4.5 mm LCP Proximal Tibia Plates. Part of the Synthes LCP Periarticular Plating System.synthes.vo.llnwd.net/o16/Mobile/Synthes North America... · 2011-10-05 · 4 Synthes 4.5 mm

4.5 mm LCP Proximal Tibia Plates.Part of the Synthes LCP PeriarticularPlating System.

Technique Guide

Table of Contents

Synthes

Introduction

Surgical Technique

Product Information

4.5 mm LCP Proximal Tibia Plates 2

AO Principles 4

Indications 5

Preparation 6

Make Incision 7

Reduce Articular Surface 7

Attach Wire Guides 8

Determine Plate Position 9

Insert Proximal Screws 10

Reduce Shaft to Tibial Plateau 12

Insert Cortex Screws in Plate Shaft 14

Insert Locking Screws in Plate Shaft 15

Insert Locking Screw into Angled Plate Hole 16

Postoperative Treatment 18

Implant Removal 18

Implants 19

Set Lists 21

Image intensifier control

4.5 mm LCP Proximal Tibia Plates

2 Synthes 4.5 mm LCP Proximal Tibia Plates Technique Guide

The Synthes 4.5 mm LCP Proximal Tibia Plate is part of theLCP Periarticular Plating System, which merges locking screwtechnology with conventional plating techniques. The LCPPeriarticular Plating System is capable of addressing complexfractures of the distal femur with the 4.5 mm LCP CondylarPlates, complex fractures of the proximal femur with the4.5 mm LCP Proximal Femur Plates and 4.5 mm LCP ProximalFemur Hook Plates, and complex fractures of the proximaltibia when using the 4.5 mm LCP Proximal Tibia Plates and4.5 mm LCP Medial Proximal Tibia Plates.

The locking compression plate (LCP) has Combi holes in theplate shaft that combine a dynamic compression unit (DCU)hole with a locking screw hole. The Combi hole providesthe flexibility of axial compression and locking capabilitythroughout the length of the plate shaft.

Note: For information on fixation principles using conven-tional and locked plating techniques, please refer to theSynthes Large Fragment Locking Compression Plate (LCP)Technique Guide.

The 4.5 mm LCP Proximal Tibia Plate has many similaritiesto traditional plate fixation methods, with a few importantimprovements. The technical innovation of locking screwsprovides the ability to create a fixed-angle construct whileusing familiar AO plating techniques. Locking capability isimportant for a fixed-angle construct in osteopenic bone ormultifragment fractures where screw purchase is compromised.These screws do not rely on plate-to-bone compression toresist patient load, but function similarly to multiple,small angled blade plates.

Synthes 3

– Anatomically contoured toapproximate the lateral aspectof the proximal tibia

– Can be tensioned to createa load-sharing construct

– Available in left and rightconfigurations, in 316L stainlesssteel or commercially pure (CP)titanium

Plate head– Three convergent threaded screw

holes accept 5.0 mm cannulatedlocking or 5.0 mm cannulatedconical screws

– Two 2.0 mm holes for preliminaryfixation with K-wires, or meniscalrepair with sutures

Plate shaft– Available with 4, 6, 8, 10, 12, 14,

16*, 18*, or 20* Combi holes inthe plate shaft

– The two round holes distal to thehead accept 4.5 mm cortex screwsand 6.5 mm cancellous bone screwsfor interfragmentary compressionor to secure plate position

– An angled, threaded hole, distalto the two round holes, acceptsthe 5.0 mm cannulated lockingscrew. The hole angle allows thislocking screw to converge with thecentral locking screw in the platehead to support a medial fragment

– Combi holes, distal to the angledlocking hole, combine a DCU holewith a threaded locking hole

– Limited-contact profile

Three locking screwholes accept 5.0 mmcannulated lockingor 5.0 mm cannulatedconical screws

Two 2.0 mmholes for K-wiresand sutures

Angled lockinghole acceptsthe 5.0 mmcannulatedlocking screwand supportsthe medialfragment

Combi holes accept 4.0 mmor 5.0 mm locking screwsin the threaded portion or4.5 mm cortex screws inthe DCU portion

Two round holesaccept 4.5 mmcortex screws and6.5 mm cancellousbone screws

Accepts articulatedtension device (to providecompression or distraction)

*Plates with 16, 18, or 20 screw holes are onlyavailable in 316L stainless steel


AO Principles

In 1958, the AO formulated four basic principles which havebecome the guidelines for internal fixation.1 Those principles,as applied to the 4.5 mm LCP Proximal Tibia Plates, are:

Anatomic reductionFacilitates restoration of the articular surface using guidewires for reduction and insertion of cannulated screws.Precontoured plate assists reduction of metaphysis todiaphysis.

Stable fixationLocking screws create a fixed-angle construct, providingangular stability.

Preservation of blood supplyTapered end simplifies submuscular plate insertion,improving tissue viability. Limited-contact design reducesplate-to-bone contact and vascular trauma.

Early, active mobilizationPlate features combined with AO technique create anenvironment for bone healing, expediting a return tooptimal function.

1. M. E. Müller, M. Allgöwer, R. Schneider, and H. Willenegger. Manual ofInternal Fixation, 3rd Edition. Berlin: Springer-Verlag. 1991.

Synthes 5

Indications

The Synthes 4.5 mm LCP ProximalTibia Plate is intended for treatmentof osteopenic bone, tibial osteotomies,nonunions, malunions and fracturesof the proximal tibia including:

– Simple, comminuted fractures

– Lateral wedge fractures

– Depression medial wedge fractures

– Bicondylar combination of lateralwedge and depression fractures

– Periprosthetic fractures

– Proximal fractures with associatedshaft fractures


Preparation

1Preparation

Required set

01.240.201 Periarticular LCP Plating Systemwith 5.0 mm Locking Screws

or01.240.209 Periarticular LCP Plating System

with 4.0 mm Locking Screws

Optional sets

01.240.401 Periarticular LCP Plating System,with 5.0 mm Titanium Locking Screws

01.240.409 Periarticular LCP Plating System,with 4.0 mm Titanium Locking Screws

Complete the preoperative radiographic assessment andprepare the preoperative plan. Determine plate lengthand instruments to be used.

Determine proximal screw placement and screw lengthsto ensure proper screw placement in the metaphysis.

Position the patient supine on a radiolucent operating table.Visualization of the proximal tibia under fluoroscopy in boththe lateral and AP views is necessary.

Synthes 7

Make Incision and Reduce Articular Surface

2Make incision

Lateral incisionA lateral “S” incision is recommended when a simplearticular fracture (AO classification 41-C1) or extra-articularfracture (AO classification 42 or 41A) is present.

Anterolateral incisionIn the presence of a complex intra-articular fracture(AO classification 41-C2 or C3), perform an anterolateralapproach. Perform arthrotomy to expose the joint forreduction. Extend the incision for adequate exposureof the joint for reduction and anatomic fixation.

3Reduce articular surface

Instrument

394.35 Large Distractor

Kirschner Wires

Technique tip: Prior to reduction, application of an externalfixator or large distractor may facilitate reduction of the joint.

Reduce the fracture fragments and confirm reduction usingimage intensification. Fragments may be reduced usingindependent Kirschner wires; however, K-wire holes are alsoprovided on the plate to help achieve provisional reduction,plate position, or fixation.


Attach Wire Guides

3Reduce articular surface continued

The locking screws do not provide interfragment or plate-to-bone compression; therefore, any desired compression mustbe achieved with traditional lag screws. The angular fragmentsmust be reduced and compression must be obtained priorto applying the 4.5 mm LCP proximal tibia plate with lockingscrews. However, 5.0 mm cannulated conical screws can beused through the head of the plate to compress the plateto the bone.

Technique tip: To verify that lag screws will not interferewith plate placement, hold the plate laterally to the bone.

4Attach wire guides

Instruments

310.243 2.5 mm Drill Tip Guide Wire, 200 mm

324.174 2.5 mm Wire Guide, for 5.0 mm screws

Before placing the plate against the bone, thread 2.5 mmwire guides into the three (3) proximal holes. If desired,thread a wire guide into the angled hole of the shaft.

Note: It is easier to thread these wire guides when the plateis off the bone, and the wire guides can be used as handlesto facilitate positioning of the plate on the bone.

Insert 2.5 mm drill tip guide wires into each of the wireguides to verify that the wire guides are properly threadedinto the plate. The wires in the plate head should be parallelto each other in the transverse plane. The oblique or kick-stand wire should buttress the central wire in the plate head.

Synthes 9

Determine Plate Position

5Determine plate position

Instruments

292.652 2.0 mm Non-Colored Threaded Guide Wire

310.243 2.5 mm Drill Tip Guide Wire

Using anatomic landmarks and fluoroscopy, mount the plateon the intact or reconstructed plateau without attempting toreduce the distal portion of the fracture. Use the wire guidesto help position the plate on the bone.

Insert a 2.5 mm guide wire through the 2.5 mm wire guide.Readjust plate position, if necessary. Place a second guidewire to prevent rotation of the plate, and to secure provisionalfixation of the plate to the tibial plateau. All three guidewires must be inserted through the 2.5 mm wire guides.

Note: Additional 2.0 mm K-wires may be placed in theproximal K-wire holes to hold the plate in position.

Confirm plate head placement. Use clinical examinationand fluoroscopy to confirm that:

– Screw trajectories in the proximal locking holes are parallelto the joint in the transverse plane, and the plate is orientedproperly on the plateau;

– Screw and plate placement are consistent with thepreoperative plan; and

– Alignment of the plate to the shaft of the tibia is correctin both the AP and lateral views. Placement of the plate atthis point will determine final flexion/extension reduction.


Insert Proximal Screws

6Insert proximal screws

Instruments

310.634 4.3 mm Cannulated Drill Bit

314.05 Cannulated Hexagonal Screwdriver

319.701 Cannulated Screw Measuring Device

Note: If required, lag screw reduction of a fragment must beaccomplished before inserting locking screws into the fragment.

Before inserting the first screw, advance each guide wire untilit reaches either the medial cortex or the desired screw tiplocation when placing convergent screws.

If the plate shifts during screw insertion, the guide wiresmust be removed and reinserted using the wire guides forthe screws to lock to the plate properly.

Screw length considerationsCentral locking hole: The locking screw holes in the proximalportion of the plate create a converging screw pattern forimproved pullout strength. When using locking screws longerthan 60 mm in the anterior and posterior of the three headholes, a central locking screw greater than 70 mm in lengthmay meet with these screws.

Measure for screw length using the cannulated screwmeasuring device. The correct length measurement willplace the screw at the tip of the guide wire.

Note: The measuring device must contact the end of thewire guide for an accurate measurement.

Technique tip: The self-drilling, self-tapping flutes of the5.0 mm screws make predrilling and pretapping unnecessaryin most cases. If necessary in dense bone, the lateral cortexcan be predrilled with the 4.3 mm cannulated drill bit, for5.0 mm screws.

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Remove the wire guide and insert the appropriate lengthscrew over the 2.5 mm guide wire and into the bone, usingthe cannulated hexagonal screwdriver. Locking screws maybe inserted using power equipment. However, DO NOT usepower to seat these screws since this may cause screws tocross-thread in the plate holes.

Important: Securely tighten all locking screws to lock themto the plate.

Note: To compress the plate to the lateral tibial plateau, it isnecessary to use a conical screw prior to any locking screws.Conical screws may be replaced with locking screws afterreduction is complete.

Reduce Shaft to Tibial Plateau


7Reduce shaft to tibial plateau

Instrument

321.12 Articulated Tension Device

Reduce the tibial plateau to the shaft of the tibia using indirectreduction techniques whenever possible. Using atraumatictechnique, temporarily secure the plate shaft to the bonewith plate holding forceps.

Confirm rotation of the extremity by clinical examination.

Once reduction is satisfactory, and if it is appropriate basedon the fracture morphology, the plate should be loaded intension using the articulated tension device.

Note: With multifragment fractures, it may not always bepossible or desirable to achieve anatomic reduction of thefracture. However, in simple fracture patterns, the articulatedtension device may facilitate anatomic reduction. This devicemay be used to generate either compression or distraction.

In addition to having threaded locking holes, the plate functionssimilarly to DCP plates which offer the ability to self-compressfracture fragments. Therefore, a combination of lag screwsand locking screws may be used.

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1 2 2 1

2 1 1 2

Correct

Incorrect

Important: If a combination of cortex (1) and locking screws(2) is used, a cortex screw should be inserted first to pull theplate to the bone.

Important: If locking screws (1) have been used to fix theplate to a fragment, subsequent insertion of a cortex screw(2) in the same fragment without loosening and retighteningthe locking screw is not recommended.


Insert Cortex Screws in Plate Shaft

8Insert 4.5 mm cortex screws in plate shaft

Instruments

03.010.150 Star /HexDrive Screwdriver, T25/3.5 mmhexagonal

03.010.151 Star /HexDrive Screwdriver Shaft, T25/3.5 mmhexagonal

310.31 3.2 mm Drill Bit, quick coupling

319.10 Depth Gauge

323.46 4.5 mm Universal Drill Guide

Insert as many standard 4.5 mm cortex screws as necessaryinto the distal portion of the plate.

Important: All of the 4.5 mm cortex screws must be insertedprior to insertion of locking screws.

Use the 4.5 mm universal drill guide to predrill for 4.5 mmcortex screws and drill through both cortices with the3.2 mm drill bit.

For the neutral position, press the drill guide down in thenonthreaded hole. To obtain compression, place the drill guideat the end of the nonthreaded hole away from the fracture.Do not apply downward pressure on the drill guide’s spring-loaded tip.

Note: The DCP and LC-DCP Drill Guides (322.44 and 323.45)are not compatible with the LCP plates.

Measure for screw length using the depth gauge. Select andinsert the appropriate length 4.5 mm cortex screw using thelarge hexagonal screwdriver.

Neutral Compression

Synthes 15

Insert Locking Screws in Plate Shaft

9Insert 4.0 mm or 5.0 mm locking screws in plate shaft

Instruments

03.010.150 Star /HexDrive Screwdriver, T25/3.5 mmhexagonal

03.010.151 Star /HexDrive Screwdriver Shaft, T25/3.5 mmhexagonal

310.31 3.2 mm Drill Bitor310.431 4.3 mm Drill Bit

319.10 Depth Gauge, for large screws

324.176 3.2 mm Drill Guide, for 4.0 mm screwsor312.449 4.3 mm Threaded Drill Guide

511.771 Torque Limiting Attachment, 4 Nmor511.774 Torque Limiting Attachment, 4 Nm,

for AO Reaming Coupler

Attach the appropriate drill guide to the locking portionof a Combi hole:

– Use the 3.2 mm drill guide when inserting 4.0 mmlocking screws

– Use the 4.3 mm threaded drill guide when inserting5.0 mm locking screws

Note: Use of the drill guide is required. It will center the drillbit in the threaded portion of the Combi hole to create a screwtrajectory that ensures the screw properly engages the plate.

Use the appropriate drill bit to drill to the desired depth:

– Use the 3.2 mm drill bit for 4.0 mm locking screws

– Use the 4.3 mm drill bit for 5.0 mm locking screws

Note: Holes for locking screws may be drilled unicorticallyor bicortically, depending on bone quality.


10Insert the 5.0 mm cannulated locking screwinto the angled hole

Instruments

310.243 2.5 mm Drill Tip Guide Wire

314.05 Cannulated Hexagonal Screwdriver


324.174 2.5 mm Wire Guide, for 5.0 mm screws

511.771 Torque Limiting Attachment, 4 Nm

Note: Use the oblique locking position to buttress amedial fragment.

If not already done, thread a 2.5 mm wire guide, for 5.0 mmscrews into the angled locking hole.

Insert a 2.5 mm drill tip guide wire through the 2.5 mm wireguide. Advance the guide wire until it reaches the desiredscrew tip location.

Measure for screw length using the cannulated screw measuringdevice. The correct length measurement will place the screwat the tip of the guide wire. Use the cannulated hexagonalscrewdriver to remove the wire guide.

Note: The measuring device must contact the end of thewire guide for an accurate measurement.

Insert Locking Screw into Angled Plate Hole

Screw length considerationsAngled locking hole: The oblique locking screw in the plateshaft converges with the central locking screw in the platehead for improved pullout strength and fixation. If theoblique locking screw exceeds 65 mm in length, it shouldcontact the proximal locking screw.

Technique tip: The self-drilling, self-tapping flutes of the5.0 mm screws make predrilling and pretapping unnecessaryin most cases. If necessary, in dense bone, the lateral cortexcan be predrilled with the 4.3 mm cannulated drill bit.

Insert the appropriate length cannulated locking screwover the 2.5 mm guide wire and into the bone using thecannulated hexagonal screwdriver. Locking screws may beinserted using power equipment. However, DO NOT usepower to seat these screws since this may cause screws tocross-thread in the plate holes.

Important:Securely tighten all locking screws to ensure they are lockedto the plate.

Always use the torque limiting attachment when using powerto insert locking screws.

Cleaning tip

Instruments

319.24 2.9 mm Cleaning Brush

319.461 2.5 mm Cleaning Stylet

Cleaning the cannulation in the threaded drill guides isimperative for proper function. Instruments should be clearedintraoperatively using the 2.5 mm cleaning stylet to preventaccumulation of debris in the cannulation. Instrumentsshould be cleaned postoperatively using the stylet and the2.9 mm cleaning brush.

Synthes 17


Postoperative treatment

Postoperative treatment with locking compression plates doesnot differ from conventional internal fixation procedures.

Postoperative Treatment and Implant Removal

Implant removal

To remove locking screws, unlock all screws from the plate;then remove the screws completely from the bone. Thisprevents simultaneous rotation of the plate when removingthe last locking screw.

Synthes 19

Screws Used with the 4.5 mm LCP Proximal Tibia PlateStainless Steel and Titanium

Stainless steel screws and screw nut are made of implant quality 316L stainless steel

Titanium screws and screw nut are made of titanium alloy (Ti-6Al-7Nb) orcommercially pure (CP) titanium

4.0 mm Locking ScrewsCreate a locked, fixed-angle screw/plate construct– Threaded conical head

– Fully threaded shaft

– Self-tapping tip

4.5 mm Cortex ScrewsCompress the plate to the bone or create axial compression– May be used in the DCU portion of the Combi holes

in the plate shaft

5.0 mm Cannulated Locking ScrewsCreate a locked, fixed-angle screw/plate construct– Threaded conical head


– Self-drilling, self-tapping tip

5.0 mm Cannulated Conical ScrewsCompress the plate to the bone and provideinterfragmentary compression– Smooth conical head

– Partially threaded shaft

– Self-drilling, self-tapping tip

5.0 mm Locking ScrewsCreate a locked, fixed-angle screw/plate construct– Threaded conical head


– Self-tapping tip

5.0 mm Screw NutOffers additional fixation and compression optionsfor complex fractures– Self-cutting, serrated tip

– Inserted from the medial aspect of the proximal tibia

– Internal threads mate with the 5.0 mm cannulatedconical screws


5.0 mm Cannulated Locking and Cannulated Conical Screws

The screw design enhances fixationand facilitates the surgical procedure.

Conical screwheadThe conical head simplifies alignmentin the plate hole. This is of particularimportance when using locking screws.The threaded screwhead must alignwith the plate hole threads to providea secure screw/plate construct. Toensure proper alignment and preventcross-threading, the appropriatethreaded wire guide or drill guide mustalways be used.

Large diameter screw coreThe large diameter screw core improvesbending and shear strength, anddistributes the load over a larger areain the bone.

Thread profileThe shallow thread profile of thelocking screws is necessary to providea larger core. This is appropriate sincelocking screws do not rely on compres-sion between the plate and the boneto maintain stability. When required,interfragmentary compression can beachieved with the partially threadedcannulated conical screws, especiallywhen near the articular surface.

Screw selection and configurationfor the plate headThe 5.0 mm cannulated locking screwsprovide a fixed-angle construct inthe metaphysis, while the 5.0 mmcannulated conical screws can be usedto gain interfragmentary compressionthrough the plate.

This plate can serve as a buttress for amedial wedge. This is accomplished bythe convergence of the locking screwsin the metaphyseal region and theoblique screw from below.

Threaded conicalscrewhead

Nonthreadedconical screwhead

5.0 mm cannulatedlocking screw

5.0 mm cannulatedconical screw

1.0 mmthreadpitch

4.4 mmcorediameter

5.0 mmthreadprofile

Synthes 21

4.5 mm LCP Proximal Tibia Plate Implant SetsStainless Steel (105.222) and Titanium (01.123.604)

Graphic Case690.367 4.5 mm LCP Proximal Tibia Plate Set

Graphic Case690.467 4.5 mm Titanium LCP Proximal Tibia Plate Set

Graphic Case

Implants in set 105.2224.5 mm LCP Proximal Tibia Plates◊

Holes Length (mm)

240.036 4 82 right240.037 4 82 left240.038 6 118 right240.039 6 118 left240.040 8 154 right240.041 8 154 left240.042 10 190 right240.043 10 190 left240.044 12 226 right240.045 12 226 left240.046 14 262 right240.047 14 262 left

Implants in set 01.123.6044.5 mm Titanium LCP Proximal Tibia Plates◊

Holes Length (mm)

440.036 4 82 right440.037 4 82 left440.038 6 118 right440.039 6 118 left440.040 8 154 right440.041 8 154 left440.042 10 190 right440.043 10 190 left440.044 12 226 right440.045 12 226 left440.046 14 262 right440.047 14 262 left

◊ Available nonsterile or sterile-packed.Add “S” to catalog number to order sterile product.


Required Set01.240.201 Periarticular LCP Plating System

with 5.0 mm Locking Screwsor01.240.209 Periarticular LCP Plating System

with 4.0 mm Locking Screws

Recommended Additional Sets01.240.401 Periarticular LCP Plating System,

with 5.0 mm Titanium Locking Screws01.240.409 Periarticular LCP Plating System,

with 4.0 mm Titanium Locking Screws102.91 General Instrument Set102.93 Interchangeable Gouge, Chisel and Impactor Set105.04 4.5 mm Cannulated Screw Instrument and

Implant Set105.190 6.5 mm/7.3 mm Combined Cannulated Screw

Instrument and Implant Set105.90 Bone Forceps Set105.909 Periarticular Reduction Forceps Set115.400 Large Fragment LCP Instrument and Implant

Set, with 4.0 mm and 5.0 mm locking screws115.700 Large Distractor Set115.86 Pelvic Reduction Instrument Set145.190 6.5 mm/7.3 mm Combined Titanium Cannulated

Screw Instrument and Implant Set146.400 Large Fragment LCP Instrument and Titanium

Implant set, with 4.0 mm and 5.0 mm lockingscrews

Also Available (sterile only)4.5 mm LCP Proximal Tibia Plates

Holes Length (mm)240.048S 16 298 right240.049S 16 298 left240.052S 18 334 right240.053S 18 334 left240.054S 20 370 right240.055S 20 370 left

4.5 mm LCP Proximal Tibia Plate Implant SetsStainless Steel (105.222) and Titanium (01.123.604) continued

Synthes 23

Periarticular LCP Plating System, with 5.0 mm Locking Screws (01.240.201)

Graphic Cases and Screw Racks60.240.201 Locking Periarticular Plating System

Graphic Case

60.240.203 Screw Rack, for 4.5 mm Cortex Screws

60.240.204 Screw Rack, for 5.0 mm Locking Screws,with T25 StarDrive Recess

60.240.205 Screw Rack, for 5.0 mm and 7.3 mmCannulated Locking Screws and 7.3 mmConical Screws

60.240.206 Screw Rack, for 5.0 mm CannulatedConical Screws

60.240.208 Locking Periarticular Plating SystemInstrument Tray

Instruments292.652 2.0 mm Non-Colored Threaded Guide Wire,

230 mm, spade point, 10 ea.

03.010.150 Star /HexDrive Screwdriver, T25/3.5 mmhexagonal, self-retaining

03.010.151 Star /HexDrive Screwdriver Shaft, T25/3.5 mmhexagonal, self-retaining, 165 mm

310.243 2.5 mm Drill Tip Guide Wire, 200 mm, 10 ea.

310.31 3.2 mm Drill Bit, quick coupling, 145 mm

310.431 4.3 mm Drill Bit, quick coupling, 180 mm,for 5.0 mm Locking Screws

310.44 4.5 mm Drill Bit, quick coupling, 145 mm

310.632 5.0 mm Cannulated Drill Bit, quick coupling,200 mm (short flute)

310.634 4.3 mm Cannulated Drill Bit, quick coupling,200 mm (long flute)

310.99 Countersink, for 4.5 mm and 6.5 mm screws

311.44 T-Handle, with quick coupling

311.449 Push-Pull Reduction Device, for use with4.5 mm LCP plates, 2 ea.

311.46 Tap for 4.5 mm Screws

312.449 4.3 mm Threaded Drill Guide, 4 ea.

312.48 4.5 mm/3.2 mm Insert Drill Sleeve

313.93 Solid Hexagonal Screwdriver, 4.0 mm widthacross flats

314.05 Cannulated Hexagonal Screwdriver, 4.0 mmwidth across flats

314.11 Holding Sleeve

314.23 Cannulated Hexagonal Screwdriver Shaft,4.0 mm width across flats


Periarticular LCP Plating System, with 5.0 mm Locking Screws (01.240.201) continued

Instruments continued

319.10 Depth Gauge, for 4.5 mm and 6.5 mm screws

319.24 2.9 mm Cleaning Brush

319.461 2.5 mm Cleaning Stylet


321.12 Articulated Tension Device

321.16 Combination Wrench, 11 mm width across flats

323.46 4.5 mm Universal Drill Guide

324.174 2.5 mm Wire Guide, for 5.0 mm screws, 5 ea.

324.175 2.5 mm Wire Guide, for 7.3 mm screws, 2 ea.

324.176 3.2 mm Drill Guide, for 4.0 mm screws, 2 ea.

338.49 Large Quick Coupling

397.706 Handle, for AO Reaming Coupler Connection

511.774 Torque Limiting Attachment, 4 Nm, for AOReaming Coupler

Implants4.5 mm Cortex Screws, self-tapping

Length Length(mm) Qty. (mm) Qty.

214.814 14 4 214.844 44 4214.816 16 4 214.846 46 2214.818 18 4 214.848 48 2214.820 20 4 214.850 50 2214.822 22 4 214.852 52 2214.824 24 4 214.854 54 2214.826 26 6 214.856 56 2214.828 28 6 214.858 58 2214.830 30 6 214.860 60 2214.832 32 6 214.862 62 2214.834 34 6 214.864 64 2214.836 36 6 214.866 66 2214.838 38 6 214.868 68 2214.840 40 6 214.870 70 2214.842 42 6

Synthes 25


Implants continued

5.0 mm Periprosthetic Locking Screws, self-tapping,with T25 StarDrive recess , 2 ea.◊

Length (mm) Length (mm)

02.221.508 8 02.221.512 1202.221.510 10

5.0 mm Locking Screws, self-tapping, with T25 StarDrive recess


212.201 14 4 212.215 42 6212.202 16 4 212.216 44 2212.203 18 4 212.217 46 2212.204 20 4 212.218 48 2212.205 22 4 212.219 50 2212.206 24 4 212.220 55 2212.207 26 6 212.221 60 2212.208 28 6 212.222 65 2212.209 30 6 212.223 70 2212.210 32 6 212.224 75 2212.211 34 6 212.225 80 2212.212 36 6 212.226 85 2212.213 38 6 212.227 90 2212.214 40 6


Periarticular LCP Plating System, with 5.0 mm Locking Screws (01.240.201) continued

Implants continued

5.0 mm Cannulated Locking Screws


02.205.025 25 2 02.205.090 90 202.205.030 30 2 02.205.095 95 202.205.035 35 2 02.205.100 100 202.205.040 40 2 02.205.105 105 202.205.045 45 2 02.205.110 110 202.205.050 50 2 02.205.115 115 202.205.055 55 4 02.205.120 120 202.205.060 60 4 02.205.125 125 202.205.065 65 4 02.205.130 130 202.205.070 70 4 02.205.135 135 202.205.075 75 4 02.205.140 140 202.205.080 80 4 02.205.145 145 202.205.085 85 4

5.0 mm Cannulated Conical Screws, 2 ea.


02.205.240 40 02.205.270 7002.205.245 45 02.205.275 7502.205.250 50 02.205.280 8002.205.255 55 02.205.285 8502.205.260 60 02.205.290 9002.205.265 65 02.205.295 95

7.3 mm Cannulated Locking Screws, 2 ea.


02.207.020 20 02.207.085 8502.207.025 25 02.207.090 9002.207.030 30 02.207.095 9502.207.035 35 02.207.100 10002.207.040 40 02.207.105 10502.207.045 45 02.207.110 11002.207.050 50 02.207.115 11502.207.055 55 02.207.120 12002.207.060 60 02.207.125 12502.207.065 65 02.207.130 13002.207.070 70 02.207.135 13502.207.075 75 02.207.140 14002.207.080 80 02.207.145 145

Synthes 27

Implants continued

7.3 mm Cannulated Conical Screws

Length (mm)

02.207.250 5002.207.255 5502.207.260 6002.207.265 6502.207.270 70

7.3 mm Cannulated Conical Screws, partially threaded

Length (mm)

02.207.450 5002.207.455 5502.207.460 6002.207.465 6502.207.470 70

222.578 5.0 mm Screw Nut, 2 ea.

Also Available5.0 mm Periprosthetic Locking Screws, self-tapping,with T25 StarDrive recess ◊

Length (mm)

02.221.514 1402.221.518 18

292.20 2.0 mm Kirschner Wire, 150 mm, trocar point

311.66 Tap for 6.5 mm Cancellous Bone Screws

312.67 6.5 mm/3.2 mm Double Drill Sleeve

394.35 Large Distractor

397.705 Handle, quick coupling, for ComPactAir Drive Connection

398.81 Self-Centering Bone Forceps

398.813 Plate Holding Forceps with swivel foot

511.761 Large Quick Coupling

511.771 Torque Limiting Attachment, 4 Nm

60.240.207 Screw Rack for 6.5 mm CancellousBone Screws

Length (mm)

02.207.475 7502.207.480 8002.207.485 8502.207.490 9002.207.495 95


Length (mm)

02.207.275 7502.207.280 8002.207.285 8502.207.290 9002.207.295 95

Synthes (USA)1302 Wrights Lane EastWest Chester, PA 19380Telephone: (610) 719-5000To order: (800) 523-0322Fax: (610) 251-9056

Synthes (Canada) Ltd.2566 Meadowpine BoulevardMississauga, Ontario L5N 6P9Telephone: (905) 567-0440To order: (800) 668-1119Fax: (905) 567-3185

© 2005 Synthes, Inc. or its affiliates. All rights reserved. Combi, DCP, LC-DCP, LCP and Synthes are trademarks of Synthes, Inc. or its affiliates. Printed in U.S.A. 10/09 J4053-H

www.synthes.com

Documents

4.5 mm LCP Proximal Tibia Plates. Part of the Synthes LCP Periarticular Plating System.synthes.vo.llnwd.net/o16/Mobile/Synthes North America... · 2011-10-05 · 4 Synthes 4.5 mm