1.5 mm instrument and implant modules 1.5 mm lcp …synthes.vo.llnwd.net/o16/llnwmb8/us...

1.5 mm Instrument and Implant Modules

1.5 mm LCP® Modular Mini Fragment SystemSurgical Technique

1.5 mm LCP® Modular Mini Fragment System Surgical Technique DePuy Synthes 1

Introduction

Surgical Technique

Product Information

Table of Contents

1.5 mm LCP® Modular Mini Fragment System 2

AO Principles 4

Indications 5

Preoperative Planning and Reduction 6

Insert Plate 7

Insert Screws 10

Implant Removal 16

Implants 17 Instruments 20

Set Lists 21

Image intensifier control

MR Information The 1.5 mm LCP® Modular Mini Fragment 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 1.5 mm LCP® Modular Mini Fragment System in the MR environment is unknown. Scanning a patient who has this device may result in patient injury.

2 DePuy Synthes 1.5 mm LCP® Modular Mini Fragment System Surgical Technique

1.5 mm LCP® Modular Mini Fragment System. 1.5 mm instrument and implant modules.

The 1.5 mm LCP® Modular Mini Fragment System consists of 1.5 mm Locking Compression Plate (LCP) Instrument and Implant Module Sets.

Plates– Low profile designed to help

minimize soft tissue irritation

– Cut-to-length feature minimizes inventory

– Coaxial Combi holes allow the use of a locking screw or a cortex screw in the same round conical plate hole

– Available with or without short threaded drill guides preassembled to the plate

– Combi holes in the LCP Plates allow use of a cortex screw in the compression side of the hole or a locking screw in the threaded side of the hole


1.5 mm LCP Modular Mini Fragment System. 1.5 mm instrument and implant modules.

Locking screws– Self-tapping tip facilitates insertion

– Self-retaining StarDrive™ Recess allows improved torque transmission and increased resistance to stripping

– Threaded head profile used with LCP Plates creates a fixed-angle construct, particularly advantageous in osteopenic bone

– Low-profile head sits flush with the plate

– Available in stainless steel or titanium

Cortex screws– Self-tapping tip facilitates insertion

– Self-retaining StarDrive Recess allows improved torque transmission and increased resistance to stripping

– Used for compression

– Low-profile head sits flush with the plate

– Available in stainless steel or titanium

preassembled plate

Coaxial Combi holes allow the use of a locking screw or a cortex screw in the same round conical plate hole

Available with or without short threaded drill guides preassembled to the plate

Cut-to-length feature minimizes inventory


AO Principles

1

4

2

3

4_Priciples_03.pdf 1 05.07.12 12:08

4 DePuy Synthes Expert Lateral Femoral Nail Surgical Technique

AO PRINCIPLES

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

1 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 Synthes 1.5 mm LCP® Modular Mini Fragment System consists of plates and screws and is intended for fixation of small bones and small bone fragments; osteotomies, arthrodeses, replantations, and reconstructions of small bones and small bone fragments, particularly in osteopenic bone.


Preoperative Planning and Reduction

Preoperative planning

Use the AO preoperative planner template for the 1.5 mm LCP Modular Mini Fragment System.

Required sets

01.114.001/ 1.5 mm LCP Modular Mini Fragment 01.114.002 Instrument and Implant Set (stainless steel or titanium) or 01.114.501/ 1.5 mm LCP Modular Mini Fragment 01.114.502 Instrument and Implant Set, with Drill Guides (stainless steel or titanium)

105.200/ Modular Hand System 145.200 (stainless steel or titanium) or 01.111.120/ Modular Mini Fragment LCP Instrument 01.111.140 and Implant Set (stainless steel or titanium)

1Reduce fracture

Instruments

292.10/ 1.0 mm Kirschner Wire, trocar point 492.10 (stainless steel or titanium) or 292.50* 1.0 mm Kirschner Wire, trocar points on both ends (stainless steel)

399.97 Reduction Forceps, with points

Reduce the fracture under imaging and, if necessary, fix with Kirschner wires or reduction forceps.

* Also available


Insert Plate

2Trim plate

Instrument

391.98* Plate Cutter, for 1.0 mm–2.0 mm plates

The plate cutter can be used on a preassembled plate without removal of the short threaded drill guides.

Optional instrument

391.962 Bending/Cutting Pliers Note: If the bending/cutting pliers are used on a plate preassembled with drill guides, the drill guides must first be removed from the plate.

Trim the plate to the desired length using the cutters and remove the burrs.

* Also available


3Contour plate (optional)

Instrument

03.114.003 Threaded Bending Pin, for 1.5 mm LCP Plates

If necessary, use threaded bending pins to contour the plate to fit the patient’s anatomy. The bending pins can be inserted over the short threaded drill guides or threaded into the screw holes. The threaded bending pins should be used to prevent deformation of the threaded holes while bending.

Optional instruments

391.962 Bending/Cutting Pliers

391.963 Universal Bending Pliers

The non-preassembled plates can also be bent using the flat-nosed pliers.

Precautions: – If possible, bend the plate between the locking/LCP Plate

holes. Do not deform the threaded part of the holes or over-bend the plate during bending as this may adversely affect insertion of locking screws.

– Reverse bending or use of the incorrect instrumentation for bending may weaken the plate and lead to premature plate failure (e.g., breakage). Do not bend the plate beyond what is required to match the anatomy.

Insert Plate


4Position plate

Instruments

292.10/ 1.0 mm Kirschner Wire, trocar point 492.10 (stainless steel or titanium) or 292.50* 1.0 mm Kirschner Wire, trocar points on both ends (stainless steel)

398.819 Plate Holding Forceps with swivel foot, 150 mm

399.97 Reduction Forceps, with points

Position the plate over the reduced fracture using forceps and fix provisionally with Kirschner wires or reduction forceps, if necessary.

Note: If using a preassembled plate, the short threaded drill guides must be removed from surrounding holes to allow plate holding forceps to sit flush on the plate. The point of pointed reduction forceps can be inserted in the cannulation of the short threaded drill guides to secure the plate to the bone.

Insert Plate

* Also available


5Determine screw type

Depending on the individual case, cortex screws and/or locking screws may be inserted. Determine where locking screws will be used. Locking or cortex screws can be used in any of the screw holes, with the exception of the nonthreaded elongated hole, which only accepts 1.5 mm cortex screws. If a combination of locking and cortex screws is planned, a cortex screw should be inserted first to pull the plate to the bone. If a locking screw is inserted first, ensure that the plate is held securely to the bone, to avoid spinning of the plate as the screw is locked into the plate.

Insert Screws


6Insert screws in plate head

Instruments

03.114.009 StarDrive Screwdriver Shaft, with Holding Sleeve, T4, 66 mm

311.01 Handle, with mini quick coupling

319.004 Depth Gauge, for 1.3 mm and 1.5 mm screws

Alternative instrument

03.114.002 Screwdriver Shaft, T4, 42 mm, self-retaining

For use with 1.5 mm locking screws

03.114.007 1.1 mm Drill Bit, mini quick coupling, 75 mm

For use with 1.5 mm cortex screws


310.141 1.5 mm Drill Bit, mini quick coupling, 65 mm

312.14 1.5 mm/1.1 mm Double Drill Sleeve

A 1.5 mm cortex screw can be inserted in the nonthreaded elongated hole. Adjust the plate as necessary and tighten the screw.

Note: The fracture pattern will dictate the optimal screw placement.

Insert 1.5 mm cortex or locking screws in the head of the plate. If a cortex screw will be inserted normal to the plate, the short threaded drill guide can be used. If a cortex screw will be angled or inserted using a lag technique, use the double drill sleeve. Use the 1.1 mm drill bit for the threaded hole and the 1.5 mm drill bit for the gliding hole. Determine the screw length using the depth gauge.

Insert Screws


6. Insert screws in plate head continued

Notes: If using a preassembled plate, the short threaded drill guide must be removed from the hole before using the double drill sleeve.

If measuring through the short threaded drill guide, subtract 5 mm from the reading, to account for the drill guide.

Drill for a 1.5 mm locking screw using the short threaded drill guide preassembled in the plate, and the 1.1 mm drill bit. Measure for screw length using the depth gauge.

Note: If measuring through the short threaded drill guide, subtract 5 mm from the reading, to account for the drill guide.

Alternative technique

Instrument

03.114.001 1.1 mm LCP® Threaded Drill Guide

On non-preassembled plates, thread the 1.1 mm threaded drill guide into the hole and drill.

Note: Remove the 1.1 mm LCP Threaded Drill Guide before measuring.

Insert Screws



7Insert screws in plate shaft

Instruments



319.004 Depth Gauge, for 1.3 mm and 1.5 mm screws



For use with 1.5 mm locking screws


For use with 1.5 mm cortex screws



312.14 1.5 mm/1.1 mm Double Drill Sleeve

A 1.5 mm cortex screw can be inserted in the nonthreaded elongated hole. Adjust the plate as necessary and tighten the screw.

Note: The fracture pattern will dictate the optimal screw placement.

Insert 1.5 mm cortex or locking screws in the plate shaft. If a cortex screw will be inserted normal to the plate, the short threaded drill guide can be used. If a cortex screw will be angled or inserted using a lag technique, use the double drill sleeve. Use the 1.1 mm drill bit for the threaded hole and the 1.5 mm drill bit for the gliding hole. Determine the screw length using the depth gauge.

Insert Screws


7. Insert screws in plate shaft continued

Notes: If using a preassembled plate, the short threaded drill guide must be removed from the hole before using the double drill sleeve. If measuring through the short threaded drill guide, subtract 5 mm from the reading, to account for the drill guide.

Drill for a 1.5 mm locking screw using the short threaded drill guide preassembled in the plate, and the 1.1 mm drill bit. Measure for screw length using the depth gauge.

Note: If measuring through the short threaded drill guide, subtract 5 mm from the reading, to account for the drill guide.


Instrument

03.114.001 1.1 mm LCP® Threaded Drill Guide

On non-preassembled plates, thread the 1.1 mm threaded drill guide into the hole and drill.

Note: Remove the 1.1 mm LCP Threaded Drill Guide before measuring.

Insert Screws


8Remove short threaded drill guides

Instruments





Note: Be sure to remove all short threaded drill guides when using preassembled plates. The removable tray located in the bottom of the module can serve as a tool to help remove the short drill guides from the screwdriver shaft. It is recommended to count the short threaded drill guides, to ensure they are all removed before closure.

Insert Screws


Implant Removal

Implant removal

Instruments





Loosen all locking screws first, to prevent the plate from rotating during removal of the last locking screw. Remove all screws in a second step. If the screw threads are stripped, a stripped screw extractor can be used. An extraction bolt or hollow reamer can be used to engage shaft threads for removal.


1.5 mm Cortex Screws, self-tapping, with T4 StarDrive Recess– Used to provide compression or neutral fixation

– Low-profile head sits flush in the plate holes

– StarDrive Recess mates with self-retaining screwdriver and provides improved torque transmission

– 6 mm to 24 mm lengths

1.5 mm Locking Screws, self-tapping, with T4 StarDrive Recess– Threaded, conical head locks securely in Combi

holes of the plate, to provide angular stability

– Locked screws allow unicortical screw fixation and load transfer to the near cortex

– StarDrive Recess mates with self-retaining screwdriver and provides improved torque transmission

– 6 mm to 24 mm lengths

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

Implants

Screws are made of implant-quality 316L stainless steel or titanium alloy (Ti-6AI-7Nb)


1.5 mm LCP PlatesStainless Steel Titanium Holes Length (mm)02.114.002 04.114.002 4 2302.114.004 04.114.004 6 36

1.5 mm LCP Adaption PlatesStainless Steel Titanium Holes Length (mm)02.114.003 04.114.003 6 2902.114.005 04.114.005 12 59

1.5 mm LCP T-PlatesStainless Steel Titanium Description02.114.006 04.114.006 3 holes head, 8 holes shaft02.114.007 04.114.007 4 holes head, 8 holes shaft

1.5 mm LCP Extended H-PlatesStainless Steel Titanium Description02.114.010 04.114.010 right02.114.009 04.114.009 left

1.5 mm LCP Y-PlateStainless Steel Titanium Description02.114.013 04.114.013 3 holes head, 8 holes shaft

1.5 mm LCP Condylar PlateStainless Steel Titanium Description02.114.014 04.114.014 6 holes shaft

Implants

Plates are made of implant-quality 316L stainless steel or commercially pure (CP) titanium


Plates, assembled with short threaded drill guides1.5 mm LCP PlatesStainless Steel Titanium Holes Length (mm)02.114.502 04.114.502 4 2302.114.504 04.114.504 6 36

1.5 mm LCP Adaption PlatesStainless Steel Titanium Holes Length (mm)02.114.503 04.114.503 6 2902.114.505 04.114.505 12 59

1.5 mm LCP T-PlatesStainless Steel Titanium Description02.114.506 04.114.506 3 holes head, 8 holes shaft02.114.507 04.114.507 4 holes head, 8 holes shaft

1.5 mm LCP Extended H-PlatesStainless Steel Titanium Description02.114.509 04.114.509 left 02.114.510 04.114.510 right

1.5 mm LCP Y-PlateStainless Steel Titanium Description02.114.513 04.114.513 3 holes head, 8 holes shaft

1.5 mm LCP Condylar PlateStainless Steel Titanium Description02.114.514 04.114.514 6 holes shaft

Implants


Instruments

03.114.001 1.1 mm LCP Threaded Drill Guide, for 1.5 mm LCP® Plates

03.114.002 StarDrive Screwdriver Shaft, T4, 42 mm, self-retaining

03.114.003 Threaded Bending Pin, for 1.5 mm LCP plates



310.971 Countersink, for 1.3 mm and 1.5 mm screws



1.5 mm LCP Modular Mini Fragment Instrument and Implant Sets Stainless Steel (01.114.001) and Titanium (01.114.002)

Module60.114.001 1.5 mm LCP Module Case306.667.96 Screw Length Marker Kit

Instruments03.114.001 1.1 mm LCP Threaded Drill Guide, for 1.5 mm

LCP Plates, 2 ea.03.114.002 StarDrive Screwdriver Shaft, T4, 42 mm,

self-retaining03.114.003 Threaded Bending Pin, for 1.5 mm LCP plates,

2 ea.03.114.007 1.1 mm Drill Bit, mini quick coupling, 75 mm,

2 ea.03.114.009 StarDrive Screwdriver Shaft, with Holding

Sleeve, T4, 66 mm310.141 1.5 mm Drill Bit, mini quick coupling, 65 mm,

2 ea.310.971 Countersink, for 1.3 mm and 1.5 mm screws

Implants1.5 mm Locking Screws, self-tapping, with T4 StarDrive Recess Length Stainless Steel Titanium (mm) Qty.

02.214.006 04.214.006 6 602.214.007 04.214.007 7 602.214.008 04.214.008 8 602.214.009 04.214.009 9 602.214.010 04.214.010 10 602.214.011 04.214.011 11 602.214.012 04.214.012 12 602.214.013 04.214.013 13 602.214.014 04.214.014 14 602.214.015 04.214.015 15 602.214.016 04.214.016 16 402.214.018 04.214.018 18 402.214.020 04.214.020 20 402.214.022 04.214.022 22 402.214.024 04.214.024 24 4

1.5 mm Cortex Screws, self-tapping, with T4 StarDrive Recess Length Stainless Steel Titanium (mm) Qty.

02.214.106 04.214.106 6 602.214.107 04.214.107 7 602.214.108 04.214.108 8 602.214.109 04.214.109 9 602.214.110 04.214.110 10 602.214.111 04.214.111 11 602.214.112 04.214.112 12 602.214.113 04.214.113 13 602.214.114 04.214.114 14 602.214.115 04.214.115 15 602.214.116 04.214.116 16 402.214.118 04.214.118 18 402.214.120 04.214.120 20 402.214.122 04.214.122 22 402.214.124 04.214.124 24 4

Note: For additional information, please refer to package insert.

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

www.synthes.com/cleaning-sterilization


1.5 mm LCP Modular Mini Fragment Instrument and Implant Sets Stainless Steel (01.114.001) and Titanium (01.114.002)

Implants continuedWithout Short Threaded Drill Guides

1.5 mm LCP Plates, 2 ea.

Stainless Steel Titanium Holes Length (mm)

02.114.002 04.114.002 4 2302.114.004 04.114.004 6 36

1.5 mm LCP Adaption Plates, 2 ea.

Stainless Steel Titanium Holes Length (mm)

02.114.003 04.114.003 6 2902.114.005 04.114.005 12 59

1.5 mm LCP T-Plates, 2 ea.

Stainless Steel Titanium Description

02.114.006 04.114.006 3 holes head, 8 holes shaft02.114.007 04.114.007 4 holes head, 8 holes shaft

1.5 mm LCP Extended H-Plates, 2 ea.


02.114.009 04.114.009 left02.114.010 04.114.010 right

1.5 mm LCP Y-Plate, 2 ea.


02.114.013 04.114.013 3 holes head, 8 holes shaft

1.5 mm LCP Condylar Plate, 2 ea.


02.114.014 04.114.014 6 holes shaft


1.5 mm LCP Modular Mini Fragment Instrument and Implant Sets with Drill Guides Stainless Steel (01.114.501) and Titanium (01.114.502)

Module60.114.001 1.5 mm LCP Module Case306.667.96 Screw Length Marker Kit

Instruments03.114.001 1.1 mm LCP Threaded Drill Guide, for 1.5 mm

LCP Plates, 2 ea.03.114.002 StarDrive Screwdriver Shaft, T4, 42 mm,

self-retaining03.114.003 Threaded Bending Pin, for 1.5 mm LCP

plates, 2 ea.03.114.007 1.1 mm Drill Bit, mini quick coupling, 75 mm,

2 ea.03.114.009 StarDrive Screwdriver Shaft, with Holding

Sleeve, T4, 66 mm310.141 1.5 mm Drill Bit, mini quick coupling, 65 mm,

2 ea.310.971 Countersink, for 1.3 mm and 1.5 mm screws

Implants1.5 mm Locking Screws, self-tapping, with T4 StarDrive Recess Length Stainless Steel Titanium (mm) Qty.

02.214.006 04.214.006 6 602.214.007 04.214.007 7 602.214.008 04.214.008 8 602.214.009 04.214.009 9 602.214.010 04.214.010 10 602.214.011 04.214.011 11 602.214.012 04.214.012 12 602.214.013 04.214.013 13 602.214.014 04.214.014 14 602.214.015 04.214.015 15 602.214.016 04.214.016 16 402.214.018 04.214.018 18 402.214.020 04.214.020 20 402.214.022 04.214.022 22 402.214.024 04.214.024 24 4

1.5 mm Cortex Screws, self-tapping, with T4 StarDrive Recess Length Stainless Steel Titanium (mm) Qty.

02.214.106 04.214.106 6 602.214.107 04.214.107 7 602.214.108 04.214.108 8 602.214.109 04.214.109 9 602.214.110 04.214.110 10 602.214.111 04.214.111 11 602.214.112 04.214.112 12 602.214.113 04.214.113 13 602.214.114 04.214.114 14 602.214.115 04.214.115 15 602.214.116 04.214.116 16 402.214.118 04.214.118 18 402.214.120 04.214.120 20 402.214.122 04.214.122 22 402.214.124 04.214.124 24 4


1.5 mm LCP Modular Mini Fragment Instrument and Implant Sets with Drill Guides Stainless Steel (01.114.501) and Titanium (01.114.502)

Implants continuedWith Short Threaded Drill Guides

1.5 mm LCP PlatesStainless Steel Titanium Holes Length (mm)

02.114.502 04.114.502 4 2302.114.504 04.114.504 6 36

1.5 mm LCP Adaption PlatesStainless Steel Titanium Holes Length (mm)

02.114.503 04.114.503 6 2902.114.505 04.114.505 12 59

1.5 mm LCP T-PlatesStainless Steel Titanium Description

02.114.506 04.114.506 3 holes head, 8 holes shaft02.114.507 04.114.507 4 holes head, 8 holes shaft

1.5 mm LCP Extended H-PlatesStainless Steel Titanium Description

02.114.509 04.114.509 left02.114.510 04.114.510 right

1.5 mm LCP Y-PlateStainless Steel Titanium Description

02.114.513 04.114.513 3 holes head, 8 holes shaft

1.5 mm LCP Condylar PlateStainless Steel Titanium Description

02.114.514 04.114.514 6 holes shaft


Also Available

Required Set01.111.120/ Modular Mini Fragment LCP Instrument 01.111.140 and Implant Set (stainless steel or titanium)

or

105.200/ Modular Hand System 145.200 (stainless steel or titanium)

Instruments03.114.008 1.1 mm Drill Bit, Stryker J-latch, 85 mm03.114.010 StarDrive Screwdriver Shaft, T4, 66 mm391.98 Plate Cutter, for 1.0 mm–2.0 mm plates292.50 1.0 mm Kirschner Wire, trocar points on

both ends

Lid and Tray60.114.003 Lid for 1.5 mm LCP Module Case60.114.004 Tray for Small Threaded Drill Guides,

for 1.5 mm module

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 2009–2017. All rights reserved.DSUS/TRM/1016/1121 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

www.depuysynthes.com

1.5 mm instrument and implant modules 1.5 mm lcp …synthes.vo.llnwd.net/o16/llnwmb8/us...

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