al Femur Plate 4.5 Open Access - medicazen.com.mxmedicazen.com.mx/.../2018/01/Femur-distal-grandes-fragmentos.pdf · The distal lateral femur plate 4.5 is part of the LOQTEQ® plate

Distal Lateral Femur Plate 4.5 Surgical Technique – Open Access

Locking Compression Technology by aap

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Distal Lateral Femur Plate 4.5 Surgical Technique – Open Access

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Disclaimer

This surgical technique is exclusively intended for medical professionals, especially physicians, and thereforemay not be regarded as a source of information for non-medical persons. The description of this surgicaltechnique does not constitute medical advice or medical recommendations nor does it convey any diagnostic ortherapeutic information on individual cases. Therefore, the attending physician is fully responsible for providingmedical advice to the patient and obtaining the informed consent of the patient which this surgical techniquedoes not supersede.The description of this surgical technique has been compiled by medical experts and trained staff of aapImplantate AG with utmost diligence and to the best of their knowledge. However, aap Implantate AG excludesany liability for the completeness, accuracy, currentness, and quality of the information as well as for materialor immaterial damages arising from the use of this information.

aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany

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Content •

• Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4• Material . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

• Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

• Indications/Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

• Processing (Sterilization & Cleaning) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

• Surgical Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6• Positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

• Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

• Preoperative Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

• Repositioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

• Positioning and fixation of the plate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

• Insertion of screws in the head of the plate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

• Insertion of screws in the shaft of the plate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

• Placing periprosthetic screws . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

• Compression of a shaft fracture with the gliding-locking hole

technology from aap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

• Explantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

• Trays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19• LOQTEQ® Distal Lateral Femur Plate 4.5, Tray C Implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

• LOQTEQ® Large Fragment Set, Instruments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22

• LOQTEQ® Large Fragment Set, Screw rack complete, basic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22

Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5

Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5


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• Introduction

The distal lateral femur plate 4.5 is part of the LOQTEQ® plate system and unifies angular stability with modern plate

design.

Material

For the manufacture of angle stable plate systems, materials are used which have been proven to be successful

in medical technology for decades. The anatomical plates and bone screws are made of titanium alloy.

All materials employed comply with national and international standards. They are characterized by good

biocompatibility, a high degree of reliability against allergic reactions and good mechanical properties.

Description

• The distal plate contour is adapted to the anatomy of the lateral condyle of

the distal femur

• The plate design follows the natural antecurvature of the femur

• A high shaft profile without undercuts guarantees excellent stability

• The flattened end of the plate shaft enables the tissue-conserving,

submuscular insertion of the plate

• Periprosthetic screws in various lengths allow monocortical fixation in the

presence of an intramedullary implant

• Gliding-locking holes in the shaft area allow compression and angular

stability with LOQTEQ® technology

• Various holes for K-wires and an oblong hole facilitate the primary fixation

of the plate

• Available as right and left version

• Standard sizes include 4-13 holes in the plate shaft

• Long sizes available sterile with 15 and 17 holes

Indications/Contraindications

Indications

• Intra-articular and extra-articular fractures

• Non-unions

• Periprosthetic fractures

• Corrections of distal femoral fractures healed in malposition

• Stabilization of distal diaphyseal fractures of the femur

Contraindications

• Infection or inflammation (localized or systemic)

• Allergies against the implant material

• Acute and chronic osteomyelitis at or close to the surgical field

• High anesthesia risk patients

• Severe soft tissue swelling impacting normal wound healing

• Insufficient soft tissue coverage

• Fractures in children and adolescents with epiphyseal plates not yet ossified

Processing (Sterilization & Cleaning)

Implants are supplied non-sterile and sterile.

Non-sterile supplied implants and instruments must be processed before every use.

Reference is here made to the Instructions for Use enclosed to the plates, instruments und trays.

Implants (sterile) out of damaged or open inner packages must not be used.

Implant components that have come or might have come into contact with infectious fluids (e.g. blood)

must not be resterilized and reused in another surgery. They must be returned to the manufacturer.

Resterilization is prohibited in this case (see Instructions for Use).


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Introduction•



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•Surgical Technique


4 holes 17 holes15 holes13 holes11 holes9 holes7 holes

o153mm

o207mm

o243mm

o279mm

o314mm

o350mm

o386mm

Positioning

• Position patient in supine position on a

radiolucent operating table. The patient´s

leg must be freely moveable in such a

way that the knee can be flexed and

lateral X-rays of the leg can be taken.

Access

• The incision for open surgery is deter-

mined by the fracture site and the length

of the plate. The distal lateral femur plate

can be placed between the periosteum

and the vastus lateralis.

Anterolateral arthrotomy is recommended

for intra-articular fractures.

Preoperative Planning

• Evaluation of the fracture situation on

the basis of the X-ray and selection of

the appropriate plate length and screw

positions. Also plan the insertion of lag

screws, if necessary.

Surgical Technique•


7Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5

Repositioning • Reduce fracture fragments and joint surface and temporarily fix

in place with K-wires. When applying temporary fixation with

K-wires, consider the later position of the plate. If necessary, use

lag screws to compress the fracture outside of the later plate

position.

• Check the reduction results using fluoroscopy.

N NOTE:

Please ensure that outer lag screws do not interfere with the

plate screws.

N CAUTION:

The LOQTEQ® distal lateral femur plate is meant to be used

only in combination with standard screws and angle stable

LOQTEQ® locking screws (red). Do not use the blue round hole

screws for this plate!


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Positioning and Fixation ofthe plate



• After correct reduction, properly position the plate on the lateral

condyle.

• For the temporary fixation of the plate, 2.0mm K-wires can be used.

• After placing the K-wires, use fluoroscopy to check the plate position

as well as length and rotation.


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INSTRUMENTS ART.-NO.Twist drill ø3.2, L 195, coil 50, quick coupling IU 7432-30Screwdriver hexagonal, ø3.5, quick coupling IU 7835-00Double drill guide ø3.2/4.5, with spring aided centering IU 8117-50Depth gauge for locking screws, large IS 7905-00

• As an alternative to primary fixation using K-wires, a standard

screw can be inserted into the oblong hole to pull the plate to

the bone. For this purpose, use a double drill guide 3.2/4.5 and a

twist drill 3.2mm. Then determine the screw length using the

depth gauge and insert the appropriate standard screw 4.5mm.

N NOTE:

The plate must be pulled to the bone before placing angle

stable screws. Do not use standard screws after angle stable

screws have been placed.


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Insertion of screws in thehead of the plate

• In the distal lateral femur plate, only LOQTEQ® locking screws (red

head) are used in the shaft and for the angle stable round holes in

the distal plate portion. Therefore, use only the red drill guide for all

screw holes.

• Drill to the desired depth using a drill ø3.8 (marked in blue-red), if

necessary under fluoroscopic monitoring.

• The screw length can be determined with the aid of a depth gauge.


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INSTRUMENTS ART.-NO.Twist drill ø3.8, L 180, coil 50, quick coupling IU 7438-18Screwdriver Duo, T25, quick coupling IU 7835-55Torque limiter 3.5 m, quick coupling IU 7870-35Drill guide for gliding hole LOQTEQ® 4.5, I-ø 3.9, red IU 8167-10K-wire with trocar point, ø2.0, L 250 NK 0020-25Large handle, cannulated, quick coupling IU 7706-00

• Select a LOQTEQ® locking screw

(red head) of the proper length and

loosely insert using the self-retaining

screwdriver T25.

• Then manually tighten the screw

using the torque limiter. Optimal

fixation is reached once an audible

click is heard.

N NOTE:

It is recommended to use a torque limiter as soon as the screw

head reaches the plate hole.

N CAUTION:

Do not use the torque limiter in automated mode;

instead, use only with the enclosed handle.


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Insertion of screws in theshaft of the plate

INSTRUMENTS ART.-NO.Depth gauge for locking screws, large IS 7905-00Drill guide for gliding hole LOQTEQ® 4.5, I-ø 3.9, red IU 8167-10Twist drill ø3.8, L 180, coil 50, quick coupling IU 7438-18

• Once all required screws have been placed in the distal area, the

shaft area can be secured.

• Insert drill guide (red).

• Drill to the desired depth using a drill bit ø3.8 (marked in

blue-red), if necessary under fluoroscopic monitoring.

• Remove the drill guide.


13Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5


• The screw length can be determined with the aid of a depth gauge.

• Select a LOQTEQ® locking screw (red head) of the proper length,

and loosely insert it using the self-retaining screwdriver T25.

Then manually tighten the screw using the torque limiter.

Optimal fixation is reached once an audible click is heard.

N NOTE:

As soon as the head of the screw reaches the plate hole, it is

compulsory to switch to the torquc limiter.

In cases of very hard bone in the diaphyseal bone, it is neces-

sary to make sure that the screw head is flush to the plate.

Therefore it is permissible in exceptionally hard bone of the

diaphysis to finish the screw without the torquc limiter.

N CAUTION:

Do not use the torque limiter in automated mode; instead, use

only with the enclosed handle.

• Once all screws have been placed, check the final positioning

once more under fluoroscopy and close the wound.


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Placement of periprosthetic screws



Compression of a shaft fracture with the gliding-locking hole technology from aap

• If an intramedullary nail or a prosthesis interferes with bicortical

screw placement, special screws for periprosthetic fractures can

be used. These periprosthetic screws feature a blunt, very short

tip. The LOQTEQ® periprosthetic screws are similar in design to

the LOQTEQ® locking screws (red) but feature a gold head(see image). They allow the plate to be fixed to the near cortex.

N NOTE:

LOQTEQ® periprosthetic screws are available in 14 and 18mm

lengths. The femur plate has a shaft thickness of 6mm.

• If compression in the shaft area is desired, it can be achieved with

standard screws, with LOQTEQ® locking screws (red) or, in cases of

an intramedullary implant, with LOQTEQ® periprosthetic screws

(view figure).

• Screw the holding pin (IU 8167-05) into an appropriate shaft

hole or, if necessary, above the fracture line. Choose a compres-

sion drill guide in accordance with the compression distance

(1mm or 2mm) and position on the holding pin, away from the

fracture gap.


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Surgical Technique •


INSTRUMENTS ART.-NO.Twist drill ø3.8, L 180, coil 50, quick coupling IU 7438-18Load Drill guide LOQTEQ® 4.5, compression 1mm IU 8167-01Load Drill guide LOQTEQ® 4.5, compression 2mm IU 8167-02Basic insert for load drill guide LOQTEQ® 4.5 IU 8167-05

OPTIONALLoad drill guide LOQTEQ® 4.5, adjustable up to 2mm IU 8167-03

• Drill to the desired depth using a drill bit ø3.8 (marked blue-red) and

determine the depth with the depth gauge. Select a LOQTEQ® locking

screw (red) of the proper length and insert. In the event of a peri-

prosthetic implant (view figure), drill monocortical and select a

LOQTEQ® periprosthetic screw (14 or 18mm).

• Alternatively, the adjustable compression drill guide (IU 8167-03)

can be used. The fracture gap serves as orientation in the setting of

the compression distance (max. 2mm). For this purpose, turn the

wheel of the compression drill guide until an appropriate gap forms

in the upper part of the instrument. Position the drill guide on the

holding pin, away from the fracture gap, and drill through the drill

guide’s open guide.


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N CAUTION:

Be sure to select the proper compression distance (1 or 2mm).

If the fracture gap is too small and the bone very hard, excessive

compression may prevent full locking of the angle stable screw.

N NOTE:

It is recommended to use a torque limiter as soon as the screw

head reaches the thread in the plate hole.

N NOTE:

In cases of very hard bone in the diaphysis it is necessary to

make sure that the screw head is flush to the plate. Therefore

it is permissible in exceptionally hard bone of the diaphysis to

finish the screw without the torquc limiter.

N CAUTION:

Do not use the torque limiter in automated mode;

instead, use only with the enclosed handle.


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Explantation INSTRUMENTS ART.-NO.Screwdriver, T25, Round Handle IU 7811-25Screwdriver, hexagonal, SW 3.5 IU 7865-00

N NOTE:

The screwdrivers in the set (T25) are self-retaining. To achive

maximum torque during screw removal, we recommend

using the appropriate explantation screwdriver, which can be

ordered separately.

• Place an incision on the old scar. Manually undo all screws

and sequentially remove them.

N NOTE:

After manually undoing all screws, the removal can be

performed in automated mode in the second step.


18 Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5

Trays •


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LOQTEQ®

Distal Femur Plate 4.5, Implants IC 6943-40

Large Fragment Set, Instruments IC 6941-10

Large Fragment Set, Screw rack, basic IC 6941-30



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•Trays


LOQTEQ® Distal Femur Plate 4.5, Tray C Implants IC 6943-40

ARTICLE QUANTITY ART.-NO.Tray C for implants LOQTEQ® DF 4.5, empty 1 IC 6943-01Lid for trays, large 1 IC 2008-00

LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/7 holes, L 207, R 1 PF 4510-07-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/9 holes, L 243, R 1 PF 4510-09-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/11 holes, L 279, R 1 PF 4510-11-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/13 holes, L 314, R 1 PF 4510-13-2

LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/7 holes, L 207, L 1 PF 4511-07-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/9 holes, L 243, L 1 PF 4511-09-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/11 holes, L 279, L 1 PF 4511-11-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/13 holes, L 314, L 1 PF 4511-13-2

OPTIONALLOQTEQ® Dist. Lateral Femur Plate 4.5, 7/4 holes, L 153, R PF 4510-04-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/15 holes, L 350, R, sterile PF 4510-15-2SLOQTEQ® Dist. Lateral Femur Plate 4.5, 7/ 17 holes, L 386, R, sterile PF 4510-17-2S

LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/4 holes, L 153, L PF 4511-04-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/15 holes, L 350, L, sterile PF 4511-15-2SLOQTEQ® Dist. Lateral Femur Plate 4.5, 7/17 holes, L 386, L, sterile PF 4511-17-2S


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LOQTEQ® Screw Rack for Extension Screw DF 4.5

Trays •


ARTICLE QUANTITY ART.-NO.Screw rack LOQTEQ® DF 4.5 for extension screw set, empty 1 IC 6943-02

LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 75 6 SK 4525-75-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 80 6 SK 4525-80-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 85 6 SK 4525-85-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 90 6 SK 4525-90-2

LOQTEQ® Periprosthetic Screw 4.5, T25, self-tapping, L 14 10 SK 4527-14-2LOQTEQ® Periprosthetic Screw 4.5, T25, self-tapping, L 18 10 SK 4527-18-2


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•Trays


LOQTEQ® Large Fragment Set, Instruments IC 6941-10

LOQTEQ® Large Fragment Set, Screw rack complete, basic IC 6941-30*

ARTICLE QUANTITY ART.-NO.Tray for instruments LOQTEQ® Large Fragment, empty 1 IC 6941-11Lid for trays, large 1 IC 2008-00

Depth gauge for locking screws, large 1 IS 7905-00Twist drill ø3.2, L 195, coil 50, quick coupling 1 IU 7432-30Twist drill ø3.8, L 180, coil 50, quick coupling 1 IU 7438-18Twist drill ø3.8, L 250, coil 50, quick coupling 1 IU 7438-25Twist drill ø4.5, L 145, coil 50, quick coupling 1 IU 7445-00Handle for quick coupling, large, cannulated 1 IU 7706-00Tap for cortical screw ø4.5, L 125/70 1 IU 7745-00Screwdriver T25, short, quick coupling 1 IU 7810-26Screwdriver hexagonal, ø3.5, quick coupling 1 IU 7835-00Screwdriver Duo, T25, quick coupling 1 IU 7835-55Torque limiter 3.5 nm, quick coupling 1 IU 7870-35Screw forceps, self-holding 1 IU 8004-00Double drill guide ø3.2/4.5 with spring aided centering 1 IU 8117-50Load drill guide LOQTEQ® 4.5, compression 1mm 1 IU 8167-01Load drill guide LOQTEQ® 4.5, compression 2mm 1 IU 8167-02Basic insert for load drill guide LOQTEQ® 4.5 1 IU 8167-05Drill guide for gliding hole LOQTEQ® 4.5, I-ø 3.9, red 2 IU 8167-10Reduction sleeve for K-wire ø2.0 2 IU 8167-15Drill guide for round hole LOQTEQ® 4.5, I-ø 3.9, blue 2 IU 8167-20K-wire with trocar point, ø2.0, L 250 5 NK 0020-25

OPTIONALLoad drill guide LOQTEQ® 4.5, adjustable up to 2mm 1 IU 8167-03

ARTICLE QUANTITY ART.-NO.Screw rack LOQTEQ® Large Fragment, empty 1 IC 6941-31

N CAUTION: Do not use blue screws in femur!


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Trays •


Screws for gliding-locking hole

Standard screws

ARTICLE QUANTITY ART.-NO.LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 14 3 SK 4525-14-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 16 3 SK 4525-16-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 18 3 SK 4525-18-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 20 3 SK 4525-20-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 22 3 SK 4525-22-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 24 3 SK 4525-24-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 26 3 SK 4525-26-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 28 3 SK 4525-28-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 30 3 SK 4525-30-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 32 4 SK 4525-32-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 34 4 SK 4525-34-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 36 4 SK 4525-36-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 38 4 SK 4525-38-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 40 4 SK 4525-40-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 42 3 SK 4525-42-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 45 3 SK 4525-45-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 50 3 SK 4525-50-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 55 3 SK 4525-55-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 60 3 SK 4525-60-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 65 3 SK 4525-65-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 70 3 SK 4525-70-2

ARTICLE QUANTITY ART.-NO.Cortical Screw 4.5, self-tapping, L 14 3 SK 4512-14-2Cortical Screw 4.5, self-tapping, L 16 3 SK 4512-16-2Cortical Screw 4.5, self-tapping, L 18 3 SK 4512-18-2Cortical Screw 4.5, self-tapping, L 20 3 SK 4512-20-2Cortical Screw 4.5, self-tapping, L 22 3 SK 4512-22-2Cortical Screw 4.5, self-tapping, L 24 3 SK 4512-24-2Cortical Screw 4.5, self-tapping, L 26 3 SK 4512-26-2Cortical Screw 4.5, self-tapping, L 28 3 SK 4512-28-2Cortical Screw 4.5, self-tapping, L 30 3 SK 4512-30-2Cortical Screw 4.5, self-tapping, L 32 4 SK 4512-32-2Cortical Screw 4.5, self-tapping, L 34 4 SK 4512-34-2Cortical Screw 4.5, self-tapping, L 36 4 SK 4512-36-2Cortical Screw 4.5, self-tapping, L 38 4 SK 4512-38-2Cortical Screw 4.5, self-tapping, L 40 4 SK 4512-40-2Cortical Screw 4.5, self-tapping, L 42 3 SK 4512-42-2Cortical Screw 4.5, self-tapping, L 45 3 SK 4512-45-2Cortical Screw 4.5, self-tapping, L 50 3 SK 4512-50-2Cortical Screw 4.5, self-tapping, L 55 3 SK 4512-55-2Cortical Screw 4.5, self-tapping, L 60 3 SK 4512-60-2Cortical Screw 4.5, self-tapping, L 65 3 SK 4512-65-2Cortical Screw 4.5, self-tapping, L 70 3 SK 4512-70-2


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•Notes

aap Implantate AGLorenzweg 5 • 12099 BerlinGermany

Phone +49 30 75019-0Fax +49 30 75019-111

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Technische Änderungen, Irrtümer und Druckfehler vorbehalten.

© aap Implantate AGWM 2005-76 / 0513

Layout, Satz: deSIGN graphic - Wolfram Passlack

Illustrationen: Karen Hilberg

WM 2005-76 / 0513

aap Implantate AGLorenzweg 5 • 12099 BerlinGermany

Phone +49 30 75019-0Fax +49 30 75019-111

[email protected]

Documents

al Femur Plate 4.5 Open Access - medicazen.com.mxmedicazen.com.mx/.../2018/01/Femur-distal-grandes-fragmentos.pdf · The distal lateral femur plate 4.5 is part of the LOQTEQ® plate