external fixation system

EXTERNAL FIXATION SYSTEM

E X T E R N A L F I X A T I O N S Y S T E M

onotube®

TRIAX™


onotube®

TRIAX™

The Monotube® Triax™ allows iinnccrreeaasseedd ffrraaccttuurree

vviissuuaalliissaattiioonn through the design of the pin clamps, which

permit X-ray visualisation in both antero-posterior and

medio-lateral planes, unlike other competitive systems which

are restricted to one visual plane.

The Monotube Triax system provides the ability to reduce

fractures with rreedduuccttiioonn hhaannddlleess.. PPoosstt--ooppeerraattiivvee ccoorrrreeccttiioonn

aanndd hhaannddlliinngg aarree ssiimmppllee..

The Monotube Triax has a built in fracture ccoommpprreessssiioonn--

ddiissttrraaccttiioonn system.

The Monotube Triax has vvaarriiaabbllee ppiinn ppoossiittiioonniinngg allowing for

multiple pin placement and good bone purchase.

The Monotube Triax system is ccoommppaattiibbllee with other Stryker®

Howmedica Fixators.

The Monotube Triax system is ccoolloouurr ccooddeedd for easy

intra-operative management.

The Monotube Triax is made of lightweight anodised aluminium.

3


onotube®

TRIAX™

MMoonnoottuubbee TTrriiaaxx

TTrriiaaxx CCllaammppss

TTrriiaaxx SSiinnggllee PPiinn CCllaammpp

TTrriiaaxx CCaarrbboonn MMoonnoottuubbee

The objective of external fixation is to bring stability to a long bone

that has sustained a fracture. This process must be as physiological

as possible and therefore, the fixation device used must be stable

enough to prevent reduction loss and resist movement in lateral

bending and torque, yet be dynamic enough to allow minute and

controlled amounts of movement at the fracture site during weight

bearing. DDyynnaammiissaattiioonn iiss tthhee tteerrmm ggiivveenn ttoo tthhee ttrraannssmmiissssiioonn ooff

ffoorrcceess aaccrroossss tthhee ffrraaccttuurree ((wwiitthhoouutt tthhee ffrraammee ccaauussiinngg ddiissttrraaccttiioonn

ooff tthhee ffrraaggmmeennttss)),, aanndd wwiitthh tthhee aaiimm ooff pprroommoottiinngg hheeaalliinngg..

“Healing of the bone fractures using external fixation takes place by

indirect consolidation, and fractures treated by micromovement heal

more quickly than those treated using a rigid external fixator (13

weeks as compared to 18)”.1

The precise amount of weight bearing is dependant on the

type of fracture, soft tissue damage, total weight of the patient,

presence of multiple trauma, pain threshold and the patient's overall

condition.

Dynamisation should occur at the first sign of periosteal

callus formation and the fixator should be set for 1mm of

micromovement at the fracture site (see protocol on page 6).

The Monotube® Triax™ is designed to provide a high degree of

stability, yet permit dynamic movement due to its built in dynamisation

module. The Monotube Triax can easily be converted from static to

dynamic mode by activating the dynamisation module.

The biology of the fracture can be modified by adjusting the external

fixator. Rigid external fixators produce primary bone healing, whereas

elastic fixators produce a greater volume of periosteal callus.2

Controlled Dynamisation

4


onotube®

TRIAX™

BBiioo--SSpprriinngg aaddjjuussttmmeenntt ssccrreeww

DDyynnaammiissaattiioonn ccoollllaarr

The second type of dynamisation is referred to as AADDJJUUSSTTAABBLLEE

BBIIOO--SSPPRRIINNGG, and is the combination of an axial telescopic function

and a compressive spring. The objective of this shock absorbing

mechanism is to counteract muscle tension and prevent the collapse

of the fragments in an unstable fracture or a leg lengthening

procedure, yet at the same time to guarantee accurate and effective

dynamisation.

The Adjustable Bio-Spring allows the surgeon to “dial in” the amount

of compression at the fracture site by simply opening the

dynamisation collar from 0 – 1mm, and set the compressive spring to

full tension, based on the fracture type and the patients weight.

Adjustable Bio-Spring is recommended in unstable fractures or

fractures in which there is no cortical contact and leg lengthening

procedures.

Adjustable Bio-Spring

5


onotube®

TRIAX™

0 Kg

Adjustable Bio-spring Force applied to bone

15 Kg

30 Kg

Spring Tension

30 Kg 30 Kg

Gap2mm

Gap1mm

Gap1mm

Gap0mm

Gap0mm

45Kg

30Kg

Gap0.5mm

30 Kg 75 Kg

30 Kg

AAdd

jjuusstt

aabbllee

BBiioo

--sspp

rriinn

gg

NNeeee

ddllee

BBeeaa

rriinn

ggss

DDyynn

aammiiss

aattiioo

nn CC

oollllaa

rr

Stable Fracture patternsBiocompression is recommended for stable fracture patterns. The

frame may be dynamised anytime after application. The following

steps should be followed:

1. Open the dynamisation collar to 1mm (one complete revolution of

the dynamisation collar equates to 1mm). Use the dynamisation

wrench if necessary.

Note: The one millimetre setting on the collar may or may not be

visible.

Unstable Fracture patternsAdjustable Bio-Spring is recommended for unstable fracture patterns

and leg lengthening. The frame may be dynamised once callus is

evident on the X-ray, approximately 21 to 28 days postoperatively. To

dynamise the frame, the following sequence should be followed:

1. Advance Adjustable Bio-Spring tension screw clockwise until fully

compressed, about 71/2 full turns. The screw will recede into the

tube as it compresses the spring.

2. Open the dynamisation collar to one millimetre. Use the

dynamisation wrench if necessary.

3. Reduce Bio-Spring tension one full turn anti-clockwise each week.

Be sure to check that biocompression collar is still set at 1mm

after each spring adjustment. The force required to dynamise the

frame will be progressively reduced (see technique guide).

Note: X-ray visualisation is required to determine callus formation.

Dynamisation Protocol

6


onotube®

TRIAX™

Monotube Lengths and Pin Options

Tube Colour (Dynamic)

Yellow

Blue

Red

DynamicMonotube

dia 15mm x 180mmFully Closed

dia 15mm x 250mmFully Opened





PinSize dia

3mm&

4mm

4mm&

5mm

5mm&

6mm

SpringTension

20kg

30kg

45kg

The Monotube® Triax™ has a built in compression distraction

mechanism, which can be used in lengthening procedures and to

adjust fracture gaps.

Compression and Distraction are achieved by turning the Lengthening

Screw – turning the 7mm squared headed screw anti-clockwise will

lengthen the tube and distract the fracture. Turning clockwise will

shorten the tube and compress the fracture.

The end of the tube is marked with a visual reference each 1/4 turn

4 dots 3 dots

2 dots 1 dot

The Monotube Triax system is available in three sizes which are

colour coded Yellow, Blue, Red.

To determine the proper frame components the size of tube selected

is determined by:

Location / type of fracture

Patient’s weight

Length of tube required

Dynamisation requirements

Distraction/Compression

7


onotube®

TRIAX™

Y Y Y Y Y Y Y B B

Y Y Y Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y

Y Y Y B B B B B B

Y Y B B B B B B B

Y B B B R R R R R

Y B B R R R R R R

Y Y B B B B B B R

Y B B B B R R R R

Fore

arm

Hum

erus

Fem

urT

ibia

Selecting Proper Dynamic Monotube® Size (Yellow, Blue, or Red)

Patient’s Weight in Kg (1kg=2.2lb)

10 20 30 40 50 60 70 80 90 100Ulna

Radius

Colles

Simple/ stable

Oblique/ comminuted/ unstable

Simple/ stable


Simple/ stable


Y=Yellow tube and clamps B=Blue tube and clamps R=Red tube and clamps

The Monotube® Triax™ Pin Clamp allows independent control of

the fracture reduction in three planes. Clamps may be placed

anywhere along the length of the tube at virtually any angle, wherever

the best bone purchase may be available.

A unique compression sleeve allows for excellent mobility in rotation

preventing deviation of the pin clamp while guaranteeing maximum

stability.

The two outer square head screws A when tightened hold the pins in

the clamp. Each screw can independently lock up to two pins in place.

The red and blue Triax Clamps have four pin positions, and the yellow

Triax Clamp has two pin positions.

The centre square head screw B allows for +/- 20° degrees of

angulation in the sagittal plane.

The side square head screw C allows for 360° of rotation in the

coronal plane.

The square head screw D at the bottom of the clamp allows for

translation along the length of the tube and for 360° rotation around

the axis of the tube.

Note: All square head screws need to be tightened to the appropriate

torque to maintain adequate stability using the torque wrench (picture

of use).

Yellow 5Nm

Blue 9Nm

Red 11Nm

Triax™ Standard Pin Clamps

8


onotube®

TRIAX™

AB

A

C

D

T-clamps are beneficial when treating proximal and distal fractures or

fractures that span a joint. The T-clamp allows for perpendicular

placement of pins.

Standard Monotube® Triax™ Clamps can be converted to T-clamps

utilising the T-adapter. Be sure you select the appropriate adapter for

the size of clamp to be modified.

Assembly Instructions1. Select the appropriate T-adapter.

2. Remove body screw and compression sleeve from T-adapter.

3. Remove body screw and compression sleeve from Standard Pin

Clamp. Separate pin connector from tube coupling.

4. Insert T-adapter into tube coupling and replace compression

sleeve. Body screws C should be introduced through the recessed

portion of clamp until fully seated and finger tight.

5. Insert pin connector onto T-adapter and replace compression

sleeves. Body screw C should be introduced through recessed

portion of the clamp until fully seated and finger tight.

NOTE: Body screws and

compression sleeves are exactly

alike and will fit in either position.

However, if body screws are not

started from recessed side of the

clamp, they will not fully seat. In

addition, the T-adapter should

always be connected to the tube

coupling before the pin connector.

Triax™ T-Clamp

9


onotube®

TRIAX™

C

C

C

D

A AB

The Monotube® Triax™ Single Pin Clamps are designed for

independent pin placement. They allow for capture and stabilisation of

fracture fragments. They are also intended for use in pathologies that

require non parallel pin position for additional stability of the frame.

The Single Pin Clamp features a snap-fit fixation mechanism which

ensures an easy and firm grip to the fixation pins. A serrated

interlocking mechanism between the jaws of the Pin Clamp provides

superior rotational locking. A 7mm square head screw allows easy

access. Pins can be placed parallel or convergent to improve stability.

The Monotube Triax Single Pin Clamps come in three sizes and

accept the following Apex® pins

Yellow 3/4mm dia. Blue 4/5mm dia. Red 5/6mm dia.

Top locking for adjustable control of the pin placement.

The Single Pin Clamp allows 360° of rotation in the coronal plane.

The square head screw positioned at the

bottom of the pin clamp allows for

translation along the length of the tube

and 360° around the axis of the tube.

The Monotube Triax tube-to-tube Clamps allow connection of Red,

Blue, and Yellow tubes in various combinations to treat complex trauma

or pelvic fractures.

Monotube Triax clamps are available in the following

configurations

Red/Red Red/Blue Blue/Blue

Blue/Yellow Yellow/Yellow

Triax™ Single Pin Clamp

10


onotube®

TRIAX™

Triax Tube-to-Tube

The Monotube® Triax™ can be connected to the TenXor™ carbon ring

by using a ring-to-tube clamp. Such a Triax Hybrid Frame was

designed to address C type fracture of the proximal and distal tibia

using K-wires. It combines the principles of the circular ring and

unilateral frame fixation to better neutralise the forces acting upon the

fracture.

The TenXor carbon ring is available in various sizes and the ring-to-

tube clamp is available in 2 sizes for blue and red Monotube Triax.

Its main features are:

Possibility of sliding along the ring in order to determine the best

position according to frame configuration

Integrated snap-fit mechanism for "clicking" the clamp on the

ring

Positioning the clamp inside or outside the ring

3 axes of rotation

7mm square head locking screws compatible with Hoffmann® II

and blue/red Monotube Triax wrenches

Easy access of locking screws

Manufactured from stainless steel and aluminium

AAddddiittiioonnaall iinnffoorrmmaattiioonn iiss aavvaaiillaabbllee iinn tthhee TTeennXXoorr™™

bbrroocchhuurree aanndd ooppeerraattiivvee tteecchhnniiqquuee..

The clamp consists of two aluminium jaws that hold the tubes and

allow 360° of rotation. A single 7mm square head screw positioned at

the top of the clamp enables the device to be locked. There are 100

radially serrated teeth between the jaws which allow precise

positioning of the tube components, each tooth movement represents

3.6° of rotation.

NOTE: TThhiiss ddeevviiccee ccaannnnoott bbee ddiissmmaannttlleedd

Triax™ Hybrid Frame

11


onotube®

TRIAX™

Triax Tube-to-Tube

Humeral

Femur

Wrist Knee Joint

12


onotube®

TRIAX™

Proximal Humerus

HumeralLengthening

Proximal Femur Femoral Shaft Femoral LengtheningSegmental Femur

Radial Shaft Bridging Floating Knee Knee Arthrodesis

Diaphyseal Humerus Distal Humerus

Ankle Pelvis

13


onotube®

TRIAX™

Proximal Tibia*

Ankle Fracture

Proximal Tibia

Pelvic Fracture

Diaphyseal Tibia* *

Distal Tibia

Segmental TibiaTibial Plateau *

Tibia LengtheningTibial Bone Transport

See page 7 for colour classification.*May also be placed antero-medial

X-rays

14


onotube®

TRIAX™

Humeral

Femur

Femur

Intra-OperativePre-Op

Pre-Op

Pre-Op

Post-Op

Intra-Operative Post-Op


X-rays

15


onotube®

TRIAX™

Tibial

Tibial

Ankle

Tibial

Pre-Op

Pre-Op

Pre-Op

Intra-Operative

Intra-Operative

Post-Op


Intra-Operative


Wrist

If no dynamisation is required or a radiotranslucent frame is needed,

Triax™ Carbon Tubes can be used in place of the Dynamic Tube.

Triax Carbon Tubes are available in 3 diameters; Yellow 15,

Blue 20, Red 25 and in lengths from 150 – 400mm

The use of Triax Carbon Tubes does not alter the surgical

protocol, except that the colour coded end caps must be

removed before placement of the Monotube® Triax™ Clamps.

Unlike the Dynamic Monotube Triax the Triax Carbon Tubes

require an external compression/distraction device.

To use the device, position the chariot over the back of the

standard Triax pin clamp, and wrap the swivel clamp around the

tube. Tighten the 7mm square head screw A, then proceed to

loosen pin clamp square head screw D.

Compression or distraction can now be achieved. Maximum

distraction/compression is:-

Yellow 20mm

Blue 30mm

Red 30mm

1 revolution of square head screw B provides 1mm of

compression or distraction. After distraction or compression is

completed, re-tighten pin clamp square head screw D. The

external compression distraction device may now be moved.

16


onotube®

TRIAX™

Triax™ Carbon Tubes

Wrench

A

BThumbwheelD

Clamp Screw

Chariot

17


onotube®

TRIAX™

Economical & Radiolucent

An uncompromising alternative.

When fracture dynamisation is not necessary or radiolucency is

desired, the Carbon Monotube® Triax™ offers an efficient and

economic solution.

Carbon Monotube Triax is available in three colour-coded diameters

and a variety of lengths. The Monotube Triax Clamps can be placed

anywhere along the tube to achieve the desired pin positioning while

making final reduction possible aafftteerr the frame is attached to the pins!

If needed, Single Pin Clamps, T adapter, and tube-to-tube clamps,

can be used with Triax Carbon Tubes.

CCaattaalloogguuee DDeessccrriippttiioonnNNuummbbeerr

5150-0-065 Dynamic Tube Assembly Yellow (15mm)5150-0-070 Dynamic Tube Assembly Blue (20mm)5150-0-075 Dynamic Tube Assembly Red (25mm)

5150-0-465 Dynamic Tube Yellow (15mm)5150-0-470 Dynamic Tube Blue (20mm)5150-0-475 Dynamic Tube Red (25mm)

5150-3-065 Pin Clamp Yellow (15mm)5150-3-070 Pin Clamp Blue (20mm)5150-3-075 Pin Clamp Red (25mm)

5150-3-165 Single Pin Clamp Yellow (15mm)5150-3-170 Single Pin Clamp Blue (20mm)5150-3-175 Single Pin Clamp Red (25mm)

5150-4-065 T-Adapter Yellow (15mm)5150-4-070 T Adapter Blue (20mm)5150-4-075 T-Adapter Red (25mm)

5150-3-415 Tube-to-Tube Clamp Yellow (15mm)5150-3-420 Tube-to-Tube Clamp Blue/Blue (20mm)5150-3-425 Tube-to-Tube Clamp Red/Red (25mm)5150-3-435 Tube-to-Tube Clamp Yellow (15mm)/Blue (20mm)5150-3-445 Tube-to-Tube Clamp Blue (20mm)/Red (25mm)

18


onotube®

TRIAX™

Products

22

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19


onotube®

TRIAX™

CCaattaalloogguuee DDeessccrriippttiioonnNNuummbbeerr

5150-1-115 Carbon Tube Assembly Yellow Ø15/150mm5150-1-120 Carbon Tube Assembly Yellow Ø15/200mm5150-1-125 Carbon Tube Assembly Yellow Ø15/250mm5150-1-130 Carbon Tube Assembly Yellow Ø15/300mm

5150-2-371 Carbon Tube Yellow Ø15/150mm5150-2-381 Carbon Tube Yellow Ø15/200mm5150-2-391 Carbon Tube Yellow Ø15/250mm5150-2-396 Carbon Tube Yellow Ø15/300mm

5150-2-431 Carbon Tube Blue Ø20/200mm5150-2-421 Carbon Tube Blue Ø20/250mm5150-2-411 Carbon Tube Blue Ø20/300mm5150-2-401 Carbon Tube Blue Ø20/350mm

5150-2-451 Carbon Tube Red Ø25/250mm5150-2-461 Carbon Tube Red Ø25/300mm5150-2-471 Carbon Tube Red Ø25/350mm5150-2-481 Carbon Tube Red Ø25/400mm

Products

5150-9-265 Long Handle Wrench Yellow5150-9-270 Long Handle Wrench Blue5150-9-275 Long Handle Wrench Red

5150-9-585 Reduction Handles Blue/Red Clamps

5054-8-009 Spanner Wrench

5150-9-465 Compression Distraction Device Yellow (15mm)5150-9-470 Compression Distraction Device Blue (20mm)5150-9-475 Compression Distraction Device Red (25mm)

5150-9-115 Dynamisation Wrench Yellow5150-9-120 Dynamisation Wrench Blue5150-9-125 Dynamisation Wrench Red

5150-9-916 Monotube® Triax™ Yellow case5150-9-946 Monotube® Triax™ Red/Blue Case

Instruments

Stryker®, Hoffmann®, Hoffmann® II, Apex®, Monotube®, Triax™, Compact™ and Tenxor™are trademarks of Stryker Corporation.

Hoffmann®II Swiss Patent Application: 01-709/94-3. Other Patents Pending. * Patents: EU 385,929; 374,093;Canada 1,193,506; U.S. 5,160,335 and 5,207,676. ** Swiss Patent Application: 02-709/94-3. Other Patents Pending.*** Patents: EU 230,856; Swiss CH 671,150; U.S. 4,978,350.†Data on file at Stryker® Howmedica Osteonics USA.

REFERENCES1. Kenwright J, Richardson JB, Cunningham JL, White SH, Goodship AE, Adams MA, Magnussen PA, Newman JH.

Axial movement and tibial fractures. J Bone Joint Surgery 1991:73b.

2. Hart MB, Wu JJ, Chao EYS, Kelly PJ. External skeletal fixation of canine tibial osteotomies. Compressioncompared with no compression. J Bone Joint Surgery 1985; 67 A:598.

Dynamic Monotube®

COMPRESSION/DISTRACTIONADJUSTMENT SCREW

BIO-SPRINGADJUSTMENTSCREW

DYNAMISATIONCOLLAR

"O"-RING

DY

NA

MIS

ATIO

NS

EG

ME

NT

LEN

GT

HE

NIN

G S

EG

ME

NT

"O"-RING

The Monotube® Triax™ external fixation system was developed in

cooperation with Prof. J. Lazo-Zbikowski and Prof. J. Cañadell.

Its design consists of a dynamic axial fixator designed to maintain

rotational and angular stability while allowing the bone to share the

load in the axial plane.

The Monotube Triax has been designed to handle a wide variety of

orthopaedic and trauma applications keeping in mind the need for

ccoonnttrroolllleedd ddyynnaammiissaattiioonn. The built in dynamisation collar allows 0-

1mm axial compression thus allowing the surgeon to initiate the

nnaattuurraall ccaalllluuss ffoorrmmaattiioonn that is critical to the healing process.

Its absolute modularity and uunnrreessttrriicctteedd rreeppoossiittiioonn ppoossssiibbiilliittiieess

allow restoration of the correct anatomy in three planes.

The system consists of tthhrreeee bbaassiicc ccoommppoonneennttss. The dynamic tube,

the pin clamp, and the single pin clamp. Speciality clamps and

accessories are also available.

Overview

The Monotube® Triax™ system can be ddyynnaammiiccaallllyy llooaaddeedd

upon muscular contraction and weightbearing. This allows the

system to be converted from a static to a ddyynnaammiicc mmooddee by

activating the built in dynamisation collar. This will stimulate

and enhance callus formation and promote faster healing.1

The Monotube Triax is mmiinniimmaallllyy iinnvvaassiivvee using only

percutaneous Apex® Pins which are nnoonn ccoonniiccaall and therefore

avoid radial stresses at the bone to pin interface

and reduce soft tissue disruption.

The Monotube Triax simple design characteristics make

its use eexxttrreemmeellyy vveerrssaattiillee and easy to apply thanks to

uunniivveerrssaall iinnssttrruummeennttaattiioonn and few basic components.

The Monotube Triax is ssiimmppllee ttoo uussee,, by sliding the desired

clamps anywhere along the tube. Fine tuning the reduction is

simple, and requires no additional components.

The Monotube Triax system is available in tthhrreeee ssiizzeess allowing

the surgeon to choose the appropriate fixator according to

patient size and indication requirements.

All the adjustments on the tube and clamp use 7mm square

head screws in the red and blue and 5mm square head screws

in the yellow and require only one instrument.

The Monotube Triax is ffuunnccttiioonnaall,, allowing patients partial

weightbearing from the beginning of the treatment.

The Monotube® Triax™ system is designed to permit two types of

dynamisation, BBiiooccoommpprreessssiioonn aanndd AAddjjuussttaabbllee BBiioo--SSpprriinngg. The first

is an axial telescopic function in which an outer tube slides over an

inner tube, allowing a recommended 1mm micromovement at the

fracture site.

Biocompression allows the surgeon to “dial in” the amount of

compression at the fracture site by simply opening the dynamisation

collar from 0 – 1mm from the beginning. This micromotion is

controlled by a specially designed needle-bearing technology that

allows the tube to slide effortlessly even if not axially aligned. Other

systems have a tendency to jam in this situation. This specialised

technology guarantees appropriate dynamisation and therefore,

callus formation leading to faster healing.

Biocompression is recommended for stable fractures or in fractures

where there is substantial cortical contact.

Immediate transmission of the forces through the fracture

Biocompression

Rigid Fixation

Force After Callus

Gap1mm

Gap1mm

ForceForce After Callus

Biocompression


onotube®

TRIAX™

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CCaatt NNoo:: 55007755--22--550000

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MMAANNUUFFAACCTTUURREERR::

Unilateral frame system designed to handle a wide variety of fracturesand limb-lengthening applications. This simple, colour-coded systemoffers both dynamic and carbon tubes for individualised performanceand economy. True simplicity, versatility, and economy.

Modular frames which allow for true independent pin placement.Completely compatible with Original Hoffmann® components, this newsystem improves flexibility and ease-of-use, while enhancing frameeconomics through minimal componentry. It’s external fixation with a“snap.”

Designed to complement the anatomy of the distal radius by allowing independentmovement of its clamps in multiple planes. Standard unilateral or bi-lateral bridgingframes for intra-articular fractures and peri-articular non-bridging frames for extra-articular fractures. Fully compatible with the Hoffmann® II System, based on aspring-loaded snap-fit mechanism that improves flexibility and ease-of-use.

The DJD II is a Dynamic Elbow Joint Distractor. Fully compatible withthe Hoffmann® II Compact™ System, it is designed to treat post-traumatic elbow stiffness as well as acute elbow trauma cases.

The Tenxor™ System is a hybrid system providing advanced technologyand ease of application. Fully compatible with Hoffmann® II andMonotube® Triax™, based on a spring-loaded, snap-fit mechanism thatimproves flexibility and ease of use.

Every Fixator incorporates the high quality pin-to-bone interfaceprovided by Apex® Pins. The Apex® Pin cuts more sharply with lesstorque, friction and heat upon insertion improving purchase whileminimising the risk of pin tract problems.† Available in self-drilling andblunt tip designs, only from Stryker® Howmedica Osteonics!


onotube® TRIAX™

®

™ CompactEXTERNAL FIXATION SYSTEM

*

**

***

external fixation system

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