LCP Compact Hand 1.5. Instrument and implant module. - Synthes

LCP Compact Hand 1.5. Instrumentand implant module.

Technique Guide

Synthes 1

Table of Contents

Introduction

Surgical Technique

Product Information

LCP Compact Hand 1.5 2

AO Principles 4

Indications 5

Preparation 6

Implantation 8

Implant Removal 17

Screws 18

Plates 20

Plates, with Preassembled Short LCP Drill Sleeves 21

Instruments 22

Sets 24

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.

NoteFor information on fixation principles using conventional and locked platingtechniques, please refer to the technique guide for LCP Locking Compression Plate(036.000.019).

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

2 Synthes LCP Compact Hand 1.5 Technique Guide

LCP Compact Hand 1.5. Instrument andimplant module.

Adaptable Locking Plates forVarious Indications

Minimized soft tissue irritation

Option for preassembled drill sleeves

Low profile plates with rounded edgesand highly polished surface to minimizesoft tissue irritation.

All plates are available either with or without short drill sleeves preassembled.

Locking or non-locking screwoption

Self-tapping screws with low-profilescrew head sit flush with the plate.Coaxial locking holes and LCP holes accept both, cortex and locking screws.

LCP Plate 1.5, straight

Locking Plate 1.5, straight

Locking T-Plate 1.5

Locking Strut Plate 1.5

Locking Y-Plate 1.5

Locking Condylar Plate 1.5

Synthes 3

Part of the LCP Compact Hand System

4 modules, 5 dimensions:– Adaptable plates for different indications – Complete range of implants

1.0 mm1.3 mm1.5 mm (new locking)2.0 mm (locking)2.4 mm (locking)

– Broad range of non-locking, locking and LCP plates to address various fracture patterns

– The use of locking screws allows creating a fixed-angle construct, which is particularly advantageous in osteopenicbone or in fractures near the joint


AO Principles

In 1958, the AO formulated four basic principles, whichhave become the guidelines for internal fixation.1,2 Thoseprinciples as applied to the LCP Compact Hand 1.5 are:

Anatomic reductionAnatomic plate profile assists in reduction and facilitatesrestoration anatomical relationships.

Stable fixationThe combination of conventional and locking screws offersoptimum fixation regardless of bone density. Locking screwscreate a fixed-angle construct, providing angular stability.

Preservation of blood supplyLimited-contact plate design reduces plate-to-bone contactand helps to preserve the periosteal blood supply. Taperedends for submuscular plate insertion preserve tissue viability.

Early, active mobilizationEarly mobilization per standard AO technique creates an environment for bone healing, expediting a return to optimalfunction.

1 Müller ME, Allgöwer M, Schneider R, Willenegger H (1995) Manual of InternalFixation. 3rd, expanded and completely revised ed. 1991. Berlin, Heidelberg,New York: Springer

2 Rüedi TP, Buckley RE, Moran CG (2007) AO Principles of Fracture Management.2nd expanded ed. 2002. Stuttgart, New York: Thieme

Synthes 5

Indications

− Fracture fixation of the phalanges and metacarpals− Osteotomies− Arthrodeses− Replantations and reconstructions of phalanges and

metacarpals, particularly in osteopenic bone

Holes Length0X.114.002 4 23 mm0X.114.004 6 36 mm

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For use only with the Original AO System ofInstruments and Implants

Synthes GmbHEimattstrasse 3CH-4436 Oberdorfwww.synthes.com

0 10 20 30 40 50 60 70 80 90 100 mm

1.15 Magnification

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0X.214.006–024 Locking Screw Stardrive 1.5 mm,self-tapping, length 6–24 mm

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0X.214.106–124 Cortex Screw Stardrive 1.5 mm,self-tapping, length 6–24 mm

Holes Length0X.114.003 6 29 mm0X.114.005 12 59 mm


Shaft Head0X.114.014 6 Holes 2 Holes

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0X.214.006–024 Locking Screw Stardrive 1.5 mm,self-tapping, length 6–24 mm

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Locking T-Plate 1.5

0X.214.106–124 Cortex Screw Stardrive 1.5 mm,self-tapping, length 6–24 mm

Locking Strut Plate 1.5, oblique-angled left and right



Holes0X.114.009 8 oblique left

Holes0X.114.010 8 oblique right

Locking Y-Plate 1.5

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Preparation

1Preoperative planning

Complete the preoperative radiographic assessment and prepare the preoperative plan. Use the x-ray templates forLCP Compact Hand 1.5 (Art. Nos. 034.000.570/575) to determine the length of the plate and the position of thescrews.

Synthes 7

2Select implant

Required sets

01.114.104 LCP Compact Hand 1.5 (Titanium Implants)or01.114.102 LCP Compact Hand 1.5 (Stainless Steel Implants)

01.110.003 Standard Instrument Set for LCP Compact Hand

The plates of the LCP Compact Hand Module 1.5 are available either with or without short drill sleeves preassem-bled to the plate. The plates with preassembled drill sleevesare available sterile only.

Select the plate according to the fracture pattern and theanatomy of the patient.

Notes:– This technique guide describes the application of the

LCP Compact Hand 1.5 system using a Locking CondylarPlate 1.5.

– Familiarity with the use of LCP plates or instruction froman experienced surgeon is recommended (see LCP LockingCompression Plate technique guide 036.000.019).

Implantation

1Reduce fracture

Reduce the fracture under image intensifier control and,if necessary, fix with Kirschner wires or reduction forceps.The reduction method will be fracture-specific.

2Trim plate

Instrument

391.962 Bending/Cutting Pliers

Trim the plate to the desired length using the bending/cutting pliers and remove the burrs.

Note: If the bending/cutting pliers are used on a platewith preassemble drill sleeves, the drill sleeves must first beremoved from the plate.


1

2

Synthes 9

3Contour plate

Instruments

03.114.003 Bending Pin for LCP Plates 1.5, with thread

347.901 Pliers, flat-nosed, pointed, for Plates 1.0 to 2.4

If necessary, contour the plate to suit anatomical conditions.

Non-preassembled platesUse the bending pins for LCP Plates and thread the pins intothe screw holes to contour the plate. (1)

The plate can also be bent using two flat nosed pliers.

Preassembled platesUse the non-threaded ends of the bending pins over theshort threaded drill sleeves. (2)

Note: If possible, bend the plate between the locking/LCP holes. Do not deform the threaded part of the holes orover-bend the plate during bending as this may adversely affect insertion of locking screws.

1

2


4Position plate

Instrument

399.970 Reduction Forceps with Points, ratchet lock

Position the plate over the reduced fracture and, if necessary,fix provisionally with Kirschner wires or reduction forceps. (1)

When using reduction forceps with points on a preassembledplate, insert one branch of the forceps in the cannulationof the short drill sleeve to secure the plate to the bone. (2)

Optional instrument

398.819 Holding Forceps with Swivel Foot, for Plates 1.3 to 2.4, speed lock

When using the holding forceps with swivel foot to holdthe plate, remove the drill sleeves from the surrounding holesso that the holding forceps sit flush on the plate.

Implantation

Synthes 11

5Determine screw type

Depending on the individual case, cortex screws and/or locking screws may be inserted. Determine where lockingscrews will be used.

The LCP and the locking holes accept both, cortex and lock-ing screws. The elongated hole only accepts cortex screws.

If a locking screw is inserted first, ensure that the plate isheld securely to the bone to prevent the plate from spinningas the screw locks into the plate.

The final screw placement and the use of locking and cortexscrews is determined by the fracture pattern.

LCP hole (cortex or locking screw) Locking hole (cortex or locking screw)

Elongated hole (cortex screw only)

1

2

3

6AInsert screws in non-preassembled plate

Implantation


Insert locking screw

Instruments

03.114.001 LCP Drill Sleeve 1.5, for Drill Bits � 1.1 mm

03.114.007 Drill Bit � 1.1 mm, length 75/61 mm, 2-flute, for Mini Quick Coupling

319.003 Depth Gauge for Screws � 1.3 to 1.5 mm, measuring range up to 24 mm

03.114.009 Screwdriver Shaft Stardrive 1.5, with Holding Sleeve, length 66 mm, for Mini Quick Coupling

311.012 Handle, medium, with Mini Quick Coupling

Optional instrument

03.114.002 Screwdriver Shaft, Stardrive 1.5, T4, short, self-holding, for Mini QuickCoupling

Pre-drill the hole for a 1.5 mm locking screw using the1.1 mm drill bit and the LCP drill sleeve 1.5. (1)

Determine the screw length with the corresponding depthgauge. (2)

Insert the screw manually with the screwdriver shaft withholding sleeve and the handle with mini quick coupling. (3)

1

2

Insert cortex screw

Instruments

312.140 Double Drill Guide 1.5/1.1


310.141 Drill Bit � 1.5 mm, length 65/50 mm, 2-flute, for Quick Coupling, Stainless Steel

319.003 Depth Gauge for Screws � 1.3 to 1.5 mm, measuring range up to 24 mm



Optional instrument

03.114.002 Screwdriver Shaft, Stardrive 1.5, T4, short, self-holding, for Mini QuickCoupling

Pre-drill the hole for a 1.5 mm cortex screw with the 1.1 mmdrill bit using the double drill guide. To drill a glidinghole, use the 1.5 mm drill bit with the double drill guide. (1)

To adjust the plate position, a 1.5 mm cortex screw canbe inserted in the non-threaded elongated hole (in T-, Y- andCondylar Plate). Insert the 1.5 mm cortex screw, adjust theplate position if necessary and tighten the screw.

Determine the screw length with the corresponding depthgauge. (2)

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3



Implantation

1

2

3

Synthes 15

6BInsert screws in plate with preassembled short drill sleeves

Instrument






Optional instrument

03.114.002 Screwdriver Shaft, Stardrive 1.5, T4, short, self-holding, for Mini Quick Coupling

Pre-drill the screw hole using the short LCP drill sleevesthat are preassembled to the plate. To drill for a cortex screwin an angle other than 90° to the plate, use the doubledrill guide. Before using the double drill guide, remove theshort drill sleeve. (1, 2,3)

Note: Screw length may be measured either with or with-out the short drill sleeve assembled to the plate.When measured directly through the drill sleeve, subtract5 mm from the reading to account for the drill sleeve. (3)

4

5

6



Important:– Remove all preassembled short drill sleeves before closure.

Use the self-retaining T4 screwdriver shaft or the screw-driver shaft with holding sleeve and the handle with miniquick coupling to unscrew them from the plate (5, 6).A tray which can serve as a tool to help remove the shortdrill sleeves from the screwdriver is optionally available.

– It is recommended to count the short LCP drill sleeves toensure they are all removed before closure.

Implantation

Synthes 17

Implant Removal

Instruments



Optional instrument


To remove the implants, first unlock all locking screws beforeremoving them completely. Otherwise, the plate may rotateand damage the soft tissue.

Screws

Cortex Screw Stardrive, � 1.5 mm,self-tapping

– Used to provide compression or neutral fixation– Low-profile head sits flush in the plate holes

Art. No. Length (mm)

0X.214.106 6

0X.214.107 7

0X.214.108 8

0X.214.109 9

0X.214.110 10

0X.214.111 11

0X.214.112 12

0X.214.113 13

0X.214.114 14

0X.214.115 15

0X.214.116 16

0X.214.118 18

0X.214.120 20

0X.214.122 22

0X.214.124 24


X=2: Stainless SteelX=4: TAN

Implants are available non-sterile or sterile packed. Add suffix “S” to article number to order sterile product.

Locking Screw Stardrive, � 1.5 mm, self-tapping

– Threaded, conical head locks securely in combi- and locking hole of the plate to provide angular stability

– Locked screws allow monocortical screw fixation andload transfer to the near cortex

Art. No. Length (mm)

0X.214.006 6

0X.214.007 7

0X.214.008 8

0X.214.009 9

0X.214.010 10

0X.214.011 11

0X.214.012 12

0X.214.013 13

0X.214.014 14

0X.214.015 15

0X.214.016 16

0X.214.018 18

0X.214.020 20

0X.214.022 22

0X.214.024 24

Synthes 19

X=2: Stainless SteelX=4: TAN


Plates


Holes Length (mm)

0X.114.002 4 23

0X.114.004 6 36


Holes Length (mm)

0X.114.003 6 29

0X.114.005 12 59

Locking T-Plate 1.5

Holes Length (mm)

0X.114.006 Shaft 8, head 3 44.5

0X.114.007 Shaft 8, head 4 44.5


Holes Length (mm)

0X.114.010 Right 8 23

0X.114.009 Left 8 23

Locking Y-Plate 1.5

Holes Length (mm)

0X.114.013 Shaft 8, head 3 47


Holes Length (mm)

0X.114.014 Shaft 6, head 2 36


X=2: Stainless SteelX=4: Pure Titanium (CP4)


Plates, with PreassembledShort LCP Drill Sleeves


Holes Length (mm)

0X.114.502S 4 23

0X.114.504S 6 36


Holes Length (mm)

0X.114.503S 6 29

0X.114.505S 12 59

Locking T-Plate 1.5

Holes Length (mm)

0X.114.506S Shaft 8, head 3 44.5

0X.114.507S Shaft 8, head 4 44.5


Holes Length (mm)

0X.114.510S Right 8 23

0X.114.509S Left 8 23

Locking Y-Plate 1.5

Holes Length (mm)

0X.114.513S Shaft 8, head 3 47


Holes Length (mm)

0X.114.514S Shaft 6, head 2 36

X=2: Stainless SteelX=4: Pure Titanium (CP4)

Note: The plates with preassembled short drill sleeves areavailable sterile only.

Synthes 21

Instruments






310.971 Countersink for Screws � 1.3 and 1.5 mm,Stainless Steel


319.003 Depth Gauge for Screws � 1.3 to 1.5 mm,measuring range up to 24 mm

311.012 Handle, medium, withMini Quick Coupling

Drill Bits are available non-sterile or sterile packed. Add suffix ”S” to article numberto order sterile product.


Additional instruments

391.962 Bending/Cutting Pliers

347.901 Pliers, flat-nosed, pointed, for Plates 1.0 to 2.4

399.970 Reduction Forceps with Points, ratchet lock

Optional

03.114.008 Drill Bit � 1.1 mm, for Stryker Coupling

310.143 Drill Bit � 1.5 mm, for Stryker Coupling

03.114.002 Screwdriver Shaft, Stardrive 1.5, T4, short,self-holding, for Mini Quick Coupling

398.819 Holdig Forceps with Swivel Foot, for Plates 1.3 to 2.4, speed lock

Synthes 23


01.114.104 LCP Compact Hand 1.5 (Titanium Implants)

Module

68.114.001 Module LCP Compact Hand 1.5, with Lid, without Contents

Implants

04.214.006 – Locking Screw Stardrive � 1.5 mm, self-tapping, length 04.214.015 6 mm to 15 mm, Titanium Alloy (TAN), 1 mm increments

04.214.016 – Locking Screw Stardrive � 1.5 mm, self-tapping, 04.214.024 length 16 mm to 24 mm, Titanium Alloy (TAN), 2 mm increments

04.214.106 – Cortex Screw Stardrive � 1.5 mm, self-tapping, 04.214.115 length 6 mm to 15 mm, Titanium Alloy (TAN), 1 mm increments

04.214.116 – Cortex Screw Stardrive � 1.5 mm, self-tapping, 04.214.124 length 16 mm to 24 mm, Titanium Alloy (TAN), 2 mm increments

04.114.002 LCP Plate 1.5, straight, 4 holes, length 23 mm, Pure Titanium

04.114.003 Locking Plate 1.5, straight, 6 holes, length 29 mm, Pure Titanium

04.114.004 LCP Plate 1.5, straight, 6 holes, length 36 mm, Pure Titanium

04.114.005 Locking Plate 1.5, straight, 12 holes, length 59 mm, Pure Titanium

04.114.006 Locking T-Plate 1.5, shaft 8 holes, head 3 holes, Pure Titanium

04.114.007 Locking T-Plate 1.5, shaft 8 holes, head 4 holes, Pure Titanium

04.114.009 Locking Strut Plate 1.5, 8 holes, oblique angled, left, Pure Titanium

04.114.010 Locking Strut Plate 1.5, 8 holes, oblique angled, right, Pure Titanium

04.114.013 Locking Y-Plate 1.5, shaft 8 holes, head 3 holes, Pure Titanium

04.114.014 Locking Condylar Plate 1.5, shaft 6 holes, head 2 holes, Pure Titanium

Instruments


310.971 Countersink for Screws � 1.3 and 1.5 mm, Stainless Steel

312.140 Double Drill Guide 1.5/1.1, for No. 311.150





Optional




60.114.004 Tray for LCP Drill Sleeves 1.5, short

01.114.102 LCP Compact Hand 1.5 (Stainless Steel Implants)

Module

68.114.001 Module LCP Compact Hand 1.5, with Lid, without Contents

Implants

02.214.006 – Locking Screw Stardrive � 1.5 mm, self-tapping, length 02.214.015 6 mm to 15 mm, Stainless Steel, 1 mm increments

02.214.016 – Locking Screw Stardrive � 1.5 mm, self-tapping, 02.214.024 length 16 mm to 24 mm, Stainless Steel, 2 mm increments

02.214.106 – Cortex Screw Stardrive � 1.5 mm, self-tapping, 02.214.115 length 6 mm to 15 mm, Stainless Steel, 1 mm increments

02.214.116 – Cortex Screw Stardrive � 1.5 mm, self-tapping, 02.214.124 length 16 mm to 24 mm, Stainless Steel, 2 mm increments

02.114.002 LCP Plate 1.5, straight, 4 holes, length 23 mm, Stainless Steel

02.114.003 Locking Plate 1.5, straight, 6 holes, length 29 mm, Stainless Steel

02.114.004 LCP Plate 1.5, straight, 6 holes, length 36 mm, Stainless Steel

02.114.005 Locking Plate 1.5, straight, 12 holes, length 59 mm, Stainless Steel

02.114.006 Locking T-Plate 1.5, shaft 8 holes, head 3 holes, Stainless Steel

02.114.007 Locking T-Plate 1.5, shaft 8 holes, head 4 holes, Stainless Steel

02.114.009 Locking Strut Plate 1.5, 8 holes, oblique angled, left, Stainless Steel

02.114.010 Locking Strut Plate 1.5, 8 holes, oblique angled, right, Stainless Steel

02.114.013 Locking Y-Plate 1.5, shaft 8 holes, head 3 holes, Stainless Steel

02.114.014 Locking Condylar Plate 1.5, shaft 6 holes, head 2 holes, Stainless Steel

Instruments


310.971 Countersink for Screws � 1.3 and 1.5 mm, Stainless Steel

312.140 Double Drill Guide 1.5/1.1, for No. 311.150





Optional



60.114.004 Tray for LCP Drill Sleeves 1.5, short



Sets


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All technique guides are available as PDF files at www.synthes.com/lit 0123

LCP Compact Hand 1.5. Instrument and implant module. - Synthes

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Transcript of LCP Compact Hand 1.5. Instrument and implant module. - Synthes