could eat only mashed food, day, these distractors are still known as the Zurich
yogurt, soups and pureed food. Now four years old, Design. At the time KLS Martin showed that,
something had to be done to eliminate the severe thanks to its flat hierarchies, it is capable of acting
functional limitations with deglutition, mastication fast and it has done so on many occasions ever
and speech. A barely 10 millimeter long piece was since. This is largely the achievement of a Develop
separated from the end of the existing jaw half and ment Division capable of filling special individual
joined to a distractor for bone transport. The distractor orders differing from the standard serial products
is then activated day by day to move exactly one within just a few days. In fact, the company
millimeter each day. In this way callus is generated c learly distinguishes itself not only by its flexibility
in the narrow gap between the existing jaw half and in developing customized solutions, but also by
the separated bone piece soft, still pliable bone its capacity to quickly take them to serial pro
tissue that joins the two bone ends. duction as well. Needless to say, top quality is
guaranteed consistently.
3
O R A L A N D M A X I L L O FA C I A L S U R G E R Y: S t o r i e s f r o m t h e O . R .
B efore A fter
4
The possibilities that For adults, these implants are usually made of
this allows can be seen titanium, a material which the organism tolerates
in cases in which the easily, or of polyether ether ketone (PEEK), a high-
orbital floor is fractured. performance, biocompatible plastic that is very
A strong shock can light, sterilizable and extremely stable a material
crumble the fragile of the future. Such implants are fixed to the cranial
bone as though it were bone as wafer thin, low-profile titanium plate de
a potato chip. It is then signs, as offered as part of KLS Martins ultra-low-
impossible to join all the individual pieces together profile Neuro System, so that the patient is hardly
again. In order to stabilize the ocular bulb, a resorb aware of the artificial implant. But in the case of the
able foil is inserted. However, depending on the little boy, neither material is suitable. His cranium
extent of fracture, this does not always prevent a is still growing inserting rigid implants would be
secondary reconstruction with a permanent implant. out of the question. With poly-DL-lactic acid (PDLLA),
Otherwise, the eye would lose its support as soon however, the situation is different. KLS Martin
as the resorbable implant dissolves. But how is the developed this unique poly-D- and L-lactide mixture
orbital floor reconstructed when it has fractured into in the 1990s to use it for resorbable implants. This
countless bone fragments that can never be put material, which is completely absorbed in the body
together again? KLS Martins Development Division has by hydrolysis, has now been used successfully
solved this problem by mirroring the CT data of the for many years in craniomaxillofacial surgery and
healthy orbital floor on the computer. On this basis, neurosurgery.
an exactly fitting implant can be manufactured
that simply has to be inserted via a narrow incision But its use on a large scale in the cranial cap
below the eye and fixed during the operation. is altogether new. This was made possible by insert
ing underneath a mixture of hydroxylapatite and
KLS Martin is one of the few global suppliers tricalcium phosphate, a bone substitute material
c apable of developing, manufacturing and deliver that ossifies to the same extent as the resorbable
ing such implants in a very short time. implant dissolves.
5
C M F S U R G E R Y: T h e p r o d u c t r a n g e
7
Its the head that counts and the face. There is nothing
with which we identify ourselves more than with the face.
We are how we see ourselves. And more still: four of our
five senses sight, hearing, smell, and taste are located
in the head and the face.
C M F surgery: T h e p r o d u c t r a n g e
This brochure gives you a succinct overview of everything needed for CMF
operations from plates, meshes, screws, pins, distractors and patient-specific
implants all the way to lasers, HF generators, operating lights and pendant
systems that supply all the needed media.
9
C M F S U R G E R Y: D i s t r a c t i o n a n d r e s o r b a b l e i m p l a n t s
KLS Martin offers internal mandibular distractors In addition, KLS Martin excels with a prototyping
with the lowest profiles and at the same time capability that enables us to respond to requests
the highest retention stability. Moreover, our exten for patient-specific models within just two weeks.
sive portfolio includes hundreds of other distractors After having already played an essential role in
for horizontal, transversal and vertical distraction, the development and manufacture of the Zurich
midface distraction, extraoral mandibular distraction, design that is now used clinically all over the world
and much more. with great success, prototyping again gives us the
lead in the industry as a trailblazer and partner of
CMF surgeons.
10
The solution is in the dissolution.
Resorbable implants with SonicWeld Rx .
With SonicWeld Rx, KLS Martin has developed a Both the meshes and the pins are made of a
revolutionary technique for use in craniomaxillofacial 100% amorphous poly-DL-lactic acid (PDLLA)
osteosynthesis. It combines highly advanced ultra a completely biodegradable material. The method
sound technology with resorbable implants to com is clinically certified and validated and very patient-
pletely eliminate the need for a second operation. friendly as well. These implants degrade through
The procedure is simple: resorbable meshes are natural hydrolysis in a controlled process.
heated up, shaped to fit the application site and then SonicWeld Rx is primarily stable, convenient, fast,
fixed in place with SonicPins inserted into predrilled easy and safe. Designed for cranial fixation, ideal
holes. This is done with a sonotrode that liquefies for pediatric trauma, and indicated also for cancel
the pins, thus causing them to bond with the meshes lous bone structures.
and penetrate into the bone cavities to anchor
The KLS Martin SonicWeld Rx Solution is based on the
themselves securely. BoneWelding technology1) protected by the industrial
property rights of WoodWelding AG, Switzerland, and has
been licensed by this company.
1)
BoneWelding is a registered Swiss trademark
11
C M F S U R G E R Y: L e v e l O n e a n d N e u r o S e t
With Level One, KLS Martin offers the innovative Level One a smart concept without which
storage system for use in osteosynthesis. It consists o steosynthesis would be simply unthinkable.
of basic modules, storage modules and color-coded The application areas of Level One include:
screw clip magazines that can be filled individually
and combined with each other as required. Traumatology
Orthognathia
Surgeons can always select among preconfig Craniofacial surgery
ured storage modules or create their own systems Neurosurgery
if preferable. There is no limit to configuration Mandibular reconstruction
options. Skull base surgery
Oculoplastic surgery
12
Specifically for cranial interventions.
Plates, screws and meshes.
The human skull is covered by a soft tissue layer A comprehensive selection of different plate
that is very thin. Therefore, it is all the more impor g eometries allows the reconstruction of the most
tant for neurosurgeons performing cranial surgery frequent cranial bone defects and fractures. It is
to have self-tapping and self-retaining screws with ideal for fixing patient-specific implants in place as
an extremely low profile, along with plates that allow well. Traceability and identification are 100% guar
fast and secure application. For patients, in turn, anteed thanks to innovative tabs attached to each
the essential point is that the plates, screws and and every plate, without prejudice to the modularity
meshes will not cause any inconvenience: that they that is at the core of the Level One philosophy.
wouldnt feel them and that one cannot see them. All screws are available in clip magazines that make
KLS Martins product portfolio satisfies both require charging, screw-picking and reordering an easy process.
ments fast and secure application with just The product range is versatile, well-conceived and
minimal palpability and cosmetic unobtrusiveness. user-friendly.
13
C M F S U R G E R Y: Pa t i e n t - s p e c i f i c i m p l a n t s , i n s t r u m e n t s a n d l a s e r s u r g e r y
Polyether ether ketone (PEEK), titanium mesh and KLS Martin belongs to the select global circle
solid titanium these are the materials used for the of just a few suppliers that are capable of making
patient-specific implants offered by KLS Martin. such patient-specific implants and delivering
PEEK is an innovative, biocompatible high-performance them on short notice. The associated procedure is
plastic elastic, low-weight, yet very strong and extremely user-friendly: surgeons simply upload
thermostable. Thanks to its physical properties, PEEK their patient-specific data via the online portal of
is very similar to cortical bone. the KLSMartin website and KLS Martin takes care
of the rest: processing the data, manufacturing the
Titanium, in contrast, offers second-to-none bio implants and dispatching them in the shortest
compatibility. Titanium implants are also designed possible time.
and manufactured to fit each patients needs. They
come either in mesh form or as solid, high-strength But our services include more than patient-specific
versions used in reconstruction. implants. The following web page also allows you to
request anatomical models to optimize preoperative
planning: www.klsmartin.com/psi
14
Scissors, swab and scalpel.
16,000 options for the
p erfect cut.
Particularly gentle.
The diomax diode laser.
15
C M F S U R G E R Y: H F s u r g e r y, s t e r i l i z i n g c o n t a i n e r s , l i g h t s y s t e m s a n d p e n d a n t s y s t e m s
16
All good things come from above.
marLED and Independant .
True, operating lights using LEDs as light sources are But with KLS Martin, it is not just the light that
not a rarity but marLED is different. KLS Martin counts among the good things coming from above.
offers you a light system that is not only smaller and The Independant pendant system, a modular ceiling-
more compact, but more efficient in light yield and mounting supply and suspension system, offers
less costly in its power requirements as well. Most variable multi-function service heads with gas, elec
importantly, however, marLED offers a unique light tricity and media connections, plus adequately
quality thanks to the special mixing process taking sized installation platforms and supports for HF
place right inside the LED engines. This effectively units, laser systems and TFT flat screen monitors.
eliminates any unwelcome color shadow casting. Infusion stands can be optionally integrated as well.
Another unrivaled feature is the light field adapta All KLS Martin ceiling pendants are available as
tion function enabling surgeons to use an oval or customized versions to fit in just perfectly. Not sur
circular light field for best illumination of the oper prisingly, these systems have become very popular
ating site. Color temperature is variable too, as you in many fields surgery, endoscopy, anesthesia,
can choose between day-light quality and warm- intensive care medicine and as monitor supports.
white artificial light. And to round it all off, we are Independant systems carry loads from 30 kg to
proud to say that marLED has won prestigious, up to 1,000 kg, save you space and provide for
internationally recognized awards for its outstand flexible positioning of any equipment required in
ing design. state-of-the-art operating rooms.
17
C M F S U R G E R Y: C l o s e c o o p e r a t i o n w i t h c u s t o m e r s
18
A truly impressive product portfolio.
Backed by a speed of response
not easily found elsewhere.
KLS Martin offers you almost everything you need work with biodegradable materials under clean-room
for successful operations: from indispensable conditions. Or take the osteosynthesis revolution
instrument sets and specific solutions all the way to where the company showed the same degree of
peripheral equipment needed in any operating room. commitment and determination to deliver results
What makes the difference in the final instance, in close collaboration with Prof. Champy and the
however, is the flexibility on which you can rely. SORG founders. This entrepreneurial spirit still drives
KLS Martin is always ready to seek new solutions KLS Martin today as evidenced by our patient-
in close collaboration with surgeons and to explore specific implants. We are looking forward to push
new paths without hesitation. We have a record ing the limits still further in an ongoing effort to
to back this statement. Take the development of explore new medical territory. Who knows, perhaps
resorbable implants when our experts began to with you anytime soon?
19
Karl Leibinger GmbH & Co. KG KLS Martin France SARL Nippon Martin K.K. Gebrder Martin GmbH & Co. KG
78570 Mhlheim Germany 68000 Colmar France Osaka 541-0046 Japan Representative Office
Tel. +49 7463 838-0 Tel. +33 3 8921 6601 Tel. +81 662 28 90 75 201203 Shanghai China
info@klsmartin.com france@klsmartin.com nippon@klsmartin.com Tel. +86 21 2898 6611
china@klsmartin.com
KLS Martin GmbH + Co. KG Martin Italia S.r.l. KLS Martin L.P.
79224 Umkirch Germany 20059 Vimercate (MB) Italy Jacksonville, Fl 32246 USA Gebrder Martin GmbH & Co. KG
Tel. +49 7665 9802-0 Tel. +39 039 60 56 731 Tel. +1 904 641 77 46 Representative Office
info@klsmartin.com italia@klsmartin.com usa@klsmartin.com Dubai United Arab Emirates
Tel. +971 4 454 16 55
Stuckenbrock Medizintechnik GmbH Martin Nederland/Marned B.V. Gebrder Martin GmbH & Co. KG middleeast@klsmartin.com
78532 Tuttlingen Germany 1270 AG Huizen The Netherlands Representative Office
Tel. +49 7461 16 58 80 Tel. +31 35 523 45 38 121471 Moscow Russia
verwaltung@stuckenbrock.de nederland@klsmartin.com Tel. +7 499 792-76-19
russia@klsmartin.com
Rudolf Buck GmbH KLS Martin UK Ltd.
78570 Mhlheim Germany Reading RG1 3EU United Kingdom
Tel. +49 7463 99 516-30 Tel. +44 1189 000 570
info@klsmartin.com uk@klsmartin.com
10.11 90-470-02-04 Printed in Germany Copyright by Gebrder Martin GmbH & Co. KG Alle Rechte vorbehalten Technische nderungen vorbehalten
We reserve the right to make alterations Cambios tcnicos reservados Sous rserve de modifications techniques Ci riserviamo il diritto di modifiche tecniche