stable fixation of normal and osteoporotic ribssynthes.vo.llnwd.net/o16/llnwmb8/int mobile/synthes...

SURGICAL TECHNIQUE

This publication is not intended for distribution in the USA.

MATRIXRIBTM

Stable fixation of normal and osteoporotic ribs

Image intensifier control

WarningThis description alone does not provide sufficient background for direct use of the instrument set. Instruction by a surgeon experienced in handling these instruments is highly recommended.

Reprocessing, Care and Maintenance of Synthes InstrumentsFor general guidelines, function control and dismantling of multi-part instruments, please contact your local sales representative or refer to: www.synthes.com/reprocessing

TABLE OF CONTENTS

MatrixRIB Surgical Technique DePuy Synthes 1

INTRODUCTION

SURGICAL TECHNIQUE

PRODUCT INFORMATION

MatrixRIB 2

AO Principles 4

Indications 5

Patient Positioning 5

Plating Rib 6

Splint Insertion 16

Minimally Invasive Plate Osteosynthesis (MIPO) 25

MatrixRIB Trocar Instruments Instructions 26

Threaded Reduction Tool (TRT) Instructions 28

90° Screwdriver for MatrixRIB System Instructions 31

Implants 33

Instruments 34

Bibliography 41

R8-9

R3

R4-5

R6-7

FEATURES AND BENEFITS

MATRIXRIB

1 DePuy Synthes MatrixRIB Surgical Technique

The Synthes MatrixRIB Fixation System consists of precon-toured locking plates, locking screws, and intramedullary splints for the fi xation and stabilization of ribs.

Although some rib fractures are treated with pain man-agement and bracing, as well as endotracheal intubation and mechanical ventilation if necessary, some patients could benefi t from surgical stabilization (osteosynthesis). Potential benefi ts of surgical stabilization of fractures include reduced duration of mechanical ventilation support, shortened ICU stays and hospitalization, better secretion management through effi cient cough, and minimized chest wall deformities resulting from trauma.1,2

• Designed to be used without removing periosteum, to maximize blood supply to the bone

• All implants are manufactured from titanium alloy* for fl exibility and strength

• Drill bit with stop to prevent over-drilling• Self-retaining screwdriver blades

*Ti-6Al-7Nb

Locking screws• Screws work with self-retaining screwdriver blades to

reduce cam-out• Locking design for increased stable fi xation• One screw diameter for use with all plates and splints

Locking holes

Longitudinal twist

In-plane radius

Right plates

rib 3

rib 4

rib 5

rib 6

rib 7

rib 8

rib 9

rib 3

rib 4

rib 5

rib 6

rib 7

rib 8

rib 9

L6-7

L8-9

L3

L4-5R4-5

R6-7

R8-9

R3

MatrixRIB


Locking plates• Plates are precontoured to fi t an average rib shape,

which minimizes intraoperative bending3

• Locking plate construct provides stable fi xation• Low-profi le 1.5 mm thick plates• Plates are color-coded to distinguish left and

right designs• Plates are etched on medial end to indicate the

corresponding rib curvature• A universal plate with 8 holes is available

Left plates

Tubular radius

Out of plane radius

Etching

L3

L4-5

L6-7

L8-9

Intramedullary splints• Intramedullary splints allow less invasive procedures• Three widths available (3 mm, 4 mm, 5 mm)• Only one screw needed to secure splint

AO PRINCIPLES

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

Anatomic reductionFracture reduction and fixation to restore functional anatomical relationships.

Stable fixationStability by rigid fixation or splintage, as the personality of the fracture and the injury requires.

Preservation of blood supplyPreservation of the blood supply to soft tissue and bone by careful handling and gentle reduction techniques.

Early, active mobilizationEarly and safe mobilization of the part and patient.

* M. E. Müller, M. Allgöwer, R. Schneider, and H. Willenegger. Manual of Internal Fixation, 3rd Edition. Berlin: Springer-Verlag. 1991.



The Synthes MatrixRIB Fixation System is indicated for the fixation and stabilization of rib fractures, fusions and osteotomies of normal and osteoporotic bone.

Warning: Medical devices containing stainless steel may elicit allergic reactions in patients with hyper-sensitivity to nickel.

INDICATIONS

PATIENT POSITIONINGPosition patientPosition the patient to optimize access to the rib to be repaired.

For pure lateral chest injuries, a lateral thoracotomy may be used with the patient in a lateral decubitus position, and the arms abducted 90° on padded arm rests.

Anterolateral chest injuries may be approached with an anterolateral thoracotomy with the patient in a supine position, with both arms abducted 90°.

PLATING RIB


1Exposure fractured rib

Make an incision over the fracture area.

Expose the rib to allow a minimum of three screws on each side of the fracture.

Remove any nonviable bone.

Precaution: Avoid significant muscle division to pre-serve as much respiratory function as possible. The serratus anterior muscle insertions on the chest wall are generally the only muscle fibers that are divided for anterolateral injuries.

Notes:• For lateral chest wall injuries, the anterior aspect

of the latissimus dorsi can be dissected to gain access to the fracture

• Removal of the periosteum is not required

Plating Rib


2Determine rib thickness

Instrument

03.501.065 Caliper

Optional instrument

03.501.074 Universal Caliper

Make a small incision in the intercostal space at the superior border of the rib to allow insertion of the cali-per tip. Insert the caliper tip through the incision and determine the rib thickness.

Note: If an existing access into the intercostal space is available for determining the rib thickness, it is recommended to insert the caliper tip using the ex-isting access.

To select the appropriate drill bit with stop and the appropriate screw length, add 2 mm to allow for the plate thickness.

Precaution: Take care to avoid damaging the nerve and vessel bundle at the inferior border of the rib.

3Approximate broken rib segments

Instrument

398.400 Reduction Forceps with Points, narrow, ratchet lock, length 132 mm

Use the forceps to approximate the broken rib segments.

Plating Rib


4Cut and contour plate template (optional)

Instrument

03.501.072 MatrixRIB Bending Template for Rib Plates

Cut the bending template to a length that allows placement of a minimum of three screws on each side of the fracture.

Contour the template to the rib.

Plating Rib

5Select and cut plate (optional)

Instrument

391.990 Cutting Pliers for Plates and Rods

Use the plate template contoured in Step 4 to select the best matching plate.

Notes:• Position the precontoured plate with the marking

toward the sternum • A universal plate is available for use in place of

a precontoured plate (see implants on page 33) If necessary, cut the plate to the desired length.

Precaution: Use a minimum of three screws on each side of the fracture, to properly secure the plate.


6Contour plate (optional)

Instrument

329.142 Bending Pliers with Nose, for Pure Titanium Plates 2.4 and 2.7

Using the bending pliers, contour the plate to match the template.

Precaution: If contouring is necessary, avoid sharp bends, reverse bends, or bending the implant at a screw hole. Avoid notching or scratching the im-plant. These factors may produce internal stresses which may become the focal point for eventual breakage of the implant.

Plating Rib


7Position plate

Instrument

03.501.071 MatrixRIB Plate Holding Forceps, small

Optional instruments

03.501.030 MatrixRIB Plate Holding Forceps, small, with ball tip

03.501.031 MatrixRIB Plate Holding Forceps, large, with ball tip

03.501.704 Threaded Reduction Tool for MatrixRIB, with AO Quick Coupling (see page 28 for instructions)

03.501.708 MatrixRIB Plate Holding Forceps, upright

03.501.709 MatrixRIB Plate Holding Forceps, large

Position the plate on the rib over the fracture, allowing a minimum of three screws on each side of the fracture.

Verify that the contour of the plate matches the rib.

Using the plate holding forceps, hold the plate on the rib.

Precaution: It is recommended to insert the forceps from the superior border of the rib to avoid damaging the nerve and vessel bundle located at the inferior border of the rib.

Plating Rib


8Drill

Instruments

03.501.033 MatrixRIB Drill Guide 2.2 for Plates

03.501.036– MatrixRIB Drill Bits 2.2 mm with stop,03.501.044 length 135, 6 mm to 14 mm, 2 flute, for J-latch coupling


03.501.700 MatrixRIB Drill Guide, long



Thread the drill guide into the plate. This will help ensure safe drilling and alignment of the drill hole with the plate hole.

Select the drill bit with stop as determined in Step 2 and drill.

Drill bits with stop are available with stop lengths rang-ing from 6 mm to 14 mm, in 2 mm increments, match-ing the locking screw lengths.

Precautions: • Do not drill any deeper than necessary, to avoid

the risk of pneumothorax.• Irrigate during drilling to avoid thermal damage

to the bone.• Drilling speed should never exceed 1800 rpm.

Higher speeds can result in thermal necrosis of the bone and increased hole diameter and may lead to unstable fixation.

Remove the 2.2 mm drill guide after drilling.

Plating Rib


Options• The MatrixRIB Trocar Instruments may be used

for screw insertion (see MatrixRIB Trocar Instruments instructions on page 26)

• The 90° Screwdriver for MatrixRIB system may be used for screw insertion (see 90° screwdriver for MatrixRIB instructions on page 31)

Plating Rib


9Confirm rib thickness (optional)

Instruments

03.501.001 Depth Gauge for Sternal Cable

Optional instrument

03.503.085 Depth Gauge for MatrixMANDIBLE, measuring range up to 40 mm

Use the depth gauge through the plate to confirm the appropriate screw length determined in Step 2.

Precaution: Do not extend the tip of the depth gauge too far beyond the posterior cortex of the rib.

10Select and insert screw

Instruments

03.503.071 Screwdriver Shaft MatrixMANDIBLE, medium, self-holding, for Hexagonal Coupling

311.023 Ratcheting Screwdriver Handle, with Hexagonal Coupling

Optional instrument

03.503.072 Screwdriver Shaft MatrixMANDIBLE, long, self-holding, for Hexagonal Coupling

Select and insert the locking screw (with proper length determined in Step 2) through the plate and tighten until secure.

Precautions:• The screw should be no longer than necessary

to engage the posterior cortex, to avoid deeper injury. The tip of the screw should not extend more than 1 mm beyond the posterior cortex

• The screw length indicator on the module can be used to select the appropriate screws

• Use a minimum of three screws on each side of the fracture to properly secure the plate.

Options• 10 and 12 mm nonlocking screws are available

to ensure the plate sits flush with the bone. These nonlocking screws are for temporary fixation and will need to be replaced with locking screws before closure

• The MatrixRIB Trocar Instruments may be used for screw insertion (see MatrixRIB Trocar Instruments instructions on page 26)

• The 90° Screwdriver for MatrixRIB system may be used for screw insertion (see 90° screwdriver for MatrixRIB instructions on page 31)

Plating Rib


11Drill and place remaining screws

Verify proper reduction of the fracture.

Insert a second screw on the opposite side of the frac-ture following Steps 8 and 9. Insert remaining screws in the same manner.

Note: If nonlocking screws were used, remember to replace with the proper locking screw.

Plating Rib


Intramedullary splints improve the ability to fi x posterior rib fractures.

The intramedullary splints have a rectangular profi le for rotational stability within the canal, and a locking feature to limit migration and rotation of the implant.

Intramedullary splints• Intramedullary splints allow less invasive procedures• Three widths available (3 mm, 4 mm, 5 mm)• Only one screw needed to secure splint

1Expose fractured rib

Make incisions over the fractured area.

Expose the fractured rib to allow splint head placement. A minimum of 50 mm on the medial side of the fracture is recommended.

Remove any nonviable bone.

Notes: • It is recommended to minimize the dissection of

the soft tissue on the lateral side of the fracture• Removal of the periosteum is not recommended

Precaution: Avoid signifi cant muscle division to pre-serve as much respiratory function as possible.

SPLINT INSERTION


2Determine rib thickness

Instrument

03.501.065 Caliper

Optional instrument

03.501.074 Universal Caliper

Make a small incision in the intercostal space at the superior border of the rib to allow insertion of the caliper tip.

Insert the caliper tip through the incision and determine the rib thickness.

Note: If an existing access into the intercostal space is available for determining the rib thickness, it is recommended to insert the caliper tip using the existing access.

To select the appropriate drill bit with stop and the appropriate screw, add 1 mm to allow for the splint thickness.

Precaution: Take care to avoid damaging the nerve and vessel bundle at the inferior border of the rib.

Splint Insertion


3Prepare splint insertion hole

Instruments

03.501.055 MatrixRIB Drill Guide 5.5 for Intramedullary Splint Insertion

03.501.070 MatrixRIB Drill Bit 5.5 mm with Stop, length 125 mm, 2-fl ute, for J-Latch Coupling*



03.501.032 MatrixRIB Intramedullary Splint Driver

03.501.075 Drill Guide 5.5, for MatrixRIB Intramedullary Splints, without Handle

Insert the hook end of the drill guide into the intra-medullary canal of the medial segment until it is seated fully on the rib.

Notes:• It is recommended to insert the hook near the

superior edge of the rib, and to drill an entry hole in the upper 2/3 of the rib

• The small plate holding forceps can be used to hold the drill guide against the rib during drilling

Precaution: If the drill guide without handle is used, ensure the tapered end, labeled “Fracture”, is aligned with the fracture to ensure the hole is ap-proximately 30 mm from the fracture line

Note: The splint driver may be threaded into the drill guide to act as a handle, as needed.

Splint Insertion


*Drill bit with AO/ASIF quick coupling also available.

4Select splint

Instruments


03.501.061 MatrixRIB Template for Intramedullary Splint, small

03.501.062 MatrixRIB Template for Intramedullary Splint, medium

03.501.066 Mallet


The splint template is used to prepare the canal and se-lect the correct size of splint. It is recommended to start with the small template before using the medium template.

Splint Insertion

Ensure the medial end of the drill guide contacts the bone.

Using the 5.5 mm drill bit with stop, drill monocortically.

Remove the drill guide and verify the hole is approxi-mately 30 mm from the fracture line.

Precautions:• Ensure the lateral fracture segment is long enough

to accommodate the insertion length of the splint before drilling.

• Irrigate during drilling to avoid thermal damage to the bone.


Thread the splint driver into the splint template and insert the template into the insertion hole prepared in Step 3.

Remove the splint template.

Fully insert the template into the canal of the lateral fracture segment.

Remove the splint template.

Notes:• If the small template fi ts snugly, use the 3 mm wide

splint• If the medium template fi ts snugly, use the 4 mm

wide splint• If the medium template fi ts loosely, use the 5 mm

wide splint• Use the mallet to assist insertion of the splint tem-

plate, if needed

Use bone reduction forceps to hold the rib segment during splint template insertion.

Splint Insertion


Splint Insertion

5Insert splint

Instruments


03.501.066 Mallet


Thread the splint driver into the splint selected in Step 4, with the splint marking facing up toward the handle.

Insert the splint through the insertion hole prepared in Step 3.

Drive the splint across the fracture line and into the canal of the lateral segment. The splint is fully inserted when the head of the splint rests fl ush on the outside of the rib.

Remove the splint driver after the splint is fully seated.

Precautions: • To prevent additional injuries to the rib, do not in-

sert the splint head further once it is seated in the insertion hole.

• Take care to avoid any steep angle during splint insertion to prevent damage of the posterior cortex of the rib.

Note: The mallet can be used to assist insertion of the splint, if needed.


6Drill screw hole

Instruments


03.501.036– MatrixRIB Drill Bits 2.2 mm with stop,03.501.044 length 135, 6 mm to 14 mm, 2 flute, for J-latch coupling


Optional instrument


Thread the drill guide into the splint. This will help en-sure safe drilling and alignment of the screw with the splint locking hole.

Select the drill bit with stop as determined in Step 2 and drill.

Drill bits with stop are available with stop lengths rang-ing from 6 mm to 14 mm, in 2 mm increments, match-ing the locking screw lengths.

Precautions:• Do not drill any deeper than necessary, to avoid


to the bone.

Remove the 2.2 mm drill guide after drilling.

Splint Insertion


Splint Insertion

7Confirm rib thickness (optional)

Instrument



03.503.085 Depth Gauge for MatrixMANDIBLE, measuring range up to 40 mm

Use the depth gauge through the splint to confirm the screw length determined in Step 2.

Precaution: Do not extend the tip of the depth gauge too far beyond the posterior cortex of the rib.



Instruments

03.503.071 Screwdriver Shaft MatrixMANDIBLE, medium, self-holding, for Hexagonal Coupling


Optional instrument

03.503.072 Screwdriver Shaft MatrixMANDIBLE, long, self-holding, for Hexagonal Coupling

Select and insert the locking screw (with proper length determined in Step 2) through the splint and tighten until secure.

Precautions:• The screw should be no longer than necessary

to engage the posterior cortex, to avoid deeper in-jury. The tip of the screw should not extend more than 1 mm beyond the posterior cortex

• The screw length indicator on the module can be used to select the appropriate screws

Splint Insertion


The versatile MIPO instruments offer additional approach options that are less invasive than the original MatrixRIB system. These instruments overcome vari-ous access challenges by extending their reach without increasing incision size. The instruments also enable rib stabiliza-tion of sub-scapula fractures with MatrixRIB implants.

The MIPO instrumentation includes the following: trocar instruments, threaded reduction tool and instruments for the 90° Screwdriver.


MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS (MIPO)

SMARTER APPROACH. SMALLER INCISION.

1Insert Cannula

Instruments

397.211 Universal Handle for Drill Sleeves


03.501.702 Cannula for MatrixRIB

03.501.703 Trocar for MatrixRIB

After creating a stab incision, pass the cannula with trocar carefully through the soft tissue over the plate hole, then remove the trocar.

Note: The cannula can be used with or without the universal handle for drill sleeves.


MATRIXRIB TROCAR INSTRUMENTS INSTRUCTIONS

2Drill

Instrument


Optional instrument

03.506.003 Retractor Forceps

Thread drill guide into the plate through the cannula.

Select the appropriate drill bit with stop* and drill.

*Length determined in Step 2 of plating rib instructions on page 7

Precautions:• Do not drill any deeper than necessary to avoid



Higher speeds can result in thermal necrosis of the bone and increased hole diameter and may lead to unstable fixation.

Remove drill guide.

Note: Retraction forceps may be used to retract soft tissue.


MatrixRIB Trocar Instruments Instructions


Select the appropriate length screw* and insert into the cannula and through the plate, and tighten until secure.

Precaution: The screw should be no longer than nec-essary to engage the posterior cortex, to avoid deeper injury. The tip of the screw should not extend more than 1 mm beyond the posterior cortex. The screw length indicator on the module can be used to select the appropriate screws.

*Length determined in Step 2 plating rib instructions on page 7


THREADED REDUCTION TOOL (TRT) INSTRUCTIONS

2Thread drill guide to plate

Instrument


Optional instrument


Thread the drill guide into the plate through the cannula.

1Insert Cannula

Instruments





After creating a stab incision, pass the cannula with trocar carefully through the soft tissue over the plate hole, then remove the trocar.

Note: The cannula can be used with or without the universal handle for drill sleeves.


3Insert TRT through drill guide

Instrument

03.501.704 Threaded Reduction Tool for MatrixRIB, with AO Quick Coupling

With the TRT attached to a power source, place it in drill guide.

With the reduction nut in the highest position possible, begin power insertion of the TRT slowly.

Precaution: The TRT has a maximum insertion length of 15 mm. To avoid injuries, limit the insertion depth according to the patient’s rib thick-ness. Stop insertion before the TRT contacts the top surface of the drill guide. Continuing to power after contacting the top surface of the drill guide may cause the TRT threads to strip in the bone.

Threaded Reduction Tool (TRT) Instructions

Reduction nut at highest position


Threaded Reduction Tool (TRT) Instructions

4Remove the power source

Remove the power source and begin tightening the reduction nut toward the drill guide while monitoring progress of bone/plate contact.

5Reduce bone to plate

Stop when the desired reduction is achieved.

Note: The TRT is designed to allow later placement of a 2.9 mm MatrixRIB locking screw in the same hole – after removal of the TRT.


90° SCREWDRIVER FOR MATRIXRIB SYSTEM INSTRUCTIONS

1 Drilling with 90° Screwdriver

Instrument

03.501.751 MatrixRIB Drill Guide 2.2 mm for Screwdriver 90° with 0°/90° angle

03.501.752 MatrixRIB Drill Guide 2.2, for Screwdriver 90° with 45°/45° angle

03.501.756- MatrixRIB Drill Bit 2.2 mm, with Stop,03.501.764 length 6 mm to 14 mm, 2-fl ute, for Screwdriver 90°

Choose the appropriate drill guide angle. Engage and hold the drill guide on the desire plate hole.

Note: Ensure the head of drill guide is seated fl at on top of the plate to ensure proper engagement.

Select the appropriate drill bit with stop* and drill.

Precautions: • Do not drill any deeper than necessary to avoid



Higher speeds can result in thermal necrosis of the bone and increased hole diameter and may lead to unstable fi xation.

Remove drill guide after drilling.

Notes:• 90° Screwdriver may stall during drilling, if drill

bit is misaligned with the drill guide.• The drill bit length indicator on the side of the 90°

screwdriver module can be used to reconfi rm the length of the drill bit.

*Length determined in Step 2 of plating rib instructions on page 7


2 Insert Screw

Instrument

03.501.750 MatrixRIB Screwdriver Blade, self-holding, for Screwdriver 90°

Select the appropriate length screw* and insert it through the plate and tighten until secure.

Precaution: The screw should be no longer than nec-essary to engage the posterior cortex, to avoid deeper injury. The tip of the screw should not ex-tend more than 1 mm beyond the posterior cortex. The screw length indicator on the module can be used to select the appropriate screws.

*Length determined in Step 2 of the plating rib instructions on page 7

90° Screwdriver for MatrixRIB System Instructions

IMPLANTS


MatrixRIB Pre-Contoured Plates, Titanium Alloy (TAN)*

04.501.001 15 holes, for left rib 304.501.002 15 holes, for right rib 304.501.003 16 holes, for left ribs 4 and 504.501.004 16 holes, for right ribs 4 and 504.501.005 17 holes, for left ribs 6 and 704.501.006 17 holes, for right ribs 6 and 704.501.007 18 holes, for left ribs 8 and 904.501.008 18 holes, for right ribs 8 and 9

04.501.009 MatrixRIB Universal Plate, 8 holes, Titanium Alloy (TAN)*

* For sterile plates and splints add suffix “S”** For screws in packs of 5, add suffix “.05”; for sterile screws add suffix “.01S”

Right plate (rose red) 04.501.002

Left plate (light blue) 04.501.001

MatrixRIB LOCK Screws, 2.9 mm, self-tapping,Titanium Alloy (TAN)** (in 2 mm increments)

04.501.016.01– 6 mm –14 mm04.501.024.01

MatrixRIB NON-LOCK Screws 2.9 mm, self-tapping, Titanium Alloy (TAN)** 04.501.040.01 10 mm04.501.042.01 12 mm

MatrixRIB Intramedullary Splints, Titanium Alloy (TAN)*

04.501.010 Small, 3 mm width04.501.011 Medium, 4 mm width04.501.012 Large, 5 mm width

INSTRUMENTS



03.501.030 MatrixRIB Plate Holding Forceps, small, with ball tip

03.501.031 MatrixRIB Plate Holding Forceps, large, with ball tip


03.501.036– MatrixRIB Drill Bits 2.2 mm with stop,03.501.044 length 135, 6 mm to 14 mm, 2 fl ute, for J-latch coupling*


* For sterile drill bits add suffi x “S”.


03.501.055 MatrixRIB Drill Guide 5.5 for Intramedullary Splint Insertion

03.501.061 MatrixRIB Template for Intramedullary Splint, small

03.501.062 MatrixRIB Template for Intramedullary Splint, medium

03.501.066 Mallet

03.501.070 MatrixRIB Drill Bit 5.5 mm with Stop, length 125 mm, 2-fl ute, for J-Latch Coupling*

03.501.065 Calliper

* For sterile drill bits add suffi x “S”

03.501.606– MatrixRIB Drill Bit 2.2 mm, with Stop,03.501.614 length 135/6 mm to 14 mm, 2-fl ute, for AO/ASIF Quick Coupling*

Instruments



03.501.072 MatrixRIB Bending Template for Rib Plates

03.501.074 Universal Calliper

03.501.075 Drill Guide 5.5, for MatrixRIB Intramedullary Splints, without Handle

Screwdriver Shaft MatrixMANDIBLE, self-holding, for Hexagonal Coupling03.503.071 medium03.503.072 long

* For sterile drill bits add suffi x “S”

03.501.085 MatrixRIB Drill Bit 5.5 mm, with Stop, length 125 mm, 2-fl ute, for AO/ASIF Quick Coupling*

Instruments



329.142 Bending Pliers with Nose, for Pure Titanium Plates 2.4 and 2.7

391.990 Cutting Pliers for Plates and Rods



Instruments


03.506.003 Retractor Forceps




03.501.704 Threaded Reduction Tool for MatrixRIB, with AO Quick Coupling



Instruments


03.505.003 Shaft for Screwdriver 90°

03.505.004 Handle for Screwdriver 90°

03.505.005 Turning Handle for Screwdriver 90°

03.501.750 MatrixRIB Screwdriver Blade, self-holding, for Screwdriver 90°

03.501.751 MatrixRIB Drill Guide 2.2 mm fo Screwdriver 90° with 0°/90° angle

03.501.752 MatrixRIB Drill Guide 2.2, for Screwdriver 90° with 45°/45° angle

Instruments


03.501.756 length 6 mm

03.501.758 length 8 mm

03.501.760 length 10 mm

03.501.762 length 12 mm

03.501.764 length 14 mm

MatrixRIB Drill Bits 2.2 mm, with Stop, 2-flute, for Screwdriver 90°


BIBLIOGRAPHY

1. Z. Ahmed, Z. Mohyuddin. “Management of flail chest injury: internal fixation versus endotracheal intubation and ventilation.” J Thorac Cardiovasc Surg. 1995 Dec; 110(6):1676-80.

2. H. Tanaka, T. Yukioka, Y. Yamaguti, S. Shimizu, H. Goto, H. Matsuda, S. Shimazaki. “Surgical stabiliza-tion of internal pneumatic stabilization. A prospective randomized study of management of severe flail chest patients.”J Trauma. 2002;52(4):727-32; discussion 32.

3. M. Mohr, E. Abrams, C. Engel, W.B. Long, M. Bottlang. “Geometry of Human Ribs Pertinent to Or-thopaedic Chest-Wall Reconstruction.” J Biomech. 2007;40(6):1310-7.

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Manufacturer:Synthes GmbHEimattstrasse 3CH-4436 Oberdorfwww.depuysynthes.com

This publication is not intended for distribution in the USA.

All technique guides are available as PDF files at www.synthes.com/lit

stable fixation of normal and osteoporotic ribssynthes.vo.llnwd.net/o16/llnwmb8/int mobile/synthes...

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