orthopedic foot instruments. dedicated instruments for ... foot instruments.pdf · orthopedic foot...
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Orthopedic Foot Instruments.Dedicated instruments for reconstructivefoot surgery.
Handling Technique
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Synthes 1
Table of Contents
Introduction
Handling Techniques
Product Information
Orthopedic Foot Instruments 2
Indications 4
Compression/Distraction Device Set 5
Bone Harvesting Set 12
Chisel Set 19
Instruments 22
Sets 25
Replacement Articles 28
Image intensifier control
WarningThis description alone does not provide sufficient background for direct use ofthe instrument set. Instruction by a surgeon experienced in handling theseinstruments is highly recommended.
Reprocessing, Care and Maintenance of Synthes InstrumentsFor general guidelines, function control and dismantling of multi-part instruments,please refer to: www.synthes.com/reprocessing
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2 Synthes Orthopedic Foot Instruments Handling Technique
Compression/Distraction Device Set,in modular trayFields of application– Compression and distraction of joints
or bones– Fracture treatment– Arthrodeses (e.g. subtalar arthrodesis)– Osteotomies (e.g. lateral calcaneal
lengthening osteotomy)
Bone Harvesting Set, in modular trayFields of application– Bone harvesting
(e.g. from the calcaneus, proximaltibia or iliac crest)
– Bone biopsies
Orthopedic Foot Instruments. Dedicated instruments for reconstructivefoot surgery.
System Overview
The Orthopedic Foot Instruments havebeen designed to perform specific procedures on the foot more efficiently. The system consists of three modularsets: Compression/Distraction DeviceSet, Bone Harvesting Set and Chisel Set.
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Chisel Set, in modular trayFields of application– Preparation of joints for arthrodeses– Removal of joint cartilage and bone– Removal of exostoses– Removal of osteophytes
Features and Benefits
Bone Harvesting Set– Different trephine diameters enable accurate
local bone grafting– Corresponding extraction attachments enable
the safe removal of bone graft
Chisel Set– Different shapes of chisels and a cartilage
remover facilitate proper joint preparation– Silicon handles for optimal grip
Compression/Distraction Device Set– Placement of 2.0, 2.5 and 3.0 mm K-wires at
various angles– Precise compression/distraction mechanism– Two extra K-wire holes for more stability
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Indications
− Fractures in the foot and ankle− Skeletal deformities and/or skeletal defects in the foot
and ankle− Instability of the foot and ankle − Tumors in bones and cartilage in the foot and ankle− Non-unions of small and large bones in the foot and ankle − Pseudoarthrosis in the foot and ankle− Osteoarthritis in the foot and ankle− Rheumatoid arthritis in the foot and ankle− Exostoses in the foot and ankle
4 Synthes Orthopedic Foot Instruments Handling Technique
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Handling TechniquesCompression/Distraction Device Set
Set
01.111.476 Compression/Distraction Device Set for Orthopedic Foot Instruments, with Lid, with Contents
Set content
03.111.021 Compression/Distraction Device for Foot and Ankle
03.111.022 Holding Sleeve � 2.0 mm for Compression/Distraction Device for Foot and Ankle
03.111.023 Holding Sleeve � 2.5 mm for Compression/Distraction Device for Foot and Ankle
03.111.024 Holding Sleeve � 3.0 mm for Compression/Distraction Device for Foot and Ankle
292.250 Kirschner Wire � 2.5 mm with trocar tip, length 150 mm, Stainless Steel
292.750 Kirschner Wire � 2.5 mm with threaded tip, length 150/15 mm, Stainless Steel
292.790 Kirschner Wire � 2.0 mm with threaded tip, length 150/15 mm, Stainless Steel
292.820 Kirschner Wire � 3.0 mm with threaded tip, length 150/15 mm, Stainless Steel
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1Preparation
Expose the indicated area. The approach will depend on thesurgical procedure.
Handling TechniquesCompression/Distraction Device Set
2Prepare Compression/Distraction Device
Instruments
03.111.021 Compression/Distraction Device for Foot and Ankle
03.111.022 Holding Sleeve � 2.0 mm for Compression/Distraction Device for Foot and Ankle
03.111.023 Holding Sleeve � 2.5 mm for Compression/Distraction Device for Foot and Ankle
03.111.024 Holding Sleeve � 3.0 mm for Compression/Distraction Device for Foot and Ankle
Thread the corresponding holding sleeves into the threadedfixation holes of the fixation arms.
For 2.0 mm K-wires use 2.0 mm holding sleeves.For 2.5 mm K-wires use 2.5 mm holding sleeves.For 3.0 mm K-wires use 3.0 mm holding sleeves.
Note: Do not tighten holding sleeves at this point.
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Open all locking-clamps of the compression/distraction device.
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Adjust the rotation and distance of the arms until initialalignment for the surgical procedure is defined.
Tips– lock the rotational mechanism first– lock both arms – adjust space between the arms
Note: A range of different adjustment approaches may beused.
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3Insert K-wires
Instruments
292.250 Kirschner Wire � 2.5 mm with trocar tip, length 150 mm, Stainless Steel
292.750 Kirschner Wire � 2.5 mm with threaded tip, length 150/15 mm, Stainless Steel
292.790 Kirschner Wire � 2.0 mm with threaded tip, length 150/15 mm, Stainless Steel
292.820 Kirschner Wire � 3.0 mm with threaded tip, length 150/15 mm, Stainless Steel
Position the device in such a way that the ends of the holding sleeves are as close to the bone as possible.
Drill two K-wires through the corresponding holding sleevesinto the bone.
Handling TechniquesCompression/Distraction Device Set
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If more stability is desired, additional 2.0 mm K-wires can bedrilled through the extra K-wire holes of the arms.
Finger-tighten the holding sleeves. This will fix the device tothe K-wires.
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4Compress or distract
Perform the surgical procedure once the K-wires have beeninserted.
Choose whether compression or distraction is desired by adjusting the switch mechanism.
Turn the wing bolt to compress or distract.
Warning: Avoid excessive distraction. Too much distractioncan damage the surrounding soft tissue.
Handling TechniquesCompression/Distraction Device Set
5Remove compression/distraction device
Loosen the holding sleeves first, then open the lockingclamps.
Carefully remove the device.
Remove K-wires.
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Set
01.111.477 Bone Harvesting Set for Orthopedic Foot Instruments, with Lid, with Contents
Set content
03.111.012 Handle, long, with Quick Couplingor03.111.013 Handle, short, with Quick Coupling
02.111.001 Guide Wire � 3.2 mm with Stop, tip 1.2 mm, Stainless Steel
03.111.030 Shaft for Trephine and Extraction Attachment
03.111.031 Stylet for Trephine and Extraction Attachment
03.111.025 Trephine Attachment � 5.5 mm
03.111.026 Trephine Attachment � 7.0 mm
387.659 Trephine Attachment � 8.5 mm
387.660 Trephine Attachment � 9.5 mm
387.661 Trephine Attachment � 10.5 mm
387.662 Trephine Attachment � 12.5 mm
387.663 Trephine Attachment � 14.0 mm
03.111.027 Extraction Attachment � 5.5 mm
03.111.028 Extraction Attachment � 7.0 mm
387.669 Extraction Attachment � 8.5 mm
Handling TechniquesBone Harvesting Set
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387.670 Extraction Attachment � 9.5 mm
387.671 Extraction Attachment � 10.5 mm
387.672 Extraction Attachment � 12.5 mm
387.673 Extraction Attachment � 14.0 mm
Important– Trephines have sharp cutting edges that may cause injury.– Handle the attachments with care. Damage to the cutting
edges may cause failure and will alter the precision of theinstrument.
– Only use instruments with sharp edges.
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Handling TechniquesBone Harvesting Set
1Preparation
Expose the indicated area. The approach will depend on thesurgical procedure.
2Place guide wire
Instrument
02.111.001 Guide Wire � 3.2 mm with Stop, tip 1.2 mm, Stainless Steel
Drill the guide wire into the location where bone removal isrequired.
Technique Tip: In case that insertion of the guide wire byhand is not possible, use a power tool to drill the guide wireinto the bone.
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3Cut bone graft
Instruments
03.111.012 Handle, long, with Quick Couplingor03.111.013 Handle, short, with Quick Coupling
03.111.030 Shaft for Trephine and Extraction Attachment
03.111.025 Trephine Attachment � 5.5 mm
03.111.026 Trephine Attachment � 7.0 mm
387.659 Trephine Attachment � 8.5 mm
387.660 Trephine Attachment � 9.5 mm
387.661 Trephine Attachment � 10.5 mm
387.662 Trephine Attachment � 12.5 mm
387.663 Trephine Attachment � 14.0 mm
Attach the shaft for trephine and extraction attachments to ahandle.
Select the preferred trephine size and attach it to the shaft.
Slide the trephine over the guide wire to the bone.
Note: The trephine cannot be disengaged from the shaftwhen it is inserted over the guide wire.
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Use gentle rotational movements to cut into the bone.
Use the guide wire to read the length of the bone graft.
Cut to the desired depth.
Handling TechniquesBone Harvesting Set
The extracted bone graft should remain in the trephine.
Important: If the bone graft cannot be removed with thetrephine, use the bone extraction attachment to remove thebone graft from the bone. This technique is described onpage 18.
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1
2
4Remove bone graft from trephine
Instrument
03.111.031 Stylet for Trephine and Extraction Attachment
Remove the handle and insert the stylet into the back of thetrephine shaft (1).
Push the bone graft carefully out from the front of thetrephine along with the guide wire (2).
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Removal of bone graft with the bone extractionattachment
Instruments
03.111.012 Handle, long, with Quick Couplingor03.111.013 Handle, short, with Quick Coupling
03.111.030 Shaft for Trephine and Extraction Attachment
03.111.027 Extraction Attachment � 5.5 mm
03.111.028 Extraction Attachment � 7.0 mm
387.669 Extraction Attachment � 8.5 mm
387.670 Extraction Attachment � 9.5 mm
387.671 Extraction Attachment � 10.5 mm
387.672 Extraction Attachment � 12.5 mm
387.673 Extraction Attachment � 14.0 mm
Note: All trephines have a corresponding size extraction attachment.
Slide the extraction attachment over the guide wire and insert it until you reach the limited depth (the handle shouldnot rotate).
To break the graft dowel free, turn the holder slowly untilyou hear a cracking noise or feel no more resistance in turning. Remove the holder. Both the bone dowel and the guide wire remain in the extraction attachment.
The technique to remove the bone graft is the same as whenusing a trephine.
Tips– It is possible to use a hammer in combination with
the handles.– Use light, controlled hammer blows.
Handling TechniquesBone Harvesting Set
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Handling TechniquesChisel Set
Set
01.111.475 Chisel Set for Orthopedic Foot Instruments, with Lid, with Contents
Set content
03.111.012 Handle, long, with Quick Couplingor03.111.013 Handle, short, with Quick Coupling
03.111.014 Cartilage Remover, for Foot
03.111.015 Chisel, for Foot, straight, narrow, width 10 mm, length 124 mm
03.111.016 Chisel, for Foot, straight, wide, width 15 mm, length 124 mm
03.111.017 Chisel, for Foot, 20° bend, narrow, width 10 mm, length 124 mm
03.111.018 Chisel, for Foot, 20° bend, wide, width 15 mm, length 124 mm
03.111.019 Chisel, for Foot, curved, narrow, width 10 mm, length 124 mm
03.111.020 Chisel, for Foot, curved, wide, width 15 mm, length 124 mm
Important– Chisels and cartilage remover have sharp cutting edges
that may cause injury.– Handle the instruments with care. Damage to the cutting
edges may cause failure and will alter the precision of theinstrument.
– Only use instruments with sharp edges.
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Handling TechniquesChisel Set
1Preparation
Expose the indicated area. The approach will depend on thesurgical procedure.
2Choose instrument
Instruments
03.111.012 Handle, long, with Quick Couplingor03.111.013 Handle, short, with Quick Coupling
03.111.014 Cartilage Remover, for Foot
03.111.015 Chisel, for Foot, straight, narrow, width 10 mm, length 124 mm
03.111.016 Chisel, for Foot, straight, wide, width 15 mm, length 124 mm
03.111.017 Chisel, for Foot, 20° bend, narrow, width 10 mm, length 124 mm
03.111.018 Chisel, for Foot, 20° bend, wide, width 15 mm, length 124 mm
03.111.019 Chisel, for Foot, curved, narrow, width 10 mm, length 124 mm
03.111.020 Chisel, for Foot, curved, wide, width 15 mm, length 124 mm
Attach the desired chisel or the cartilage remover to a handle.
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3Prepare joints and/or bones
Tips– It is possible to use a hammer in combination with
the handles.– Use light, controlled hammer blows.
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03.111.021 Compression/Distraction Device for Footand Ankle
03.111.022 Holding Sleeve � 2.0 mm forCompression/Distraction Device for Footand Ankle
03.111.023 Holding Sleeve � 2.5 mm forCompression/Distraction Device for Footand Ankle
03.111.024 Holding Sleeve � 3.0 mm forCompression/Distraction Device for Footand Ankle
292.250* Kirschner Wire � 2.5 mm with trocar tip,length 150 mm, Stainless Steel
292.750* Kirschner Wire � 2.5 mm with threadedtip, length 150/15 mm, Stainless Steel
292.790* Kirschner Wire � 2.0 mm with threadedtip, length 150/15 mm, Stainless Steel
292.820* Kirschner Wire � 3.0 mm with threadedtip, length 150/15 mm, Stainless Steel
03.111.012 Handle, long, with Quick Coupling
*Add suffix "S" to article number to order sterile product.
Instruments
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03.111.014 Cartilage Remover, for Foot
03.111.015 Chisel, for Foot, straight, narrow, width 10 mm, length 124 mm
03.111.016 Chisel, for Foot, straight, wide, width 15 mm, length 124 mm
03.111.017 Chisel, for Foot, 20° bend, narrow, width 10 mm, length 124 mm
03.111.018 Chisel, for Foot, 20° bend, wide, width 15 mm, length 124 mm
03.111.019 Chisel, for Foot, curved, narrow, width 10 mm, length 124 mm
03.111.020 Chisel, for Foot, curved, wide, width 15 mm, length 124 mm
03.111.030 Shaft for trephine and extractionattachment
02.111.001* Guide Wire � 3.2 mm with Stop, tip 1.2 mm, Stainless Steel
03.111.031 Stylet for trephine and extractionattachment
03.111.013 Handle, short, with Quick Coupling
*Add suffix ”S“ to article to order sterile product.
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Trephine Attachments
03.111.025 Trephine Attachment � 5.5 mm
03.111.026 Trephine Attachment � 7.0 mm
387.659 Trephine Attachment � 8.5 mm
387.660 Trephine Attachment � 9.5 mm
387.661 Trephine Attachment � 10.5 mm
387.662 Trephine Attachment � 12.5 mm
387.663 Trephine Attachment � 14.0 mm
Extraction Attachments
03.111.027 Extraction Attachment � 5.5 mm
03.111.028 Extraction Attachment � 7.0 mm
387.669 Extraction Attachment � 8.5 mm
387.670 Extraction Attachment � 9.5 mm
387.671 Extraction Attachment � 10.5 mm
387.672 Extraction Attachment � 12.5 mm
387.673 Extraction Attachment � 14.0 mm
Instruments
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01.111.476 Compression/Distraction Device Set for Orthopedic Foot Instruments, with Lid, with Contents
Sets
Synthes 25
Art. no. Description Quantity
03.111.021 Compression/Distraction Device for Foot and Ankle 1
03.111.022 Holding Sleeve � 2.0 mm for Compression/Distraction Device for Foot and Ankle 2
03.111.023 Holding Sleeve � 2.5 mm for Compression/Distraction Device for Foot and Ankle 2
03.111.024 Holding Sleeve � 3.0 mm for Compression/Distraction Device for Foot and Ankle 2
292.250.10 Kirschner Wire � 2.5 mm with trocar tip, length 150 mm, Stainless Steel, pack of 10 units 1
292.750.10 Kirschner Wire � 2.5 mm with threaded tip, length 150/15 mm, Stainless Steel, pack of 10 units 1
292.790.10 Kirschner Wire � 2.0 mm with threaded tip, length 150/15 mm, Stainless Steel, pack of 10 units 1
292.820.10 Kirschner Wire � 3.0 mm with threaded tip, length 150/15 mm, Stainless Steel, pack of 10 units 1
68.000.102 Lid for Instrument Tray, size ¼ 1
68.111.466 Tray for Compression/Distraction Device, for Orthopedic Foot Instruments, without Lid, without Contents 1
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01.111.475 Chisel Set for Orthopedic Foot Instruments, with Lid, with Contents
Sets
Art. no. Description Quantity
03.111.013 Handle, short, with Quick Coupling 1
03.111.014 Cartilage Remover, for Foot 1
03.111.015 Chisel, for Foot, straight, narrow, width 10 mm, length 124 mm 1
03.111.016 Chisel, for Foot, straight, wide, width 15 mm, length 124 mm 1
03.111.017 Chisel, for Foot, 20° bend, narrow, width 10 mm, length 124 mm 1
03.111.018 Chisel, for Foot, 20° bend, wide, width 15 mm, length 124 mm 1
03.111.019 Chisel, for Foot, curved, narrow, width 10 mm, length 124 mm 1
03.111.020 Chisel, for Foot, curved, wide, width 15 mm, length 124 mm 1
68.000.102 Lid for Instrument Tray, size ¼ 1
68.111.465 Tray for Chisel, for Orthopedic Foot Instruments, without Lid, without Contents 1
68.111.475 Module for Chisels, for Orthopedic Foot Instruments, without Lid, without Contents 2
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01.111.477 Bone Harvesting Set for Orthopedic Foot Instruments, with Lid, with Contents
Synthes 27
Art. no. Description Quantity
03.111.012 Handle, long, with Quick Coupling 1
03.111.030 Shaft for Trephine and Extraction Attachment 1
02.111.001 Guide Wire � 3.2 mm with Stop, tip 1.2 mm, Stainless Steel 1
03.111.031 Stylet for Trephine and Extraction Attachment 1
03.111.025 Trephine Attachment � 5.5 mm 1
03.111.026 Trephine Attachment � 7.0 mm 1
387.659 Trephine Attachment � 8.5 mm 1
387.660 Trephine Attachment � 9.5 mm 1
387.661 Trephine Attachment � 10.5 mm Optional
387.662 Trephine Attachment � 12.5 mm Optional
387.663 Trephine Attachment � 14.0 mm Optional
03.111.027 Extraction Attachment � 5.5 mm 1
03.111.028 Extraction Attachment � 7.0 mm 1
387.669 Extraction Attachment � 8.5 mm 1
387.670 Extraction Attachment � 9.5 mm 1
387.671 Extraction Attachment � 10.5 mm Optional
387.672 Extraction Attachment � 12.5 mm Optional
387.673 Extraction Attachment � 14.0 mm Optional
68.111.467 Tray for Hollow Reamer and Instruments for Bone Graft Harvesting, for Orthopedic Foot Instruments, without Lid, without Contents 1
68.000.102 Lid for Instrument Tray, size ¼ 1
68.111.476 Module for Bone Harvesting Trephines, for Orthopedic Foot Instruments, without Lid, without Contents 2
68.111.477 Module for Bone Harvesting Instruments, for Orthopedic Foot Instruments, without Lid, without Contents 1
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60043900 Spring for Handles
Replacement Articles
60030145 Spring for Compression/DistractionDevice
For detailed information ask your Synthes sales representative.
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All technique guides are available as PDF files at www.synthes.com/lit
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