Össur RESOLVE HALO RING Manual Del Usuario página 9

4. Position ring on head with the positioning pins. If necessary, move positioning pins to accommodate access to
selected skull pin sites (Figure 6).
5. Check appropriate placement and slope of ring on head (Figure 7). Note: The closed back ring is provided with a
posterior hole to attach to the Össur Universal Halo Adaptor #581 (Mayfield type).
– Parallel to head to allow perpendicular pin penetration
– Below largest equator of skull
– As low as possible without any contact with ears or eyebrows
6. Inject local anesthetic to skull pin sites from either the top or bottom of the ring. You may find it helpful to hold
a pen light up to the ring holes to light the area of pin placement through the halo. Anesthetize down to the
periosteum. Note: Anesthetic without epinephrine should be used in order to avoid necrosing around the injection
site.
7. Patient should close eyes tightly for skull pin application to prevent skin bunching. Thread all skull pins through
halo ring holes until they touch the skin. Then finger tighten all skull pins according to one of the below pin
tightening methods. Finally, tighten all skull pins using a torque driver first to 4 in. lbs., then to 6 in. lbs., and
then to 8 in. lbs. as applicable per the included torque driver. Note: During pin application, if excessive resistance is
felt, the pin may be cross-threaded. Do not force the pin. Remove the pin, re-align with the threaded hole and apply
again. If a sudden drop in torque is noted, stop and evaluate.
The order of pin tightening can be accomplished by one of two methods; opposing pair method or posterior-
anterior method.
• Opposing pair: pins opposite to each other are tightened simultaneously (Figure 8).
• Posterior-anterior: two posterior pins are tightened followed by the two anterior pins (Figure 9).
* Skull pins should be tightened to 6 in. lbs, or 8 in. lbs., as indicated by the included preset torque driver. If, at the
attending physician's discretion, higher or lower torque is needed, use Össur Adjustable Torque Driver # 575S.
8. Remove positioning pins.
9. Apply and finger-tighten lock nuts. Do not use a wrench.
10. After approximately 30 min (or at the end of vest application if halo was applied first) loosen lock nuts, check
skull pin torque, and re-tighten lock nuts. Follow up by checking pin torque 24–36 hours after. Retighten skull
pins with the torque driver or Adjustable Torque Driver # 575S as needed.
OPTIONAL/HELPFUL HINTS
Traction Hoop: Position traction hoop symmetrically on patient and connect to halo on holes not used by skull
pins. The S-hook is then placed through the hole in the top of the traction hoop and used to apply the appropriate
traction load (Figure 10).
J-Tongs: If using Össur J-Tongs in conjunction with the Halo ring, orient V down to fit around base of tongs
(Figure 11).
AFTERCARE
Note: these instructions are directed towards practitioners/physicians applying a halo, and are not intended as patient
care instructions. Refer to Össur Patient Information Manual for patient home hygiene and care instructions.
1. Provide and explain information to patient for daily halo care.
2. Schedule a 24–36 hour follow up visit post-application to check pin tightness and for signs of complications.
Pins should maintain the torque applied at initial fitting at this time.
3. 3 week visits for liner changes and pin-site inspections should be scheduled. During pin-site inspections, check
for redness, discharge, or other signs of infection.
4. At 4 weeks, pin torque should be maintained to at least 6 in lbs.*
5. At 8 weeks, pin torque should be maintained to at least 4 in lbs. and can remain at that level for the duration of
healing and halo use.*
* These are suggested torques only. Patient's needs while healing may vary.
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