CN109316231A - Percutaneous posterior cervical single open-door internal fixation system - Google Patents
Percutaneous posterior cervical single open-door internal fixation system Download PDFInfo
- Publication number
- CN109316231A CN109316231A CN201811468675.3A CN201811468675A CN109316231A CN 109316231 A CN109316231 A CN 109316231A CN 201811468675 A CN201811468675 A CN 201811468675A CN 109316231 A CN109316231 A CN 109316231A
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- China
- Prior art keywords
- fixing piece
- single open
- internal fixation
- door internal
- fixation system
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
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- 230000008676 import Effects 0.000 claims description 3
- 238000005516 engineering process Methods 0.000 abstract description 5
- 210000004872 soft tissue Anatomy 0.000 abstract description 4
- 238000010586 diagram Methods 0.000 description 8
- 206010052428 Wound Diseases 0.000 description 5
- 208000027418 Wounds and injury Diseases 0.000 description 5
- 238000000034 method Methods 0.000 description 4
- 230000006835 compression Effects 0.000 description 2
- 238000007906 compression Methods 0.000 description 2
- 210000003205 muscle Anatomy 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 208000004550 Postoperative Pain Diseases 0.000 description 1
- 206010048038 Wound infection Diseases 0.000 description 1
- 230000000712 assembly Effects 0.000 description 1
- 238000000429 assembly Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 238000000338 in vitro Methods 0.000 description 1
- 238000012423 maintenance Methods 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7049—Connectors, not bearing on the vertebrae, for linking longitudinal elements together
- A61B17/705—Connectors, not bearing on the vertebrae, for linking longitudinal elements together for linking adjacent ends of longitudinal elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7053—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant with parts attached to bones or to each other by flexible wires, straps, sutures or cables
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Neurology (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
The invention discloses a kind of percutaneous posterior cervical single open-door internal fixation systems, including the first fixing piece, the second fixing piece, the traction piece for connecting the first fixing piece and the second fixing piece, it is respectively arranged with vertebral plate fixed part and pedicle of vertebral arch fixed part on first fixing piece and the second fixing piece, the first fixing piece can be tightened in by the second fixing piece by the traction piece.The fixation device that this system passes through percutaneously merging Laminoplasty, Percutaneous endoscopic technology auxiliary can be used by traction piece and carry out single open-door operation, the percutaneous manipulation for having accomplished single open-door operation, reduces the operation wound to cervical vertebra rear soft tissue, makes " single open-door " operation more minimally invasiveization.
Description
Technical field
The present invention relates to percutaneous spinal internal fixation systems, and in particular to fixed system in a kind of percutaneous posterior cervical single open-door
System.
Background technique
Existing posterior cervical " single open-door " technology needs to cut skin, removing vertebra side soft tissue and muscle from cervical vertebra rear,
Exposure cervical vertebra rear structure, rubs side vertebral plate and lateral mass has a common boundary (enabling side), and other side vertebral plate mono cortex abrades (door-hinge side),
Then it is raised to door-hinge side, is in " single open-door " state using line or interior fixed maintenance vertebral plate.Relative to Percutaneous endoscopic menisectomy,
Prior art wound is big, increases the incidence of wound infection risk and postoperative pain, then increases post-operative recovery time.
Summary of the invention
In view of this, the purpose of the present invention is to provide a kind of percutaneous posterior cervical single open-door internal fixation system, pass through through
Skin is placed in the fixation device of Laminoplasty, and Percutaneous endoscopic technology auxiliary can be used by traction piece and carry out single open-door operation, accomplish
The percutaneous manipulation of single open-door operation, reduces the operation wound to cervical vertebra rear soft tissue, keeps " single open-door " operation more micro-
Woundization.
Percutaneous posterior cervical single open-door internal fixation system, including the first fixing piece, the second fixing piece, the first fixing piece of connection
With the traction piece of the second fixing piece, vertebral plate fixed part and pedicle of vertebral arch are respectively arranged on first fixing piece and the second fixing piece
First fixing piece can be tightened in the second fixing piece by the traction piece by fixed part.
Further, the traction piece is the drawstring for connecting the first fixing piece and the second fixing piece.
Further, the fixed system further includes carrying out at the both ends of drawstring with the first fixing piece and the second fixing piece respectively
Fixed the first locking assembly and the second locking assembly.
Further, first fixing piece includes first screw fixed with vertebral plate.
Further, first locking assembly includes passing through the first nut being threadedly engaged with the first screw, with the first spiral shell
The threaded hole of cap intersects through a draw cord channel is equipped on the first nut, and the spiral shell of the first nut is arranged in the draw cord channel
The tail portion of pit.
Further, second fixing piece includes second screw fixed with pedicle of vertebral arch.
Further, second locking assembly include be movably set in the second screw and for drawstring guiding guide part,
By the fixed fixation kit over the guide of drawstring.
Further, the guide channel for drawstring guiding is provided on the guide part, the fixation kit includes difference
Drawstring is fixed in the import and export of the guide channel locating part and compressing member are set, and the guide part passes through compression
Part is pressed in locating part.
Further, the locating part and compressing member are towards being equipped with non-slip texture on the side of guide part.
Further, the locating part is the bottom that the inlet side of guide channel is arranged in and connect with the second screw thread
Piece, the compressing member are the second nut that the outlet side of guide channel is arranged in and connect with the second screw thread.
Beneficial effects of the present invention: the merging of percutaneous screw can reduce operation to avoid the removing to rear paravertebral muscles
Wound, while cooperating cervical vertebra Percutaneous endoscopic technology, the detachment and part that vertebral plate is completed under mirror abrade the more accurate and peace that makes to perform the operation
Entirely.Meanwhile system locking device also under tape channel, using pedicle of vertebral arch as anchor point, vertebral plate nail is in vitro under locking rope drawing
The degree that can be opened the door with auxiliary door opening and locking.This system can percutaneously complete single open-door operation, reduce operation wound, be patient's
Quick recovery provides powerful guarantee.
Detailed description of the invention
The invention will be further described with reference to the accompanying drawings and examples:
Fig. 1 is the structural schematic diagram of this system embodiment 1；
Fig. 2 is the use state diagram of this system embodiment 1；
Fig. 3 is the structural schematic diagram of embodiment 2；
Fig. 4 is the structural schematic diagram of embodiment 3.
Specific embodiment
Fig. 1 is the structural schematic diagram of this system embodiment 1, and Fig. 2 is the use state diagram of this system embodiment 1, this
Invent a kind of percutaneous posterior cervical single open-door internal fixation system, including the first fixing piece 1, the second fixing piece 2, the first fixation of connection
Be respectively arranged on the traction piece of part 1 and the second fixing piece 2, first fixing piece 1 and the second fixing piece 2 vertebral plate fixed part and
First fixing piece 1 can be tightened in the second fixing piece 2 by traction piece by pedicle of vertebral arch fixed part.This system is first consolidated first respectively
Determine part 1 and the second fixing piece 2 merging vertebral plate and pedicle of vertebral arch is fixed, the first fixing piece 1 is tightened in second by traction piece
Fixing piece 2, the first fixing piece 1 are rotated around door-hinge side, are raised to door-hinge side, are realized and are opened the door, and Percutaneous endoscopic can be used in this system
Technology auxiliary carries out single open-door operation, has accomplished the percutaneous manipulation of single open-door operation, has reduced the hand to cervical vertebra rear soft tissue
Art wound.
In the present embodiment, the traction piece is that one end is fixedly connected with the first fixing piece 1, and the other end is actively arranged in the
The drawstring 3 of two fixing pieces 2.Drawstring 3 can be bolted directly with the first fixing piece 1, and the other end is the freedom across the second fixing piece 2
Aforesaid operations can be realized by drawing the free end of drawstring 3 in end.
In the present embodiment, the fixed system further includes the locking assembly for the both ends of drawstring 3 to be fixed.Locking
Component includes the first locking assembly that the both ends of drawstring 3 are fixed with the first fixing piece 1 and the second fixing piece 2 respectively and
Two locking assemblies.It, can be respectively with the first locking assembly and the second locking assembly by the two of drawstring 3 after terminating single open-door operation
End lock onto the first fixing piece 1 and the second fixing piece 2, forms certain pretightning force, realizes locking and opens the door, prevents vertebra at enabling
The compressing again of plate.
In the present embodiment, first fixing piece 1 includes first screw fixed with vertebral plate, and the first screw is in hollow
Empty screw, the guiding for guide pin.First locking assembly includes passing through the first nut 4 being threadedly engaged with the first screw,
Intersect with the threaded hole of the first nut 4 through a draw cord channel 5 is equipped on the first nut, draw cord channel 5 is arranged first
The tail portion of the threaded hole of nut 4.During being placed in the first screw, guide pin first is squeezed into vertebral plate, is then squeezed by guide pin
First screw, the first screw inner hollow are provided with the blind hole for accommodating guide pin, outer shape and existing operation screw phase
Together, specifically squeezing into mode is also to belong to the prior art, and details are not described herein.It is appreciated that the first nut 4 is provided with threaded hole
, so that the outer end of the first screw is threadedly coupled, and the threaded hole of the first nut 4 is communicated with draw cord channel 5, and drawstring is logical
The tail portion of the threaded hole of the first nut 4 is arranged in road 5, right when the first screw screws in the tail end of 4 threaded hole of the first nut
The drawstring 3 of 5 the inside of draw cord channel is held out against, to play fixed operation, facilitates the progress of operation.
In the present embodiment, second fixing piece 2 includes second screw fixed with pedicle of vertebral arch, and the second screw 21 is hollow
Hollow screw, the guiding for guide pin.The implantation mode of second screw is identical as the first screw.Second locking assembly includes living
Drawstring 3 is fixed on the fixation kit on guide part 6 by the dynamic guide part 6 for being sheathed on the second screw and being oriented to for drawstring 3.It leads
The guide channel 7 being oriented to for drawstring 3 is provided on part 6, the fixation kit includes being separately positioned on the guide channel 7
Import and export locating part 8 and compressing member 9 that drawstring 3 is fixed, the guide part 6 is pressed in limit by compressing member 9
Part 8.The present embodiment compressing member 9 uses egative film and second using the second nut connecting with the second screw thread, locating part 8
Screw thread connection, be adjustable in the axial direction in this way.It, can be simultaneously to drawstring 3 using locating part 8 and compressing member 9
Carry out a compression positioned at the two sides of guide channel 7, to play the operation fixed to drawstring 3, facilitate subsequent procedures into
Row.
In the present embodiment, the locating part 8 and compressing member 9, can be with towards being equipped with non-slip texture on the side of guide part 6
Increase locating part 8 and compressing member 9 to the pretightning force of drawstring 3, wherein 10 be human body deep tissues.
Fig. 3 be this system embodiment 2 structural schematic diagram, the present embodiment the difference from embodiment 1 is that, embodiment 2
Guide channel 7 is two, is arranged on guide part 6 in the same direction, is symmetricly set on the two sides at 6 center of guide part, the present embodiment drawstring 3
After draw cord channel 5, both ends are free end, two guide channels 7 of guide part 6 are each passed through, using such setting side
Formula can make the process of traction more stable, and surgical procedure is facilitated more smoothly to carry out, while fixation after the completion of performing the operation is more firm
It leans on.
Fig. 4 be this system embodiment 3 structural schematic diagram, the present embodiment the difference from embodiment 1 is that, embodiment 2
Guide channel is two, but one is arranged on guide part 6, another is arranged on egative film 8, and the present embodiment drawstring 3 passes through
After draw cord channel 5, both ends are free end, and two guide channels being each passed through on guide part 6 and egative film 8 are set using such
The mode of setting can make the process of traction more stable, and surgical procedure is facilitated more smoothly to carry out.
Finally, it is stated that the above examples are only used to illustrate the technical scheme of the present invention and are not limiting, although referring to compared with
Good embodiment describes the invention in detail, those skilled in the art should understand that, it can be to skill of the invention
Art scheme is modified or replaced equivalently, and without departing from the objective and range of technical solution of the present invention, should all be covered at this
In the scope of the claims of invention.
Claims (10)
1. percutaneous posterior cervical single open-door internal fixation system, it is characterised in that: including the first fixing piece, the second fixing piece, connection
The traction piece of first fixing piece and the second fixing piece is respectively arranged with vertebral plate on first fixing piece and the second fixing piece and fixes
First fixing piece can be tightened in the second fixing piece by the traction piece by portion and pedicle of vertebral arch fixed part.
2. percutaneous posterior cervical single open-door internal fixation system according to claim 1, it is characterised in that: the traction piece is
Connect the drawstring of the first fixing piece and the second fixing piece.
3. percutaneous posterior cervical single open-door internal fixation system according to claim 2, it is characterised in that: the fixed system
It further include the first locking assembly that the both ends of drawstring are fixed with the first fixing piece and the second fixing piece respectively and the second lock
Tight component.
4. percutaneous posterior cervical single open-door internal fixation system according to claim 3, it is characterised in that: described first is fixed
Part includes first screw fixed with vertebral plate.
5. percutaneous posterior cervical single open-door internal fixation system according to claim 4, it is characterised in that: first locking
Component includes passing through the first nut being threadedly engaged with the first screw, intersects with the threaded hole of the first nut and passes through on the first nut
It is equipped with a draw cord channel, the tail portion of the threaded hole of the first nut is arranged in the draw cord channel.
6. percutaneous posterior cervical single open-door internal fixation system according to claim 3, it is characterised in that: described second is fixed
Part includes second screw fixed with pedicle of vertebral arch.
7. percutaneous posterior cervical single open-door internal fixation system according to claim 6, it is characterised in that: second locking
Component includes being movably set in the second screw and for the guide part of drawstring guiding, the fixation group by drawstring fixation over the guide
Part.
8. percutaneous posterior cervical single open-door internal fixation system according to claim 7, it is characterised in that: on the guide part
It is provided with the guide channel for drawstring guiding, the fixation kit includes the import and export for being separately positioned on the guide channel
To locating part and compressing member that drawstring is fixed, the guide part is pressed in locating part by compressing member.
9. percutaneous posterior cervical single open-door internal fixation system according to claim 8, it is characterised in that: the locating part and
Compressing member is towards being equipped with non-slip texture on the side of guide part.
10. percutaneous posterior cervical single open-door internal fixation system according to claim 8, it is characterised in that: the locating part
For the egative film that the inlet side of guide channel is arranged in and connect with the second screw thread, the compressing member is that setting is logical in guiding
The outlet side in road and the second nut being connect with the second screw thread.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811468675.3A CN109316231A (en) | 2018-12-03 | 2018-12-03 | Percutaneous posterior cervical single open-door internal fixation system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811468675.3A CN109316231A (en) | 2018-12-03 | 2018-12-03 | Percutaneous posterior cervical single open-door internal fixation system |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN109316231A true CN109316231A (en) | 2019-02-12 |
Family
ID=65256953
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201811468675.3A Pending CN109316231A (en) | 2018-12-03 | 2018-12-03 | Percutaneous posterior cervical single open-door internal fixation system |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN109316231A (en) |
Citations (15)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4653481A (en) * | 1985-07-24 | 1987-03-31 | Howland Robert S | Advanced spine fixation system and method |
| CN2860379Y (en) * | 2005-07-18 | 2007-01-24 | 王建华 | Inner fixator in opening and shaping operation of cervical vertebra |
| CN101073513A (en) * | 2006-05-15 | 2007-11-21 | 巴奥米特西班牙整形公司 | Surgical screw system and its application |
| CN101147693A (en) * | 2007-11-05 | 2008-03-26 | 周跃 | Percutaneous cervical arc root screw internal fixing system |
| CN101327146A (en) * | 2008-07-31 | 2008-12-24 | 中国人民解放军第三军医大学第二附属医院 | Double-groove channel-to-channel connection type percutaneous vertebral pedicle screw nail internal fixation system |
| CN101511288A (en) * | 2006-07-21 | 2009-08-19 | K·R·秦 | Systems and methods for spinal fixation |
| CN201379636Y (en) * | 2009-04-09 | 2010-01-13 | 彭庄 | Percutaneous puncturing spine posterior vertebral pedicle nail bar fixing system |
| CN102458279A (en) * | 2009-06-17 | 2012-05-16 | 斯恩蒂斯有限公司 | Revision connector for spinal constructs |
| CN102883670A (en) * | 2010-03-30 | 2013-01-16 | S·华 | Systems and methods for pedicle screw stabilization of spinal vertebrae |
| CN103070725A (en) * | 2013-01-14 | 2013-05-01 | 北京市富乐科技开发有限公司 | Minimally invasive extension jib pedicle screw |
| CN203059887U (en) * | 2013-01-28 | 2013-07-17 | 侯志勇 | Screw capable of mounting steel-wire cerclage simultaneously |
| CN104688323A (en) * | 2015-03-31 | 2015-06-10 | 首都医科大学附属北京友谊医院 | 3D-printing cervical vertebra side block screw guide embedded plate and manufacturing method thereof |
| CN104758095A (en) * | 2015-04-16 | 2015-07-08 | 倪文飞 | Oblique interbody fusion cage |
| CN104887300A (en) * | 2015-05-26 | 2015-09-09 | 王欢 | Split lengthening pedicle screw |
| CN209564189U (en) * | 2018-12-03 | 2019-11-01 | 重庆医科大学附属第二医院 | Percutaneous posterior cervical single open-door internal fixation system |
-
2018
- 2018-12-03 CN CN201811468675.3A patent/CN109316231A/en active Pending
Patent Citations (15)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4653481A (en) * | 1985-07-24 | 1987-03-31 | Howland Robert S | Advanced spine fixation system and method |
| CN2860379Y (en) * | 2005-07-18 | 2007-01-24 | 王建华 | Inner fixator in opening and shaping operation of cervical vertebra |
| CN101073513A (en) * | 2006-05-15 | 2007-11-21 | 巴奥米特西班牙整形公司 | Surgical screw system and its application |
| CN101511288A (en) * | 2006-07-21 | 2009-08-19 | K·R·秦 | Systems and methods for spinal fixation |
| CN101147693A (en) * | 2007-11-05 | 2008-03-26 | 周跃 | Percutaneous cervical arc root screw internal fixing system |
| CN101327146A (en) * | 2008-07-31 | 2008-12-24 | 中国人民解放军第三军医大学第二附属医院 | Double-groove channel-to-channel connection type percutaneous vertebral pedicle screw nail internal fixation system |
| CN201379636Y (en) * | 2009-04-09 | 2010-01-13 | 彭庄 | Percutaneous puncturing spine posterior vertebral pedicle nail bar fixing system |
| CN102458279A (en) * | 2009-06-17 | 2012-05-16 | 斯恩蒂斯有限公司 | Revision connector for spinal constructs |
| CN102883670A (en) * | 2010-03-30 | 2013-01-16 | S·华 | Systems and methods for pedicle screw stabilization of spinal vertebrae |
| CN103070725A (en) * | 2013-01-14 | 2013-05-01 | 北京市富乐科技开发有限公司 | Minimally invasive extension jib pedicle screw |
| CN203059887U (en) * | 2013-01-28 | 2013-07-17 | 侯志勇 | Screw capable of mounting steel-wire cerclage simultaneously |
| CN104688323A (en) * | 2015-03-31 | 2015-06-10 | 首都医科大学附属北京友谊医院 | 3D-printing cervical vertebra side block screw guide embedded plate and manufacturing method thereof |
| CN104758095A (en) * | 2015-04-16 | 2015-07-08 | 倪文飞 | Oblique interbody fusion cage |
| CN104887300A (en) * | 2015-05-26 | 2015-09-09 | 王欢 | Split lengthening pedicle screw |
| CN209564189U (en) * | 2018-12-03 | 2019-11-01 | 重庆医科大学附属第二医院 | Percutaneous posterior cervical single open-door internal fixation system |
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