Orthopedic Foot Instruments. Dedicated instruments for ...synthes.vo.llnwd.net/o16/LLNWMB8/INT...

Orthopedic Foot Instruments.Dedicated instruments for reconstructive foot surgery.

Surgical Technique

This publication is not intended for distribution in the USA.

Instruments and implants approved by the AO Foundation.

Orthopedic Foot Instruments Surgical Technique DePuy Synthes 1

Table of Contents

Introduction

Handling Techniques

Product Information

Orthopedic Foot Instruments 2

Indications 4

Compression/Distraction Device Set 5

Bone Harvesting Set 11

Chisel Set 18

Instruments 21

Sets 24

Replacement Articles 27

Image intensifier control

WarningThis description alone does not provide sufficient background for direct use of DePuy Synthes products. Instruction by a surgeon experienced in handling these products is highly recommended.

Processing, Reprocessing, Care and MaintenanceFor general guidelines, function control and dismantling of multi-part instruments, as well as processing guidelines for implants, please contact your local sales representative or refer to:http://emea.depuysynthes.com/hcp/reprocessing-care-maintenanceFor general information about reprocessing, care and maintenance of Synthes reusable devices, instrument trays and cases, as well as processing of Synthes non-sterile implants, please consult the Important Information leaflet (SE_023827) or refer to: http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance

2 DePuy Synthes Orthopedic Foot Instruments Surgical 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, proximal tibia or iliac crest)

– Bone biopsies

Orthopedic Foot Instruments. Dedicated instruments for reconstructive foot surgery.

System Overview

The Orthopedic Foot Instruments have been designed to perform specific procedures on the foot more efficiently. The system consists of three modular sets: Compression/Distraction Device Set, Bone Harvesting Set and Chisel Set.


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 correct 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 Kirschner

wires at various angles – Precise compression/distraction mechanism – Two extra Kirschner wire holes for more

stability


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


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 B 2.0 mm for Compression/Distraction Device for Foot and Ankle



292.250 Kirschner Wire B 2.5 mm with trocar tip, length 150 mm, Stainless Steel

292.750 Kirschner Wire B 2.5 mm with threaded tip, length 150/15 mm, Stainless Steel



03.111.041 Holding Sleeve Tightening Device for Compression/Distraction Device


1Preparation

Expose the indicated area. The approach will depend on the surgical procedure.


2Prepare Compression/Distraction Device

Instruments





Thread the corresponding holding sleeves into the threaded fixation holes of the fixation arms.

For 2.0 mm Kirschner wires use 2.0 mm holding sleeves.For 2.5 mm Kirschner wires use 2.5 mm holding sleeves.For 3.0 mm Kirschner wires use 3.0 mm holding sleeves.

Note: Do not tighten holding sleeves at this point.


Open all locking-clamps of the compression/distraction device.

Adjust the rotation and distance of the arms until initial alignment for the surgical procedure is defined.

Note: – lock the rotational mechanism first – lock both arms – adjust space between the arms

Note: A range of different adjustment approaches may be used.


3Insert Kirschner wires

Instruments

292.250 Kirschner Wire B 2.5 mm with trocar tip, length 150 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 Kirschner wires through the corresponding holding sleeves into the bone.



If more stability is desired, additional 2.0 mm or 2.5 mm Kirschner wires can be drilled through the extra Kirschner wire holes of the arms.

Finger-tighten the holding sleeves. This will fix the device to the Kirschner wires.

The blue tightening device may be used to achieve a stronger fixation between the holding sleeve and the Kirschner wire.

Precaution: Apart from the blue tightening device, do not use any other instruments to tighten or loosen the holding sleeves as they may cause damage.


4Compress or distract Perform the surgical procedure once the Kirschner wires have been inserted.

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 distraction can damage the surrounding soft tissue.


5Remove compression/distraction device

Loosen the holding sleeves first, then open the locking clamps.

Note: Use the blue tightening device to loosen the holding sleeves.

Carefully remove the device.

Remove Kirschner wires.


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 B 3.2 mm with Stop, tip 1.6 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 B 5.5 mm


387.659 Trephine Attachment B 8.5 mm





03.111.027 Extraction Attachment B 5.5 mm


387.669 Extraction Attachment B 8.5 mm

Handling TechniquesBone Harvesting Set






Warning: – 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 the instrument.

– Only use instruments with sharp edges.



1Preparation


2Place guide wire

Instrument

02.111.001 Guide Wire B 3.2 mm with Stop, tip 1.6 mm, Stainless Steel

Drill the guide wire into the location where bone removal is required.

Precaution: Drill the 3.2 mm guide wire until the stop at the end of the 1.2 mm tip.

Note: In case that insertion of the guide wire by hand is not possible, use a power tool to drill the guide wire into the bone.


3Cut bone graft

Instruments










Attach the shaft for trephine and extraction attachments to a handle.

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 shaft when it is inserted over the guide wire.



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.

The extracted bone graft should remain in the trephine.

Note: If the bone graft cannot be removed with the tre-phine, use the bone extraction attachment to remove the bone graft from the bone. This technique is described on page 18.

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 the trephine shaft (1).

Push the bone graft carefully out from the front of the trephine along with the guide wire (2).



Removal of bone graft with the bone extraction attachment

Instruments










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 should not rotate).

To break the graft dowel free, turn the holder slowly until you 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 when using a trephine.

Note – It is possible to use a hammer in combination with

the handles. – Use light, controlled hammer blows.


Handling TechniquesChisel Set

Set

01.111.475 Chisel Set for Orthopedic Foot Instruments, with Lid, with Contents

Set content


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

Precaution – 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 the instrument.

– Only use instruments with sharp edges.


1Preparation


2Choose instrument

Instruments







03.111.019 Chisel, for Foot, curved, narrow, width 10 mm, length 124 mm


Attach the desired chisel or the cartilage remover to a handle.


3Prepare joints and/or bones

Note: – It is possible to use a hammer in combination with

the handles. – Use light, controlled hammer blows.

Handling TechniquesChisel Set






292.250* Kirschner Wire B 2.5 mm with trocar tip, length 150 mm, Stainless Steel

292.750* Kirschner Wire B 2.5 mm with threaded tip, 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








03.111.019 Chisel, for Foot, curved, narrow, width 10 mm, length 124 mm


03.111.030 Shaft for trephine and extraction attachment

02.111.001* Guide Wire B 3.2 mm with Stop, tip 1.6 mm, Stainless Steel

03.111.031 Stylet for trephine and extraction attachment

03.111.013 Handle, short, with Quick Coupling

*Add suffix ”S“ to article to order sterile product.

Instruments


Trephine Attachments








Extraction Attachments









01.111.476 Compression/Distraction Device Set for Orthopedic Foot Instruments, with Lid, with Contents

Sets

Art. no. Description Quantity

03.111.021 Compression/Distraction Device for Foot and Ankle 1

03.111.022 Holding Sleeve B 2.0 mm for Compression/Distraction Device for Foot and Ankle 2



292.250.10 Kirschner Wire B 2.5 mm with trocar tip, length 150 mm, Stainless Steel, pack of 10 units 1

292.750.10 Kirschner Wire B 2.5 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


01.111.475 Chisel Set for Orthopedic Foot Instruments, with Lid, with Contents


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


68.111.465 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


01.111.477 Bone Harvesting Set for Orthopedic Foot Instruments, with Lid, with Contents


03.111.012 Handle, long, with Quick Coupling 1

03.111.030 Shaft for Trephine and Extraction Attachment 1

02.111.001 Guide Wire B 3.2 mm with Stop, tip 1.6 mm, Stainless Steel 1

03.111.031 Stylet for Trephine and Extraction Attachment 1

03.111.025 Trephine Attachment B 5.5 mm 1

03.111.026 Trephine Attachment B 7.0 mm 1

387.659 Trephine Attachment B 8.5 mm 1

387.660 Trephine Attachment B 9.5 mm 1

387.661 Trephine Attachment B 10.5 mm Optional



03.111.027 Extraction Attachment B 5.5 mm 1

03.111.028 Extraction Attachment B 7.0 mm 1

387.669 Extraction Attachment B 8.5 mm 1

387.670 Extraction Attachment B 9.5 mm 1

387.671 Extraction Attachment B 10.5 mm Optional



68.111.467 Tray for Hollow Reamer and Instruments for Bone Graft Harvesting, for Orthopedic Foot Instruments, without Lid, without Contents 1


68.111.476 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

Sets


60043900 Spring for Handles

Replacement Articles

60030145 Spring for Compression/Distraction Device

For detailed information ask your Synthes sales representative.

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Synthes GmbHEimattstrasse 34436 OberdorfSwitzerlandTel: +41 61 965 61 11Fax: +41 61 965 66 00www.depuysynthes.com

This publication is not intended for distribution in the USA.

All surgical techniques are available as PDF files at www.depuysynthes.com/ifu ©

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Orthopedic Foot Instruments. Dedicated instruments for ...synthes.vo.llnwd.net/o16/LLNWMB8/INT...

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