Flower Medium Headless & Cannulated Screws

PROCEDURE GUIDE

www.flowerortho.com

INDICATIONS FOR USE: The Flower Small and Medium Implants set is intended for use for internal fixation of fractures and reconstruction of bones, including the scapula, olecranon, humerus, radius, ulna, pelvis, distal tibia, fibula, hand and foot in adults and for use in long bones in adolescents (12-21) in whom the growth plates have fused. Examples of these internal fixations and reconstructions include compression fractures, intra-articular and extra-articular fractures, displaced fractures, osteotomies, non-unions and mal-unions. This system can be used for palmar, ventral, dorsal and orthogonal application. The Flower Orthopedics Bone Screw set is intended to be used for the fixation of bone structures, fusion of joints of bone reconstruction.

2 Flower Medium Headless & Cannulated Screws

The Flower Foot & Ankle Application

NC FUSION PLATE 2-HOLECOMPRESSION

PLATE

TMT FUSION PLATE

6-HOLE STRAIGHT PLATE

COMPRESSION Y-PLATE

COMPRESSION T-PLATE, OBLIQUE

LAPIDUS FUSION PLATE

MTP FUSION PLATE

AKIN PLATE

Flower Medium Headless & Cannulated Screws 3

Flower Medium Headless & Cannulated Screws – Surgical Benefits

Flower Medium Headless & Cannulated Screws – Portfolio

• Proximal Head has tapered design to facilitate fragment compression & sits flush in bone

• Pitch differential between the leading and trailing

thread maximizes and maintains compression • Threads have aggressive self-drilling and self-tapping

flutes for smooth insertion

• Low Profile head design for maximum compression • Self-tapping and self-cutting flutes to ensure cortical

bone engagement • Available in 3.0, 3.5, 4.0 & 4.5 diameters

HEADLESS 3.0mm & 4.0mm

PARTIALLY THREADED 3.0mm & 4.0mm

1.1 CoCr Wire

T15 Torx

Self-cutting Flutes

Shaft Threaded Minor Shaft Max Head Diameter Diameter Diameter

3.0 2.0 4.7 4.0 2.6 5.0

Shaft Threaded Minor Shaft Max Head Diameter Diameter Diameter

3.0 2.0 4.3 3.5 2.4 5.9 4.0 2.6 5.9 4.5 3.0 5.9

Medium Cannulated Headless & Partially Threaded Screws are found in the Medium Cannulated Screw Cube. The screws use two different pilot hole drill bits depending on the size (CDB 020 – 3.0 Screws & CDB 026 4.0 Screws) and the Guide Wire Kit (GWK 200) for insertion.

Step 1 – Exposure Prepare Osteotomy (MTP Arthrodesis Shown) a. Take care to avoid the EHL tendon and neurovascular structures. Perform capsular release and expose joint.

4 Flower Medium Headless & Cannulated Screws

Step 2 – Reaming of the MTP Joint Remove cartilage and osteophytes a. Once joint is exposed, remove osteophytes with saw or rongeur to shape

metatarsal head and proximal phalanx contour. b. Expose metatarsal head and place guide wire provided in the Cannulated

Reamer Kit (CRK XXX) down the center of the shaft of the metatarsal head. Use cup shaped reamer to shape head removing all cartilage and dense bone down to cancellous bone. Note: Three sizes of cannulated reamers are available (18mm, 21mm & 24mm). A reamer trial (FIS 613) can be used to determine the appropriate reamer size.

c. Repeat above step on proximal phalanx aiming guide wire down axis of toe and use cone shaped reamer in similar fashion, exposing cancellous bone.

Fenestrate joint surface a. Place small drill holes with k-wire or 2.0mm Drill Bit (DBK 030) into joint

surfaces to increase blood flow to arthrodesis site.

Flower Medium Headless & Cannulated Screws – Surgical Procedure

Step 3 – Guide Wire Insertion a. Once the fragments are in the desired position, insert a

1.1mm Guide Wire (GWK 200) to hold the alignment. b. The Guide Wires are inserted dorsal to plantar, until

reaching the far cortex. Confirm position of the 1.1mm CoCr Guide Wire visually and on AP, oblique and lateral x-rays. Note: Additional guide wires may be used to temporarily fixate the bone fragments and provide stability during drilling and screw insertion. Extra guide wires are provided in GWK 111.

Step 4 – Measuring a. Prior to measuring for the required screw length,

countersinking may be required. i. Countersinking is typically required for headed screws ii. Countersinking is not necessary for Headless Compression Screws.

b. Place the sharp end of the Cannulated Depth Gauge (GWK 100) over the guide wire and firmly place against the bone.

c. Read the required screw length from the end of the guide wire.

Flower Medium Headless & Cannulated Screws 5

Flower Medium Headless & Cannulated Screws – Surgical Procedure

Step 5 – Drill Pilot Hole a. Both Cannulated Headless & Partially Threaded screws are

self-drilling, however in cases of dense bone, a pilot hole may be preferred. Use (CDB 020 for 3.0mm HCS or CDB 026 for 4.0mm HCS) to drill the pilot hole, by placing directly over the guide wire.

b. IMPORTANT: For Headless Compression Screws only, the near cortex must be drilled with (CDB 035, 3.5mm Cannulated Drill Bit). This allows the head of the screw to engage with the near cortex when inserting the screw.

Step 6 – Screw Insertion a. Using a Medium T15 Cannulated screwdriver

(GWK 200). Cannulated Headless or Partially ThreadedScrews are inserted over the Guide Wire, compressingthe bone fragments.Note: Do not overtighten, as this could lead to loss ofbone engagement.

Final Construct The final construct shows the compression achieved and correct alignment of the first metatarsal for a Headless Compression Screw and a Partially Threaded Screw. Both screw options will eliminate the chance of soft tissue impingement or irritation.

HEADLESS COMPRESSION SCREW

6 Flower Medium Headless & Cannulated Screws

Flower Medium Headless & Cannulated Screws – Implant Selection

Product No. Product Description HCS 210 D:3.0mm x L:10mm HCS 212 D:3.0mm x L:12mm HCS 214 D:3.0mm x L:14mm HCS 216 D:3.0mm x L:16mm HCS 218 D:3.0mm x L:18mm HCS 220 D:3.0mm x L:20mm HCS 222 D:3.0mm x L:22mm HCS 224 D:3.0mm x L:24mm HCS 226 D:3.0mm x L:26mm HCS 228 D:3.0mm x L:28mm HCS 230 D:3.0mm x L:30mm HCS 232 D:3.0mm x L:32mm HCS 234 D:3.0mm x L:34mm HCS 236 D:3.0mm x L:36mm HCS 238 D:3.0mm x L:38mm HCS 240 D:3.0mm x L:40mm HCS 245 D:3.0mm x L:45mm HCS 250 D:3.0mm x L:50mm

3.0MM HEADLESS COMPRESSION SCREWS

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4

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Product No. Product Description CSP 210 D:3.0mm x L:10mm CSP 212 D:3.0mm x L:12mm CSP 214 D:3.0mm x L:14mm CSP 216 D:3.0mm x L:16mm CSP 218 D:3.0mm x L:18mm CSP 220 D:3.0mm x L:20mm CSP 222 D:3.0mm x L:22mm CSP 224 D:3.0mm x L:24mm CSP 226 D:3.0mm x L:26mm CSP 228 D:3.0mm x L:28mm CSP 230 D:3.0mm x L:30mm CSP 232 D:3.0mm x L:32mm CSP 234 D:3.0mm x L:34mm

3.0MM PARTIALLY THREAD CANNULATED SCREWS

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Product No. Product Description CNP 416 D:4.0mm x L:16mm CNP 418 D:4.0mm x L:18mm CNP 420 D:4.0mm x L:20mm CNP 422 D:4.0mm x L:22mm CNP 424 D:4.0mm x L:24mm CNP 426 D:4.0mm x L:26mm CNP 428 D:4.0mm x L:28mm CNP 430 D:4.0mm x L:30mm CNP 432 D:4.0mm x L:32mm CNP 434 D:4.0mm x L:34mm CNP 436 D:4.0mm x L:36mm CNP 438 D:4.0mm x L:38mm CNP 440 D:4.0mm x L:40mm CNP 445 D:4.0mm x L:45mm CNP 450 D:4.0mm x L:50mm CNP 455 D:4.0mm x L:55mm CNP 460 D:4.0mm x L:60mm

4.0MM PARTIALLY THREAD CANNULATED SCREWS

Product No. Product Description HCS 414 D:4.0mm x L:14mm HCS 416 D:4.0mm x L:16mm HCS 418 D:4.0mm x L:18mm HCS 420 D:4.0mm x L:20mm HCS 422 D:4.0mm x L:22mm HCS 424 D:4.0mm x L:24mm HCS 426 D:4.0mm x L:26mm HCS 428 D:4.0mm x L:28mm HCS 430 D:4.0mm x L:30mm HCS 432 D:4.0mm x L:32mm HCS 434 D:4.0mm x L:34mm HCS 436 D:4.0mm x L:36mm HCS 438 D:4.0mm x L:38mm HCS 440 D:4.0mm x L:40mm HCS 445 D:4.0mm x L:45mm HCS 450 D:4.0mm x L:50mm HCS 455 D:4.0mm x L:55mm HCS 460 D:4.0mm x L:60mm

4.0MM HEADLESS COMPRESSION SCREWS

Flower Medium Headless & Cannulated Screws – Single-Use Instrument Overview

CANNULATED DRILL BIT KIT Part # Content of Kit

CDB 020 2.0mm Cannulated Drill Bit for 3.0mm Screws CDB 026 2.6mm Cannulated Drill Bit for 4.0mm Screws CDB 030 3.0mm Cannulated Drill Bit for 4.5mm Screws CDB 040 4.0mm Cannulated Drill Bit for 5.5mm Screws

GUIDE WIRE KIT Part # Content of Kit

T15 Cannulated Screwdriver Medium Cannulated Depth Gauge

GWK 200 and Countersink Guide Wires (2) 1.1mm x 140mm (CoCr)

Flower Medium Headless & Cannulated Screws 7

POWER DRIVER G-WIRE KIT

Part # Content of Kit

FIM 015 Power Driver G-Wire Kit, 3.0mm/4.0mm/3.5mm/4.5mm Screws

Flower Orthopedics Corporation 100 Witmer Road • Suite 280 • Horsham, PA 19044 • T: 877-778-8587 • F: 215-394-8904

www.flowerortho.com

FOCPG-HCS 1/19

Reduce OR Turn Over Time • Complete several back-to-back cases from

one FlowerCube

Complete Case Faster • Single-use instruments are always

sharp, pristine and specifically designed to reduce surgical steps

Decrease Infection Risk • Individually packaged instruments are always

sterile, reducing infection potential

Eliminate Set Processing • Ready-for-Surgery platform completely

eliminates pre-op sterilization and post-op decontamination

We Build a More Efficient Case

The FlowerCube™

Flower Orthopedics is the leader in Ready-for-Surgery™ bone fixation. We deliver efficiencies throughout the supply chain that reduce the overall cost of care. Designed for specific surgical indications, the FlowerCube™ contains all of the implants and instruments required for the case. All products are sterile packaged, single-use and always Ready-for-Surgery.