Handling Techniquesynthes.vo.llnwd.net/o16/LLNWMB8/INT Mobile/Synthes... · 2013-07-12 · Handling...

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Orthopedic Foot Instruments. Dedicated instruments for reconstructive foot surgery. Handling Technique

Transcript of Handling Techniquesynthes.vo.llnwd.net/o16/LLNWMB8/INT Mobile/Synthes... · 2013-07-12 · Handling...

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Orthopedic Foot Instruments.Dedicated instruments for reconstructivefoot surgery.

Handling Technique

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Synthes 1

Table of Contents

Introduction

Handling Techniques

Product Information

Orthopedic Foot Instruments 2

Indications 4

Compression/Distraction Device Set 5

Bone Harvesting Set 12

Chisel Set 19

Instruments 22

Sets 25

Replacement Articles 28

Image intensifier control

WarningThis description alone does not provide sufficient background for direct use ofthe instrument set. Instruction by a surgeon experienced in handling theseinstruments is highly recommended.

Reprocessing, Care and Maintenance of Synthes InstrumentsFor general guidelines, function control and dismantling of multi-part instruments,please refer to: www.synthes.com/reprocessing

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2 Synthes Orthopedic Foot Instruments Handling Technique

Compression/Distraction Device Set,in modular trayFields of application– Compression and distraction of joints

or bones– Fracture treatment– Arthrodeses (e.g. subtalar arthrodesis)– Osteotomies (e.g. lateral calcaneal

lengthening osteotomy)

Bone Harvesting Set, in modular trayFields of application– Bone harvesting

(e.g. from the calcaneus, proximaltibia or iliac crest)

– Bone biopsies

Orthopedic Foot Instruments. Dedicated instruments for reconstructivefoot surgery.

System Overview

The Orthopedic Foot Instruments havebeen designed to perform specific procedures on the foot more efficiently. The system consists of three modularsets: Compression/Distraction DeviceSet, Bone Harvesting Set and Chisel Set.

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Synthes 3

Chisel Set, in modular trayFields of application– Preparation of joints for arthrodeses– Removal of joint cartilage and bone– Removal of exostoses– Removal of osteophytes

Features and Benefits

Bone Harvesting Set– Different trephine diameters enable accurate

local bone grafting– Corresponding extraction attachments enable

the safe removal of bone graft

Chisel Set– Different shapes of chisels and a cartilage

remover facilitate proper joint preparation– Silicon handles for optimal grip

Compression/Distraction Device Set– Placement of 2.0, 2.5 and 3.0 mm Kirschner

wires at various angles– Precise compression/distraction mechanism– Two extra Kirschner wire holes for more

stability

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Indications

− Fractures in the foot and ankle− Skeletal deformities and/or skeletal defects in the foot

and ankle− Instability of the foot and ankle − Tumors in bones and cartilage in the foot and ankle− Non-unions of small and large bones in the foot and ankle − Pseudoarthrosis in the foot and ankle− Osteoarthritis in the foot and ankle− Rheumatoid arthritis in the foot and ankle− Exostoses in the foot and ankle

4 Synthes Orthopedic Foot Instruments Handling Technique

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Handling TechniquesCompression/Distraction Device Set

Set

01.111.476 Compression/Distraction Device Set for Orthopedic Foot Instruments, with Lid, with Contents

Set content

03.111.021 Compression/Distraction Device for Foot and Ankle

03.111.022 Holding Sleeve � 2.0 mm for Compression/Distraction Device for Foot and Ankle

03.111.023 Holding Sleeve � 2.5 mm for Compression/Distraction Device for Foot and Ankle

03.111.024 Holding Sleeve � 3.0 mm for Compression/Distraction Device for Foot and Ankle

292.250 Kirschner Wire � 2.5 mm with trocar tip, length 150 mm, Stainless Steel

292.750 Kirschner Wire � 2.5 mm with threaded tip, length 150/15 mm, Stainless Steel

292.790 Kirschner Wire � 2.0 mm with threaded tip, length 150/15 mm, Stainless Steel

292.820 Kirschner Wire � 3.0 mm with threaded tip, length 150/15 mm, Stainless Steel

03.111.041 Holding Sleeve Tightening Device for Compression/Distraction Device

Synthes 5

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1Preparation

Expose the indicated area. The approach will depend on thesurgical procedure.

Handling TechniquesCompression/Distraction Device Set

2Prepare Compression/Distraction Device

Instruments

03.111.021 Compression/Distraction Device for Foot and Ankle

03.111.022 Holding Sleeve � 2.0 mm for Compression/Distraction Device for Foot and Ankle

03.111.023 Holding Sleeve � 2.5 mm for Compression/Distraction Device for Foot and Ankle

03.111.024 Holding Sleeve � 3.0 mm for Compression/Distraction Device for Foot and Ankle

Thread the corresponding holding sleeves into the threadedfixation holes of the fixation arms.

For 2.0 mm Kirschner wires use 2.0 mm holding sleeves.For 2.5 mm Kirschner wires use 2.5 mm holding sleeves.For 3.0 mm Kirschner wires use 3.0 mm holding sleeves.

Note: Do not tighten holding sleeves at this point.

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Open all locking-clamps of the compression/distraction device.

Synthes 7

Adjust the rotation and distance of the arms until initialalignment for the surgical procedure is defined.

Tips– lock the rotational mechanism first– lock both arms – adjust space between the arms

Note: A range of different adjustment approaches may beused.

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3Insert Kirschner wires

Instruments

292.250 Kirschner Wire � 2.5 mm with trocar tip, length 150 mm, Stainless Steel

292.750 Kirschner Wire � 2.5 mm with threaded tip, length 150/15 mm, Stainless Steel

292.790 Kirschner Wire � 2.0 mm with threaded tip, length 150/15 mm, Stainless Steel

292.820 Kirschner Wire � 3.0 mm with threaded tip, length 150/15 mm, Stainless Steel

03.111.041 Holding Sleeve Tightening Device for Compression/Distraction Device

Position the device in such a way that the ends of the holding sleeves are as close to the bone as possible.

Drill two Kirschner wires through the corresponding holdingsleeves into the bone.

Handling TechniquesCompression/Distraction Device Set

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If more stability is desired, additional 2.0 mm or 2.5 mmKirschner wires can be drilled through the extra Kirschnerwire holes of the arms.

Finger-tighten the holding sleeves. This will fix the device tothe Kirschner wires.

The blue tightening device may be used to achieve a strongerfixation between the holding sleeve and the Kirschner wire.

Caution: Apart from the blue tightening device, do not use any other instruments to tighten or loosen the holdingsleeves as they may cause damage.

Synthes 9

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4Compress or distract

Perform the surgical procedure once the Kirschner wires havebeen inserted.

Choose whether compression or distraction is desired by adjusting the switch mechanism.

Turn the wing bolt to compress or distract.

Warning: Avoid excessive distraction. Too much distractioncan damage the surrounding soft tissue.

Handling TechniquesCompression/Distraction Device Set

5Remove compression/distraction device

Loosen the holding sleeves first, then open the lockingclamps.

Technique Tip: use the blue tightening device to loosen the holding sleeves.

Carefully remove the device.

Remove Kirschner wires.

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Synthes 11

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Set

01.111.477 Bone Harvesting Set for Orthopedic Foot Instruments, with Lid, with Contents

Set content

03.111.012 Handle, long, with Quick Couplingor03.111.013 Handle, short, with Quick Coupling

02.111.001 Guide Wire � 3.2 mm with Stop, tip 1.6 mm, Stainless Steel

03.111.030 Shaft for Trephine and Extraction Attachment

03.111.031 Stylet for Trephine and Extraction Attachment

03.111.025 Trephine Attachment � 5.5 mm

03.111.026 Trephine Attachment � 7.0 mm

387.659 Trephine Attachment � 8.5 mm

387.660 Trephine Attachment � 9.5 mm

387.661 Trephine Attachment � 10.5 mm

387.662 Trephine Attachment � 12.5 mm

387.663 Trephine Attachment � 14.0 mm

03.111.027 Extraction Attachment � 5.5 mm

03.111.028 Extraction Attachment � 7.0 mm

387.669 Extraction Attachment � 8.5 mm

Handling TechniquesBone Harvesting Set

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387.670 Extraction Attachment � 9.5 mm

387.671 Extraction Attachment � 10.5 mm

387.672 Extraction Attachment � 12.5 mm

387.673 Extraction Attachment � 14.0 mm

Important– Trephines have sharp cutting edges that may cause injury.– Handle the attachments with care. Damage to the cutting

edges may cause failure and will alter the precision of theinstrument.

– Only use instruments with sharp edges.

Synthes 13

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Handling TechniquesBone Harvesting Set

1Preparation

Expose the indicated area. The approach will depend on thesurgical procedure.

2Place guide wire

Instrument

02.111.001 Guide Wire � 3.2 mm with Stop, tip 1.6 mm, Stainless Steel

Drill the guide wire into the location where bone removal isrequired.

Important: Drill the 3.2 mm guide wire until the stop at theend of the 1.2 mm tip.

Technique Tip: In case that insertion of the guide wire byhand is not possible, use a power tool to drill the guide wireinto the bone.

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3Cut bone graft

Instruments

03.111.012 Handle, long, with Quick Couplingor03.111.013 Handle, short, with Quick Coupling

03.111.030 Shaft for Trephine and Extraction Attachment

03.111.025 Trephine Attachment � 5.5 mm

03.111.026 Trephine Attachment � 7.0 mm

387.659 Trephine Attachment � 8.5 mm

387.660 Trephine Attachment � 9.5 mm

387.661 Trephine Attachment � 10.5 mm

387.662 Trephine Attachment � 12.5 mm

387.663 Trephine Attachment � 14.0 mm

Attach the shaft for trephine and extraction attachments to a handle.

Select the preferred trephine size and attach it to the shaft.

Slide the trephine over the guide wire to the bone.

Note: The trephine cannot be disengaged from the shaftwhen it is inserted over the guide wire.

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Use gentle rotational movements to cut into the bone.

Use the guide wire to read the length of the bone graft.

Cut to the desired depth.

Handling TechniquesBone Harvesting Set

The extracted bone graft should remain in the trephine.

Important: If the bone graft cannot be removed with thetrephine, use the bone extraction attachment to remove thebone graft from the bone. This technique is described onpage 18.

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1

2

4Remove bone graft from trephine

Instrument

03.111.031 Stylet for Trephine and Extraction Attachment

Remove the handle and insert the stylet into the back of thetrephine shaft (1).

Push the bone graft carefully out from the front of thetrephine along with the guide wire (2).

Synthes 17

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Removal of bone graft with the bone extractionattachment

Instruments

03.111.012 Handle, long, with Quick Couplingor03.111.013 Handle, short, with Quick Coupling

03.111.030 Shaft for Trephine and Extraction Attachment

03.111.027 Extraction Attachment � 5.5 mm

03.111.028 Extraction Attachment � 7.0 mm

387.669 Extraction Attachment � 8.5 mm

387.670 Extraction Attachment � 9.5 mm

387.671 Extraction Attachment � 10.5 mm

387.672 Extraction Attachment � 12.5 mm

387.673 Extraction Attachment � 14.0 mm

Note: All trephines have a corresponding size extraction attachment.

Slide the extraction attachment over the guide wire and insert it until you reach the limited depth (the handle shouldnot rotate).

To break the graft dowel free, turn the holder slowly untilyou hear a cracking noise or feel no more resistance in turning. Remove the holder. Both the bone dowel and the guide wire remain in the extraction attachment.

The technique to remove the bone graft is the same as whenusing a trephine.

Tips– It is possible to use a hammer in combination with

the handles.– Use light, controlled hammer blows.

Handling TechniquesBone Harvesting Set

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Handling TechniquesChisel Set

Set

01.111.475 Chisel Set for Orthopedic Foot Instruments, with Lid, with Contents

Set content

03.111.012 Handle, long, with Quick Couplingor03.111.013 Handle, short, with Quick Coupling

03.111.014 Cartilage Remover, for Foot

03.111.015 Chisel, for Foot, straight, narrow, width 10 mm, length 124 mm

03.111.016 Chisel, for Foot, straight, wide, width 15 mm, length 124 mm

03.111.017 Chisel, for Foot, 20° bend, narrow, width 10 mm, length 124 mm

03.111.018 Chisel, for Foot, 20° bend, wide, width 15 mm, length 124 mm

03.111.019 Chisel, for Foot, curved, narrow, width 10 mm, length 124 mm

03.111.020 Chisel, for Foot, curved, wide, width 15 mm, length 124 mm

Important– Chisels and cartilage remover have sharp cutting edges

that may cause injury.– Handle the instruments with care. Damage to the cutting

edges may cause failure and will alter the precision of theinstrument.

– Only use instruments with sharp edges.

Synthes 19

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Handling TechniquesChisel Set

1Preparation

Expose the indicated area. The approach will depend on thesurgical procedure.

2Choose instrument

Instruments

03.111.012 Handle, long, with Quick Couplingor03.111.013 Handle, short, with Quick Coupling

03.111.014 Cartilage Remover, for Foot

03.111.015 Chisel, for Foot, straight, narrow, width 10 mm, length 124 mm

03.111.016 Chisel, for Foot, straight, wide, width 15 mm, length 124 mm

03.111.017 Chisel, for Foot, 20° bend, narrow, width 10 mm, length 124 mm

03.111.018 Chisel, for Foot, 20° bend, wide, width 15 mm, length 124 mm

03.111.019 Chisel, for Foot, curved, narrow, width 10 mm, length 124 mm

03.111.020 Chisel, for Foot, curved, wide, width 15 mm, length 124 mm

Attach the desired chisel or the cartilage remover to a handle.

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3Prepare joints and/or bones

Tips– It is possible to use a hammer in combination with

the handles.– Use light, controlled hammer blows.

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03.111.021 Compression/Distraction Device for Footand Ankle

03.111.022 Holding Sleeve � 2.0 mm forCompression/Distraction Device for Footand Ankle

03.111.023 Holding Sleeve � 2.5 mm forCompression/Distraction Device for Footand Ankle

03.111.024 Holding Sleeve � 3.0 mm forCompression/Distraction Device for Footand Ankle

292.250* Kirschner Wire � 2.5 mm with trocar tip,length 150 mm, Stainless Steel

292.750* Kirschner Wire � 2.5 mm with threadedtip, length 150/15 mm, Stainless Steel

292.790* Kirschner Wire � 2.0 mm with threadedtip, length 150/15 mm, Stainless Steel

292.820* Kirschner Wire � 3.0 mm with threadedtip, length 150/15 mm, Stainless Steel

03.111.012 Handle, long, with Quick Coupling

*Add suffix "S" to article number to order sterile product.

Instruments

22 Synthes Orthopedic Foot Instruments Handling Technique

03.111.041 Holding Sleeve Tightening Device for Compression/Distraction Device

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03.111.014 Cartilage Remover, for Foot

03.111.015 Chisel, for Foot, straight, narrow, width 10 mm, length 124 mm

03.111.016 Chisel, for Foot, straight, wide, width 15 mm, length 124 mm

03.111.017 Chisel, for Foot, 20° bend, narrow, width 10 mm, length 124 mm

03.111.018 Chisel, for Foot, 20° bend, wide, width 15 mm, length 124 mm

03.111.019 Chisel, for Foot, curved, narrow, width 10 mm, length 124 mm

03.111.020 Chisel, for Foot, curved, wide, width 15 mm, length 124 mm

03.111.030 Shaft for trephine and extractionattachment

02.111.001* Guide Wire � 3.2 mm with Stop, tip 1.6 mm, Stainless Steel

03.111.031 Stylet for trephine and extractionattachment

03.111.013 Handle, short, with Quick Coupling

*Add suffix ”S“ to article to order sterile product.

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Trephine Attachments

03.111.025 Trephine Attachment � 5.5 mm

03.111.026 Trephine Attachment � 7.0 mm

387.659 Trephine Attachment � 8.5 mm

387.660 Trephine Attachment � 9.5 mm

387.661 Trephine Attachment � 10.5 mm

387.662 Trephine Attachment � 12.5 mm

387.663 Trephine Attachment � 14.0 mm

Extraction Attachments

03.111.027 Extraction Attachment � 5.5 mm

03.111.028 Extraction Attachment � 7.0 mm

387.669 Extraction Attachment � 8.5 mm

387.670 Extraction Attachment � 9.5 mm

387.671 Extraction Attachment � 10.5 mm

387.672 Extraction Attachment � 12.5 mm

387.673 Extraction Attachment � 14.0 mm

Instruments

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01.111.476 Compression/Distraction Device Set for Orthopedic Foot Instruments, with Lid, with Contents

Sets

Synthes 25

Art. no. Description Quantity

03.111.021 Compression/Distraction Device for Foot and Ankle 1

03.111.022 Holding Sleeve � 2.0 mm for Compression/Distraction Device for Foot and Ankle 2

03.111.023 Holding Sleeve � 2.5 mm for Compression/Distraction Device for Foot and Ankle 2

03.111.024 Holding Sleeve � 3.0 mm for Compression/Distraction Device for Foot and Ankle 2

292.250.10 Kirschner Wire � 2.5 mm with trocar tip, length 150 mm, Stainless Steel, pack of 10 units 1

292.750.10 Kirschner Wire � 2.5 mm with threaded tip, length 150/15 mm, Stainless Steel, pack of 10 units 1

292.790.10 Kirschner Wire � 2.0 mm with threaded tip, length 150/15 mm, Stainless Steel, pack of 10 units 1

292.820.10 Kirschner Wire � 3.0 mm with threaded tip, length 150/15 mm, Stainless Steel, pack of 10 units 1

68.000.102 Lid for Instrument Tray, size ¼ 1

68.111.466 Tray for Compression/Distraction Device, for Orthopedic Foot Instruments, without Lid, without Contents 1

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01.111.475 Chisel Set for Orthopedic Foot Instruments, with Lid, with Contents

Sets

Art. no. Description Quantity

03.111.013 Handle, short, with Quick Coupling 1

03.111.014 Cartilage Remover, for Foot 1

03.111.015 Chisel, for Foot, straight, narrow, width 10 mm, length 124 mm 1

03.111.016 Chisel, for Foot, straight, wide, width 15 mm, length 124 mm 1

03.111.017 Chisel, for Foot, 20° bend, narrow, width 10 mm, length 124 mm 1

03.111.018 Chisel, for Foot, 20° bend, wide, width 15 mm, length 124 mm 1

03.111.019 Chisel, for Foot, curved, narrow, width 10 mm, length 124 mm 1

03.111.020 Chisel, for Foot, curved, wide, width 15 mm, length 124 mm 1

68.000.102 Lid for Instrument Tray, size ¼ 1

68.111.465 Tray for Chisel, for Orthopedic Foot Instruments, without Lid, without Contents 1

68.111.475 Module for Chisels, for Orthopedic Foot Instruments, without Lid, without Contents 2

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01.111.477 Bone Harvesting Set for Orthopedic Foot Instruments, with Lid, with Contents

Synthes 27

Art. no. Description Quantity

03.111.012 Handle, long, with Quick Coupling 1

03.111.030 Shaft for Trephine and Extraction Attachment 1

02.111.001 Guide Wire � 3.2 mm with Stop, tip 1.6 mm, Stainless Steel 1

03.111.031 Stylet for Trephine and Extraction Attachment 1

03.111.025 Trephine Attachment � 5.5 mm 1

03.111.026 Trephine Attachment � 7.0 mm 1

387.659 Trephine Attachment � 8.5 mm 1

387.660 Trephine Attachment � 9.5 mm 1

387.661 Trephine Attachment � 10.5 mm Optional

387.662 Trephine Attachment � 12.5 mm Optional

387.663 Trephine Attachment � 14.0 mm Optional

03.111.027 Extraction Attachment � 5.5 mm 1

03.111.028 Extraction Attachment � 7.0 mm 1

387.669 Extraction Attachment � 8.5 mm 1

387.670 Extraction Attachment � 9.5 mm 1

387.671 Extraction Attachment � 10.5 mm Optional

387.672 Extraction Attachment � 12.5 mm Optional

387.673 Extraction Attachment � 14.0 mm Optional

68.111.467 Tray for Hollow Reamer and Instruments for Bone Graft Harvesting, for Orthopedic Foot Instruments, without Lid, without Contents 1

68.000.102 Lid for Instrument Tray, size ¼ 1

68.111.476 Module for Bone Harvesting Trephines, for Orthopedic Foot Instruments, without Lid, without Contents 2

68.111.477 Module for Bone Harvesting Instruments, for Orthopedic Foot Instruments, without Lid, without Contents 1

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60043900 Spring for Handles

Replacement Articles

60030145 Spring for Compression/DistractionDevice

For detailed information ask your Synthes sales representative.

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