SurgicalTechnique - synthes.vo.llnwd.netsynthes.vo.llnwd.net/o16/LLNWMB8/INT Mobile/Synthes...

DCP and LC-DCP Systems. Dynamic Compression Plates (DCP) and DynamicCompressionPlateswithLimited Bone Contact (LC-DCP).

SurgicalTechnique

ThispublicationisnotintendedfordistributionintheUSA.

Instruments and implantsapprovedbytheAOFoundation.

Imageintensifiercontrol

Thisdescriptionalonedoesnotprovidesufficientbackgroundfordirectuse oftheinstrumentset.Instructionbyasurgeonexperiencedinhandlingtheseinstrumentsishighlyrecommended.

Processing, Reprocessing, Care and MaintenanceForgeneralguidelines,functioncontrolanddismantlingofmulti-partinstruments,aswellasprocessingguidelinesforimplants,pleasecontactyourlocalsalesrepresentativeorreferto:http://emea.depuysynthes.com/hcp/reprocessing-care-maintenanceForgeneralinformationaboutreprocessing,careandmaintenanceofSynthesreusabledevices,instrumenttraysandcases,aswellasprocessingofSynthesnon-sterileimplants,pleaseconsulttheImportantInformationleaflet(SE_023827)orreferto: http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance

Surgical Technique DCP and LC-DCP Systems DePuy Synthes 1

Table of Contents

Introduction DCP and LC-DCP Systems 2

AOPrinciples 4

IntendedUse 5

Indications 6

Surgical Technique Preparation 7

DrillGuidesforDCPandLC-DCP 9

CompressionPlate:SimpleFracture 12

CompressionPlate:MultifragmentaryFracture 15

Buttress Plate 18

Neutralization Plate (Protecting Plate) 20

Product Information Screws,DrillsandTaps 21

MiniFragmentSystem1.5,2.0,2.7 23

CompactHand1.0,1.3,1.5,2.0,2.4 33

CompactHandModule1.0/1.3 33

CompactHandModule1.5 35



2 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

mid section

Non-symmetrical holesSomeDynamicCompressionPlatesfeaturenon-symmetricalholeswhichallowtoachievecompressioninonlyonedirection.Theseplatesfeatureamidsectionwhichisplacedatthepositionoffragmentstobecompressed.

Thenon-symmetricalDCPholesareshapedlikeaportionofaninclinedandangledcylinder.Theypossessonecompres-sionpointattheinclinedsideandoneneutralpointinthemiddle.

DynamicCompressionPlatesareavailableindimensionsrangingfrom1.3to4.5mm,LimitedContactDynamicCompressionPlatesrangefrom2.0to4.5mm.

DCP and LC-DCP Systems. Dynamic Compression Plates (DCP) and DynamicCompressionPlateswithLimited Bone Contact (LC-DCP).

Plate hole geometries

Symmetrical holesMost1.3to3.5mmDynamicCompressionPlateshavesym-metricalholessimilartotheLC-DCPhole.Thesymmetricalshapeoftheplateholesenablescompressiontobeachievedinbothdirections,thusplatepositioningisnotrestrictedbythepresenceofamid-section.

SymmetricallyshapedDCPholespossessonecompressionandoneneutralpointonbothsides.Withsomesmallandminiplates,theneutralpointsmeetinthemiddle.


UndercutsoftheLC-DCPlimitcontactbetweenplateandbone,minimizingtheriskoftissuenecrosisundertheplate.

Non-symmetrical holesTheDCPallowsupto25longitudinaland7transversescrewangulation.

Symmetrical holesTheDCPholeallowsupto50longitudinalscrewangulationforanincreasedrangeofapplications.LC-DCPholesallowevenwiderangulationsupto80.Bothplatetypesallowfor14transversescrewangulation.

Undercuts

Screw angulations

TheuniformstiffnessoftheLC-DCPallowssmoothcontouringoftheplatetothebone.Itprotectstheplatefromlocalizedhighbendingstresses.

Uniform stiffness (LC-DCP only)

LC-DCP

Standard

SymmetricalLC-DCPhole

1

4

2

3

4_Priciples_03.pdf 1 05.07.12 12:08

4 DePuy Synthes Expert Lateral Femoral Nail Surgical Technique

AO PRINCIPLES

In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation1, 2.

1 Mller ME, M Allgwer, R Schneider, H Willenegger. Manual of Internal Fixation. 3rd ed. Berlin Heidelberg New York: Springer. 1991.

2 Redi TP, RE Buckley, CG Moran. AO Principles of Fracture Management. 2nd ed. Stuttgart, New York: Thieme. 2007.

Anatomic reductionFracture reduction and fixation to restore anatomical relationships.

Early, active mobilizationEarly and safe mobilization and rehabilitation of the injured part and the patient as a whole.

Stable fixationFracture fixation providing abso-lute or relative stability, as required by the patient, the injury, and the personality of the fracture.

Preservation of blood supplyPreservation of the blood supply to soft tissues and bone by gentle reduction techniques and careful handling.


AO Principles

1MllerME,AllgwerM,SchneiderR,WilleneggerH.ManualofInternalFixation. 3rded.Berlin,Heidelberg,NewYork:Springer.1991.

2RediTP,BuckleyRE,MoranCG.AOPrinciplesofFractureManagement.2nd ed. Stuttgart,NewYork:Thieme.2007.

Stable fixationFracturefixationprovidingabsoluteorrelativestability,asrequiredbythepatient,theinjury,andthepersonalityofthefracture.

Anatomic reductionFracturereductionandfixation torestoreanatomicalrelationships.

Early, active mobilizationEarlyandsafemobilizationand rehabilitationoftheinjuredpartandthepatientasawhole.

Preservation of blood supplyPreservationofthebloodsupply tosofttissuesandbonebygentle reductiontechniquesandcarefulhandling.

In1958,theAOformulatedfourbasicprinciples,whichhavebecometheguidelinesforinternalfixation1,2.


Intended Use

Intended UseDCPandLC-DCPSystemImplantsareintendedfortempo-raryfixation,correctionorstabilizationofbonesinvariousanatomical regions.


Indications

ThistechniqueguideappliestothebelowSynthesDCPandLC-DCPsystemsandplatelines:

Mini Fragment System 1.5, 2.0, 2.7 Fracturesofthemiddleanddistalphalangesandtarsals Fracturesofthemetacarpalsandmetatarsals Osteotomiesandarthrodesesonthehandandfoot Fracturesofthedistalradius(double-platetechnique)

Compact Hand 1.0, 1.3, 1.5, 2.0, 2.4Implantsizes1.0/1.3: Fixationofsmallfragments Fracturesofthedistalandintermediatephalanges Avulsionfractures

Implantsizes1.5: Fracturesofthephalangesandmetacarpals Capturingoffragmentswithlagscrewtechnique

Implantsizes2.0/2.4: Fracturesofthephalangesandmetacarpals Capturingoffragmentswithlagscrewtechnique

Cloverleaf Plates 3.5 Distaltibiaforcomminutedfracturestobuttressitsmedial

side Proximalhumerusforcomminutedfracturesofthehu-meralhead

One-third tubular plate 3.5 Fracturesofsmallersizedbonessuchasfibula,humerus

and ulna.

Low Profile 3.5 Pelvic System PelvicandAcetabularFracturesandOsteotomies

LC-DCP/DCP 3.5 Straight Plate, DCP 3.5 T-Plate

Fracturefixationandfixationafterforexampleosteoto-mies,malunions,nonunionsincludingbutnotlimitedtodistalradius,proximalanddisitaltibia,proximalhumerus,clavicula.

LC-DCP/DCP 4.5 Straight Plate, DCP 4.5 T-Plate/ T-Buttress Plate/L-Plate Fracturesandosteotomiesoflargebonessuchasfemur,tibiaandhumerus

Standard Reconstruction Plate 3.5/4.5 PelvicandAcetabularFracturesandOsteotomies

Semi-Tubular Plate 4.5 Fracturesandosteotomiesofsmallersizedbonessuchashumerus,radius,ulna,clavicula,fibula,tibiaandpelvis

Condylar Buttress Plate 4.5 Buttressingofmultifragmentarydistalfemurfractures Supracondylarfractures Intra-articularandextra-articularcondylarfractures Malunionsandnonunionsofthedistalfemur Periprostheticfractures

Lateral Tibial Head Buttress Plate 4.5 Indicatedforthestabilizationoffracturesoftheproximaltibia.Theseincludeproximalshaftfractures,metaphysealfractures,intra-articularfractures,periprostheticfractures

Proximal Tibial Plate 4.5Intendedfornonunions,malunionsandfracturesoftheproximaltibiaincludingsimple,comminuted,lateralwedge,depression,medialwedge,bicondylarandcombinationsoflateralwedgeanddepressionfractures.


Preparation

1Plate contouring

Forthetreatmentofjuxta-articularfractures(distaltibia,tibialplateau,distalfemur,distalhumerus,radiusetc.),goodplatecontouringtotheshapeoftheboneisveryimportant.Onlythensatisfactoryreductionandadequatestabilitymaybeachieved.

Puretitaniumhasmechanicalpropertiesdifferingfromstain-lesssteel.Duetoitslowermodulusofelasticity,titaniumismorespringy.Therefore,titaniumplatesshouldbeslightlyover-benttoobtainthedesiredcontour.

ThedesignoftheLC-DCplateensuresuniformrigidity,henceacontinuouscurvatureafterbending.Theplatesshouldnotbebentbeyondthenecessaryextent.

Usebendingpliersorbendingironsforplatecontouring.

Precaution: Avoidrepeatedbending. Sharpindentationsontheplatesurface,especiallyaroundtheplateholes,mayimpairresistancetofatigueandshouldbeavoided.

Reversebendingoruseoftheincorrectinstrumentationforbendingmayweakentheplateandleadtoprematureplatefailure(e.g.breakage).Donotbendtheplatebe-yondwhatisrequiredtomatchtheanatomy.


Reductioninimplantstressbyusingalagscrewthroughtheplate1.

2Use of lag screws to achieve additional stability

Incertaincircumstances,theuseofaplateforfracturecom-pressionmaybesufficient.Inmanyfractures,however,itisadvantageoustoinsertalagscrewthroughtheplatetoin-creasefracturestabilityandtoachieveinterfragmentarycompressioninthefarcortex.Ifafracturegapremains,theplateissubjectedtohighbendingstresses.

Usingalagscrewthroughtheplatereducesimplantstress.1

1KlaueKetal.(1982)DieEntlastungderOsteosyntheseplattedurchinterfragmentrePlattenzugschraube.Helv.Chir.Acta52,1923

Preparation


a b

DifferentdrillguidetypesareavailabletoperformdrillingforDCPandLC-DCPfixationinbothneutralandcompressionmode.

1Standard drill guides (DCP, sizes 1.3 4.5)

Standarddrillguidesfeatureasimpletubetoprotectsofttissueswhiledrilling.Dependingonthepositioningofthetubewithinthehole,neutraloreccentric(compression)drill-ingcanbeperformed.

Drill Guides for DCP and LC-DCP

Neutral and eccentric drilling

Example

a Drilling in neutral position PositionthetubeinthemiddleoftheDCPhole.

b Drilling in eccentric position compression Positionthetubeinplateholeremotefromthefracture.


neutral position

inclined position

compression position

buttressposition

2Universal drill guides (DCP and LC-DCP, sizes 1.5 4.5)

Universaldrillguidesfeatureoneendwithaspring-loadedmechanismwhichfacilitatesalltypesofapplications:Neutralposition,compressionposition,buttressposition(LC-DCPonly)andespeciallythepositioningofinclinedlagscrewsthroughtheplate.

a Neutral position Depressthedrillguide.Theupperpartoftheinnersleeveprojects.Positionthedrillguideintheplateholewhichisremotefromthefracture(LC-DCP).WhenusedwithDCplatesthedrillguideautomaticallyslidesintothecorrectmiddlepositionwhendepressed.

b Compression position Donotdepressthedrillguide.Theupperpartisflush.Positionthedrillguideintheplateholeremotefromthefracture.

c Inclined position Thistechniqueisusedforinsertinglagscrewsthroughtheplate.Placethedrillguideintheholeadjacenttothefracture,depress(upperpartprojects),andsetthedesireddrill angle.

d Buttress position (LC-DCP only) Depressthedrillguideasshownforneutralposition(upperpartprojects).Positionthedrillguideintheplateholeadjacenttothefracture.

a c b

d

DrillGuidesforDCPandLC-DCP


neutral position

buttresspositionarrowpointsawayfromthefracture

compression position

=symbolforafractureline

3LC-DCP drill guides (3.5 and 4.5 LC-DC plates)

TheLC-DCPdrillguidescanbeusedwithLC-DCplatesonly.Theyfeaturededicatedendsforneutralapplication(green)andforapplicationincompressionmode(yellow).

LC-DCPdrillguidescarryanarrowenablingcorrectposition-ingofthescrew. a Neutral position Usethegreendrillguidetoplaceascrewinneutralposition.Thearrowonthegreendrillguidemustpointtowardsthefracture.Compressioncannotbeachievedwiththegreendrillguide.

b Compression Usetheyellowdrillguidetoachievecompression.Thearrowontheyellowdrillguidemustpointtowardsthefracture.

c Buttress position Usethegreendrillguide.Abuttresseffectisachievedwhenthearrowpointsawayfromthefracture.

Pre-drillingininclinedpositionwithLC-DCPdrillguidesisnotrecommendedbecausecorrectpositioningofthescrewcannotbeensured.LC-DCPdrillguidesaredesignedtoonlyfittheholeinamoreorlessverticalposition.Forpre-drillingininclinedpositionusetheuniversaldrillguideinstead (referto2c).

Implant Removal Incasethephysiciandecidestoremovetheimplants,theycanberemovedbyusinggeneralsurgicalinstruments.

green

green yellow

green yellow

a b

c


1Drill first hole adjacent to fracture

Useanappropriatelysizeddrillbitforthreadedholesanddrillthefirstholeadjacenttothefracture.Usethegreendrillguideinneutralpositionwiththearrowpointingtowardsthefracture.Alternatively,usetheuniversaldrillguideindepressedmode(upperpartprojects)andplaceitintheholeremotefromthefracture.

Determinescrewlength,tapthethread,andinsertthescrew.

Wheneverpossible,thescrewsforaxialcompressionshouldbeplacedinsuchawaythattheapexofthefragmentisdrawnintotheopenwedgebetweenplateandbone.Thisgreatlyreducestheriskofthefragmentslipping.

Alternative:Whenusingashaftscrewwithanunthreadedportionbelowthehead,overdrillthenearcortexusinga tissue protecting sleeve or standard drill guide and an appropriatelysizeddrillbitforglidingholes.

Compression Plate: Simple Fracture

Note: RequireddrillbitsforthreadedandglidingholesandtapsfortheindividualscrewsizescanbefoundinthechapterScrews,DrillsandTaps(refertopage20).

Chooseaplateoftheappropriatelength.Ensurethatthereareenoughplateholesoverbothfragmentsandthatalagscrewcanbeinsertedifnecessary.

Illustrationsshowtheprocedurewiththeneutralandcom-pressiondrillguideoftheLC-DCPdrillguideusinga3.5and4.5LC-DCplate.


2Drill second hole

Drillthroughbothcorticesintotheoppositefragmentwiththeyellowdrillguideincompressionposition(arrowpointstowardsthefracture).Alternatively,usetheuniversaldrillguideplacingitintheholeremotefromthefracture.Donotdepressit(upperpartstandsflush).

Determinescrewlength,tapthethread,andinsertthescrew.

yellow

Wheneverpossible,thescrewsforaxialcompressionshouldbeplacedinsuchawaythattheapexofthefragmentisdrawnintotheopenwedgebetweenplateandbone.Thisgreatlyreducestheriskofthefragmentslipping.

Alternative: Whenusingashaftscrewwithanunthreadedportionbelowthehead,overdrillthenearcortexusinga tissue protecting sleeve or standard drill guide and an appropriatelysizeddrillbitforglidingholes.


3Insert interfragmentary lag screw

Toincreasestabilityinthefarcortexandtodecreaseplatewear,insertaninterfragmentarylagscrew.

Drillthroughbothcorticeswithanuniversaldrillguideinde-pressedmode(innersleeveprojects)andanappropriatelysizeddrillbitforthreadedholes.Thehemisphericundersideoftheuniversaldrillguidepermitsidealpositioningofthescrewhead.

Widentheholeinthenearcortexwithadrillbitforglidingholes.Pushthetissueprotectingsleeveupwards,insertthedrillbitintothehole,thenslidethetissueprotectingsleevedownuntilittouchestheplate.Whendrilling,careshouldbetakenthatthecourseoftheglidingholefollowsexactlythatofthepreviousdrillhole.

Asanalternativetoaregularcortexscrewashaftscrew,usedasalagscrew,maybeinserted.Thisensuresefficientglidingofthescrewshaftintheglidingholeresultinginaconsiderablyhighertensioneffect.Likethisinthefarcortextensionisachieved,too.

Intheremainingscrewholesinsertscrewsinneutralpositionapartfromtheholedirectlyabovethefracture.


CompressionPlate:SimpleFracture


Compression Plate: MultifragmentaryFracture


Fracturesshouldbetreatedconsecutively.

1Treat first fracture

Fortreatmentofthefirstfracture,followthepreviouslydescribedexamplestepbystep.


2Treat second fracture

Treatthesecondfractureusingtheuniversaldrillguide.Drillaholeintothethirdfragmentusingtheuniversaldrillguideincompressionpositionandadrillbitforthreadedholes.Seatthedrillguideatthesideoftheholeremotefromthefracturewithoutdepressingthedrillguide(upperpartisflush).

Drillaglidinghole,measurescrewlengthandtapthethread.

Insertascrewintothehole.Theuseofashaftscrewisrec-ommended.

Nextinsertascrewintothemiddlefragment.Preparethescrewholewithadrillbitforthreadedholesandtheuniver-saldrillguidedepressedforneutralposition(upperpartofinnersleeveprojecting).

CompressionPlate:MultifragmentaryFracture


Prepareseatingforthelagscrewwiththeuniversaldrillguideandadrillbitforthreadedscrews.Positiontheuniver-saldrillguideadjacenttothefracture,depressthedrillguide(innersleeveprojects),setdrillingangleanddrill.Ifthereistheriskofthedrillbitcollidingwiththescrewinthevicinity,thedrillbithastobeinclined.

Placethescrew.

Byinsertingashaftscrewaslagscrew,additionalstabilityisachieved.Tightenlagandcompressionscrewsalternately.Theremainingscrewholesarefilledwithneutrallyplacedscrews.

Drilltheglidinghole.Widenthenearcortexusinganappro-priatelysizeddrillbitforglidingholesandthetissueprotect-ingsleeve.Measurethescrewlengthandtapthethread.



green

Buttress Plate


Thebuttressplatetechniqueisshownusingtheexampleofashearfractureofthelateralpartofthetibialheadcom-binedwithashortobliquefracture.

Firstthedistalobliquefractureistreatedasinthepreviouslyillustratedexamples.


Allthescrewholesinthebuttressregionarepreparedwiththeuniversaldrillguideorthegreendrillguide(neutralposi-tion)oftheLC-DCPdrillguide.

Thearrowofthedrillguidemustpointawayfromthefrac-ture.Theproximallypositionedcancellousbonescrewsandcortexscrewsactaslagscrews.Thethreadgripsonlyintheoppositefragment,sothatthereiscompressionbetweenthefragments.Theuseofthegreendrillguidewiththearrowpointingawayfromthefracturepreventsthetibialplateaufragmentandtheplatefromslipping.Inthissituation,thescrewheadsarebuttressedbytheholeedgeadjacenttothefracture.



green

Neutralization Plate (Protecting Plate)

Adaptspiralfracturewithtwoseparatelagscrews.

PositiontheplatetobridgethefractureusingtheLC-DCPdrillguide(3.5and4.5screwsonly)ortheuniversaldrillguide.

WhenusingthegreendrillguideoftheLC-DCPdrillguidethearrowmustpointtowardsthefracture.Whenusingtheuniversaldrillguideseatitattheholeedgeremotefromthefracture,depresstheoutersleevesothattheupperpartprojectsforneutralposition.

Tocompletefracturetreatment,determinescrewlengthsandinsertscrewsafterhavingtappedthethreads.


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Screws,DrillsandTaps


Mini Fragment System 1.5, 2.0, 2.7

Cases and Modules

StainlessSteel Titanium

305.500 305.505 GraphicCaseforMiniInstrumentSet,withoutContents

Instruments

310.110 Drill Bit B1.1mm,length60/35mm,2-flute,forQuickCoupling

310.150 DrillBitB1.5mm,length85/60mm,2-flute,forQuickCoupling

310.190 DrillBitB2.0mm,length100/75mm,2-flute,forQuickCoupling

310.260 Drill Bit B2.7mm,length100/75mm,2-flute,forQuickCoupling

310.870 Countersink2.7,length62mm

310.880 Countersink1.5to2.4,length52mm, forMiniQuickCoupling

310.950 HandlewithMiniQuickCoupling

311.010 HandlewithMiniQuickCoupling, Stainless Steel

311.150 TapforCortexScrewsB1.5mm, length50/20mm



311.430 HandlewithQuickCoupling, length110mm

312.140 DoubleDrillGuide1.5/1.1,forNo.311.150

312.200 TripleDrillGuide2.0,with3holes

312.220 DoubleDrillGuide2.0/1.5


314.020 Screwdriver,hexagonal,small, withHoldingSleeve

314.030 ScrewdriverShaft,hexagonal,small, B2.5mm

Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.


314.060 HoldingSleeve,forNos.314.020,314.030,314.070,314.550and314.570

314.670 ScrewdriverShaft1.5/2.0,cruciform, withHoldingSleeve,length66mm,blue

319.040 DepthGaugeforScrews,measuringrangeupto50mm

319.110 DepthGaugeforScrewsB1.5and2.0mm,measuringrangeupto26mm

319.390 SharpHook,length155mm

319.970 ScrewForceps,self-holding,length85mm

329.010 BendingIronforPlates1.5and2.0, length130mm

329.120 BendingPliersforPlates1.5to2.7, length140mm

391.820 WireBendingPliers,length155mm, forWiresuptoB1.25mm

391.950 CuttingPliersforPlates1.5to2.7, length256mm

391.970 WireCutter,short,length175mm

392.020 BendingIronforKirschnerWires, forWiresB0.8to1.25mm

398.400 ReductionForcepswithPoints,narrow,ratchetlock,length132mm

398.410 ReductionForceps,withPoints,wide,ratchetlock,length132mm

398.960 StagbeetleForceps,ratchetlock, length125mm

398.990 HoldingForcepsforSmallPlates, ratchetlock,length135mm

399.000 HoldingForcepsforFingerPlates, ratchetlock,length135mm

399.180 BoneLever,small,shortnarrowtip, width6mm,length160mm

399.190 BoneLever,small,shortnarrowtip, width8mm,length160mm

399.450 BoneLever,width15mm,length120mm,endofhandlering-shaped


MiniFragmentSystem1.5,2.0,2.7


399.480 PeriostealElevator,slightlycurvedblade,straightedge,width3mm, length187/87mm

399.970 ReductionForcepswithPoints, ratchetlock,length130mm



Plates


246.190 446.190 MiniPlate1.5,straight, 20holes,length100mm

246.230 446.230 MiniT-Plate1.5, head3holes,shaft9holes,length50mm

446.233 MiniT-Plate1.5, shaft8holes,head3holes,length44mm,PureTitanium

446.234 MiniT-Plate1.5, shaft8holes,head4holes,length44mm,PureTitanium


246.480 446.480 MiniH-Plate1.5,4holes

246.610 MiniCondylarPlate1.5, pinleft,StainlessSteel

246.620 MiniCondylarPlate1.5, pinright,StainlessSteel

446.630 MiniCondylarPlate1.5, shaft6holes,length36mm,pinleft,PureTitanium

446.640 MiniCondylarPlate1.5, shaft6holes,length36mm,pinright,PureTitanium

243.090 MiniAdaptionPlate2.0, 20holes,length100mm

243.130 MiniPlate2.0,straight, 3holes,length17mm








243.190 443.190 MiniPlate2.0,straight, 20holes,length100mm



243.310 MiniL-Plate2.0,left, head2holes,shaft2holes

243.320 MiniL-Plate2.0,right, head2holes,shaft2holes

243.330 MiniL-Plate2.0,oblique,left,head2holes,shaft2holes

243.340 MiniL-Plate2.0,oblique,right,head2holes, shaft2holes

243.410 MiniT-Plate2.0, head2holes,shaft2holes

243.540 443.540 DCP2.0,4holes, length22mm








243.610 443.610 MiniCondylarPlate2.0, pinleft

243.620 443.620 MiniCondylarPlate2.0, pinright

242.030 442.030 QuarterTubularPlate2.7withCollar,3holes,length26mm






242.310 L-Plate2.7,left,shaft3holes,head2holes

242.320 L-Plate2.7,right,shaft 3holes,head2holes

242.330 442.330 L-Plate2.7,oblique,left, shaft3holes,head2holes

242.340 442.340 L-Plate2.7,oblique,right,shaft3holes,head2holes

242.410 442.410 T-Plate2.7,shaft3holes,head2holes

242.610 442.610 CondylarPlate2.7,6holes,pinleft

242.620 442.620 CondylarPlate2.7,6holes,pinright






244.030 DCP2.7,3holes, length28mm








244.110 DCP2.7,11holes, length92mm



449.936 LC-DCP2.0,6holes, length36mm





Screws and Washers

Cortex Screw B1.5 mm

Stainless Steel Titanium Length(mm)

210.006 400.006 6

210.007 400.007 7

210.008 400.008 8

210.009 400.009 9

210.010 400.010 10

210.011 400.011 11

210.012 400.012 12

210.014 400.014 14

210.016 400.016 16

210.018 400.018 18

210.020 400.020 20



211.006 401.006 6

211.008 401.008 8

211.010 401.010 10

211.012 401.012 12

211.014 401.014 14

211.016 401.016 16

211.018 401.018 18

211.020 401.020 20

211.022 401.022 22

211.024 401.024 24

211.026 26

211.028 28

211.030 30

211.032 32

211.034 34

211.036 36

211.038 38






202.006 402.006 6

202.008 402.008 8

202.010 402.010 10

202.012 402.012 12

202.014 402.014 14

202.016 402.016 16

202.018 402.018 18

202.020 402.020 20

202.022 402.022 22

202.024 402.024 24

Washer B7.0/3.6mm

Stainless Steel Titanium

219.980 419.980 forScrewsB2.7to4.0mm



Also available (production on request)

243.000.509 DCP2.0,9holes,StainlessSteel

243.000.510 DCP2.0,10holes,length52mm, Stainless Steel

243.000.512 DCP2.0,12holes,length62mm, Stainless Steel

243.880 MiniT-Plate1.5/2.0,shaft4holes, length35mm,StainlessSteel

243.234 T-AdaptionPlate2.0,head3holes, shaft10holes,StainlessSteel

310.511 DrillBitB1.8mm,length100/64mm,2-flute,forJacobsChuck

310.531 DrillBitB2.4mm,length100/64mm,2-flute,forJacobsChuck

Wires

Cerclage Wire

Stainless Steel B (mm) Length(mm)

291.240 0.6 175

291.260 0.8 200

Kirschner WireWith trocar tip, pack of 10 units

Stainless Steel B (mm) Length(mm)

292.060.10 0.6 70

292.080.10 0.8 70

292.100.10 1.0 150

292.120.10 1.25 150

292.160.10 1.6 150




Compact Hand 1.0, 1.3, 1.5, 2.0, 2.4

Compact Hand Module 1.0/1.3

Module


682.483 682.480 ModuleCompactHand1.0/1.3,withLid,withoutContents,green/yellow

Instruments



314.413 ScrewdriverShaft1.3,cruciform, withHoldingSleeve,length62mm, forMiniQuickCoupling

314.481 ScrewdriverShaft1.0,cruciform, withHoldingSleeve,length62mm, withMiniQuickCoupling

316.385 DrillBitB0.8mm,length40/16mm,2-flute,forMiniQuickCoupling



Plates


221.312 421.312 AdaptionPlate1.3,12holes

221.320 421.320 StrutPlate1.3,oblique- angled,right,8holes

221.321 421.321 StrutPlate1.3,oblique- angled,left,8holes

221.333 421.333 T-AdaptionPlate1.3, head3holes,shaft8holes


221.335 421.335 Y-AdaptionPlate1.3,11holes



Screws

Cortex Screw B1.0 mm, self-tapping


200.526 400.526 6

200.527 400.527 7

200.528 400.528 8

200.529 400.529 9

200.530 400.530 10

200.531 400.531 11

200.532 400.532 12

200.533 400.533 13

200.534 400.534 14



200.686 400.686 6

200.687 400.687 7

200.688 400.688 8

200.689 400.689 9

200.690 400.690 10

200.691 400.691 11

200.692 400.692 12

200.693 400.693 13

200.694 400.694 14

200.695 400.695 15

200.696 400.696 16

200.698 400.698 18


CompactHand1.0,1.3,1.5,2.0,2.4CompactHandModule1.0/1.3


Compact Hand Module 1.5

Module


682.488 682.485 ModuleCompactHand1.5,withLid,withoutContents,red

Instruments


312.140 DoubleDrillGuide1.5/1.1,forNo.311.150

314.667 ScrewdriverShaft1.5,cruciform,withHoldingSleeve,length66mm,withMiniQuickCoupling





Plates





246.242 446.242 Y-AdaptionPlate1.5, 11holes,prebentprofile

246.482 446.482 StrutPlate1.5,oblique- angled,right,8holes, prebentprofile

246.483 446.483 StrutPlate1.5,oblique- angled,left,8holes, prebentprofile

446.612 Y-Plate1.5,shaft8holes,head3holes,length46mm,Pure Titanium


CompactHand1.0,1.3,1.5,2.0,2.4CompactHandModule1.5


Screws



200.806 400.806 6

200.807 400.807 7

200.808 400.808 8

200.809 400.809 9

200.810 400.810 10

200.811 400.811 11

200.812 400.812 12

200.813 400.813 13

200.814 400.814 14

200.816 400.816 16

200.818 400.818 18

200.820 400.820 20

200.822 400.822 22

200.824 400.824 24




Module


682.493 682.490 ModuleCompactHand2.0,withLid,withoutContents,blue

Instruments




323.200 UniversalDrillGuide2.0




CompactHand1.0,1.3,1.5,2.0,2.4


Plates


223.588 443.588 LC-DCP2.0,8holes, length51mm


243.231 443.231 T-AdaptionPlate2.0,head3holes,shaft8holes


243.242 443.242 Y-AdaptionPlate2.0,11holes

243.480 443.480 MiniH-Plate2.0,4holes




243.587 443.587 LC-DCP2.0,7holes,length45mm

447.032 Plate2.0,straight,12holes,length71mm,PureTitanium

447.232 T-Plate2.0,shaft8holes,head2holes,length53mm,Pure Titanium

447.233 T-Plate2.0,shaft8holes,head3holes,length53mm,Pure Titanium

447.612 Y-Plate2.0,3+8holes,length55mm,PureTitanium



Screws



201.806 401.806 6

201.807 401.807 7

201.808 401.808 8

201.809 401.809 9

201.810 401.810 10

201.811 401.811 11

201.812 401.812 12

201.813 401.813 13

201.814 401.814 14

201.816 401.816 16

201.818 401.818 18

201.820 401.820 20

201.822 401.822 22

201.824 401.824 24

201.826 401.826 26

201.828 401.828 28

201.830 401.830 30

201.832 401.832 32

201.834 401.834 34

201.836 401.836 36

201.838 401.838 38





Module


682.513 682.510 ModuleCompactHand2.4,withLid,withoutContents,violet

Instruments


312.920 DrillSleeve1.8,withcenteringthread

313.940 Screwdriver,cruciform,withHoldingSleeve,forCortexScrewsB2.4mm


317.861 Drill Bit B1.8mm,length80/66mm,2-flute,forMiniQuickCoupling

317.871 Drill Bit B2.4mm,length80/66mm,2-flute,forMiniQuickCoupling

323.202 UniversalDrillGuide2.4



Plates


449.906 Plate2.4,straight,6holes, 36mm,PureTitanium

249.912 449.912 AdaptionPlate2.4,12holes,forCompactHand2.4

249.913 449.913 T-AdaptionPlate2.4, head2holes,shaft8holes, forCompactHand2.4

249.914 449.914 T-AdaptionPlate2.4, head3holes,shaft8holes,forCompactHand2.4

249.919 T-AdaptionPlate2.4, head3holes,shaft10holes

249.915 449.915 Y-AdaptionPlate2.4, 11holes,forCompact Hand2.4

249.916 449.916 CondylarPlate2.4,pinright,forCompactHand2.4

249.917 449.917 CondylarPlate2.4,pinleft,forCompactHand2.4

249.924 449.924 LC-DCP2.4,4holes, length35mm,forCompactHand2.4






Screws and Buttress Pins

Cortex Screw B2.4 mm, self-tapping, for Compact Hand 2.4


201.636 401.636 6

201.637 401.637 7

201.638 401.638 8

201.639 401.639 9

201.640 401.640 10

201.641 401.641 11

201.642 401.642 12

201.643 401.643 13

201.644 401.644 14

201.646 401.646 16

201.648 401.648 18

201.650 401.650 20

201.652 401.652 22

201.654 401.654 24

201.656 401.656 26

201.658 401.658 28

201.660 401.660 30

201.662 401.662 32

201.664 401.664 34

201.666 401.666 36

201.668 401.668 38

201.670 401.670 40



Also available

446.032 Plate1.5,straight,12holes,length59mm,Pure Titanium

446.031 Plate1.5,straight,6holes,length29mm,Pure Titanium

Buttress Pin B1.8 mm


201.962 401.962 12

201.964 401.964 14

201.966 401.966 16

201.968 401.968 18




MRI Information

Torque, Displacement and Image Artifacts according toASTMF2213-06,ASTMF2052-06e1and ASTM F 2119-07Non-clinicaltestingofworstcasescenarioina3TMRI systemdidnotrevealanyrelevanttorqueordisplacement oftheconstructforanexperimentallymeasuredlocalspatialgradientofthemagneticfieldof3.69T/m.Thelargestimageartifactextendedapproximately169mmfromtheconstructwhenscannedusingtheGradientEcho(GE).Testingwasconductedona3TMRIsystem.

Radio-Frequency-(RF-)induced heating according to ASTM F 2182-11aNon-clinicalelectromagneticandthermaltestingofworst casescenarioleadtopeaktemperatureriseof9.5C withanaveragetemperatureriseof6.6C(1.5T)anda peaktemperatureriseof5.9C(3T)underMRIConditionsusingRFCoils(wholebodyaveragedspecificabsorptionrate[SAR]of2W/kgfor6minutes[1.5T]andfor15minutes [3T]).

Precautions:Theabovementionedtestreliesonnon-clini- caltesting.TheactualtemperatureriseinthepatientwilldependonavarietyoffactorsbeyondtheSARandtimeof RFapplication.Thus,itisrecommendedtopayparticularattentiontothefollowingpoints: Itisrecommendedtothoroughlymonitorpatientsunder-goingMRscanningforperceivedtemperatureand/orpainsensations.

PatientswithimpairedthermoregulationortemperaturesensationshouldbeexcludedfromMRscanningproce- dures.

Generally,itisrecommendedtouseaMRsystemwith lowfieldstrengthinthepresenceofconductiveimplants. Theemployedspecificabsorptionrate(SAR)shouldbe reducedasfaraspossible.

Usingtheventilationsystemmayfurthercontributeto reducetemperatureincreaseinthebody.

SynthesGmbHEimattstrasse 34436OberdorfSwitzerlandTel:+41619656111Fax:+41619656600www.depuysynthes.com 0123

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ThispublicationisnotintendedfordistributionintheUSA.

AllsurgicaltechniquesareavailableasPDFfilesatwww.depuysynthes.com/ifu

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.2016.Allrightsreserved.

036.001.093DSEM/TRM/1115/055605/16
http://www.depuysynthes.com/ifu

SurgicalTechnique - synthes.vo.llnwd.netsynthes.vo.llnwd.net/o16/LLNWMB8/INT Mobile/Synthes...

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