IRENE Locking Compression Plates System

IRENE Locking Compression Plates System

Surgical Technique

NATON Medical Group

Tianjin ZhengTian Medical Instrument Co., Ltd.

IRENE Surgical Technique Locking Compression Plates System

Table of Contents

Introduction

Locking Compression Plates System

AO Principles

Indications

Fixation Principles

Surgical Technique

Preparation and Reduction

Screw Insertion

Screw Placement Verification

Postoperative Treatment

Implant Removal

Product Information

Implants

Instruments


Locking Compression Plates System


AO Principles

In 1958, the AO formulated four basic principles, which have become the guidelines for

internal fixation. These principles, as applied to locking compression plates, are:

Anatomic Reduction

Facilities restoration of the articular surface by exact screw placement using wire sleeves.

Stable Fixation

Locking screws create a fixed‐angle construct, providing angular stability.

Preservation of Blood Supply

Tapered end allows submuscular plate insertion, preserving tissue viability.

Limited‐contact plate design reduces plate‐to‐bone contact, limiting vascular trauma and

insult to bone.

Early and Active Mobilization

Locking compression plates create an environment for bone healing, expediting a return to

optimal function.

Indications

IRENE Locking Compression Plates are intended for fixations of fractures, osteotomies or

nonunions of almost all part of upper and lower extremities and pelvis. As for indications for

each specific plate, please refer to IRENE Product Catalog 2010.


Fixation Principles


Preparation and Reduction

1. Plate Selection

The IRENE locking compression plates are available in various lengths. If necessary, use a

bending plate template to determine plate length.

Instrument

C21020 Plate Template



(These items are included in IRENE Small Fragment Instruments Set and IRENE Large

Fragment Instruments Set.)

2. Contouring

Use the bending instruments to contour the locking compression plate to anatomy.

Instrument

C21018 Plate Bender, Left

C21019 Plate Bender, Right

(These items are included in IRENE Small Fragment Instruments Set and IRENE Large

Fragment Instruments Set.)

*Notes: the plate holes have been designed to accept some degree of deformation. When

bending the plate, place the bending irons on two consecutive holes. This ensures that the

threaded holes will not be distorted. Significant distortion of the locking holes will reduce

locking effectiveness.

*Warning: do not try to bend the plate using the Threaded Drill Guide because damage may

occur to the plate hole threads.

3. Reduction and Temporary Plate Placement

The plate may be temporarily held in place with standard plate holding forceps or the

push‐pull reduction device.

*Notes: the middle of the plate should be positioned over the facture site if compression of

the fracture fragments is desired.


Screw Insertion

Determine first whether conventional cortical screws, cancellous bone screws or locking

screws will be used for fixation. A combination of all may be used.

*Notes: if a combination of cortical, cancellous and locking screws is used, a conventional

screw should be inserted first to pull the plate to the bone.

4. Insertion of conventional screw

5. Insertion of 3.5mm/5.0mm locking screws

*Notes: the locking screw is not a lag screw. Use standard screws when requiring a precise

anatomical reduction or interfragmentary compression. Before inserting the first locking

screw, perform anatomical reduction and fix the fracture with lag screws, if necessary. After

the insertion of locking screws, an anatomical reduction will no longer be possible without

loosening the locking screws.

5.1 Screw the Threaded Drill Guide into an LCP plate hole until it is fully seated.

5.2 Use the Drill Bit to drill the near cortex through the Threaded Drill Guide. The Drill

Stopper can be used to help drilling the desired the depth.

5.3 Use the Locking Screw Holder to hold the appropriate length locking screw and seat it

into the locking hole in the plate.

5.4 Use the Torque Wrench Handle and Shaft to final tightening each locking screw until

the screw head is securely locking with the locking hole.

Instrument

For inserting 3.5mm Locking Screw

C09006 Ø2.8 Threaded Drill Guide

C09003 Ø4.5 Tightening Wrench for Threaded Drill Guide

C09004 Ø2.8 Drill Bit

C09005 Ø2.8 Drill Stopper

C09013 W2.5 Tightening Wrench for Drill Stopper

C09009 W2.5 Locking Screw Holder

C09010 Ø5.5/1.5N.M Torque Wrench Handle

C09011 Ø2.5/Ø5.5 Torque Wrench Shaft


C09018 Ø4.3 Threaded Drill Guide

C09003 Ø4.5 Tightening Wrench for Threaded Drill Guide

C09016 Ø4.3 Drill Bit

C09017 Ø4.3 Drill Stopper

C09013 W2.5 Tightening Wrench for Drill Stopper

C09021 W3.5 Locking Screw Holder

C09022 Ø5.5/4.0N.M Torque Wrench Handle


C09023 Ø3.5/Ø5.5 Torque Wrench Shaft

Optional Instruments

C09007 Ø2.8 Reduction Drill

C09008 Ø3.5 Bone Tap

C09019 Ø4.0 Reduction Drill

C09020 Ø5.0 Bone Tap

C06017 Ø5.5 Quick‐release T Handle

6. Screw Placement Verification

Since the direction of a locking screw is determined by plate design, final screw insertion may

be verified with a Guide Pin prior to insertion. This becomes especially important when the

plate has been contoured or applied in metaphyseal regions around joint surfaces.

6.1 Screw the Guide Pin Sleeve into the LCP plate hole until fully seated.

6.2 Insert a Guide Pin through the Guide Pin Sleeve and drill to the desired depth.

6.3 Verify the Guide Pin placement under image intensification to determine if final screw

placement is acceptable.

6.4 Measurement may be taken by sliding the tapered end of a direct measuring device

over the Guide Pin down to the Guide Pin Sleeve.

6.5 Remove the measuring device, Guide Pin and Guide Pin Sleeve.

6.6 Insert the locking screw following the procedures 5.1 to 5.4.

Instrument


C09001 Φ1.5 Guide Pin

C09002 Φ1.5 Guide Pin Sleeve





Postoperative Treatment and Implant Removal

Postoperative Treatment

Postoperative treatment with locking compression plates does not differ from conventional

internal fixation procedures.

Implant Removal

To remove locking screws, unlock all screws from the plate; then remove the screws

completely from the bone. This prevents simultaneous rotation of the plate when removing

the last locking screw.


Implants

Please refer to IRENE Products Catalog 2010.


Instrument

IRENE Standard Instruments Set for LCP system

Tray 1 (for 3.5mm LCP plates)

Code Description Specifications Qty

C09001 Φ1.5 Guide Pin Φ1.5×150 5

C09002 Φ1.5 Guide Pin Sleeve Φ1.5 2

C09003 Tightening Wrench for Threaded Drill Guide Φ4.5 1

C09004 Drill Bit Φ2.8 2

C09005 Drill Stopper Φ2.8 2

C09013 Tightening Wrench for Drill Stopper W2.5 1

C09006 Threaded Drill Guide Φ2.8 2

C09007 Reduction Drill Φ2.8 1

C09008 Bone Tap Φ3.5 Φ3.5 1

C09009 3.5mm Locking Screw Holder W2.5 1

C09010 Torque Wrench Handle Φ5.5/1.5N.M 1

C09011 Torque Wrench Shaft Φ2.5/Φ5.5 2

C09012 Drill Sleeve for Compression Holes Φ2.5 1

C06017 Quick‐release T Handle (Triangle Hole) Φ5.5 1

Tray 2 (for 5.0mm LCP plates)

Code Description Specifications Qty

C09014 Φ2.0 Guide Pin Φ2.0×200 5

C09015 Φ2.0 Guide Pin Sleeve Φ2.0 2

C09003 Tightening Wrench for Threaded Drill Guide Φ4.5 1

C09016 Drill Bit Φ4.3 2

C09017 Drill Stopper Φ4.3 2

C09013 Tightening Wrench for Drill Stopper W2.5 1

C09018 Threaded Drill Guide Φ4.3 2

C09019 Reduction Drill Φ4.0 1

C09020 Bone Tap Φ5.0 Φ5.0 1

C06017 Quick‐release T Handle (Triangle Hole) Φ5.5 1

C09021 Locking Screw Holder W3.5 1

C09022 Torque Wrench Handle Φ5.5/4.0N.M 1

C09023 Torque Wrench Shaft Φ3.5/Φ5.5 2

C09024 Drill Sleeve for Compression Holes Φ3.2 1

Instrument Box

C09996 Instrument Box with Lid 1




C09003 Tightening Wrench for Threaded Drill Guide

C09004 Φ2.8 Drill Bit

C09005 Φ2.8 Drill Stopper

C09006 Φ2.8 Threaded Drill Guide

C09007 Φ2.8 Reduction Drill


C09008 Φ3.5 Bone Tap

C09009 3.5mm Locking Screw Holder

C09010 Torque Wrench Handle 1.5 N.M

C09011 Torque Wrench Shaft for 3.5mm Locking Screw

C09012 Drill Sleeve for Compression Holes, Φ2.5

C09013 Tightening Wrench for Drill Stopper




C09016 Φ4.3 Drill Bit


C09018 Φ4.3 Threaded Drill Guide

C09019 Φ4.0 Reduction Drill

C09020 Φ5.0 Bone Tap

C09021 5.0mm Locking Screw Holder


C09022 Torque Wrench Handle 4.0 N.M

C09023 Torque Wrench Shaft for 5.0mm Locking Screw

C09024 Drill Sleeve for Compression Holes, Φ3.2

Additional Instruments

for 7.0mm Locking Lag Screw for 5.0mm LCP Proximal Femur Plate

C09028 Threaded Guide Pin, Φ2.5 × 235mm

C09029 Cannulated Drill Bit, Φ4.8/Φ5.5 × 240mm


C09031 Threaded Guide Pin Sleeve, Φ2.7 × 110mm


C09032 Φ5.5 Threaded Drill Guide, Φ5.5 × 100mm

C09033 7.0 Locking Lag Screw Holder

C09034 Cannulated Screwdriver Shaft, Φ2.7 × 200mm

C09035 Torque Wrench Shaft for 7.0mm Locking Lag Screw


Documents

IRENE Locking Compression Plates System