DynaNail® TTC Fusion System– Surgical Technique Guide DynaNail® TTC Fusion System– Surgical Technique Gu | Page 5

DESIGN FEATURES The DynaNail TTC Fusion System maintains active compression across the joints using its proprietary internal NiTiNOL Compressive Element that automatically responds to changes in loading due to bone resorption or settling. The stretching and unloading of the Compressive Element can be visualized on fluoroscopy via translation of the screw holes in the Sliding Element through the slot in the Outer Body. Screw Hole in Proximal Position Out of the Package The Compressive Element is in its unstretched position with the calcaneal screw holes in the Sliding Element positioned proximal in the Nail Body slot. During Surgery The Compressive Element is stretched using the Targeting Frame causing the calcaneal screw holes to shift distally in the Nail Body slot, a distance that corresponds to the amount of desired compression. While the DynaNail Frame holds the Compressive Element in the stretched position, screws are placed in the calcaneus and tibia. Stretching of the Element Screw Position when Stretched Immediate Post-Surgery Once the Targeting Frame is removed, the Compressive Element is now in its stretched activated position with the calcaneal screws oriented in the distal end of the slot and the Sliding Element extending plantarly from the Nail Body. Post-Operatively As the Compressive Element unloads (i.e., recovers its stretched length) in response to bone resorption or settling, the calcaneal screws will progressively shift proximally. The amount of unloading can be measured on radiograph by the position of the screws. The Compressive Element has completely unloaded back to its resting state when the calcaneal screws are at the proximal end of the slot. Screw Position after Unloading 5