uattro Bolt
®
Tenodesis Screw
Flexor Hallucis Longus (FHL) Tendon Transfer
Surgical Technique Guide
FHL Tendon transfer is commonly performed to augment an Achilles tendon reconstruction
by supplementing tendon debridement in patients with Achilles tendinosis. The Quattro®
Bolt Tenodesis Screw System provides a simple, strong solution for tendon-in-socket fixation
in the calcaneus bone.
The Quattro® Bolt Tenodesis Screws are intended
to provide soft tissue fixation to bone. The all PEEK
screws are available in 5mm, 6mm, 7mm, 8mm,
and 9mm sizes.
Quattro® Bolt
Tenodesis Screw
cayennemedical.com | 1-888-229-3661
Quattro® Bolt Tenodesis Screw
1
Dissect and release the FHL tendon.
Note: the tendon should be released at the most distal attachment point.
2
Whip-stitch the distal end of the tendon using TRU-LINK™ Suture with Needle. Leave a 2-3mm tail of
tendon from the most distal stitch on the tendon.
Note: For required fixation, the threads of the Quattro® Bolt Tenodesis
Screw must engage bone in the bone socket on the cut tendon end.
3
Measure the diameter of the FHL tendon. This will determine
the size of the bone socket and implant to use.
Please refer to the recommended sizing table.
Tendon Size
Socket Size
Screw Size
3mm
4mm
5mm
4mm
5mm
6mm
5mm
6mm
7mm
6mm
7mm
8mm
7mm
8mm
9mm
Note: Hard bone may require a larger hole size.
4
Drill the bone socket: Drill the socket a few millimeters
deeper than the length of the screw size selected.
(Drill to a depth of ~17mm for the 7x14mm Bolt screw)
After creating the bone socket, clear surrounding soft
tissue for easy screw insertion.
5
Load the TRU-LINK™ suture tails through the snare of the Quattro® Bolt Tenodesis Screw. Pull the snare
ring from the proximal end of the driver to load the sutures into the screw. Sutures will now be exiting
the proximal end of the driver.
Cayenne Medical Inc.
This description of technique is an educational tool and clinical aid to assist properly
licensed medical professionals in the usage of specific Cayenne Medical products.
FHL Tendon Transfer Surgical Technique Guide
6
Feed the sutures through the Quattro® Bolt Driver until the screw tip contacts the tendon. Secure the
suture tails into the suture cleat of the driver to lock the tendon into place.
Note: There should be no suture slack
between the tendon and the screw.
Suture Cleat
7
Insert the Quattro® Bolt Tenodesis Screw and tendon into the bone socket:
Note: For required fixation, the threads of the Quattro® Bolt Tenodesis
Screw must engage bone in the bone socket on the cut tendon end.
a
Mallet proximal end of driver until screw threads of the anchor contact the bone surface.
b
Using forward pressure, turn the screw driver clockwise to advance the screw into
the socket until the screw head is flush with the bone surface.
8
Release the suture tails from the suture cleat on the driver and
pull back on the driver to disengage from the screw.
9
Trim the excess suture. Close per surgeon preference.
The medical professional should rely on their own training and experience and should conduct
a thorough review of pertinent medical literature as well as the product’s Instructions For Use.
cayennemedical.com | 1-888-229-3661
Quattro® Bolt Tenodesis Screw (Sterile)
CM-9505
Quattro® Bolt Tenodesis Screw, 5mm x 10mm
CM-9506
Quattro® Bolt Tenodesis Screw, 6mm x 12mm
CM-9507
Quattro® Bolt Tenodesis Screw, 7mm x 14mm
CM-9508
Quattro® Bolt Tenodesis Screw, 8mm x 16mm
CM-9509
Quattro® Bolt Tenodesis Screw, 9mm x 16mm
TRU-LINK™ Suture w/Needle
CM-0205N
TRU-LINK™ w/Needle White/Blue Co-Braid Size 2 Suture
CM-0206N
TRU-LINK™ w/Needle White/Black Co-Braid Size 2 Suture
Accessory Drill Kits (Sterile)
CM-9540
Accessory Drill Kit, 4mm
CM-9550
Accessory Drill Kit, 5mm
CM-9560
Accessory Drill Kit, 6mm
CM-9570
Accessory Drill Kit, 7mm
CM-9580
Accessory Drill Kit, 8mm
online at cayennemedical.com | 1-888-229-3661
40243 Rev. A
Contact Cayenne Medical for order information
Cayenne Medical is a trademark of Cayenne Medical Inc. These products are covered by one or more U.S. patents pending.
16597 North 92nd St, Suite 101 | Scottsdale, AZ 85260 | ©Copyright 2015 Cayenne Medical, Inc. All rights reserved.