LCP Locking Compression PlateSurgical Technique
Image intensifier control
This description alone does not provide sufficient background for direct use of DePuy Synthes products. Instruction by a surgeon experienced in handling these products is highly recommended.
Processing, Reprocessing, Care and MaintenanceFor general guidelines, function control and dismantling of multi-part instruments, as well as processing guidelines for implants, please contact your local sales representative or refer to:http://emea.depuysynthes.com/hcp/reprocessing-care-maintenanceFor general information about reprocessing, care and maintenance of Synthes reusable devices, instrument trays and cases, as well as processing of Synthes non-sterile implants, please consult the Important Information leaflet (SE_023827) or refer to: http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance
Surgical Technique LCP Locking Compression Plate DePuy Synthes 1
Table of Contents
Introduction LCP Locking Compression Plate 2
LCP Metaphyseal Plates 4
AO Principles 5
Intended Use, Indications and Contraindications 6
Surgical Technique Standard Plate Technique 8
Insert Self-tapping Locking Screws 15
Insert Self-drilling, Self-tapping Locking Screws 24
Indirect Reduction with Locking Screws 26
Drilling with the LCP Universal Drill Guide 29
Insert LCP Spacers 31
Metaphyseal Plates for extra articular fractures 32
Examples of the Combination Technique 36
Remove the Implant 37
Product Information Basic LCP Plates 38
Screws 48
Spacers 51
Cerclage 52
Instruments 54
Discontinued Implants 59
MRI Information 61
Stardrive
Hex drive
1 DePuy Synthes LCP Locking Compression Plate Surgical Technique
System overview
LCP Locking Compression Plate
Angular stable implant
Angular stable support of fragments
LCP and screw constructs work as a unit, avoiding sequential screw failure seen in non-locked plating, providing increased stability1
Limited plate-periosteum contact
Locking screws provide hold also in osteoporotic bone and in multiple fragment fractures2
Stability of the implant and the construct: Locking screws can be placed in each locking hole of the plate
Because the screws are tightly locked in the plate, the risk is reduced for:• Tension on the bone• Compression between the plate
and bone
The plate does not have to be precisely shaped to the bone to provide stability
1 Yaffe MA, Saucedo JM, Kalainov DM. Non-locked and locked plating technology for hand fractures. J Hand Surg Am. Dec 2011;36(12):2052-5.
2 Wagner M. General principles for the clinical use of the LCP. Injury. Nov 2003;34 Suppl 2:B31-42.
A
B
F
Surgical Technique LCP Locking Compression Plate DePuy Synthes 1
Reduction maintained under a load LCP combi-hole
Stable bridging of comminuted fractures
The stable plate-screw connection reduces the risk of secondary loss of reduction in the epiphyseal and metaphyseal regions2
The screws are locked in the plate, and the physiological load (F) is transferred from the bone to the plate
2 Wagner M. General principles for the clinical use of the LCP. Injury. Nov 2003;34 Suppl 2:B31-42.
The fragments are fi xed in their reduced position without regard to the plate model (internal fi xator)
The bone fragments are fi xed in the position assumed at the time the screws are locked
A Stable plate-screw connection• Locking screws reduce the risk of
screw loosening• Excessive torque is not applied to
the cortical bone• The conical screw head facilitates
screw insertion
B Compatibility• The dynamic compression hole
allows the use of standard (Cortex or Cancellous Bone) screws
Self-tapping locking screws
• Use after precisely measuring the length (metaphysis)
• Monocortical or bicortical use• Not necessary to separately tap
thread
Standard (Cortex or Cancellous Bone) screws
• Dynamic compression is created by the eccentric insertion of the stan-dard screws (analogous to LC-DCP)
4 DePuy Synthes LCP Locking Compression Plate Surgical Technique
LCP Metaphyseal Plates. For extra-articular fractures.
LCP combi-holes allow uncompromising combinationsThe combi-hole allows an internal plate fixation using standardscrews, angular stable locking screws, or a combination of both. This takes into account the most diverse intraoperative requirements.
Angular stability allows for improved fixationThe angle- and axis-stable locking screws may prevent loss of reduction under load. A precise anatomical contouring of the plate is unnecessary when using this system as a locking internal fixator.
Feasability of plate contouring due to thinned plate profileThe plate design facilitates anatomical contouring con-siderably, whilst taking into account the distinctive fea-tures of the metaphyseal bone area (e.g. complex bone shapes, thin soft tissue envelope).
Extra-articular fixation with the advantage of angled locking screwsThe two distal holes in the thinned area of the plate, which are angled at 11° towards the centre of the plate, may allow an application of the locking screws in the epiphyseal area.
Additional design features• Bullet nose plate tip for application of the minimally
invasive surgical technique.• Temporary fixation can be achieved through the
suture hole.• Improved vascularization of the periost due to plate
undercuts that reduce the plate-to-bone contact.• The elongated hole in the shaft are designed to allow
fine tuning of the reduction in the longitudinal axis.
Features
LCP Metaphyseal Plate 3.5
LCP Metaphyseal Plate 3.5/4.5/5.0
1
4
2
3
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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.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 5
AO Principles
1 Müller ME, Allgöwer M, Schneider R, Willenegger H. Manual of Internal Fixation. 3rd ed. Berlin, Heidelberg, New York: Springer. 1991.
2 Rüedi TP, Buckley RE, Moran CG. AO Principles of Fracture Management. 2nd ed. Stuttgart, New York: Thieme. 2007.
Stable fixationFracture fixation providing absolute or relative stability, as required by the patient, the injury, and the personality of the fracture.
Anatomic reductionFracture reduction and fixation to restore anatomical relation-ships.
Early, active mobilizationEarly and safe mobilization and rehabilitation of the injured part and the patient as a whole.
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 fixation1,2.
6 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Intended Use, Indications and Contraindications
Intended Use Locking Compression Plate (LCP) Implants are intended for temporary fixation, correction or stabilization of bones in various anatomical regions.
This Surgical Technique applies to the Depuy Synthes LCP Locking Compression Plate Systems and product lines listed below, which include but are not limited to the following indications:
IndicationsThe indications for each system will be presented indi-vidually.
Small Fragment plates (3.5) LCP Plates 3.5Fixation of small bone fragments using the five standard AO plating principles (buttress plate, neutralization plate, tension band plate, bridge plate, compression plate).
LCP Reconstruction Plates 3.5Fixation of small bone fragments using the five standard AO plating principles (buttress plate, neutralization plate, tension band plate, bridge plate, compression plate).
LCP T-Plates 3.5Fixation of small bone fragments using the five standard AO plating principles (buttress plate, neutralization plate, tension band plate, bridge plate, compression plate). Fracture fixation and fixation after osteotomies, mal-unions, non-unions; e.g. including but not limited to distal radius, proximal and distal tibia, proximal humerus, clavicular.
LCP One-third Tubular Plates 3.5 The LCP One-third Tubular Plates 3.5 are indicated for plating of fractures of long and small bones. The plate should only be used for load-sharing purposes, e.g. but-tressing, tension banding, neutralization or compression.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 7
LCP Methaphyseal 3.5The LCP Metaphyseal Plates are indicated to fix extra- articular fractures in the metaphyseal area that can extend into the shaft area. The 3.5 mm plates are indi-cated to fix fractures of the distal humerus and distal fibula.
Large Fragment plates (4.5/5.0)LCP Methaphyseal 3.5/4.5/5.0The LCP Metaphyseal Plates are indicated for Extra- arti cular fractures of the metaphyseal area that extend into the shaft area.
The 4.5/5.0 plates are indicated to fix fractures of the proximal humerus and distal tibial.
LCP 4.5/5.0 Narrow PlatesLCP T-Plates 4.5/5.0LCP 4.5/5.0 Broad PlatesLCP 4.5/5.0 Broad Curved PlatesLCP Reconstruction Plates 4.5/5.0
In general the LCP Generic Plates & Instruments (Large Fragment) are indicated for the osteosynthesis of frac-tures at the Femur, Tibia, Humerus and Pelvic at proxi-mal, distal and shaft areas.
In the case of metaphyseal fractures, comminuted frac-tures and osteoporotic bone, the clinical results can be improved by the angular stable screw/plate connection.
ContraindicationsNo specific contraindications.
8 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Standard Plate Technique
1. Reduce the fracture
Reduce the fracture under the image intensifier. As needed, provide fixation with Kirschner wire or reducing forceps.
AlternativeReduce the fracture indirectly using the plate by means of standard screws (for lag screw technique: to generate interfragmentary compression, use cancellous bone or cortical bone screws, see examples of the Combination Technique on page 36).
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 con-tainer.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 9
2. Bend the plate
Instruments
Small fragment
329.040 Bending Iron for Plates 2.4 to 3.5, length 145 mm (for use with 329.050)
329.050 Bending Iron for Plates 2.4 to 3.5, length 145 mm (for use with 329.040)
329.150 Bending Pliers for Plates 2.4 to 4.0, length 230 mm
329.290 Bending Pliers for Reconstruction Plates 2.7 and 3.5
Large fragment
329.300 Bending Press, length 400 mm
329.240 Bending Pliers for Plates 4.5, length 250 mm, complete, with Anvils Nos. 329.250 and 329.260
329.020 Bending Iron for LC-DCP 4.5 and DCP 4.5, length 250 mm (two required)
329.080 Bending Iron for Reconstruction Plates 3.5 and 4.5, length 190 mm
Precisely contour the LCP plate to the anatomy using the appropriate bending instruments (as for standard plates), especially in the case of joint fractures.
Precautions:• Reverse bending or use of the incorrect instrumen-
tation 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.
• Do not bend the plate at the level of the holes.
Note: The LCP combi-holes are asymmetrical in the plate. In straight plates, the hole alignment changes in the middle of the plate. This asymmetry enables unidirectional dynamic compression to be exerted.
11 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Standard Plate Technique
3. Position plate
Position the plate on the bone, and preliminarily fix it. If axial dynamic compression is used, make sure that the middle of the plate is above the fracture line.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 11
4. Select the drill guide position
Instruments
Small fragment
323.360 Universal Drill Guide 3.5
Large fragment
323.460 Universal Drill Guide 4.5/3.2, for neutral and load position
a. Select the neutral positionPress the spring-loaded guide against the bone in the DC part of the LCP hole. The inner sleeve retracts. The rounded end of the outer sleeve slides along the hole angle into neutral position. This enables neutral pre-drilling.
b. Select eccentric position (dynamic compression)Place the universal drill guide on the edge of the DC part of the LCP hole without exerting any pressure. The inner sleeve remains in its original state. The dynamic com-pression is generated by setting and tightening the cortex screw.
Note: The LC-DCP Drill Guides are unsuitable for LCP plates.
11 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Standard Plate Technique
5. Drill screw hole
Instruments
Small fragment
310.230 Drill Bit B 2.5 mm, length 180/155 mm, 2-flute, for Quick Coupling
Large fragment
310.290 Drill Bit B 3.2 mm, length 195/170 mm, 2-flute, for Quick Coupling
Drill with an appropriate drill bit.
6. Determine screw length
Instruments
Small fragment
319.010 Depth Gauge for Screws B 2.7 to 4.0 mm, measuring range up to 60 mm
Large fragment
319.100 Depth Gauge for Screws B 4.5 to 6.5 mm, measuring range up to 110 mm
Measure the screw length with the depth gauge.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 11
7. Option: Tap the thread
Instruments
Small fragment
311.320 Tap for Cortex Screws B 3.5 mm, length 110/50 mm
Large fragment
311.460 Tap for Cortex Screws B 4.5 mm, length 125/70 mm
If non-self-tapping screws are used, tap a thread manually.
14 DePuy Synthes LCP Locking Compression Plate Surgical Technique
8. Insert standard (Cortex or Cancellous Bone) screw
Instruments
311.440 T-Handle with Quick Coupling
Small fragment
314.070 Screwdriver, hexagonal, small, 2.5 mm, with Groove
Large fragment
314.270 Screwdriver, hexagonal, large, B 3.5 mm, with Groove, length 245 mm
Using the screwdriver, manually insert and tighten a standard screw with the measured length. Depending on the selected type of predrilling, no compression (a) or dynamic compression (b) may be generated.
Option: Insert a 2.7 mm cortex screw in a small fragment plate Place an LCP Washer 2.7/3.5 (X19.981) in the DC hole part of the 3.5 mm LCP plate. In this case, predrill with a Drill Bit with a 2.0 mm diameter (310.190).
Notes: • The holes in the straight LCP plates are larger at
the two ends to allow the insertion of cancellous bone screws.
• If a combination of cortex and locking screws is used, a cortex screw should be inserted first to generate interfragmentary compression.
(a) no compression (b) dynamic compression
Standard Plate Technique
Surgical Technique LCP Locking Compression Plate DePuy Synthes 15
Insert Self-tapping Locking Screws
1. Reduce the fracture and preliminarily fix it
Reduce the fracture under the image intensifier, and fix it with Kirschner wires or reducing forceps.
2. Bend the plate
Adapt the plate to the anatomy using the appropriate bending instruments. (See section 2 “Bend the plate” on page 9).
Precautions:• Reverse bending or use of the incorrect instrumen-
tation 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.
• Do not bend the plate at the level of the holes.
3. Position the plate and preliminarily fix it
Position the plate on the bone, and preliminarily fix it (for preliminary fixation using an LCP centering sleeve for Kirschner wires, see step 5).
Before setting the first locking screw, make sure that the plate is provisionally fixed well to prevent rotating since it could damage soft tissue when locking the screw.
16 DePuy Synthes LCP Locking Compression Plate Surgical Technique
4. Insert LCP drill sleeve
Instruments
Small fragment
323.027 LCP Drill Sleeve 3.5, for Drill Bits B 2.8 mm
Large fragment
323.042 LCP Drill Sleeve 5.0, for Drill Bits B4.3 mm
Carefully screw the LCP drill sleeve into the desired LCP hole until it is gripped completely by the thread.
Precaution: The use of the LCP drill sleeve is man-datory in order to ensure that the locking screw is drilled in the proper perpendicular angle and cor-rectly locked in the plate.
Notes: • To make it easier for the drill sleeve to grip the
thread, it may be useful to slightly rotate it to the left (back).
• In the case of meta-epiphyseal plates, the threaded hole is usually not perpendicular to the plate sur-face due to the anatomy.
Insert Self-tapping Locking Screws
Surgical Technique LCP Locking Compression Plate DePuy Synthes 17
5. Option: Insert Kirschner wire
Instruments
Small fragment
323.055 Centering Sleeve for Kirschner Wire B 1.6 mm, length 70 mm, for Nos. 323.027 and 323.054
or324.081 Centering Sleeve for Kirschner Wire
B 1.25 mm
292.120.01 Kirschner Wire B 1.25 mm with trocar tip, length 150 mm, Stainless Steel
292.160.01 Kirschner Wire B 1.6 mm with trocar tip, length 150 mm, Stainless Steel
Large fragment
323.044 Centering Sleeve for Kirschner Wire B 2.0 mm, length 110 mm, for No. 323.042
292.200.01 Kirschner Wire B 2.0 mm with trocar tip, length 150 mm, Stainless Steel
Insert the centering sleeve for Kirschner wires into the LCP drill sleeve. To allow the locking screw alignment to be checked later, use a power tool to insert a Kirschner wire and check its position under the image intensifier (see section metaphyseal plates). This check is especially recommendable in the metaphyseal region. Remove the Kirschner wire and the centering sleeve for Kirschner wires.
Note: If the angle of the locking screw is not opti-mal, it can be corrected. Bend the plate as needed, or move it in a proximal or distal direction. This technique is also suitable to preliminarily fix the plate to the bone.
18 DePuy Synthes LCP Locking Compression Plate Surgical Technique
6. Drill screw hole
Instruments
Small fragment
310.284 LCP Drill Bit B 2.8 mm with Stop, length 165 mm, 2-flute, for Quick Coupling
Large fragment
310.430 LCP Drill Bit B 4.3 mm with Stop, length 221 mm, 2-flute, for Quick Coupling
Carefully drill the screw hole using an appropriate drill bit.
Shove the stop ring down to the drill sleeve to make reading easier. Remove the drill sleeve.
Note: Replacement stop rings can be ordered from the local Depuy Synthes representative.
Insert Self-tapping Locking Screws
Surgical Technique LCP Locking Compression Plate DePuy Synthes 19
7. Determine screw length
Read the drilled depth directly from the laser mark on the drill bit.
Alternative
Instruments
Small fragment
319.010 Depth Gauge for Screws B 2.7 to 4.0 mm, measuring range up to 60 mm
Large fragment
319.100 Depth Gauge for Screws B 4.5 to 6.5 mm, measuring range up to 110 mm
Determine the screw length with the depth gauge.
11 DePuy Synthes LCP Locking Compression Plate Surgical Technique
8. Insert locking screw
Instruments
Small fragment
511.770 Torque Limiter, 1.5 Nm, for Compact Air Drive and Power Drive
or511.115 Torque Limiter, 1.5 Nm,
for Compact Air Drive and Power Drive
314.116 Screwdriver Shaft Stardrive 3.5, T15, self-holding, for AO/ASIF Quick Coupling
314.030 Screwdriver Shaft, hexagonal, small, B 2.5 mm
Large fragment
511.771 Torque Limiter, 4.0 Nm, for Compact Air Drive and Power Drive
314.119 Screwdriver Shaft Stardrive 4.5/5.0, T25, self-holding, for AO/ASIF Quick Coupling
or314.163 Torque-limiting Screwdriver Stardrive,
T25, self-holding, for Locking Screws B 5.0 mm
314.150 Screwdriver Shaft, hexagonal, large, B 3.5 mm
or314.152 Screwdriver Shaft 3.5, hexagonal,
self-holdingor324.052 Torque-limiting Screwdriver 3.5, self-
holding, for Locking Screws B 5.0 mm
397.705 Handle for Torque Limiter Nos. 511.770 and 511.771
311.431 Handle with Quick Coupling
Before setting the first locking screw, anatomical recon-struction must have occurred and, where necessary, fixed with lag screws. After setting the locking screws, additional reduction can no longer occur without remov-ing the locking screws. The locking screws can either be inserted with a power tool without locking or manually.
Warning: If a locking screw is used first, care should be taken to ensure that the plate is held securely to the bone to avoid spinning of the plate about the bone.
Insert Self-tapping Locking Screws
Surgical Technique LCP Locking Compression Plate DePuy Synthes 11
a. Insertion with a power toolTo insert the locking screw using a power tool, fit a torque limiter to the power tool. Then insert the screw-driver shaft into the torque limiter.
Pick up the locking screw and insert it into the plate hole. To insert the screw, start the power tool slowly, increase the speed and then reduce it again before the screw is fully tightened. Uncouple the power tool, and mount the handle with the CAD coupling or the handle with the quick coupling, and manually tighten the screw. After one click, the optimum torque is reached.
Warning: Locking screws may be partially inserted using power equipment alone. However, always use a torque limiting attachment (TLA) when using power to insert locking screws.
Note: Do not lock the screws at full speed to reduce the risk of stripping the head. This can make it diffi-cult to remove the implant.
Precaution: For long screws and thick cortical bone, ensure sufficient cooling during insertion.
11 DePuy Synthes LCP Locking Compression Plate Surgical Technique
The following table shows combinations of various drives and torque limiters, and the associated attachments:
Insert Self-tapping Locking Screws
Drive Torque limiter (TLA)
Small fragment511.770(1.5 Nm)
Small fragment511.773(1.5 Nm)
Small fragment511.115(1.5 Nm)
Large fragment511.771(4 Nm)
Large fragment511.774(4 Nm)
Power Drive direct without attachment
attachment 511.750 attachment 511.750 direct without attachment
attachment 511.785
Colibri attachment 532.017
Other power drives
AO/ASIFquick coupling
AO/ASIFquick coupling
AO/ASIFquick coupling for reamer
Handle for Torque Limiter (TLA)
397.705 311.431 311.431 397.705 397.706
Stardrive 314.116 314.116 314.116 314.119 314.119 screwdriver shaft
Hexagonal 314.030 314.030 314.030 314.150 314.150 screwdriver shaft
Surgical Technique LCP Locking Compression Plate DePuy Synthes 11
b. Manual insertionTo insert the locking screw manually, attach the torque limiter handle to the torque limiter and insert a screw-driver shaft. Screw in the locking screw, and lock it in the plate.
Only for locking screws large fragment: Alternatively, the Torque-limiting Screwdriver can be used (Hex 324.052, Stardrive 314.163).
14 DePuy Synthes LCP Locking Compression Plate Surgical Technique
1. Preliminary fixation
Provisionally fix the LCP locking plate to the bone.
Note: The self-drilling screws are primarily inserted in bone regions where a precise determination of length is not required (diaphysis). They can only be set monocortically.
Precaution: Do not insert the drill tip into the oppo-site cortical bone to prevent damage of the opposite side structure and to avoid removal problems.
Insert Self-drilling, Self-tapping Locking Screws
Surgical Technique LCP Locking Compression Plate DePuy Synthes 15
2. Insert locking screw
Instruments
Small fragment
511.770 Torque Limiter, 1.5 Nm, for Compact Air Drive and Power Drive
or511.115 Torque Limiter, 1.5 Nm,
for Compact Air Drive and Power Drive
314.116 Screwdriver Shaft Stardrive 3.5, T15, self-holding, for AO/ASIF Quick Coupling
314.030 Screwdriver Shaft, hexagonal, small, B 2.5 mm
Large fragment
511.771 Torque Limiter, 4 Nm, for Compact Air Drive and Power Drive
or511.774 Torque Limiter, 4 Nm, for AO/ASIF
Quick Coupling for Reamers
314.119 Screwdriver Shaft Stardrive 4.5/5.0, T25, self-holding, for AO/ASIF Quick Coupling
314.150 Screwdriver Shaft, hexagonal, large, B 3.5 mm
or314.152 Screwdriver Shaft 3.5, hexagonal,
self-holding
397.705 Handle for Torque Limiter Nos. 511.770 and 511.771
For additional combinations, see the table on page 22.
Insert a self-drilling locking screw of the desired length using a power tool with the torque limiting attachment and the screwdriver shaft along the thread axis of the hole and screw it in. Stop the power tool before the screw is locked. Remove the power tool and mount the handle. Lock the screw and tighten it until a click can be heard.
Notes:• Especially when the cortical bone is thick and the
locking screw is set perpendicular, drilling with the LCP Universal Drill Guide (small fragment: 323.505; large fragment: 323.500) is recommended. The universal drill guide is also used when insert-ing self-tapping screws in the diaphyseal region. For further information, see page 29.
• You can alternatively follow steps 4–7 on pages 16–19.
Precaution: Always irrigate during drilling to avoid thermal damage to the bone. Cooling is especially recommended for longer screws.
16 DePuy Synthes LCP Locking Compression Plate Surgical Technique
1. Shove the screw holding sleeve over the torque limiting screwdriver
Instruments
Small fragment
314.091 Holding Sleeve for Screws, for LCP 3.5
314.041 Screwdriver Stardrive 3.5, T15, with Groove, length 200 mm
314.070 Screwdriver, hexagonal, small, 2.5 mm, with Groove
Large fragment
314.281 Holding Sleeve for Screws, for LCP 4.5/5.0
314.164 Screwdriver Stardrive 4.5/5.0, T25, with Groove, length 252 mm
314.270 Screwdriver, hexagonal, large, B 3.5 mm, with Groove, length 245 mm
or324.052 Torque-limiting Screwdriver 3.5, self-
holding, for Locking Screws B 5.0 mm
Mount the screw holding sleeve on the screwdriver. Hold the locking screw by placing the screw holding sleeve over the head of the screw.
Indirect Reduction with Locking Screws
Surgical Technique LCP Locking Compression Plate DePuy Synthes 17
2. Insert screw
Insert the screw. The screw holding sleeve prevents the screw from locking in the plate. As soon as the screw holding sleeve reaches the plate, the bone is approached by continuing to screw the screw in the plate.
3. Retract the screw holding sleeve
After the desired reduction is attained, retract the screw holding sleeve from the head of the locking screw.
18 DePuy Synthes LCP Locking Compression Plate Surgical Technique
4. Lock the screw
Instruments
Small fragment
511.770 Torque Limiter, 1.5 Nm, for Compact Air Drive and Power Drive
314.116 Screwdriver Shaft Stardrive 3.5, T15, self-holding, for AO/ASIF Quick Coupling
314.030 Screwdriver Shaft, hexagonal, small, B 2.5 mm
Large fragment
511.771 Torque Limiter, 4 Nm, for Compact Air Drive and Power Drive
314.119 Screwdriver Shaft Stardrive 4.5/5.0, T25, self-holding, for AO/ASIF Quick Coupling
or314.163 Torque-limiting Screwdriver Stardrive,
T25, self-holding, for Locking Screws B 5.0 mm
314.150 Screwdriver Shaft, hexagonal, large, B 3.5 mm
or314.152 Screwdriver Shaft 3.5, hexagonal,
self-holding or324.052 Torque-limiting Screwdriver 3.5, self-
holding, for Locking Screws B 5.0 mm
397.705 Handle for Torque Limiter Nos. 511.770 and 511.771
For additional combinations, see the table on page 22.
Remove the screwdriver and holding sleeve. Place the torque limiter handle on the torque limiter, and insert a screwdriver shaft. Screw in the locking screw, and lock it in the plate.
Only for locking screws large fragment: Alternatively, the Torque-limiting Screwdriver can be used (Hex 324.052, Stardrive 314.163).
Note: This technique is only suitable for pulling the bone to the plate. To generate interfragmentary com-pression, use cancellous bone or cortical bone screws (lag screw principle).
Indirect Reduction with Locking Screws
Surgical Technique LCP Locking Compression Plate DePuy Synthes 19
The LCP universal drill guide is only available with a Hex drive.
Instruments
Small fragments
323.505 LCP Universal Drill Guide 3.5, Stainless Steel
314.030 Screwdriver Shaft, hexagonal, small, B 2.5 mm
Large fragments
323.500 LCP Universal Drill Guide 4.5/5.0
314.150 Screwdriver Shaft, hexagonal, large, B 3.5 mm
or314.152 Screwdriver Shaft 3.5, hexagonal,
self-holding
The LCP universal drill guide can alternatively be used for drilling. The universal drill guide has a drill guide on one side that enables centric and eccentric drilling; a short drill bit is on the other side (small fragments B 2.8 mm; large fragments B 4.3 mm).
1. Insert the LCP universal drill guide
Insert the universal drill guide into the threaded part of the LCP hole.
Drilling with the LCP Universal Drill Guide
11 DePuy Synthes LCP Locking Compression Plate Surgical Technique
2. Drill through the cortical bone
Use a power tool to drill through the proximal cortical bone with the screwdriver shaft in the drill guide.
Drilling with the LCP Universal Drill Guide
3. Remove the LCP universal drill guide
Remove the drill guide.
4. Set locking screw
Set the self-drilling, self-tapping locking screw as described on page 24.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 11
Instruments
Steel Titanium
Small fragment
213.009 413.009 Spacer B 3.5 mm
Large fragment
213.309 413.309 Spacer B 5.0 mm
To reduce the plate-to-bone contact to a minimum, screw an LCP spacer in the plate before positioning the plate. The spacer ensures that a distance of 2 mm will be maintained between the plate and the bone when the screws are later inserted.
The spacer can be removed after setting the locking screws.
Insert LCP Spacers
11°
11 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Metaphyseal Plates for extra articular fractures
Implant preparationAdapt the LCP Metaphyseal Plate to the anatomy of the bone.
Precautions: • Reverse bending or use of the incorrect instrumen-
tation 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.
• Do not bend the plate at the level of the holes. Plate fixation
Instruments
Small fragment
323.027 LCP Drill Sleeve 3.5, for Drill Bits B 2.8 mm
324.081 Centering Sleeve for Kirschner Wire B 1.25 mm
292.120.01 Kirschner Wire B 1.25 mm with trocar tip, length 150 mm, Stainless Steel
292.160.01 Kirschner Wire B 1.6 mm with trocar tip, length 150 mm, Stainless Steel
Large fragment:
323.042 LCP Drill Sleeve 5.0, for Drill Bits B4.3 mm
323.044 Centering Sleeve for Kirschner Wire B 2.0 mm, length 110 mm, for No. 323.042
292.200.01 Kirschner Wire B 2.0 mm with trocar tip, length 150 mm, Stainless Steel
The two distal holes in the thinned area of the plate, which are angled at 11° towards the centre of the plate, allow for an appropriate anatomical application of the locking screws in the epiphyseal area. Take this into con-sideration when bending the plate and threading in the threaded LCP Drill Sleeve for 2.8 mm drill bits.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 11
The threaded LCP drill sleeves ensure axially correct drill-ing.
Insert Kirschner wires to determine the direction of the screws or to temporarily fix the plate using the centering sleeve for Kirschner wires.
Verify the Kirschner wire position under the image inten-sifier.
The simultaneous use of two threaded LCP drill sleeves in the thinned plate area also assists insertion in the min-imally invasive surgical tech nique.
Note: For patient positioning and surgical approach refer for example to Rüedi TP, Buckley RE, Moran CG (2007) AO Principles of Fracture Management. 2nd expanded ed. 2002. Stuttgart, New York: Thieme.
Warning: Do not position the thinner portion of the plate over the fracture site.
1 2 3
14 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Fixation with 3.5 mm locking screws
Instruments
Small fragment
323.027 LCP Drill Sleeve 3.5, for Drill Bits B 2.8 mm
511.115 Torque Limiter, 1.5 Nm, for Compact Air Drive and Power Drive
511.770 Torque Limiter, 1.5 Nm, for Compact Air Drive and Power Drive
314.030 Screwdriver Shaft, hexagonal, small, B 2.5 mm
314.116 Screwdriver Shaft Stardrive 3.5, T15, self-holding, for AO/ASIF Quick Coupling
311.431 Handle with Quick Coupling
Large fragment
323.042 LCP Drill Sleeve 5.0, for Drill Bits B4.3 mm
511.771 Torque Limiter, 4 Nm, for Compact Air Drive and Power Drive
314.152 Screwdriver Shaft 3.5, hexagonal, self-holding
314.119 Screwdriver Shaft Stardrive 4.5/5.0, T25, self-holding, for AO/ASIF Quick Coupling
397.705 Handle for Torque Limiter Nos. 511.770 and 511.771
324.052 Torque-limiting Screwdriver 3.5, self- holding, for Locking Screws B 5.0 mm
314.163 Torque-limiting Screwdriver Stardrive, T25, self-holding, for Locking Screws B 5.0 mm
1. Axially correct drilling for the self-tapping 3.5 mm locking screws requires the threaded LCP Drill Sleeve for 2.8 mm drill bits.
2. Use the Torque Limiter 1.5 Nm and the Screwdriver Shaft for the motor-driven insertion of the locking screw.
3. Stop the motor before locking, fix the torque limiter and the screw-driver shaft to the Handle with Quick Coupling and tighten the screw. After one click, the optimal torque is reached.
Metaphyseal Plates for extra articular fractures
1 2
43
Surgical Technique LCP Locking Compression Plate DePuy Synthes 15
Fixation with 5.0 mm locking screws4. Axially correct drilling for the self-tapping 5.0 mm
locking screws requires the threaded LCP Drill Sleeve for 4.3 mm drill bits.
5. Use the Torque Limiter 4.0 Nm and the Screwdriver Shaft for the motor-driven insertion of the locking screw.
6. Stop the motor before locking, fix the torque limiter and the screw driver shaft to the Handle and tighten the screw. After one click, the optimal torque is reached.
7. Alternatively, use the Torque-limiting Screwdriver to tighten the screw manually.
1 2 1
1 2 3
1 2 1
16 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Examples of the Combination Technique
Standard screws and angular-stable locking screws can be combined.
Example AIf a plate is first fixed with standard screws (1), locking screws can be introduced later (2) to fix the fragments at a stable angle.
Example BIf a plate is first fixed to a fragment with locking screws (1), do not insert standard screw afterwards in the same fragment (2). In this case, the locking screws must be re-moved first before inserting the standard screws.
Example CIf the metaphyseal fragment is fixed with locking screws (1), the fracture can be dynamically compressed with standard screws (2). To increase the stability of fixation, insert additional locking screws into the diaphyseal frag-ment (3).
Example DIn the case of a diaphyseal fracture, standard screws can be inserted after the locking screws to draw the oppos-ing fragments closer to the plate.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 17
Remove the Implant
Implant RemovalUnlock all screws from the plate, then remove the screws completely from the bone. This prevents simulta-neous rotation of the plate when unlocking the last locking screw.
For details regarding implant removal refer to the surgical technique “Screw Extraction Set” DSEM/TRM/0614/0104.
18 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Basic LCP Plates
LCP PlatesLCP Plates 3.5
Stainless Steel Titanium (TiCP) Holes Length (mm)
223.541 423.541 4 59
223.551 423.551 5 72
223.561 423.561 6 85
223.571 423.571 7 98
223.581 423.581 8 111
223.591 423.591 9 124
223.601 423.601 10 137
223.611 423.611 11 150
223.621 423.621 12 163
223.631 13 176
223.641 14 189
223.651 15 202
223.661 16 215
223.671 18 241
223.681 20 267
223.691 22 293
All implants are also available sterile packed. Add Suffix “S” to part number.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 19
LCP Plates 4.5/5.0, broad
Stainless Steel Titanium (TiCP) Holes Length (mm)
226.561 426.561 6 116
226.571 426.571 7 134
226.581 426.581 8 152
226.591 426.591 9 170
226.601 426.601 10 186
226.611 426.611 11 206
226.621 426.621 12 229
226.631 426.631 13 242
226.641 426.641 14 260
226.651 426.651 15 278
226.661 426.661 16 296
226.671 426.671 17 314
226.681 426.681 18 332
226.701 426.701 20 368
226.721 426.721 22 404
226.741 426.741 24 440
All implants are also available sterile packed. Add Suffix “S” to part number.
41 DePuy Synthes LCP Locking Compression Plate Surgical Technique
LCP Plates 4.5/5.0, broad curved
Stainless Steel Titanium (TiCP) Holes Length (mm)
226.622 426.622 12 229
226.632 426.632 13 247
226.642 426.642 14 265
226.652 426.652 15 282
226.662 426.662 16 300
226.672 426.672 17 318
226.682 426.682 18 336
226.692 426.692 19 354
226.702 426.702 20 372
226.712 426.712 21 390
226.722 426.722 22 408
226.732 426.732 23 426
226.742 426.742 24 443
226.752 426.752 25 461
226.762 426.762 26 479
Basic LCP PlatesLCP Plates
All implants are also available sterile packed. Add Suffix “S” to part number.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 41
LCP One-third Tubular Plates 3.5
Stainless Steel Titanium (TiCP) Holes Length (mm)
241.321 441.321 2 28
241.331 441.331 3 40
241.341 441.341 4 52
241.351 441.351 5 64
241.361 441.361 6 76
241.371 441.371 7 88
241.381 441.381 8 100
241.391 441.391 9 112
241.401 441.401 10 124
241.421 441.421 12 148
All implants are also available sterile packed. Add Suffix “S” to part number.
41 DePuy Synthes LCP Locking Compression Plate Surgical Technique
LCP Plates 4.5/5.0, narrow
Stainless Steel Titanium (TiCP) Holes Length (mm)
224.521 424.521 2 44
224.531 424.531 3 62
224.541 424.541 4 80
224.551 424.551 5 98
224.561 424.561 6 116
224.571 424.571 7 134
224.581 424.581 8 152
224.591 424.591 9 170
224.601 424.601 10 188
224.611 424.611 11 206
224.621 424.621 12 224
224.631 424.631 13 242
224.641 424.641 14 260
224.651 424.651 15 278
224.661 424.661 16 296
224.681 424.681 18 332
224.701 424.701 20 368
224.721 424.721 22 404
224.741 424.741 24 440
Basic LCP PlatesLCP Plates
All implants are also available sterile packed. Add Suffix “S” to part number.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 41
* no combi-holesAll implants are also available sterile packed. Add Suffix “S” to part number.
LCP Reconstruction Plates 3.5
Stainless Steel Titanium (TiCP) Holes Length (mm)
245.051 445.051 5 70
245.061 445.061 6 84
245.071 445.071 7 99
245.081 445.081 8 113
245.091 445.091 9 128
245.101 445.101 10 142
245.121 445.121 12 171
245.141 445.141 14 200
245.161 445.161 16 228
245.181 445.181 18 257
245.201 445.201 20 286
245.221 445.221 22 315
Round Hole Reconstruction Locking Plates 3.5*
Stainless Steel Titanium (TiCP) Holes Length (mm)
245.052 445.052 5 58
245.062 445.062 6 70
245.072 445.072 7 82
245.082 445.082 8 94
245.092 445.092 9 106
245.102 445.102 10 118
245.122 445.122 12 142
245.142 445.142 14 166
245.162 445.162 16 190
245.182 445.182 18 214
245.202 445.202 20 238
245.222 445.222 22 262
44 DePuy Synthes LCP Locking Compression Plate Surgical Technique
LCP Reconstruction Plates 4.5/5.0
Stainless Steel Titanium (TiCP) Holes Length (mm)
229.331 429.331 3 56
229.341 429.341 4 75
229.351 429.351 5 94
229.361 429.361 6 113
229.371 429.371 7 132
229.381 429.381 8 151
229.391 429.391 9 170
229.401 429.401 10 189
229.411 429.411 11 208
229.421 429.421 12 227
229.431 429.431 13 246
229.441 429.441 14 265
229.451 429.451 15 284
229.461 429.461 16 303
All implants are also available sterile packed. Add Suffix “S” to part number.
Basic LCP PlatesLCP Plates
Surgical Technique LCP Locking Compression Plate DePuy Synthes 45
All implants are also available sterile packed. Add Suffix “S” to part number.
LCP Metaphyseal Plates 3.5
Stainless Steel Titanium (TiCP) Holes Length (mm)
223.406 423.406 6 86
223.407 423.407 7 99
223.408 423.408 8 112
223.409 423.409 9 125
223.410 423.410 10 138
223.411 423.411 11 151
223.412 423.412 12 164
223.414 423.414 14 190
223.416 423.416 16 216
223.418 423.418 18 242
LCP Metaphyseal Plates 3.5/4.5/5.0
Stainless Steel Titanium (TiCP) Holes Length (mm)
224.753 424.753 5+3 118
224.754 424.754 5+4 136
224.755 424.755 5+5 154
224.756 424.756 5+6 172
224.757 424.757 5+7 190
224.758 424.758 5+8 208
224.759 424.759 5+9 226
224.761 424.761 5+11 262
224.763 424.763 5+13 298
224.765 424.765 5+15 334
46 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Basic LCP PlatesLCP Plates
LCP T-Plates 3.5, right-angled
Stainless Steel Titanium (TiCP) Holes Length (mm)
241.131 441.131 3 50*
241.141 441.141 4 56**
241.151 441.151 5 67*
241.161 441.161 6 78**
** = 3 head holes** = 4 head holes
LCP T-Plates 3.5, oblique-angled
Stainless Steel Titanium (TiCP) Holes Length (mm)
241.031 441.031 3 52 right
241.041 441.041 4 63 right
241.051 441.051 5 74 right
241.931 441.931 3 52 left
241.941 441.941 4 63 left
241.951 441.951 5 74 left
All implants are also available sterile packed. Add Suffix “S” to part number.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 47
All implants are also available sterile packed. Add Suffix “S” to part number.
LCP T-Plates 4.5/5.0
Stainless Steel Titanium (TiCP) Holes Length (mm)
240.131 440.131 3 67
240.141 440.141 4 83
240.151 440.151 5 99
240.161 440.161 6 115
240.171 440.171 7 131
240.181 440.181 8 147
240.201 440.201 10 179
240.221 440.221 12 211
Kirschner Wire with trocar tip
Stainless Steel B (mm) length (mm)
292.120.01 1.25 150
292.120S 1.25 150
292.160.01 1.6 150
292.160S 1.6 150
292.200.01 2.0 150
292.200S 2.0 150
48 DePuy Synthes LCP Locking Compression Plate Surgical Technique
All implants are also available sterile packed. Add Suffix “S” to part number.
Locking Screws with Hex driveSelf-tapping
B 3.5 mm
Stainless Steel TAN Length (mm)
213.010 413.010 10
213.012 413.012 12
213.014 413.014 14
213.016 413.016 16
213.018 413.018 18
213.020 413.020 20
213.022 413.022 22
213.024 413.024 24
213.026 413.026 26
213.028 413.028 28
213.030 413.030 30
213.032 413.032 32
213.034 413.034 34
213.035 413.035 35
213.036 413.036 36
213.038 413.038 38
213.040 413.040 40
213.042 413.042 42
213.044 413.044 44
213.045 413.045 45
213.046 413.046 46
213.048 413.048 48
213.050 413.050 50
213.052 413.052 52
213.055 413.055 55
213.058 413.058 58
213.060 413.060 60
213.062 413.062 62
213.065 413.065 65
213.070 413.070 70
213.075 413.075 75
213.080 413.080 80
213.085 413.085 85
213.090 413.090 90
213.095 413.095 95
B 5.0 mm
Stainless Steel TAN Length (mm)
213.314 413.314 14
213.316 413.316 16
213.318 413.318 18
213.320 413.320 20
213.322 413.322 22
213.324 413.324 24
213.326 413.326 26
213.328 413.328 28
213.330 413.330 30
213.332 413.332 32
213.334 413.334 34
213.336 413.336 36
213.338 413.338 38
213.340 413.340 40
213.342 413.342 42
213.344 413.344 44
213.346 413.346 46
213.348 413.348 48
213.350 413.350 50
213.355 413.355 55
213.360 413.360 60
213.365 413.365 65
213.370 413.370 70
213.375 413.375 75
213.380 413.380 80
213.385 413.385 85
213.390 413.390 90
Screws
Surgical Technique LCP Locking Compression Plate DePuy Synthes 49
Locking Screws with Hex driveSelf-drilling, self-tapping
B 3.5 mm
Stainless Steel Length (mm)
213.112 12
213.116 16
213.120 20
213.124 24
213.130 30
213.135 35
213.140 40
213.145 45
213.150 50
213.155 55
213.160 60
All implants are also available sterile packed. Add Suffix “S” to part number.
51 DePuy Synthes LCP Locking Compression Plate Surgical Technique
All implants are also available sterile packed. Add Suffix “S” to part number.
Screws
Locking Screws with StardriveSelf-tapping
B 3.5 mm
Stainless Steel TAN Length (mm)
212.101 412.101 10
212.102 412.102 12
212.103 412.103 14
212.104 412.104 16
212.105 412.105 18
212.106 412.106 20
212.107 412.107 22
212.108 412.108 24
212.109 412.109 26
212.110 412.110 28
212.111 412.111 30
212.112 412.112 32
212.114 412.114 35
212.116 412.116 38
212.117 412.117 40
212.118 412.118 42
212.134 412.134 44
212.119 412.119 45
212.136 412.136 46
212.120 412.120 48
212.121 412.121 50
212.122 412.122 52
212.123 412.123 55
212.124 412.124 60
212.125 412.125 65
212.126 412.126 70
212.127 412.127 75
212.128 412.128 80
212.129 412.129 85
212.130 412.130 90
212.131 412.131 95
B 5.0 mm
Stainless Steel TAN Length (mm)
212.201 412.201 14
212.202 412.202 16
212.203 412.203 18
212.204 412.204 20
212.205 412.205 22
212.206 412.206 24
212.207 412.207 26
212.208 412.208 28
212.209 412.209 30
212.210 412.210 32
212.211 412.211 34
212.212 412.212 36
212.213 412.213 38
212.214 412.214 40
212.215 412.215 42
212.216 412.216 44
212.217 412.217 46
212.218 412.218 48
212.219 412.219 50
212.220 412.220 55
212.221 412.221 60
212.222 412.222 65
212.223 412.223 70
212.224 412.224 75
212.225 412.225 80
212.226 412.226 85
212.227 412.227 90
Surgical Technique LCP Locking Compression Plate DePuy Synthes 51
All implants are also available sterile packed. Add Suffix “S” to part number.
Spacers
Locking Screws B 5.0 mm for Periprosthetic Fractures
Hex drive
Stainless Steel TAN Length (mm)
02.221.458 04.221.458 8
02.221.460 04.221.460 10
02.221.462 04.221.462 12
222.402 422.402 14
222.404 422.404 18
Stardrive
Stainless Steel TAN Length (mm)
02.221.508 04.221.508 8
02.221.510 04.221.510 10
02.221.512 04.221.512 12
02.221.514 04.221.514 14
02.221.518 04.221.518 18
Spacer B 5.0 mm
Hex drive
Stainless Steel TAN Length (mm)
213.309 413.309 2
219.981 Washer B 3.5/2.7 mm, Stainless Steel
419.981 Washer B 3.5/2.7 mm, Titanium Alloy (TAN)
All washers are also available sterile packed. Add Suffix “S” to part number.
Spacer B 3.5 mm
Hex drive
Stainless Steel TAN Length (mm)
213.009 413.009 2
51 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Cerclage
Cerclage Positioning Pins, Eyes and CerclageFixX98.838.01 Positioning Pin 3.5 with thread, for LCPX98.838.01S Positioning Pin 3.5 with thread, for LCP,
sterile
X98.803.01 Positioning Pin 4.5 with thread, for LCPX98.803.01S Positioning Pin 4.5 with thread, for LCP,
sterile
X98.837 Cerclage Positioning Pin for LCP 3.5 and LC-DCP 3.5
X98.837S Cerclage Positioning Pin for LCP 3.5 and LC-DCP 3.5, sterile
X98.839 Cerclage Positioning Pin for LCP 4.5 and LC-DCP 4.5
X98.839S Cerclage Positioning Pin for LCP 4.5 and LC-DCP 4.5, sterile
0X.221.002.05 Cerclage Eye for Screws B 3.5 mm, Stardrive and hexagonal socket,
pack of 5 units0X.221.002S Cerclage Eye for Screws B 3.5 mm, Stardrive and hexagonal socket, sterile
0X.221.003.05 Cerclage Eye for Screws B 4.5 mm, Stardrive and hexagonal socket,
pack of 5 units0X.221.003S Cerclage Eye for Screws B 4.5 mm, Stardrive and hexagonal socket, sterile
0X.221.004.05 Cerclage Eye for Hexagonal Socket, B 4.0 mm, cannulated, pack of 5 units
0X.221.004S Cerclage Eye for Hexagonal Socket, B 4.0 mm, cannulated, sterile
X81.001 CerclageFix InsertX81.001S CerclageFix Insert, sterile
X81.002 CerclageFix for LPC 4.5/5.0X81.002S CerclageFix for LCP 4.5/5.0, sterile
Surgical Technique LCP Locking Compression Plate DePuy Synthes 51
Cerclage Cables
298.801.01 Cerclage Cable with Crimp B 1.7 mm, Stainless Steel
298.801.01S Cerclage Cable with Crimp B 1.7 mm, Stainless Steel, sterile
611.105.01 Cerclage Cable with Crimp, B 1.7 mm, Cobalt-chrome Alloy
611.105.01S Cerclage Cable with Crimp B 1.7 mm, Cobalt-chrome Alloy, sterile
X98.800.01 Cerclage Cable with Crimp B 1.0 mmX98.800.01S Cerclage Cable with Crimp B 1.0 mm,
sterile
498.806* TRD – Trochanter Reattachment Device, small, for Cable System, Titanium Alloy (TAN)498.806S* TRD – Trochanter Reattachment Device, small, for Cable System, Titanium Alloy (TAN), sterile
498.807* TRD – Trochanter Reattachment Device, large, for Cable System, Titanium Alloy (TAN)498.807S* TRD – Trochanter Reattachment Device, large, for Cable System, Titanium Alloy (TAN), sterile
X=2: Stainless SteelX=4: Titanium
* TRD – Trochanter Reattachment Device: CE0086 Manufactured by: Pioneer Surgical Technology, Inc. 375 River Park Circle, Marquette MI 49855 USA Distributed by: Synthes, GmbH, Eimattstrasse 3, 4436 Oberdorf, Switzerland
54 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Drill Sleeves
Art. No. Description Small Large fragment fragment
323.027 LCP Drill Sleeve 3.5, X for Drill Bits B 2.8 mm
323.042 LCP Drill Sleeve 5.0, X for Drill Bits B 4.3 mm
324.007 Drill Sleeve 7.2/4.3, X length 130 mm, for LISS
Instruments
Drill Bits
Art. No. Description Small Large fragment fragment
310.284 LCP Drill Bit B 2.8 mm X with Stop, length 165 mm, 2-flute, for Quick Coupling
310.430 LCP Drill Bit B 4.3 mm X with Stop, length 221 mm, 2-flute, for Quick Coupling
310.423* Drill Bit B 4.3 mm, X length 280 mm, for No. 324.007
Replacement stop rings can be ordered from the local Depuy Synthes representative.
* calibrated for Drill Sleeve 324.007
Surgical Technique LCP Locking Compression Plate DePuy Synthes 55
Torque Limiters and Corresponding Handles
Torque Limiter Handle
Art. No. Description Art. No. Small Large fragment fragment
511.770 1.5 Nm, for Compact 397.705 X Air Drive and Power Drive
511.773 1.5 Nm, for AO/ASIF 311.431 X Quick Coupling
511.115 1.5 Nm, for Compact 311.431 X Air Drive and Power Drive
511.771 4 Nm, for Compact 397.705 X Air Drive and Power Drive
511.774 4 Nm, for AO/ASIF 397.706 X Quick Coupling for Reamers
56 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Instruments
Holding Sleeves for Screws
Art. No. Description Small Large fragment fragment
314.091 for LCP 3.5 X
314.281 for LCP 4.5/5.0 X
Hexagonal Screwdrivers, non-self-holding
Art. No. Small Large fragment fragment
314.070 X
314.270 X
Hexagonal Screwdriver Shafts
Art. No. Description Small Large fragment fragment
314.030 non-self-holding X
314.150 non-self-holding X
314.152 self-holding X
Surgical Technique LCP Locking Compression Plate DePuy Synthes 57
SHS Screwdrivers, non-self-holding
Art. No. Description Small Large fragment fragment
03.400.101 Screwdriver Shaft 2.5, X hexagonal, Stardrive T15
03.400.111 Handle for X Screwdriver Shaft 2.5
03.400.102 Screwdriver Shaft 3.5, X hexagonal, Stardrive T25
03.400.112 Handle for X Screwdriver Shaft 3.5
Stardrive Screwdrivers, non-self-holding
Art. No. Description Small Large fragment fragment
314.041 T15 X
314.164 T25 X
Stardrive Screwdriver Shafts, self-holding
Art. No. Description Small Large fragment fragment
314.116 T15 X
314.119 T25 X
Torque-limiting Screwdrivers self-holding, for Locking Screws B 5.0 mm
Art. No. Description
324.052 Hex drive
314.163 Stardrive T25
58 DePuy Synthes LCP Locking Compression Plate Surgical Technique
Instruments
Centering Sleeves for Kirschner Wires
Art. No. Description Small Large fragment fragment
324.081 B 1.25 mm X
323.055 B 1.6 mm, X length 70 mm
323.044 B 2.0 mm, X length 110 mm
Surgical Technique LCP Locking Compression Plate DePuy Synthes 59
Discontinued Implants
Stainless Steel Titanium (TiCP)
241.831 441.831
241.841 441.841
241.851 441.851
241.861 441.861
Stainless Steel Titanium (TiCP)
240.341 440.341
240.351 440.351
240.361 440.361
Stainless Steel
240.231 240.431
240.241 240.441
240.251 240.451
240.261 240.461
Titanium (TiCP)
440.231 440.431
440.241 440.441
440.251 440.451
440.261 440.461
LCP L-Buttress Plates 4.5/5.0 (Discontinued – December 2016)
LCP T-Buttress Plates 4.5/5.0 (Discontinued – December 2016)
LCP Clover Leaf Plates 3.5 (Discontinued – December 2016)
61 DePuy Synthes LCP Locking Compression Plate Surgical Technique
B 3.5 mm (Discontinued – June 2016)
TAN
413.112
413.116
413.120
413.124
413.130
413.135
413.140
413.145
413.150
413.155
413.160
B 5.0 mm (Discontinued – June 2017)
Stainless Steel TAN
213.414 413.414
213.418 413.418
213.422 413.422
213.426 413.426
213.430 413.430
213.435 413.435
213.440 413.440
213.445 413.445
213.450 413.450
213.455 413.455
213.460 413.460
213.465 413.465
213.470 413.470
213.475 413.475
213.480 413.480
213.485 413.485
213.490 413.490
Locking Screws with Hex drive, Self-drilling, self-tapping
Discontinued Implants
MRI Information
Torque, Displacement and Image Artifacts according to ASTM F 2213-06, ASTM F 2052-14 and ASTM F 2119-07Non-clinical testing of worst case scenario in a 3 T MRI -system did not reveal any relevant torque or displace-ment of the construct for an experimentally measured local spatial gradient of the magnetic field of 3.69 T/m. The largest image artifact extended approximately 169 mm from the construct when scanned using the Gradient Echo (GE). Testing was conducted on a 3 T MRI system.
Radio-Frequency-(RF-)induced heating according to ASTM F 2182-11aNon-clinical electromagnetic and thermal testing of worst case scenario lead to peak temperature rise of 9.5 °C with an average temperature rise of 6.6 °C (1.5 T) and a peak temperature rise of 5.9 °C (3 T) under MRI Conditions using RF Coils (whole body averaged specific absorption rate [SAR] of 2 W/kg for 6 minutes [1.5 T] and for 15 minutes [3 T]).
Precautions: The above mentioned test relies on non-clinical testing. The actual temperature rise in the patient will depend on a variety of factors be-yond the SAR and time of RF application. Thus, it is recommended to pay particular attention to the following points:• It is recommended to thoroughly monitor patients
undergoing MR scanning for perceived tempera-ture and/or pain sensations.
• Patients with impaired thermoregulation or temperature sensation should be excluded from MR scanning procedures.
• Generally, it is recommended to use a MR system with low field strength in the presence of conduc-tive implants. The employed specific absorption rate (SAR) should be reduced as far as possible.
• Using the ventilation system may further contrib-ute to reduce temperature increase in the body.
Surgical Technique LCP Locking Compression Plate DePuy Synthes 61
Synthes GmbHEimattstrasse 34436 OberdorfSwitzerlandTel: +41 61 965 61 11Fax: +41 61 965 66 00www.depuysynthes.com 0123
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