Part of the DePuy Synthes LCP Periarticular Plating System ...synthes.vo.llnwd.net/o16/LLNWMB8/US Mobile/Synthes... · Fixation. 3rd ed. Berlin Heidelberg New York: Springer. 1991

Part of the DePuy Synthes LCP® Periarticular Plating System

4.5 mm LCP® Medial Proximal Tibia PlatesSurgical Technique

Image intensifier control

4.5 mm LCP® Medial Proximal Tibia Plates Surgical Technique DePuy Synthes 1

Introduction

Surgical Technique

Product Information

Table of Contents

4.5 mm LCP Medial Proximal Tibia Plates 2

AO Principles 4

Indications 5

Preparation and Planning 6

Reduce Articular Surface 7

Position Plate 8

Insert Proximal Screws 10

Reduce Plate to Plateau 12

Insert Screws in Plate Shaft 15

Screws 20

Set Lists 22

MR Information The 4.5 mm LCP Medial Proximal Tibia Plate System has not been evaluated for safety and compatibility in the MR environment. It has not been tested for heating, migration or image artifact in the MR environment. The safety of the 4.5 mm LCP Medial Proximal Tibia Plate System in the MR environment is unknown. Scanning a patient who has this device may result in patient injury.

2 DePuy Synthes 4.5 mm LCP® Medial Proximal Tibia Plates Surgical Technique

4.5 mm LCP® Medial Proximal Tibia Plates

The DePuy Synthes 4.5 mm LCP® Medial Proximal Tibia Plate is part of the LCP Periarticular Plating System, which merges locking screw technology with conventional plating techniques.

The 4.5 mm LCP Medial Proximal Tibia Plate is available in stainless steel and has a limited-contact shaft profile. The head and neck portions of the plate accept 5.0 mm cannulated locking and 5.0 mm cannulated conical screws. The screw hole pattern allows a raft of subchondral locking screws to buttress and maintain reduction of the articular surface. This provides fixed-angle support to the tibial plateau.

The Locking Compression Plate (LCP) System has Combi holes in the plate shaft that combine a dynamic compression unit (DCU) hole with a locking screw hole. The Combi hole provides the flexibility of axial compression and locking capability throughout the length of the plate shaft.

Note: For information on fixation principles using conventional and locked plating techniques, please refer to the DePuy Synthes Large Fragment Locking Compression Plate (LCP) Surgical Technique.


4.5 mm LCP Medial Proximal Tibia Plates

Three locking screw holes accept 5.0 mm cannulated locking or 5.0 mm cannulated conical screws

Combi holes combine a DCU hole with a threaded locking hole

Two 2.0 mm holes for K-wires and sutures

Angled locking holes accept 5.0 mm cannulated locking screws or 5.0 mm cannulated conical screws and support the proximal screws

For articulated tension device

Available in left and right plates, in implant quality 316L stainless steel.

Plate head– Anatomically contoured to

approximate the anteromedial proximal tibia.

– Three convergent threaded screw holes accept 5.0 mm cannulated locking screws or 5.0 mm cannulated conical screws.

– Two 2.0 mm holes for preliminary fixation with K-wires, or meniscal repair with sutures.

Plate shaft– The two angled locking holes distal

to the plate head accept a 5.0 mm cannulated locking screw or 5.0 mm cannulated conical screw to secure the plate position. The hole angles allow the locking screws to converge with two of the three screws in the plate head.

– Combi holes, distal to the angled locking holes, combine a DCU hole with a threaded locking hole. The Combi holes accept 4.0 mm or 5.0 mm locking screws in the threaded portion of the hole and 4.5 mm cortex screws or 4.5 mm shaft screws in the DCU portion of the hole.

– Available with 4, 6, 8, 10, 12, 14, or 16 Combi holes in the plate shaft.

– Limited-contact profile.


AO Principles

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

2 Rüedi 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.

In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation.1,2

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 absolute 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.

1. Müller ME, Allgöwer M, Schneider R, Willenegger H. Manual of Internal Fixation. 3rd ed. Berlin, Heidelberg, New York: Springer-Verlag; 1991.

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


Indications

The 4.5 mm LCP® medial proximal tibia plates are intended to buttress metaphyseal fractures of the medial tibia plateau, split-type fractures of the medial tibia plateau, medial split fractures with associated depressions and split or depression fractures of the medial tibia plateau. The plates may also be used for fixation of the proximal quarter (lateral and medial) of the tibia, as well as segmental fractures of the proximal tibia.

The 4.5 mm version may also be used for fixation of nonunions and malunions of the medial proximal tibia and tibia shaft, as well as opening and closing wedge tibial osteotomies.

Complete the preoperative radiographic assessment and prepare the preoperative plan. Determine plate length and instruments to be used.

Note: Determine proximal screw placement and screw lengths to ensure proper screw placement in the metaphysis.

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

Precautions: – Instruments and screws may have sharp edges or moving

joints that may pinch or tear user’s glove or skin .– Handle devices with care and dispose worn bone cutting

instruments in an approved sharps container.


Preparation and Planning

1Preparation and preoperative planning

Required Set

01.240.201 Periarticular LCP® Plating System, with 5.0 mm Locking Screws or 01.240.209 Periarticular LCP Plating System,

with 4.0 mm Locking Screws

Also Available Sets

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

105.210 Periarticular LCP Plating System Instrument and Screw Set


Reduce Articular Surface

2Reduce articular surface

Optional Sets

115.700 Large Distractor Set

115.720 Large External Fixator Set with Self-Drilling Schanz Screws

Instruments

394.35 Large Distractor or External Fixator

Note: Prior to reduction, application of an external fixator or large distractor may facilitate visualization and reduction of the joint.

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

The locking screws do not provide interfragment or plate-to-bone compression; therefore, any desired compression must be achieved with traditional lag screws or 5.0 mm cannulated conical screws. The articular fragments must be reduced and compression must be obtained prior to applying the 4.5 mm LCP Medial Proximal Tibia Plate with locking screws.

Note: To verify that independent lag screws will not interfere with plate placement, hold the plate to the bone.

Apply the distractor to assist in the visualization and reduction of the joint.


Position Plate

3Determine plate position

Instruments

292.652 2.0 mm Non-Colored Threaded Guide Wire, 230 mm, spade point

324.174 2.5 mm Wire Guide, for 5.0 mm screws

Using anatomic landmarks and fluoroscopy, mount the plate on the intact or reconstructed plateau without attempting to reduce the distal portion of the fracture.

Mount the plateWith a 2.5 mm wire guide for 5.0 mm screws attached to the central hole in the head of the plate, insert a 2.0 mm threaded wire through a K-wire hole. Readjust the plate position, if necessary. Place a second wire in the other K-wire hole to prevent rotation of the plate and to secure provisional fixation of the plate to the tibial plateau.


Position Plate

4Insert proximal provisional (conical) screw

Instruments

310.243 2.5 mm Drill Tip Guide Wire

310.634 4.3 mm Cannulated Drill Bit, quick coupling, for 5.0 mm screws

319.701 Cannulated Screw Measuring Device

Insert guide wireWhile the plate is placed against the bone, insert the 2.5 mm drill tip guide wire through the 2.5 mm wire guide in the central screw hole in the plate head. It is imperative to drill using fluoroscopy to ensure proper screw trajectory and screw placement. Advance the guide wire through to the lateral cortex or to the desired screw tip location.

Determine proper screw trajectory by using clinical examination and fluoroscopy to confirm:– Guide wire trajectory in the proximal locking hole is

parallel to the joint and the reduction is maintained;

– That the screw and plate placement will be consistent with the preoperative plan; and

– Alignment of the plate to the shaft of the tibia is correct in both the AP and lateral views. Placement of the plate at this point will determine final flexion/extension.

Measure for screw lengthMeasure for screw length using the cannulated screw measuring device.

Notes: – The measuring device must contact the end of the wire

guide for an accurate measurement. – The self-drilling, self-tapping flutes of the 5.0 mm

cannulated conical screws make predrilling and pretapping unnecessary in most cases. If necessary, in dense bone, the lateral cortex can be predrilled with the 4.3 mm cannulated drill bit.


Insert Proximal Screws


Instruments

314.05 Cannulated Hexagonal Screwdriver

314.23 Cannulated Hexagonal Screwdriver Shaft

511.771 Torque Limiting Attachment, 4 Nm or 511.774 Torque Limiting Attachment, 4 Nm,

for AO Reaming Coupler

Use the 4.0 mm cannulated hexagonal screwdriver to remove the wire guide. Using the torque limiting attachment (TLA), insert a 5.0 mm cannulated conical screw in the central hole in the plate head to pull the plate to the bone and gain interfragmentary compression through the plate. Insert a screw that is approximately 5 mm shorter than the measurement from the cannulated screw measuring device.

Warning: If the TLA is unavailable, do not tighten the screws to the plate using power. Perform final tightening by hand.

Note: Locking screws are not lag screws. When interfragmentary compression is desired, use 5.0 mm cannulated conical screws.

Insert Proximal Screws


Reduce Plate to Plateau

5Secure the plate to the plateau

Instruments






511.771 Torque Limiting Attachment, 4 Nm or 511.774 Torque Limiting Attachment, 4 Nm,

for AO Reaming Coupler

Attach 2.5 mm wire guides for 5.0 mm screws to the anterior and posterior holes in the head of the plate. Insert 2.5 mm drill tip guide wires through these wire guides to the desired screw tip location. Use the cannulated screw measuring device to measure for screw length. Use the 4.0 mm cannulated hexagonal screwdriver to remove the wire guides.

Remove the 2.0 mm Kirschner wires.


Insert the appropriate length 5.0 mm cannulated locking screws into the bone with power using the torque limiting attachment (TLA) and cannulated hexagonal screwdriver shaft.

Warning: If the torque limiting attachment (TLA) is unavailable, do not tighten the screws to the plate using power. Perform final tightening by hand.

Note: The self-drilling, self-tapping flutes of the 5.0 mm cannulated locking screws make predrilling and pretapping unnecessary in most cases. If necessary, in dense bone, the lateral cortex can be predrilled with the 4.3 mm cannulated drill bit.

Once both the anterior and posterior locking screws are securely locked to the plate, the central 5.0 mm cannulated conical screw may be removed and replaced with a third 5.0 mm cannulated locking screw using the technique described above.




6Reduce shaft to the tibial plateau

Instruments

321.12 Articulated Tension Device

398.81 Bone Forceps or 398.813 Plate Holding Forceps

Reduce the tibial plateau to the shaft of the tibia, using indirect reduction techniques whenever possible. Using atraumatic technique, secure the plate to the tibial shaft with bone forceps.

Confirm rotational alignment of the extremity by clinical examination.

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

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

7Insert screws in plate shaft

In addition to having threaded locking holes, the plate functions similarly to DCP plates which offer the ability to axially compress fracture fragments. Therefore, a combination of cortex screws and locking screws may be used.

Notes: – If a combination of cortex (1) and locking screws (2) is

used, a cortex screw should be inserted first to pull the plate to the bone.

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


Insert Screws in Plate Shaft

2 1 1 2

Incorrect

1 2 2 1

Correct



Instruments

03.010.150 Star/HexDrive Screwdriver, T25, 3.5 mm Hexagonal

310.31 3.2 mm Drill Bit

319.10 Depth Gauge

323.46 4.5 mm Universal Drill Guide

4.5 mm cortex screwsInsert as many self-tapping 4.5 mm cortex screws as necessary into the distal portion of the plate.

Note: All of the 4.5 mm cortex screws must be inserted prior to insertion of 4.0 mm or 5.0 mm locking screws.

Use the 4.5 mm universal drill guide to predrill for the 4.5 mm cortex screws and drill through both cortices with the 3.2 mm drill bit.

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

Measure for screw length using the depth gauge. Select and insert the appropriate length 4.5 mm cortex screw.



Instruments

03.010.150 Star/HexDrive Screwdriver, T25, 3.5 mm Hexagonal

03.010.151 Star/HexDrive Screwdriver Shaft, T25/ 3.5 mm Hexagonal

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

312.449 4.3 mm Threaded Drill Guide, for 5.0 mm Locking Screws

5.0 mm locking screwsAttach the 4.3 mm drill guide to the locking hole in the plate shaft. Drill a hole using the 4.3 mm drill bit.

Note: Use of the drill guide is mandatory for screws to lock to the plate properly.

Remove the drill guide and measure screw length using the depth gauge. Insert the appropriate length 5.0 mm locking screw with the StarDriveTM Screwdriver, or StarDrive Screwdriver shaft. Repeat as necessary to insert additional locking screws.

Examine the limb clinically and radiographically. It is important that the tibial plateau is in proper orientation to the tibial shaft.

Note: Securely tighten all locking screws again.


Alternative Instruments

310.31 3.2 mm Drill Bit

324.176 3.2 mm Drill Guide

Alternatively, when using 4.0 mm locking screws, use the appropriate 3.2 mm drill guide and 3.2 mm drill bit.



8 Insert 5.0 mm cannulated locking screws in the angled holes

Instruments






Note: Use the oblique locking positions to buttress a medial fragment.

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

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

Measure for screw length using the cannulated screw measuring device. The correct length measurement will place the screw tip at the tip of the guide wire. Use the 4.0 mm cannulated hexagonal screwdriver to remove the wire guide. Insert the appropriate length 5.0 mm cannulated locking screw, using the cannulated hexagonal screwdriver.

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


Repeat steps for locking screw insertion for the remaining angled hole.


Screw length considerationsWhen using the appropriate length screws in the angled locking holes, the screw tips should meet the proximal locking screws.

Suggested screw lengths to achieve desired screw convergence.

Note: Securely tighten all locking screws to lock them to the plate.


70 mm

65 mm

65 mm


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

– Fully threaded shaft

– Self-drilling, self-tapping tip

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


– Self-tapping tip

5.0 mm Cannulated Conical ScrewCompresses the plate to the lateral femoral condyle and provides interfragmentary compression– Smooth conical head

– Partially threaded shaft

– Self-drilling, self-tapping tip

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



4.5 mm Cortex Screw (found in the Large Fragment LCP Instrument and Implant Set, with 4.0 mm and 5.0 mm locking screws)– May be used in the DCU portion of the Combi holes

in the plate shaft

– Compresses the plate to the bone or creates axial compression


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

– Internal threads mate with the 5.0 mm cannulated conical screws

– Inserted from the lateral aspect of the proximal tibia

Note: See the DePuy Synthes 4.5 mm LCP® Condylar Plates Technique Guide for more information on use of the screw nut.

Screws Used with the 4.5 mm LCP Medial Proximal Tibia Plate


5.0 mm Cannulated Locking and Cannulated Conical ScrewsThe screw design enhances fixation and facilitates the surgical procedure.

Screw headThe conical head simplifies alignment in the plate hole. This is of particular importance when using locking screws. The threaded screw head must align with the plate hole threads to provide a secure screw/plate construct. To ensure proper alignment and prevent cross-threading, the appropriate threaded wire guide or drill guide must always be used.

Large diameter screw coreThe large diameter screw core improves bending and shear strength, and distributes the load over a larger area in the bone.

Thread profileThe shallow thread profile of the locking screws is necessary to provide a larger core. This is appropriate since locking screws do not rely on compression between the plate and the bone to maintain stability. When required, interfragmentary compression can be achieved with the partially threaded cannulated conical screws, especially when near the articular surface.

Screws Used with the 4.5 mm LCP Medial Proximal Tibia Plate


4.5 mm LCP® Medial Proximal Tibia Plate Implant Sets Stainless Steel (01.120.432) and Titanium (01.120.434)

Graphic Case690.394 4.5 mm LCP® Medial Proximal Tibia Plate Set

Graphic Case

Implants4.5 mm LCP Medial Proximal Tibia Plates◊

Stainless Steel Titanium Holes Length (mm)239.984 439.984 4 106 right239.985 439.985 4 106 left239.986 439.986 6 142 right239.987 439.987 6 142 left239.988 439.988 8 178 right239.989 439.989 8 178 left239.990 439.990 10 214 right239.991 439.991 10 214 left239.992 439.992 12 250 right239.993 439.993 12 250 left239.994 439.994 14 286 right239.995 439.995 14 286 left239.996 439.996 16 322 right239.997 439.997 16 322 left

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

Also Available Sets01.223.604 Periarticular LCP Plating System Instrument

and Titanium Screw Set01.240.401 Periarticular LCP Plating System,

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

with 4.0 mm Titanium Locking Screws105.210 Periarticular LCP Plating System Instrument

and Screw Set

◊ Available nonsterile or sterile-packed. Add ‘S’ to catalog number to order sterile product.

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

Recommended Additional Sets 105.909 Periarticular Reduction Forceps Set115.400 Large Fragment LCP Instrument and

Implant Set115.700 Large Distractor Set115.720 Large External Fixator Set with Self-Drilling

Schanz Screws146.400 Large Fragment LCP Instrument and Titanium

Implant Set, with 4.0 mm and 5.0 mm Locking Screws

146.405 Large Fragment LCP Instrument and Titanium Implant Set, with 4.0 mm and 5.0 mm Locking Screws

For detailed cleaning and sterilizationinstructions, please refer towww.synthes.com/cleaning-sterilization orsterilization instructions, if provided.


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

Graphic Case, Screw Racks, Tray60.240.201 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 mm Cannulated Locking Screws and 7.3 mm Conical Screws

60.240.206 Screw Rack for 5.0 mm Cannulated Conical Screws

60.240.208 Locking Periarticular Plating System Instrument Tray

Implants4.5 mm Cortex Screws, self-tapping, 4 ea.

Length (mm)

214.814 14214.816 16214.818 18

4.5 mm Cortex Screws, self-tapping, 6 ea.

Length (mm)

214.826 26214.828 28214.830 30214.832 32214.834 34


Length (mm)

214.844 44


Length (mm)

214.846 46 214.848 48214.850 50214.852 52214.854 54214.856 56214.858 58

Length (mm)

214.820 20214.822 22214.824 24

Length (mm)

214.836 36 214.838 38 214.840 40 214.842 42

Length (mm)

214.860 60 214.862 62 214.864 64 214.866 66 214.868 68 214.870 70


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

Implants

5.0 mm Periprosthetic Locking Screws, self-tapping, with T25 StarDrive Recess, 2 ea. Length (mm)

02.221.508 802.221.510 1002.221.512 12

5.0 mm Locking Screws, self-tapping, with T25 StarDrive Recess, 4 ea.

Length (mm)

212.201 14 212.202 16 212.203 18


Length (mm)

212.207 26212.208 28212.209 30212.210 32212.211 34


Length (mm)

212.216 44212.217 46212.218 48212.219 50212.220 55212.221 60

5.0 mm Cannulated Locking Screws, 2 ea.

Length (mm)

02.205.025 2502.205.030 3002.205.035 35

Length (mm)

212.212 36212.213 38212.214 40212.215 42

Length (mm)

212.222 65 212.223 70 212.224 75 212.225 80 212.226 85 212.227 90

Length (mm)

02.205.040 40 02.205.045 45 02.205.050 50

Length (mm)

212.204 20 212.205 22 212.206 24




Length (mm)

02.205.055 5502.205.060 6002.205.065 6502.205.070 70


Length (mm)

02.205.090 9002.205.095 9502.205.100 10002.205.105 10502.205.110 11002.205.115 115

5.0 mm Cannulated Conical Screws, 2 ea.

Length (mm)

02.205.240 4002.205.245 4502.205.250 5002.205.255 5502.205.260 6002.205.265 65


Length (mm)

02.207.020 2002.207.025 2502.207.030 3002.207.035 3502.207.040 4002.207.045 4502.207.050 5002.207.055 5502.207.060 6002.207.065 6502.207.070 7002.207.075 7502.207.080 80

Length (mm)

02.205.120 12002.205.125 12502.205.130 13002.205.135 13502.205.140 14002.205.145 145

Length (mm)

02.205.270 7002.205.275 7502.205.280 8002.205.285 8502.205.290 9002.205.295 95

Length (mm)

02.205.075 75 02.205.080 80 02.205.085 85

Length (mm)

02.207.085 8502.207.090 9002.207.095 9502.207.100 10002.207.105 10502.207.110 11002.207.115 11502.207.120 12002.207.125 12502.207.130 13002.207.135 13502.207.140 14002.207.145 145



Implants

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.

Instruments03.010.150 Star/HexDrive Screwdriver, T25/3.5 mm

Hexagonal, self-retaining

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

292.652 2.0 mm Non-Colored Threaded Guide Wire, spade point, 230 mm, 10 ea.

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 with 4.5 mm LCP® plates, 2 ea.

311.46 Tap for 4.5 mm Screws

312.449 4.3 mm Threaded Drill Guide for 5.0 mm Locking Screws, 4 ea.

312.48 4.5 mm/3.2 mm Insert Drill Sleeve

Length (mm)

02.207.275 7502.207.280 8002.207.285 8502.207.290 9002.207.295 95

Length (mm)

02.207.475 7502.207.480 8002.207.485 8502.207.490 9002.207.495 95



313.93 4.0 mm Solid Hexagonal Screwdriver

314.05 Cannulated 4.0 mm Hexagonal Screwdriver

314.11 Holding Sleeve

314.23 Cannulated 4.0 mm Hexagonal Screwdriver Shaft

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 AO Reaming Coupler

Also Available60.240.207 Screw Rack for 6.5 mm Cancellous Bone Screws

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 ComPact Air Drive Connection

398.81 Bone Forceps

398.813 Plate Holding Forceps with swivel foot

511.761 Large Quick Coupling

511.771 Torque Limiting Attachment, 4 Nm

Limited Warranty and Disclaimer: DePuy Synthes products are sold with a limited warranty to the original purchaser against defects in workmanship and materials. Any other express or implied warranties, including warranties of merchantability or fitness, are hereby disclaimed.

Please also refer to the package insert(s) or other labeling associated with the devices identified in this surgical technique for additional information.

CAUTION: Federal Law restricts these devices to sale by or on the order of a physician.

Some devices listed in this surgical technique may not have been licensed in accordance with Canadian law and may not be for sale in Canada. Please contact your sales consultant for items approved for sale in Canada.

Not all products may currently be available in all markets.

© DePuy Synthes 2006-2017. All rights reserved.DSUS/TRM/1016/1149 5/17 DV

Synthes USA, LLC 1101 Synthes AvenueMonument, CO 80132

Manufactured or distributed by:Synthes USA Products, LLC 1302 Wrights Lane EastWest Chester, PA 19380

To order (USA): 800-523-0322 To order (Canada): 855-946-8999

Note: For recognized manufacturer, refer to the product label.

www.depuysynthes.com

Documents

Part of the DePuy Synthes LCP Periarticular Plating System ...synthes.vo.llnwd.net/o16/LLNWMB8/US Mobile/Synthes... · Fixation. 3rd ed. Berlin Heidelberg New York: Springer. 1991