Post on 31-Jan-2020
The Right Solutions for Fractures Around the Elbow
Zimmer® Periarticular
Elbow Locking Plate System
Surgical Technique
DisclaimerThis document is intended exclusively for physicians and is not intended for laypersons.
Information on the products and procedures contained in this document is of a general nature and does not represent and does not constitute medical advice or recommendations. Because this information does not purport to constitute any diagnostic or therapeutic statement with regard to any individual medical case, each patient must be examined and advised individually, and this document does not replace the need for such examination and/or advice in whole or in part.
Information contained in this document was gathered and compiled by medical experts and qualified Zimmer personnel. The information contained herein is accurate to the best knowledge of Zimmer and of those experts and personnel involved in its compilation. However, Zimmer does not assume any liability for the accuracy, completeness or quality of the information in this document, and Zimmer is not liable for any losses, tangible or intangible, that may be caused by the use of this information.
1Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Table of Contents
Introduction, Indications, Contraindications 2Bone Void Fillers 2Required Instrumentation 3Preoperative Preparation and Surgical Approach 3Section 1: Distal Humerus – Two Plate Technique 90 Degree Plate Placement 4
Determine Posterolateral Plate Length 4
Fracture Reduction and Temporary Fixation 4Assemble Jig to Posterolateral Plate 5
Position Posterolateral Plate 6
Screw Trajectories and Lengths 7
Insert Distal Screws 8
Assemble Jig to Medial Plate 8
Position Medial Plate 9
Insert Distal Screws 10
Fix Shaft of Posterolateral Plate 10
Fix Shaft of Medial Plate 10
Section 2: Distal Humerus – Two Plate Technique 180 Degree Plate Placement 11
Determine Plate Length 11
Assemble Jig to Plate 12
Screw Trajectories and Lengths 13
Position Plate 12
Insert Distal Screws 14
Assemble Jig to Medial Plate 15
Position Medial Plate 16
Section 3: Olecranon Plate Technique 17Surgical Approach 17
Fracture Reduction 17
Determine Plate Length 17
Assemble Jig to the Olecranon Plate 18
Position the Olecranon Plate 19
Insert Proximal Screws 20
Insert Shaft Screws 20
Wound Closure 20
Postoperative Treatment 20
Implant Removal 20
Zimmer Periarticular Elbow Locking Plates – Information 21Plates for Distal Humerus – Two Plates Technique 90° Plate Placement 21
Plates for Distal Humerus – Two Plates Technique 180° Plate Placement 22
Plates for Proximal Ulna 23
Periarticular Elbow Locking Plates System 24Kit and Item Information 24
Graphic Cases 31General Instrument Case 31
Instrument and Implant Case –Tray 1 32
Instrument and Implant Case –Tray 2 33
Instrument and Implant Case –Tray 3 34
Instrument and Implant Case Base 35
Instrument and Implant Case Screw Caddy 36
Zimmer Periarticular Elbow Locking Plate System Surgical Technique
2 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Introduction
The Zimmer Periarticular Locking Plate System combines locking screw tech-nology with periarticular plates to cre-ate fixed-angle constructs for use in multifragmentary fractures or where de-ficient bone stock or poor bone quality is encountered. The fixed-angle plate/screw device can be used in osteopenic bone and other areas where traditional screw fixation may be compromised.
The Periarticular Locking Plates will ac-commodate standard screws, as well as locking screws with threaded heads that allow the screw to be locked into position to facilitate proper plate/screw placement. When necessary, interfrag-mentary compression can be achieved with lag screws.
The plates contain locking screw holes in the plate head and Universal Locking System (ULS) holes in the shaft. The ULS holes are figure-8 shaped and will accommodate standard or locking screws on either side of the hole.
The ULS holes enable the surgeon to:
• Treatfracturesusingcompressionplating techniques with standard cortical or cancellous screws
• Applytheimplantasaninternalfixator to bridge highly comminuted zones while providing stable fixation
• Utilizebothstandardandlockingscrews in the same construct
• Applybi-directionalaxialcompres-sion within the construct
• Utilizeunicorticallockingfixationasnecessary
CopiOs® Bone Void Filler*
• Osteoconductive/CarrierTechnologyprovides a 3-D collagen scaffold that resembles human cancellous bone for guided bone formation.
• Uniquemineralchemistryofdiba-sic calcium phosphate provides an abundance of localized minerals to promote bone healing.
• AvailableinbothSpongeandPasteformations.
Indications
The Periarticular Locking Plate System is indicated for temporary internal fixa-tion and stabilization of osteotomies and fractures, including:
• Comminutedfractures
• Supracondylarfractures
• Intra-articularandextra-articularcon-dylar fractures
• Fracturesinosteopenicbone
• Nonunions
• Malunions
Bone Void Fillers
Autograft,allograft,orsyntheticbonevoid fillers are indicated for use in bony voids or gaps created surgically or through traumatic injury, that are not intrinsic to the stability of the bone struc-ture.
Contraindications
Contraindicationsinclude:
•Infection
•Sternalorspinalfracturesordefects
* CopiOs®isaregisteredtrademarkofZimmer,Inc.oritsaffiliates. Manufacturer:KenseyNashCorporation.Distributor:Zimmer,Inc.
3Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Required Instrumentation
The following sets may be required for application of the Periarticular Elbow Locking Plates:
– Zimmer Periarticular Elbow Locking ImplantandInstrumentSet
– Zimmer Periarticular Elbow Locking GeneralInstrumentSet
Additional Instrumentation
The following sets may also be useful:
– Herbert™ Bone Screws, 3.0mm diam-eter
– Herbert/Whipple®CannulatedBoneScrews
– HerbertMiniBoneScrews
Preoperative Preparation
Afterassessingthefractureradiograph-ically and preparing a preoperative plan, consider the patient’s positioning as supine, lateral and prone positions are all possible. The lateral decubitus position is the most versatile. Resting the arm on a padded bar will allow up to 120° of elbow flexion.
Be sure that the fluoroscope can be po-sitioned to visualize the distal humerus and/or proximal ulna in both the lateral andanterior/posterior(A/P)viewstoensure adequate reduction of the joint surface, overall alignment of the limb and positioning of the implants.
Surgical Approaches
PosteriorApproach,TricepsSparingorSplittingorPosteriorApproach,OlecranonOsteotomy
Armholder
Bag
Bag
4 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Fracture Reduction and Temporary Fixation
It is imperative that accurate reduction of the fracture be obtained prior to and maintained during application of the distal humeral and proximal ulnar lock-ing plates.
Reduce the intra-articular fragments usinglinearboneclampsorKirschnerwires to temporarily hold the reduction. Use lag screws to secure the intra-ar-ticular fragments as necessary. To help avoid inserting the lag screws where they will interfere with the plate place-ment, hold the plate(s) on the bone(s) in its approximate position. Then insert the lag screws as needed.
Extra-articular reduction may be accom-plished by indirect means (e.g. external fixator, traction, joysticks, bumps, etc.).
Section 1:
Distal Humerus – Two Plate Technique 90 Degree Plate Placement
Determine Plate Length Chooseplatelengthsthatoffersuf-ficient fixation proximal to the fracture(s).
Ifdesired,plateprovisionalsmaybeused to determine the appropriate platelength.DoNOTbendthepro-visionalduringuse.Itisintendedto be used as a template only, and ben-ding it may cause the provisional to break.
Note: To avoid unnecessary stress on the diaphysis of the bone, use medial and posterolateral plates of different lengths.
Distal Posteriolateral
Humeral Locking Plate
Distal Posteriolateral
Humeral Plate Jig
DistalMedialHumeralPlate Jig
DistalMedialHumeral
Locking Plate
DistalMedialHumeral Plate Jig(Short)
DistalMedialHumeral
Locking Plate(Short)
5Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Assemble the Jig to the Posterolateral Plate Hold the Jig on the plate in the appro-priate location – a feature on the Jig will fit into the first ULS hole in the plate shaft. The Jig is designed to allow the surgeon to thread the cannulas into the plate at the appropriate angles to ensure proper engagement of the cannula with the plate and help prevent cross threading of the cannulas in the plate holes. The Cannula Inserter may used to ensure that the cannulas are fully seated in the plate hole. Once a cannula is threaded into the plate hole through the Jig, a Blue Stop Ring may be used to hold the Jig in place.
6 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Position the Posterolateral Plate Place the plate on the bone in the proper position.
Use anatomic landmarks and fluoros-copic images as guides. Because the hu-meral shaft may not be aligned with the distal fragment, the plate head should be used to determine the appropriate placement of the plate. The plate head should conform to the shape of the distal humerus. This will deter -mine the align-ment of the shaft.
Inserta3.5mmCorticalScrewwith2.7mmHead,a2.7mmConicalScrewora2.7mmCorticalScrewintheSECOND slot using the appropriate ULS Green/Gold Drill Guide and Drill Bit.
DoNOTfullytightenthescrew.Thiswillallow for some adjustment of the plate position prior to final fixation.
Note: A screwdriver shaft can be used to loosely insert the screw under pow-er but final seating MUST be accom-plished by hand to avoid cross-thread-ing of the screws in the plate or failure of the screw or driver.
Tapping is not typically necessary as the flutes of the screws are self-tap-ping.Iftheboneisdense,thelateralcortex can be tapped.
GOLDcoloredDrillGuide–2.7mmScrews
SILVERcolorDrillGuide–3.5mmScrews w/2.7mm Head
7Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Screw Trajectories and Lengths
Standard Medial Plate
Use of the Homerun Screw in hole #2 pre-vents insertion of a screw in hole #7
12
3
4
5
6
7
8
9
Ascrewplacedinhole#1mustbeapproximately10mm in length to avoid interference with screws placed in holes #3 and #4
Hole #9 is the Second Slot
I
H
G
F
E
D
C
BA
Use of the Homerun Screw in hole B prevents insertion of3.5mmscrewsinholesDandE.Itmaybepossibletouse 2.7mm screws in holes C,D,andE.
HoleIistheSecond Slot
Posterior Plate
8 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Insert the Distal Screws Thread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrew with 2.7mm Head, 2.7mm Locking Screw,3.5mmCorticalScrewwith2.7mmhead,2.7mmConicalScrew,2.7mmCorticalScrewor4.0mmCancellousScrew. Use the appropriate depth gauge to measure screw length.
Note: A Screw/Cannula/Drill Bit Chart is provided on the lid of the screw caddy for reference.
Insertthescrewsusingthe2.5mmHexScrewdriver or Screwdriver Shaft.
Screw length measurement: MetaphysealScrews–thelengthmea-surement for screws in the metaphyseal region of the plate is measured line-to-line – from the base of the screw head to the tip of the screw. Placement of the tip of the Guide Wire will determine place-ment of the tip of the screw.
Diaphyseal Screws – the length measure-ment for screws in the diaphyseal region of the plate is also measured line-to-line – from the base of the screw head to the tipofthescrew.Inordertoachievefullcortical purchase with these screws, it is recommended that 2mm be added to the screw length measurement to allow for the self-tapping flutes to penetrate the far cortex.
Note: If lag screw reduction is necessary for any fragment, the lag screw must be inserted before inserting locking screws into that fragment.
CheckthealignmentoftheshaftwithA/Pandlateralfluoroscopicviews.
Note: In comminuted fractures, it may not always be possible or desirable to achieve anatomic reduction of the frac-ture.
Note: In the distal portion of the plates, pay close attention during drilling and screw insertion. Confirm screw place-ment and length using image intensifi-cation to ensure screws do not enter the joint.
Assemble the Jig to the Medial Plate Hold the Jig on the plate in the appropri-ate location – a feature on the Jig will fit into the first ULS hole in the plate shaft. The Jig is designed to allow you to thread the cannulas into the plate at the appro-priate angles to ensure proper engage-ment of the cannula with the plate and help prevent cross threading of the can-nulas in the plate holes. Once a cannula is threaded into the plate hole through the Jig, a Blue Stop Ring may be used to hold the Jig in place.
9Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Position the Medial Plate Place the plate on the bone in the proper position.
Use anatomic landmarks and fluoroscop-ic images as guides. Because the hu-meral shaft may not be aligned with the distal fragment, the plate head should be used to determine the appropriate placement of the plate. The plate head should conform to the shape of the distal humerus. This will determine the align-ment of the shaft.
Inserta3.5mmCorticalScrewwith2.7mmHead,a2.7mmConicalScrewora2.7mmCorticalScrewintheSECOND slot using the appropriate ULS Green/Gold Drill Guide and Drill Bit.
Note: This portion of the SHORT Distal Medial Humeral Locking Plate should ALWAYS point TOWARD the Olecranon Fossa
Note: This portion of the STANDARD Distal Medial Humeral Locking Plate should ALWAYS point TOWARD the Olecranon Fossa
10 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
GOLDcoloredDrillGuide–2.7mmScrews
SILVERcolorDrillGuide–3.5mmScrews w/2.7mm Head
DoNOTfullytightenthescrew.Thiswillallow for some adjustment of the plate position prior to final fixation.
NOTE: A screwdriver shaft can be used to loosely insert the screw under pow-er but final seating MUST be accom-plished by hand to avoid cross-thread-ing of the screws in the plate or failure of the screw or driver.
Tapping is not typically necessary as the flutes of the screws are self-tap-ping.Iftheboneisdense,thelateralcortex can be tapped.
Insert the Distal Screws Thread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrew with 2.7mm Head, 2.7mm LockingScrew,3.5mmCorticalScrewwith2.7mmHead,2.7mmConicalScrew,2.7mmCorticalScrewor4.0mmCancellousScrew.
Drill carefully as interference with screws in the posterolateral plate is possible. In case of interference, stop drilling and use a screw of appropriate length.
Use the appropriate depth gauge to measure screw length.
Insertthescrewsusingthe2.5mmHexScrewdriver or Screwdriver Shaft.
Screw length measurement: MetaphysealScrews–thelengthmea-surement for screws in the metaphyseal region of the plate is measured line-to-line – from the base of the screw head to the tip of the screw. Placement of the tip of the Guide Wire will determine placement of the tip of the screw.
Diaphyseal Screws – the length mea-surement for screws in the diaphyseal region of the plate is also measured line-to-line – from the base of the screw headtothetipofthescrew.Inorderto achieve full cortical purchase with these screws, it is recommended that 2mm be added to the screw length measurement to allow for the self-tap-ping flutes to penetrate the far cortex.
Note: If lag screw reduction is neces-sary for any fragment, the lag screw must be inserted before inserting lock-ing screws into that fragment.
CheckthealignmentoftheshaftwithA/Pandlateralfluoroscopicviews.
Note: In comminuted fractures, it may not always be possible or desirable to achieve anatomic reduction of the fracture.
Fix the Shaft of the Posterolateral Plate Determine where locking and/or cortical screws will be used in the shaft of the plate. Use the appropriate screws to fix the shaft of the plate to the bone.
Note: If lag screw reduction is neces-sary for any fragment, the lag screw must be inserted before inserting lock-ing screws into that fragment.
Fix the Shaft of the Medial Plate Determine where locking and/or corti-cal screws will be used in the shaft of the plate. Use the appropriate screws to fix the shaft of the plate to the bone.
11Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Section 2:
Distal Humerus – Two Plate Technique 180 Degree Plate Placement
Determine Plate Length Chooseplatelengthsthatoffersufficientfixation proximal to the fracture(s).
Ifdesired,plateprovisionalsmaybeused to determine the appropriate plate length.DoNOTbendtheprovisionalduringuse.Itisintendedtobeused as a template only, and bending it may cause the provisional to break.
Note: To avoid unnecessary stress on the diaphysis of the bone, use medial and lateral plates of different lengths.
Distal Lateral
Humeral Locking Plate
Distal Lateral
Humeral Plate Jig
DistalMedialHumeralPlate Jig
DistalMedialHumeral Plate Jig(Short)
DistalMedialHumeral
Locking Plate
DistalMedialHumeral
Locking Plate(Short)
12 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Assemble the Jig to the Lateral PlateHold the Jig on the plate in the appropri-atelocation–afeatureontheJigwillfitintothefirstULSholeorslotintheplateshaft. The Jig is designed to allow you to thread the cannulas into the plate at the appropriate angles to ensure proper engagement of the cannula with the plate and help prevent cross threading ofthecannulasintheplateholes.Oncea cannula is threaded into the plate hole through the Jig, a Blue Stop Ring may be used to hold the Jig in place.
Position the Lateral PlatePlace the plate on the bone in the proper position.
Use anatomic landmarks and fluoro-scopic images as guides. Because the humeral shaft may not be aligned with the distal fragment, the plate head should be used to determine the appro-priate placement of the plate. The plate head should conform to the shape of the distal humerus. This will determine the alignment of the shaft.
Inserta3.5mmCorticalScrewwith2.7mmHead,a2.7mmConicalScrewora2.7mmCorticalScrewintheSECOND slot using the appropriate ULS Green/Gold Drill Guide and Drill Bit.
13Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Standard Medial Plate
Use of the Homerun Screw in hole #2 pre-vents insertion of a screw in hole #7
12
3
4
5
6
7
8
9
Ascrewplacedinhole#1mustbeapproximately10mm in length to avoid interference with screws placed in holes #3 and #4
Hole #9 is the Second Slot
F
E
D
C
B
A
Distal Lateral Plate
GOLDcoloredDrillGuide–2.7mmScrews
SILVERcoloredDrillGuide–3.5mmScrews w/2.7mm Head
Screw Trajectories and Lengths
DoNOTfullytightenthescrew.Thiswillallow for some adjustment of the plate positionpriortofinalfixation.
NOTE: A screwdriver shaft can be used to loosely insert the screw under power but final seating MUST be accomplished by hand to avoid cross-threading of the screws in the plate or failure of the screw or driver.
Tapping is not typically necessary as the flutesofthescrewsareself-tapping.Ifthe bone is dense, the lateral cortex can be tapped.
F
E
D
C
B
A
G
H
12
3BA
12
14 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Insert the Distal ScrewsThread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrew with 2.7mm Head, 2.7mm Locking Screw,2.7mmConicalScrew,2.7mmCorticalScrewor4.0mmCancellousScrew.
Use the appropriate depth gauge to measure screw length.
Insertthescrewsusingthe2.5mmHexScrewdriver or Screwdriver Shaft.
Screwlengthmeasurement:Metaphy-seal Screws – the length measurement for screws in the metaphyseal region of the plate is measured line-to-line – from the base of the screw head to the tip of the screw. Placement of the tip of the Guide Wire will determine placement of the tip of the screw.
Diaphyseal Screws – the length measure-ment for screws in the diaphyseal region of the plate is also measured line-to-line – from the base of the screw head to the tipofthescrew.Inordertoachievefullcortical purchase with these screws, it is recommended that 2mm be added to the screw length measurement to allow for the self-tapping flutes to penetrate the far cortex.
Note: If lag screw reduction is necessary for any fragment, the lag screw must be inserted before inserting locking screws into that fragment.
CheckthealignmentoftheshaftwithA/Pandlateralfluoroscopicviews.
Note: In comminuted fractures, it may not always be possible or desirable to achieve anatomic reduction of the fracture.
Note: In the distal portion of the plates, pay close attention during drilling and screw insertion. Confirm screw place-ment and length using image intensifi-cation to ensure screws do not enter the joint.
15Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Assemble the Jig to the Medial PlateHold the Jig on the plate in the appropri-ate location – a feature on the Jig will fitintothefirstULSholeintheplateshaft. The Jig is designed to allow you to thread the cannulas into the plate at the appropriate angles to ensure proper engagement of the cannula with the plate and help prevent cross threading of the cannulas in the plate holes. Once a cannula is threaded into the plate hole through the Jig, a Blue Stop Ring may be used to hold the Jig in place.
16 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Note: This portion of the STANDARD Distal Medial Humeral Locking Plate should ALWAYS point TOWARD the Olecranon Fossa
Position the Medial PlatePlace the plate on the bone in the proper position.
Use anatomic landmarks and fluoro-scopic images as guides. Because the humeral shaft may not be aligned with the distal fragment, the plate head should be used to determine the appro-priate placement of the plate. The plate head should conform to the shape of the distal humerus. This will determine the alignment of the shaft.
Inserta3.5mmCorticalScrewwith2.7mmHead,a2.7mmConicalScrewora2.7mmCorticalScrewintheSECOND slot using the appropriate ULS Green/Gold Drill Guide and Drill Bit.
DoNOTfullytightenthescrew.Thiswillallow for some adjustment of the plate positionpriortofinalfixation.
NOTE: A screwdriver shaft can be used to loosely insert the screw under power but final seating MUST be accomplished by hand to avoid cross-threading of the screws in the plate or failure of the screw or driver.
Tapping is not typically necessary as the flutesofthescrewsareself-tapping.Ifthe bone is dense, the lateral cortex can be tapped.
Note: This portion of the SHORT Distal Medial Humeral Locking Plate should ALWAYS point TOWARD the Olecranon Fossa
Insert the Distal ScrewsThread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrew with 2.7mm Head, 2.7mm Locking Screw,3.5mmCorticalScrewwith2.7mmHead,2.7mmConicalScrew,2.7mmCor-ticalScrewor4.0mmCancellousScrew.
Drill carefully as interference with screws in the lateral plate is possible. In case of interference, stop drilling and use a screw of appropriate length.
Use the appropriate depth gauge to measure screw length.
Insertthescrewsusingthe2.5mmHexScrewdriver or Screwdriver Shaft.
17Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Section 3:
Olecranon Plate Technique
Surgical Approach The incision is made on the posterior side of the elbow, and it is typically slightly curved toward the radial side to protect the ulnar nerve. The incision extends from the supracondylar area to apoint4–5cmdistaltothefracture.
Ifnecessary,performanolecranonos-teotomy, using the chevron technique, when articular visualization is needed.
Fracture Reduction Use direct or indirect reduction tech-niques to restore the fracture fragments to their normal anatomic position. Take care to ensure that the coronoid is appro-priately reduced before fixation.
Determine Plate Length Chooseplatelengthsthatoffersufficientfixation proximal to the fracture(s).
Ifdesired,plateprovisionalsmaybeused to determine the appropriate plate length.DoNOTbendtheprovisionaldur-inguse.Itisintendedtobeusedasatemplate only, and bending it may cause the provisional to break.
Proximal UlnarLocking Plate
Proximal UlnarLocking Plate
Jig
18 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Assemble the Jig to the Olecranon Plate Hold the Jig on the plate in the appropri-ate location – a feature on the Jig will fit into the first slot in the plate shaft. The Jig is designed to allow you to thread the cannulas into the plate at the appropri-ate angles to ensure proper engagement of the cannula with the plate and help prevent cross threading of the cannulas intheplateholes.Onceacannulaisthreaded into the plate hole through the Jig, a Blue Stop Ring may be used to hold the Jig in place.
19Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Hole #2 is the Homerun Screw, and itisNON-LOCKING
12
3
4
5
6
7
8
9
10
Hole #8 is the Second Slot
1
2
3 4 5
Maxlengthforscrew#1 is 26mm
To use both screws 3 and 4, the screw shafts must be 2.7mm
1 2 Homerun
5
4
6
DoNOTfullytightenthescrew.Thiswillallow for some adjustment of the plate position prior to final fixation.
Position the Olecran Plate Place the plate on the bone in the proper position.
Use anatomic landmarks and fluoroscop-ic images as guides. Because the ulnar shaft may not be aligned with the proxi-mal fragment, the plate head should be used to determine the appropriate place-ment of the plate. The plate head should conform to the shape of the olecranon. This will determine the alignment of the shaft.
Inserta3.5mmCorticalScrewwith2.7mmHead,a2.7mmConicalScrewora2.7mmCorticalScrewintheSECOND Slot using the appropriate Double Drill Sleeve.
20 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Insert the Proximal Screws Thread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrewwith2.7mmHead,3.5mmCorticalScrew with 2.7mm Head, 2.7mm Locking Screw,2.7mmConicalScrew,or2.7mmCorticalScrew.
Use the appropriate depth gauge to mea-sure screw length.
Insertthescrewsusingthe2.5mmHexScrewdriver or Screwdriver Shaft.
Insert the Shaft Screws Thread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrew with 2.7mm Head, 2.7mm Locking Screw,3.5mmCorticalScrewwith2.7mmHead,2.7mmConicalScrew,or2.7mmCorticalScrew.
Use the appropriate depth gauge to mea-sure screw length.
Insertthescrewsusingthe2.5mmHexScrewdriver or Screwdriver Shaft.
BE SURE THAT ALL SCREWS ARE SECURELY TIGHTENED.
Make a final check of the limb align-ment and fracture reduction. Then make sure that ALL LOCKING SCREWS ARE SECURELY TIGHTENED by hand before closing.
Wound Closure Use the appropriate method for surgical closure of the incisions.
Postoperative treatment Postoperative treatment with locking plates does not differ from conventional openreductioninternalfixation(ORIF)procedures.
Implant Removal To remove locking screws, use the 2.5mmHexScrewdrivertofirstunlockallscrews from the plate and then remove the screws completely.
Please refer to the package insert for product information, including contraindications, warnings, and precau-tionary information.
21Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
DistalPosterolateralHumeralLockingPlate,Right,5Hole,98mm
Distal Posterolateral Humeral Locking Plate, Right, 7 Hole, 124mm
DistalPosterolateralHumeralLockingPlate,Right,9Hole,150mm
DistalPosterolateralHumeralLockingPlate,Left,5Hole,98mm
Distal Posterolateral Humeral Locking Plate, Left, 7 Hole, 124mm
DistalPosterolateralHumeralLockingPlate,Left,9Hole,150mm
DistalPosterolateralHumeralLockingPlate,Right,3Hole,72mm,STERILE
DistalPosterolateralHumeralLockingPlate,Right,11Hole,176mm,STERILE
DistalPosterolateralHumeralLockingPlate,Right,15Hole,228mm,STERILE
DistalPosterolateralHumeralLockingPlate,Right,19Hole,280mm,STERILE
DistalPosterolateralHumeralLockingPlate,Left,3Hole,72mm,STERILE
DistalPosterolateralHumeralLockingPlate,Left,11Hole,176mm,STERILE
DistalPosterolateralHumeralLockingPlate,Left,15Hole,228mm,STERILE
DistalPosterolateralHumeralLockingPlate,Left,19Hole,280mm,STERILE
DistalMedialHumeralLockingPlate,Right,3Hole,78mm
DistalMedialHumeralLockingPlate,Right,5Hole,104mm
DistalMedialHumeralLockingPlate,Right,7Hole,130mm
DistalMedialHumeralLockingPlate,Left,3Hole,78mm
DistalMedialHumeralLockingPlate,Left,5Hole,104mm
DistalMedialHumeralLockingPlate,Left,7Hole,130mm
DistalMedialHumeralLockingPlate,Right,11Hole,182mm,STERILE
DistalMedialHumeralLockingPlate,Right,15Hole,234mm,STERILE
DistalMedialHumeralLockingPlate,Left,11Hole,182mm,STERILE
DistalMedialHumeralLockingPlate,Left,15Hole,234mm,STERILE
DistalMedialHumeralLockingPlate,Short,Right,3Hole,74mm
DistalMedialHumeralLockingPlate,Short,Right,5Hole,100mm
DistalMedialHumeralLockingPlate,Short,Right,7Hole,126mm
DistalMedialHumeralLockingPlate,Short,Left,3Hole,74mm
DistalMedialHumeralLockingPlate,Short,Left,5Hole,100mm
DistalMedialHumeralLockingPlate,Short,Left,7Hole,126mm
DistalMedialHumeralLockingPlate,Short,Right,11Hole,178mm,STERILE
DistalMedialHumeralLockingPlate,Short,Right,15Hole,230mm,STERILE
DistalMedialHumeralLockingPlate,Short,Left,11Hole,178mm,STERILE
DistalMedialHumeralLockingPlate,Short,Left,15Hole,230mm,STERILE
Zimmer Periarticular Elbow Locking Plates – Information
Implants
Plates for Distal Humerus – Two Plate Technique 90° Plate Placement
22 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Implants
Plates for Distal Humerus – Two Plate Technique 180° Plate Placement
DistalLateralHumeralLockingPlate,Right,5H,87mm
Distal Lateral Humeral Locking Plate, Right, 7H, 113mm
Distal Lateral Humeral Locking Plate, Right, 9H, 139mm
DistalLateralHumeralLockingPlate,Left,5H,87mm
Distal Lateral Humeral Locking Plate, Left, 7H, 113mm
Distal Lateral Humeral Locking Plate, Left, 9H, 139mm
DistalLateralHumeralLockingPlate,Right,5H,87mm,Sterile
Distal Lateral Humeral Locking Plate, Right, 7H, 113mm, Sterile
Distal Lateral Humeral Locking Plate, Right, 9H, 139mm, Sterile
DistalLateralHumeralLockingPlate,Left,5H,87mm,Sterile
Distal Lateral Humeral Locking Plate, Left, 7H, 113mm, Sterile
Distal Lateral Humeral Locking Plate, Left, 9H, 139mm, Sterile
DistalLateralHumeralLockingPlate,Right,11H,165mm,Sterile
DistalLateralHumeralLockingPlate,Right,15H,217mm,Sterile
DistalLateralHumeralLockingPlate,Left,11H,165mm,Sterile
DistalLateralHumeralLockingPlate,Left,15H,217mm,Sterile
DistalMedialHumeralLockingPlate,Right,3Hole,78mm
DistalMedialHumeralLockingPlate,Right,5Hole,104mm
DistalMedialHumeralLockingPlate,Right,7Hole,130mm
DistalMedialHumeralLockingPlate,Left,3Hole,78mm
DistalMedialHumeralLockingPlate,Left,5Hole,104mm
DistalMedialHumeralLockingPlate,Left,7Hole,130mm
DistalMedialHumeralLockingPlate,Right,11Hole,182mm,STERILE
DistalMedialHumeralLockingPlate,Right,15Hole,234mm,STERILE
DistalMedialHumeralLockingPlate,Left,11Hole,182mm,STERILE
DistalMedialHumeralLockingPlate,Left,15Hole,234mm,STERILE
DistalMedialHumeralLockingPlate,Short,Right,3Hole,74mm
DistalMedialHumeralLockingPlate,Short,Right,5Hole,100mm
DistalMedialHumeralLockingPlate,Short,Right,7Hole,126mm
DistalMedialHumeralLockingPlate,Short,Left,3Hole,74mm
DistalMedialHumeralLockingPlate,Short,Left,5Hole,100mm
DistalMedialHumeralLockingPlate,Short,Left,7Hole,126mm
DistalMedialHumeralLockingPlate,Short,Right,11Hole,178mm,STERILE
DistalMedialHumeralLockingPlate,Short,Right,15Hole,230mm,STERILE
DistalMedialHumeralLockingPlate,Short,Left,11Hole,178mm,STERILE
DistalMedialHumeralLockingPlate,Short,Left,15Hole,230mm,STERILE
23Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Implants
Plates for Proximal Ulna
Proximal Ulna Locking Plate, Right, 3 Hole, 77mm
ProximalUlnaLockingPlate,Right,5Hole,103mm
Proximal Ulna Locking Plate, Right, 7 Hole, 129mm
ProximalUlnaLockingPlate,Right,9Hole,155mm
Proximal Ulna Locking Plate, Left, 3 Hole, 77mm
ProximalUlnaLockingPlate,Left,5Hole,103mm
Proximal Ulna Locking Plate, Left, 7 Hole, 129mm
ProximalUlnaLockingPlate,Left,9Hole,155mm
ProximalUlnaLockingPlate,Right,11Hole,181mm,STERILE
ProximalUlnaLockingPlate,Right,13Hole,207mm,STERILE
ProximalUlnaLockingPlate,Right,15Hole,233mm,STERILE
ProximalUlnaLockingPlate,Left,11Hole,181mm,STERILE
ProximalUlnaLockingPlate,Left,13Hole,207mm,STERILE
ProximalUlnaLockingPlate,Left,15Hole,233mm,STERILE
24 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
ZS 02.00026.100 Elbow Locking Plate Set
ZS 02.00026.200 Elbow Locking Plate Set Sterile
ZS 02.00026.300 Elbow Locking Plate Screw Set
ZS 02.00026.400 Elbow Locking Plate Screw Set Sterile
KT-2360-000-06 ElbowLockingPlateGeneralInstrumentSet
KT-2360-000-07 ElbowLockingPlateInstrumentSet
ZS 02.00026.100 ZS 02.00026.200 Periarticular Elbow Locking Plate Set
00-2358-005-05 47-2358-005-05 DistalPosterolateralHumeralLockingPlate,Right,5Hole,98mm 1
00-2358-005-07 47-2358-005-07 Distal Posterolateral Humeral Locking Plate, Right, 7 Hole, 124mm 1
00-2358-005-09 47-2358-005-09 DistalPosterolateralHumeralLockingPlate,Right,9Hole,150mm 1
00-2358-006-05 47-2358-006-05 DistalPosterolateralHumeralLockingPlate,Left,5Hole,98mm 1
00-2358-006-07 47-2358-006-07 Distal Posterolateral Humeral Locking Plate, Left, 7 Hole, 124mm 1
00-2358-006-09 47-2358-006-09 DistalPosterolateralHumeralLockingPlate,Left,9Hole,150mm 1
00-2358-007-03 47-2358-007-03 DistalMedialHumeralLockingPlate,Right,3Hole,78mm 1
00-2358-007-05 47-2358-007-05 DistalMedialHumeralLockingPlate,Right,5Hole,104mm 1
00-2358-007-07 47-2358-007-07 DistalMedialHumeralLockingPlate,Right,7Hole,130mm 1
00-2358-008-03 47-2358-008-03 DistalMedialHumeralLockingPlate,Left,3Hole,78mm 1
00-2358-008-05 47-2358-008-05 DistalMedialHumeralLockingPlate,Left,5Hole,104mm 1
00-2358-008-07 47-2358-008-07 DistalMedialHumeralLockingPlate,Left,7Hole,130mm 1
00-2358-107-03 47-2358-107-03 DistalMedialHumeralLockingPlate,Short,Right,3Hole,74mm 1
00-2358-107-05 47-2358-107-05 DistalMedialHumeralLockingPlate,Short,Right,5Hole,100mm 1
00-2358-107-07 47-2358-107-07 DistalMedialHumeralLockingPlate,Short,Right,7Hole,126mm 1
00-2358-108-03 47-2358-108-03 DistalMedialHumeralLockingPlate,Short,Left,3Hole,74mm 1
00-2358-108-05 47-2358-108-05 DistalMedialHumeralLockingPlate,Short,Left,5Hole,100mm 1
00-2358-108-07 47-2358-108-07 DistalMedialHumeralLockingPlate,Short,Left,7Hole,126mm 1
00-2358-023-05 47-2358-023-05 DistalLateralHumeralLockingPlate,Right,5Hole,87mm 1
00-2358-023-07 47-2358-023-07 Distal Lateral Humeral Locking Plate, Right, 7 Hole, 113mm 1
00-2358-024-05 47-2358-024-05 DistalLateralHumeralLockingPlate,Left,5Hole,87mm 1
00-2358-024-07 47-2358-024-07 Distal Lateral Humeral Locking Plate, Left, 7 Hole, 113mm 1
00-2358-009-03 47-2358-009-03 Proximal Ulna Locking Plate, Right, 3 Hole, 77mm 1
00-2358-009-05 47-2358-009-05 ProximalUlnaLockingPlate,Right,5Hole,103mm 1
00-2358-009-07 47-2358-009-07 Proximal Ulna Locking Plate, Right, 7 Hole, 129mm 1
00-2358-009-09 47-2358-009-09 ProximalUlnaLockingPlate,Right,9Hole,155mm 1
00-2358-012-03 47-2358-012-03 Proximal Ulna Locking Plate, Left, 3 Hole, 77mm 1
00-2358-012-05 47-2358-012-05 ProximalUlnaLockingPlate,Left,5Hole,103mm 1
00-2358-012-07 47-2358-012-07 Proximal Ulna Locking Plate, Left, 7 Hole, 129mm 1
00-2358-012-09 47-2358-012-09 ProximalUlnaLockingPlate,Left,9Hole,155mm 1
REF Description Qty
Periarticular Elbow Locking Plate System – KitandItemInformation
REF Nonsterile REF Sterile Description Qty
25Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
ZS 02.00026.300 ZS 02.00026.400 Periarticular Locking Elbow Screw Set
00-2348-010-35 47-2348-010-35 3.5mmPeriCorticalScrewwith2.7mmHead,10mmLong 2
00-2348-012-35 47-2348-012-35 3.5mmPeriCorticalScrewwith2.7mmHead,12mmLong 2
00-2348-014-35 47-2348-014-35 3.5mmPeriCorticalScrewwith2.7mmHead,14mmLong 2
00-2348-016-35 47-2348-016-35 3.5mmPeriCorticalScrewwith2.7mmHead,16mmLong 2
00-2348-018-35 47-2348-018-35 3.5mmPeriCorticalScrewwith2.7mmHead,18mmLong 2
00-2348-020-35 47-2348-020-35 3.5mmPeriCorticalScrewwith2.7mmHead,20mmLong 2
00-2348-022-35 47-2348-022-35 3.5mmPeriCorticalScrewwith2.7mmHead,22mmLong 2
00-2348-024-35 47-2348-024-35 3.5mmPeriCorticalScrewwith2.7mmHead,24mmLong 2
00-2348-026-35 47-2348-026-35 3.5mmPeriCorticalScrewwith2.7mmHead,26mmLong 2
00-2348-028-35 47-2348-028-35 3.5mmPeriCorticalScrewwith2.7mmHead,28mmLong 2
00-2348-030-35 47-2348-030-35 3.5mmPeriCorticalScrewwith2.7mmHead,30mmLong 2
00-2348-032-35 47-2348-032-35 3.5mmPeriCorticalScrewwith2.7mmHead,32mmLong 2
00-2348-034-35 47-2348-034-35 3.5mmPeriCorticalScrewwith2.7mmHead,34mmLong 2
00-2348-036-35 47-2348-036-35 3.5mmPeriCorticalScrewwith2.7mmHead,36mmLong 2
00-2348-038-35 47-2348-038-35 3.5mmPeriCorticalScrewwith2.7mmHead,38mmLong 2
00-2348-040-35 47-2348-040-35 3.5mmPeriCorticalScrewwith2.7mmHead,40mmLong 2
00-2348-042-35 47-2348-042-35 3.5mmPeriCorticalScrewwith2.7mmHead,42mmLong 2
00-2348-044-35 47-2348-044-35 3.5mmPeriCorticalScrewwith2.7mmHead,44mmLong 2
00-2348-046-35 47-2348-046-35 3.5mmPeriCorticalScrewwith2.7mmHead,46mmLong 2
00-2348-048-35 47-2348-048-35 3.5mmPeriCorticalScrewwith2.7mmHead,48mmLong 2
00-2348-050-35 47-2348-050-35 3.5mmPeriCorticalScrewwith2.7mmHead,50mmLong 2
00-2348-052-35 47-2348-052-35 3.5mmPeriCorticalScrewwith2.7mmHead,52mmLong 2
00-2348-054-35 47-2348-054-35 3.5mmPeriCorticalScrewwith2.7mmHead,54mmLong 2
00-2348-056-35 47-2348-056-35 3.5mmPeriCorticalScrewwith2.7mmHead,56mmLong 2
00-2348-058-35 47-2348-058-35 3.5mmPeriCorticalScrewwith2.7mmHead,58mmLong 2
00-2348-060-35 47-2348-060-35 3.5mmPeriCorticalScrewwith2.7mmHead,60mmLong 2
00-2348-065-35 00-2348-065-35 3.5mmPeriCorticalScrewwith2.7mmHead,65mmLong 2
00-2348-070-35 00-2348-070-35 3.5mmPeriCorticalScrewwith2.7mmHead,70mmLong 2
00-2348-100-35 47-2348-100-35 3.5mmPeriCorticalScrewwith2.7mmHead,100mmLong 2
00-2348-105-35 47-2348-105-35 3.5mmPeriCorticalScrewwith2.7mmHead,105mmLong 2
00-2348-110-35 47-2348-110-35 3.5mmPeriCorticalScrewwith2.7mmHead,110mmLong 2
00-2359-014-26 47-2359-014-26 2.7mmConicalScrew,14mmLong 2
00-2359-016-26 47-2359-016-26 2.7mmConicalScrew,16mmLong 2
00-2359-018-26 47-2359-018-26 2.7mmConicalScrew,18mmLong 2
00-2359-020-26 47-2359-020-26 2.7mmConicalScrew,20mmLong 2
00-2359-022-26 47-2359-022-26 2.7mmConicalScrew,22mmLong 2
00-2359-024-26 47-2359-024-26 2.7mmConicalScrew,24mmLong 2
REF Nonsterile REF Sterile Description Qty
26 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
00-2359-026-26 47-2359-026-26 2.7mmConicalScrew,26mmLong 2
00-2359-028-26 47-2359-028-26 2.7mmConicalScrew,28mmLong 2
00-2359-030-26 47-2359-030-26 2.7mmConicalScrew,30mmLong 2
00-2359-032-26 47-2359-032-26 2.7mmConicalScrew,32mmLong 2
00-2359-034-26 47-2359-034-26 2.7mmConicalScrew,34mmLong 2
00-2359-036-26 47-2359-036-26 2.7mmConicalScrew,36mmLong 2
00-2359-038-26 47-2359-038-26 2.7mmConicalScrew,38mmLong 2
00-2359-040-26 47-2359-040-26 2.7mmConicalScrew,40mmLong 2
00-2359-010-38 47-2359-010-38 3.5mmLockingScrewwith2.7mmHead,10mmLong 2
00-2359-012-38 47-2359-012-38 3.5mmLockingScrewwith2.7mmHead,12mmLong 2
00-2359-014-38 47-2359-014-38 3.5mmLockingScrewwith2.7mmHead,14mmLong 2
00-2359-016-38 47-2359-016-38 3.5mmLockingScrewwith2.7mmHead,16mmLong 2
00-2359-018-38 47-2359-018-38 3.5mmLockingScrewwith2.7mmHead,18mmLong 2
00-2359-020-38 47-2359-020-38 3.5mmLockingScrewwith2.7mmHead,20mmLong 2
00-2359-022-38 47-2359-022-38 3.5mmLockingScrewwith2.7mmHead,22mmLong 2
00-2359-024-38 47-2359-024-38 3.5mmLockingScrewwith2.7mmHead,24mmLong 2
00-2359-026-38 47-2359-026-38 3.5mmLockingScrewwith2.7mmHead,26mmLong 2
00-2359-028-38 47-2359-028-38 3.5mmLockingScrewwith2.7mmHead,28mmLong 2
00-2359-030-38 47-2359-030-38 3.5mmLockingScrewwith2.7mmHead,30mmLong 2
00-2359-032-38 47-2359-032-38 3.5mmLockingScrewwith2.7mmHead,32mmLong 2
00-2359-034-38 47-2359-034-38 3.5mmLockingScrewwith2.7mmHead,34mmLong 2
00-2359-036-38 47-2359-036-38 3.5mmLockingScrewwith2.7mmHead,36mmLong 2
00-2359-038-38 47-2359-038-38 3.5mmLockingScrewwith2.7mmHead,38mmLong 2
00-2359-040-38 47-2359-040-38 3.5mmLockingScrewwith2.7mmHead,40mmLong 2
00-2359-042-38 47-2359-042-38 3.5mmLockingScrewwith2.7mmHead,42mmLong 2
00-2359-044-38 47-2359-044-38 3.5mmLockingScrewwith2.7mmHead,44mmLong 2
00-2359-046-38 47-2359-046-38 3.5mmLockingScrewwith2.7mmHead,46mmLong 2
00-2359-048-38 47-2359-048-38 3.5mmLockingScrewwith2.7mmHead,48mmLong 2
00-2359-050-38 47-2359-050-38 3.5mmLockingScrewwith2.7mmHead,50mmLong 2
00-2359-055-38 47-2359-055-38 3.5mmLockingScrewwith2.7mmHead,55mmLong 2
00-2359-060-38 47-2359-060-38 3.5mmLockingScrewwith2.7mmHead,60mmLong 2
00-2359-065-38 47-2359-065-38 3.5mmLockingScrewwith2.7mmHead,65mmLong 2
00-2359-070-38 47-2359-070-38 3.5mmLockingScrewwith2.7mmHead,70mmLong 2
00-4827-008-01 47-4827-008-01 2.7mmCorticalSelf-tappingScrew,8mmLong 2
00-4827-010-01 47-4827-010-01 2.7mmCorticalSelf-tappingScrew,10mmLong 2
00-4827-012-01 47-4827-012-01 2.7mmCorticalSelf-tappingScrew,12mmLong 2
00-4827-014-01 47-4827-014-01 2.7mmCorticalSelf-tappingScrew,14mmLong 2
00-4827-016-01 47-4827-016-01 2.7mmCorticalSelf-tappingScrew,16mmLong 2
REF Nonsterile REF Sterile Description Qty
27Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
00-4827-018-01 47-4827-018-01 2.7mmCorticalSelf-tappingScrew,18mmLong 2
00-4827-020-01 47-4827-020-01 2.7mmCorticalSelf-tappingScrew,20mmLong 2
00-4827-022-01 47-4827-022-01 2.7mmCorticalSelf-tappingScrew,22mmLong 2
00-4827-024-01 47-4827-024-01 2.7mmCorticalSelf-tappingScrew,24mmLong 2
00-4827-026-01 47-4827-026-01 2.7mmCorticalSelf-tappingScrew,26mmLong 2
00-4827-028-01 47-4827-028-01 2.7mmCorticalSelf-tappingScrew,28mmLong 2
00-4827-030-01 47-4827-030-01 2.7mmCorticalSelf-tappingScrew,30mmLong 2
00-4827-032-01 47-4827-032-01 2.7mmCorticalSelf-tappingScrew,32mmLong 2
00-4827-034-01 47-4827-034-01 2.7mmCorticalSelf-tappingScrew,34mmLong 2
00-4827-036-01 47-4827-036-01 2.7mmCorticalSelf-tappingScrew,36mmLong 2
00-4827-038-01 47-4827-038-01 2.7mmCorticalSelf-tappingScrew,38mmLong 2
00-4827-040-01 47-4827-040-01 2.7mmCorticalSelf-tappingScrew,40mmLong 2
00-4827-045-01 47-4827-045-01 2.7mmCorticalSelf-tappingScrew,45mmLong 2
00-4827-050-01 47-4827-050-01 2.7mmCorticalSelf-tappingScrew,50mmLong 2
00-4827-055-01 47-4827-055-01 2.7mmCorticalSelf-tappingScrew,55mmLong 2
00-4827-060-01 47-4827-060-01 2.7mmCorticalSelf-tappingScrew,60mmLong 2
00-4827-065-01 47-4827-065-01 2.7mmCorticalSelf-tappingScrew,65mmLong 2
00-4827-070-01 47-4827-070-01 2.7mmCorticalSelf-tappingScrew,70mmLong 2
00-4828-010-02 47-4828-010-02 2.7mm Locking Screw, 10mm Long 2
00-4828-012-02 47-4828-012-02 2.7mm Locking Screw, 12mm Long 2
00-4828-014-02 47-4828-014-02 2.7mm Locking Screw, 14mm Long 2
00-4828-016-02 47-4828-016-02 2.7mm Locking Screw, 16mm Long 2
00-4828-018-02 47-4828-018-02 2.7mm Locking Screw, 18mm Long 2
00-4828-020-02 47-4828-020-02 2.7mm Locking Screw, 20mm Long 2
00-4828-022-02 47-4828-022-02 2.7mm Locking Screw, 22mm Long 2
00-4828-024-02 47-4828-024-02 2.7mm Locking Screw, 24mm Long 2
00-4828-026-02 47-4828-026-02 2.7mm Locking Screw, 26mm Long 2
00-4828-028-02 47-4828-028-02 2.7mm Locking Screw, 28mm Long 2
00-4828-030-02 47-4828-030-02 2.7mm Locking Screw, 30mm Long 2
00-4828-032-02 47-4828-032-02 2.7mm Locking Screw, 32mm Long 2
00-4828-034-02 47-4828-034-02 2.7mm Locking Screw, 34mm Long 2
00-4828-036-02 47-4828-036-02 2.7mm Locking Screw, 36mm Long 2
00-4828-038-02 47-4828-038-02 2.7mm Locking Screw, 38mm Long 2
00-4828-040-02 47-4828-040-02 2.7mm Locking Screw, 40mm Long 2
00-4828-042-02 47-4828-042-02 2.7mm Locking Screw, 42mm Long 2
00-4828-044-02 47-4828-044-02 2.7mm Locking Screw, 44mm Long 2
00-4828-046-02 47-4828-046-02 2.7mm Locking Screw, 46mm Long 2
00-4828-048-02 47-4828-048-02 2.7mm Locking Screw, 48mm Long 2
REF Nonsterile REF Sterile Description Qty
28 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
KT-2360-000-07 Periarticular Elbow Locking Instrument Set
00-2360-020-16 1.6mmD-DriveCannulafor2.7mmLockingHole 4
00-2360-021-20 2.0mmD-DriveCannulafor2.7mmLockingHole 4
00-2360-088-02 2.7mmD-DriveCannulaInserter 1
00-2360-102-01 Distal Posterolateral Humeral Locking Plate Jig, Right 1
00-2360-102-02 Distal Posterolateral Humeral Locking Plate Jig, Left 1
00-2360-103-01 DistalMedialHumeralLockingPlateJig,Right 1
00-2360-103-02 DistalMedialHumeralLockingPlateJig,Left 1
00-2360-103-03 DistalMedialHumeralLockingPlateJig,Short,Right 1
00-2360-103-04 DistalMedialHumeralLockingPlateJig,Short,Left 1
00-2360-104-01 Proximal Ulnar Locking Plate Jig, Right 1
00-2360-104-02 Proximal Ulnar Locking Plate Jig, Left 1
00-2360-105-01 Distal Lateral Humeral Locking Plate Jig, Right 1
00-2360-105-02 Distal Lateral Humeral Locking Plate Jig, Left 1
00-2360-065-00 2.5mmScrewdriverStopRing 1pkgof5
00-1147-071-00 CleaningStylet 1
00-1147-076-00 CleaningBrush 1
00-2360-023-27 2.7mmStandardCannula(for3.5mmlockingscrewwith2.7mmhead) 4
00-2360-080-00 TorqueLimitingAttachment 1
00-2360-153-27 2.7mmStandardTap,QC 2
00-2360-153-35 3.5mmStandardTap,QC 2
00-2360-165-25 2.5mmHexQCStandardScrewdriverBit 2
00-2360-175-20 2.0mmStandardDrill,QC,175mmlong 2
00-2360-205-27 2.7mmStandardDrill,QC,205mmlong 2
00-4828-050-02 47-4828-050-02 2.7mmLockingScrew,50mmLong 2
00-4828-055-02 47-4828-055-02 2.7mmLockingScrew,55mmLong 2
00-4828-060-02 47-4828-060-02 2.7mm Locking Screw, 60mm Long 2
00-4840-020-01 47-4840-020-01 4.0mmCancellousScrew,PartiallyThreaded,20mmLong 2
00-4840-026-01 47-4840-026-01 4.0mmCancellousScrew,PartiallyThreaded,26mmLong 2
00-4840-030-01 47-4840-030-01 4.0mmCancellousScrew,PartiallyThreaded,30mmLong 2
00-4840-035-01 47-4840-035-01 4.0mmCancellousScrew,PartiallyThreaded,35mmLong 2
00-4840-040-01 47-4840-040-01 4.0mmCancellousScrew,PartiallyThreaded,40mmLong 2
00-4840-045-01 47-4840-045-01 4.0mmCancellousScrew,PartiallyThreaded,45mmLong 2
00-4840-050-01 47-4840-050-01 4.0mmCancellousScrew,PartiallyThreaded,50mmLong 2
00-4840-055-01 47-4840-055-01 4.0mmCancellousScrew,PartiallyThreaded,55mmLong 2
00-4840-060-01 47-4840-060-01 4.0mmCancellousScrew,PartiallyThreaded,60mmLong 2
00-4840-065-01 47-4840-065-01 4.0mmCancellousScrew,PartiallyThreaded,65mmLong 2
00-4840-070-01 47-4840-070-01 4.0mmCancellousScrew,PartiallyThreaded,70mmLong 2
00-4900-040-51 47-4900-040-51 SmallWasher,for2.7mm,3.5mm,and4.0mmScrews 2
REF Nonsterile REF Sterile Description Qty
29Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
KT-2360-000-06 Periarticular Elbow Locking General Instrument Set
00-4816-001-00 ReductionForceps,Ratchet,Serratedw/Points,Narrow,133mmlength 1
00-4816-002-00 ReductionForceps,Ratchet,Serratedw/Points,Broad,133mmlength 1
00-4816-006-00 ReductionForceps,Ratchet,w/Points,205mmlength 2
00-4816-007-00 ReductionForceps,Ratchet,SerratedJaws,145mmlength 1
00-4816-008-00 ReductionForceps,Speed-Lock,180mmLength 1
00-4816-009-00 ReductionForceps,Speed-Lock,withNarrowSerratedJaws,245mmLength 1
00-4819-002-00 BendingIron,Left,2.7/3.5Plates 1
00-4819-003-00 BendingIron,Right,2.7/3.5Plates 1
00-4813-008-00 HohmannRetractor,8mmwidth,ShortNarrowTip,165mmlength 2
00-4813-015-00 HohmannRetractor,15mmwidth,160mmlength 2
00-4811-035-00 QCTHandle 1
00-1147-053-00 CannulatedRatchetHandle,AOConnection 1
00-4812-035-00 2.5mmHexStandardScrewdriver,QC 1
00-4810-002-01 SmallDepthGauge,Measuresupto60mm 1
00-4810-002-02 SmallDepthGauge,Measuresupto150mm 1
00-4901-012-15 Kwires,1.25mmdiameter,150mmlong,10perbox 1 box
00-4901-016-15 Kwires,1.6mmdiameter,150mmlong,10perbox 1 box
00-4901-020-15 Kwires,2.0mmdiameter,150mmlong,10perbox 1 box
00-4806-100-20 2.0mmDrill,QC,100mmlong 2
00-4806-110-25 2.5mmDrill,QC,110mmlong 2
00-4836-205-25 2.5mmDrill,QC,205mmlong 2
00-4806-100-27 2.7mmDrill,QC,100mmlong 2
00-4806-110-35 3.5mmDrill,QC,110mmlong 2
00-4808-027-01 2.7mm/2.0mm Double Drill Sleeve 1
00-4808-035-01 3.5mm/2.5mmDoubleDrillSleeve 1
00-4811-100-27 2.7mmTap,QC 2
00-4811-110-35 3.5mmTap,QC 2
00-4812-035-05 Small Holding Sleeve 1
00-4812-000-00 ScrewHoldingForceps 1
00-4828-027-05 2.7mmULSCompressionDrillGuide 1
00-4828-035-05 2.7mmULSCompressionDrillGuidefor3.5mmScrew 1
00-4809-035-00 Countersink 1
00-4808-035-02 3.5/2.5InsertDrillSleeve 1
00-2358-005-00 PeriElbowLockingInstrumentBaseandTray 1
00-5900-099-00 CaseLid 1
Prod. No. Description Qty
30 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Optional Sterile Plates Qty
47-2358-005-03 Distal Posterolateral Humeral Locking Plate, Right, 3 Hole, 72mm N/A
47-2358-005-11 Distal Posterolateral Humeral Locking Plate, Right, 11 Hole, 176mm N/A
47-2358-005-15 DistalPosterolateralHumeralLockingPlate,Right,15Hole,228mm N/A
47-2358-005-19 Distal Posterolateral Humeral Locking Plate, Right, 19 Hole, 280mm N/A
47-2358-006-03 Distal Posterolateral Humeral Locking Plate, Left, 3 Hole, 72mm N/A
47-2358-006-11 Distal Posterolateral Humeral Locking Plate, Left, 11 Hole, 176mm N/A
47-2358-006-15 DistalPosterolateralHumeralLockingPlate,Left,15Hole,228mm N/A
47-2358-006-19 Distal Posterolateral Humeral Locking Plate, Left, 19 Hole, 280mm N/A
47-2358-007-11 DistalMedialHumeralLockingPlate,Right,11Hole,182mm N/A
47-2358-007-15 DistalMedialHumeralLockingPlate,Right,15Hole,234mm N/A
47-2358-008-11 DistalMedialHumeralLockingPlate,Left,11Hole,182mm N/A
47-2358-008-15 DistalMedialHumeralLockingPlate,Left,15Hole,234mm N/A
47-2358-107-11 DistalMedialHumeralLockingPlate,Short,Right,11Hole,178mm N/A
47-2358-107-15 DistalMedialHumeralLockingPlate,Short,Right,15Hole,230mm N/A
47-2358-108-11 DistalMedialHumeralLockingPlate,Short,Left,11Hole,178mm N/A
47-2358-108-15 DistalMedialHumeralLockingPlate,Short,Left,15Hole,230mm N/A
47-2358-023-09 Distal Lateral Humeral Locking Plate, Right, 9 Hole, 139mm N/A
47-2358-023-11 DistalLateralHumeralLockingPlate,Right,11Hole,165mm N/A
47-2358-023-15 DistalLateralHumeralLockingPlate,Right,15Hole,217mm N/A
47-2358-024-09 Distal Lateral Humeral Locking Plate, Left, 9 Hole, 139mm N/A
47-2358-024-11 DistalLateralHumeralLockingPlate,Left,11Hole,165mm N/A
47-2358-024-15 DistalLateralHumeralLockingPlate,Left,15Hole,217mm N/A
47-2358-009-11 Proximal Ulna Locking Plate, Right, 11 Hole, 181mm N/A
47-2358-009-13 Proximal Ulna Locking Plate, Right, 13 Hole, 207mm N/A
47-2358-009-15 ProximalUlnaLockingPlate,Right,15Hole,233mm N/A
47-2358-012-11 Proximal Ulna Locking Plate, Left, 11 Hole, 181mm N/A
47-2358-012-13 Proximal Ulna Locking Plate, Left, 13 Hole, 207mm N/A
47-2358-012-15 ProximalUlnaLockingPlate,Left,15Hole,233mm N/A
00-4814-006-00 Periosteal Elevator, curved blade, round edge, 6mm blade width 1
00-4817-001-00 Sharp Hook 1
00-4819-014-00 WireBendingPliers,155mm 1
00-2347-052-00 LinearBoneClamp,Medium 1
00-2347-057-00 MediumClampFoot 4
00-2347-060-00 ExtendedClampFoot(20mm) 4
00-2358-000-00 PeriElbowLockingGeneralInstCase 1
00-5900-099-00 CaseLid 1
Prod. No. Description Qty
31Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
Graphic Cases
00-2358-000-00 Periarticular Locking Elbow General Instrument Case
1
2
3
4
5
6
7
8 9 10
11
12
13
14
15
16
No. Prod. No. Description
1 00-4814-006-00 Pariosteal Elevator, 6mm
2 00-4813-006-00 Retractor, 8mm (2)
3 00-4813-015-00 Retractor,15mm(2)
4 00-4817-001-00 Sharp Hook
5 00-4816-006-00 ReductionForceps,Ratchet,withPoints,205mm(2)
6 00-4819-003-00 BendingIron,Right,2.7-3.5Plates
7 00-4819-002-00 BendingIron,Left,2.7-3.5Plates
8 00-4816-001-00 ReductionForceps,withPoints,Narrow
No. Prod. No. Description
9 00-4816-002-00 ReductionForceps,withPoints,Broad
10 00-4816-007-00 ReductionForceps,withSerratedJaws
11 00-2347-057-00 MediumClampFoot(4)
12 00-2347-060-00 ExtendedClampFoot(4)
13 00-4818-009-00 ReductionForceps,Speed-Lockwith
14 00-2347-052-00 MediumLinearBoneClamp
15 00-4819-014-00 WireBendingPliers,155mm
16 00-4816-008-00 ReductionForceps,Speed-Lock
32 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
00-2358-009-00 Periarticular Locking Elbow Instrument and Implant Case –Tray 1
No. Prod. No. Description
1 00-4808-035-02 3.5/2.5InsertDrillSleeve
2 00-4828-035-05 2.7mmCompressionDrillGuideFor3.5mmScrew
3 00-4828-027-05 2.7mmCompressionDrillGuide
4 00-4808-035-01 3.5/2.5DoubleDrillSleeve
5 00-4808-027-01 2.7/2.0 Double Drill Sleeve
6 00-4901-012-15 K-Wires1.25x150mm(.049”),10x
7 00-4901-016-15 K-Wires1.60x150mm(.062”),10x
8 00-4901-020-15 K-Wires2.0x150mm(.078”),10x
9 00-4806-100-20 DrillBitQ.C.2.0x100mm,10x
10 00-4806-110-27 DrillBitQ.C.2.5x110mm,2x
11 00-4836-205-25 DrillBitQ.C.2.5x205mm,2x
12 00-4806-100-27 DrillBitQ.C.2.7x100mm,2x
13 00-4806-110-35 DrillBitQ.C.3.5x110mm,2x
14 00-4811-100-27 TapQ.C.2.7x100mm,2x
15 00-4811-110-35 TapQ.C.3.5x110mm,2x
16 00-2360-175-20 2.0mmSTDDrill,QC,2.0x175mm,2x
No. Prod. No. Description
17 00-2360-205-27 2.7mmSTDDrill,QC,2.7x205mm,2x
18 00-2360-153-27 2.7mmSTDTap,QC,2x
19 00-2360-153-35 3.5mmSTDTap,QC,2x
20 00-2360-165-25 2.5mmHexSTDDriver,QC,2x
21 00-2348-1xx-35 3.5mmCorticalScrewwith2.7mmhead,Self-Tap,4x,100mm,105mm,110mm Screws
22 00-4809-035-00 Countersink
23 00-2360-020-16 1.6mmD-DriveCannual,4x
24 00-2360-021-20 2.0mmD-DriveCannual,4x
25 00-2360-023-27 2.7mmD-DriveCannual,4x
26 00-2360-103-03 04DistalMedialHumeralLockingPlate Jigs, Short
27 00-2360-104-XX Proximal Ulnar Locking Plate Jigs
28 00-2360-105-XX Distal Lateral Humeral Locking Plate Jigs
29 00-2360-103-01 02DistalMedialHumeralLockingPlate Jigs
30 00-2360-102-XX Distal Posterior/Lateral Humeral Locking Plate Jigs
1
2 3 4 5
67
8
9
10
11
12
13
14
1516
17
18
19
20
22
21
23
24
25
26
27
28 30
29
33Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
00-2358-008-00 Periarticular Locking Elbow Instrument and Implant Case –Tray 2
No. Prod. No. Description
1 00-2358-006-05 Distal Posterior/Lateral Humeral LockingPlates5H,98mm(2),Left
2 00-2358-005-05 LockingPlates5H,98mm(2),Right
3 00-2358-006-07 Locking Plates 7H, 124mm (2), Left
4 00-2358-005-07 Locking Plates 7H, 124mm (2), Right
5 00-2358-006-09 LockingPlates9H,150mm,Left
6 00-2358-005-09 LockingPlates9H,150mm,Right
7 00-2358-024-03 Distal Lateral Humeral Locking Plates 3H, 88mm (2), Left
8 00-2358-023-03 3H, 88mm (2), Right
9 00-2358-024-05 5H,112mm(2),Left
10 00-2358-023-05 5H,112mm(2),Right
11 00-2358-024-07 7H, 138mm, Left
12 00-2358-023-07 7H, 138mm, Right
13 00-2358-012-03 Proximal Ulna Locking Plates 3H, 77mm (2), Left
14 00-2358-009-03 77mm (2), Right
15 00-2358-012-05 ProximalUlnaLockingPlates5H,103mm (2), Left
16 00-2358-009-05 103mm (2), Right
1 2
3 4
5 6
7 8
9 10
11 12
13 14
15 16
17 18
19 20
2221
23 24
25 26
3230
28
3129
27
No. Prod. No. Description
17 00-2358-012-07 Proximal Ulna Locking Plates 7H, 129mm (2), Left
18 00-2358-009-07 129mm (2), Right
19 00-2358-012-09 Proximal Ulna Locking Plates 9H, 155mm,Left
20 00-2358-009-09 155mm,Right
21 00-2358-008-03 DistalMedialHumeralLockingPlates3H, 78mm (2), Left
22 00-2358-007-03 3H, 78mm (2), Right
23 00-2358-008-05 5H,104mm,Left
24 00-2358-007-05 5H,104mm,Right
25 00-2358-008-07 7H, 130mm, Left
26 00-2358-007-07 7H, 130mm, Right
27 00-2358-108-03 DistalMedialHumeralLockingPlates, Short 3H, 74mm (2), Left
28 00-2358-107-03 Plates, Short 3H, 74mm (2), Right
29 00-2358-108-05 Plates,Short5H,100mm,Left
30 00-2358-107-05 Plates,Short5H,100mm,Right
31 00-2358-108-07 Plates, Short 7H, 128mm, Left
32 00-2358-107-07 Plates, Short 7H, 128mm, Right
34 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
00-2358-007-00 Periarticular Locking Elbow Instrument and Implant Case –Tray 3
No. Prod. No. Description
1 00-4811-035-00 QCT-Handle
2 00-2360-065-00 2.5mmScrewdriverStopRing(5)
3 00-4812-035-05 Small Holding Sleeve
4 00-4812-035-00 Small Hex Screwdriver
5 00-1147-078-00 CleaningBrush
6 00-1147-071-00 CleaningStylet
7 00-4810-002-02 SmallDepthGauge,150mm(DisassembleBeforeAutoclave)
1
2
3
4
5
6
78
9
1011
12
1314
No. Prod. No. Description
8 00-4810-002-01 Small Depth Gauge, 60mm (DisassembleBeforeAutoclave)
9 00-4812-000-00 ScrewHoldingForceps
10 00-2360-088-02 D-DriveCannulaInserter
11 00-2360-088-01 3.5/2.7mmCannulaInserter(Optional)
12 00-2360-080-00 TorqueLimitingAttachment
13 00-1147-053-00 CannulatedRatchetHandle
14 00-4811-035-01 QCHandle(Optional)
35Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
00-2358-006-00 Periarticular Locking Elbow Instrument and Implant Case Base
1
2
3
4
5
6
7
8
No. Prod. No. Description
1 00-2360-005-19 Distal Posterior/Lateral Humeral Locking Plate Provisionals, Right
2 00-2360-006-19 Distal Posterior/Lateral Humeral Locking Plate Provisionals, Left
3 00-2360-007-07 DistalMedialHumeralLockingPlateProvisionals, Right and Left
4 00-2360-107-07 DistalMedialHumeralLockingPlateProvisionals, Right and Left Short
5 00-2360-009-15 Proximal Ulnar Locking Plate Provisionals, Right
No. Prod. No. Description
6 00-2360-012-15 Proximal Ulnar Locking Plate Provisionals, Left
7 00-2360-023-19 Distal Lateral Humeral Locking Plate Provisionals, Right
8 00-2360-024-19 Distal Lateral Humeral Locking Plate Provisionals, Left
36 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique
00-2358-006-50 Periarticular Locking Elbow Instrument and Implant Case Screw Caddy
No. Prod. No. Description
1 00-4827-0xx-01 2.7mmCorticalSelf-TapScrews
2 00-4828-0xx-02 2.7mm Locking Self-Tap Screws
3 00-2359-0xx-26 2.7mmConicalSelf-TapScrews
4 00-4840-0xx-01 4.0mmCancellousPartiallyThreadedScrews
5 00-2348-0xx-35 3.5mmCorticalw/2.7mmHeadSelf-Tap Screws
6 00-2359-0xx-38 3.5mmLockingw/2.7mmHeadSelf-Tap Screws
1
2
3 4
5
6
7
No. Prod. No. Description
7 00-4900-040-51 SmallWashersfor2.7mm,3.5mm,&4.0mm Screws (6)
Contact your Zimmer representative or visit us at www.zimmer.com
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+H84406016790121/$091001J09A
Lit. No. 06.01679.012–Ed.10/2009ZHUB
Please refer to package insert for complete product information, including contraindications, warnings, precautions, and adverse effects.