2.7 mm LCP Ulna Osteotomy System Powerpoint

Transcription

2.7 mm LCP Ulna Osteotomy System
Low profile angular stable fixation for ulna shortening
osteotomies.
Index
–
Introduction
–
Features & Benefits
–
Indications
–
X-ray Case Example
–
Implants & Instrumentation
–
Technique
–
–
Oblique (45°)
Transverse (90°)
UOS In-Service / April 2012 / For Synthes Sales Consultant use only. Do not distribute.
DJ8675-A
Introduction
–
The 2.7 mm LCP Ulna Osteotomy System offers the surgeon options to
perform either a freehand or more guided shortening of the ulna with
specific instrumentation.
–
The system aims to minimize soft tissue irritation through
–
improved implant surface
–
tapered shape and reduced bulk of the plate
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Indications
DJ8675-A
Indications
The 2.7 mm LCP Ulna Osteotomy System is indicated for
fixation of fractures, osteotomies, nonunions, replantations,
and fusions of small bones and small bone fragments,
including osteopenic bone, in the ulna. The 2.7 mm LCP Ulna
Osteotomy System is indicated for use in both adults and
adolescents (12-21 years) in which growth plates have fused,
or in which growth plates will not be crossed by screw fixation.
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X-ray Case Example
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X-ray Case Example
Pre-op
Results from case studies are not predictive of results in other cases. Results in other cases may vary.
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X-ray Case Example
Post-op
Results from case studies are not predictive of results in other cases. Results in other cases may vary.
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Features and Benefits
DJ8675-A
Features and Benefits
Features
Benefits
Low-profile angular stable plate with rounded edges
and tapered ends; available in 6- and 8-holes, SS or
Ti
Minimize likelihood of soft tissue irritation; ability to
bury lag screw in plate (oblique cuts)
Combi-holes for 2.7 mm locking and 2.7 mm cortex
screws (Outer screw holes for locking screws only)
Flexible screw placement:
–
lag for oblique cuts (most central holes)
–
neutral
–
locking
Parallel saw blades for transverse (90°) and oblique
(45°) cuts of 2.0, 2.5, 3.0, 4.0, and 5.0 mm widths
Ability to create osteotomy in one cut
Drill templates for pre-drilling of plate fixation holes
before osteotomy; correspond to parallel saw blade
widths
Ensure correct rotational alignment
Saw guide
Assisted guidance during oblique cuts
Compression/distraction instrument for compression
or distraction of osteotomy; accepts 2.0 mm K-wires
(self-drilling)
Aids in obtaining adequate compression to help
promote proper bone union
–
Only compatible with Synthes Power
Allows for shortenings >5 mm with freehand
technique (no drill template)
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Implants and Instrumentation
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Implants: Plates
–
2.7 mm LCP Ulna Osteotomy Plate
–
0X.111.900: 6 holes (length 62 mm)
–
0X.111.901: 8 holes (length 76 mm)
–
Three-part center hole:
–
Plate is slightly bent (2° on each side, radius 45 cm)
X = 2: Stainless Steel
X = 4: Titanium Alloy (TAN)
DJ8675-A
Implants: Screws and Wires
–
2.7 mm Cortex Screw Stardrive, T8 StarDrive, self-tapping
–
–
2.7 mm Locking Screw, T8 StarDrive, self-tapping
–
–
X02.870 – 90 (10 – 30 mm)
X02.868 - 24 (8 – 24 mm)
2.0 mm Kirschner Wire with drill tip
–
Length 100 mm, Stainless Steel
–
Length 150 mm, Stainless Steel
X = 2: Stainless Steel
X = 4: Titanium Alloy (TAN)
DJ8675-A
Instruments
–
Drill templates for 2.7 mm LCP Ulna Osteotomy Plate
Item Number
Shortening
03.111.900
2.0 mm
03.111.901
2.5 mm
03.111.902
3.0 mm
03.111.903
4.0 mm
03.111.904
5.0 mm
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Instruments
–
Parallel Saw Blades for LCP Ulna Osteotomy Plate: compatible to Synthes
Small Battery Drive with Oscillating Saw Attachment
Art. No.
Osteotomy angle
Shortening
Art. No.
Osteotomy angle
Shortening
532.081S
Transverse (90°)
2.0 mm
532.091S
Oblique (45°)
2.0 mm
532.082S
Transverse (90°)
2.5 mm
532.092S
Oblique (45°)
2.5 mm
532.083S
Transverse (90°)
3.0 mm
532.093S
Oblique (45°)
3.0 mm
532.084S
Transverse (90°)
4.0 mm
532.094S
Oblique (45°)
4.0 mm
532.085S
Transverse (90°)
5.0 mm
532.095S
Oblique (45°)
5.0 mm
DJ8675-A
Instruments
– Handle with Quick Coupling
– Handle for Torque Limiting
Attachment
– Torque Limiting Attachment, 0.8 Nm,
quick coupling
– StarDrive Screwdriver Shaft, T8, 105
mm
– StarDrive Screwdriver Shaft, T8, 55
mm
– 2.0 mm Drill Bit, with depth mark,
quick coupling, 85 mm
– 2.7 mm Drill Bit, quick coupling, 100
mm
DJ8675-A
Instruments
– Depth Gauge for 2.0 mm, 2.4 mm,
and 2.7 mm Screws
– 2.0 mm Threaded Drill Guide, with
depth gauge
– 2.7 mm Universal Drill Guide
– Holding Forceps with ball tip, soft
lock, 156 mm
–
Reduction Forceps, serrated jaw,
ratchet, 144 mm
DJ8675-A
Instruments
– Saw Guide
– Holding Sleeve
– Tap for 2.7 mm Cortex Screws
– Tap for 2.7 mm Locking Screws
– Compression/Distraction Instrument
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Surgical Technique:
For an oblique (45°) osteotomy
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Technique: Approach
1. Preparation and Patient
Postitioning
Place the patient in a supine position
with the forearm positioned on a
hand table in full supination and the
shoulder in 90° abduction. The use
of a tourniquet and magnifying loops
is recommended.
Make a longitudinal incision to
approach the volar side of the ulna.
Plate placement: between distal and
middle third of ulna, just proximal to
pronator quadratus muscle.
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Technique: Surgical steps
2. Position and fix drill template
Choose the drill template according
to the intended amount of
shortening. The shape of the drill
template is identical to the shape of
the short LCP Ulna Osteotomy Plate
2.7.
Fix the Drill Template on the bone
with the two different lengths KWires available (bicortical fixation).
The position of the drill template
corresponds to the later plate
position (short plate). The drill
template should fit properly to the
bone, if not plate contouring is
necessary.
DJ8675-A
3. Apply compression/distraction
instrument
Position the compression/distraction
instrument with the 100 mm 2.0 mm
Kirschner wires (02.111.902.01) in the
inner part of the clamps. Tighten clamps
clockwise to retain the Kirschner wires.
For additional support, insert the 150 mm
2.0 mm Kirschner wires (02.111.903.01)
into the outer part of the clamps.
Note:
–
Both tips of the compression/distraction
instrument should be in contact with the
bone
–
Be sure Kirschner wires do not collide
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Select parallel saw blade
Choose an oblique (45°) cut saw
blade indicated for the desired
amount of shortening.
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4. Perform oblique osteotomy
Attach the saw guide to the drill template
for guidance while making the cut.
With the Drill template in contact with the
bone and the parallel saw blade in
motion, create the oteotomy.
Remember to irrigate during sawing to
avoid excessive heating.
Once cut is complete, turn the spindle on
the compression/distraction instrument
clockwise to reduce the osteotomy.
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5. Remove drill template and place
plate
After osteotomy completion, remove
drill template and place the plate
over the K-Wires.
Always include the oblong holes
with the most proximal and the most
distal K-Wire.
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6. Insert cortex screws
Remove the K-Wire distal to the
osteotomy, measure with depth
gauge, and insert the appropriate
2.7 mm cortex screw.
Repeat with second distal k-wire
and proximal k-wire.
Note: The holding forceps with ball
tip can be placed in the proximal
locking hole to keep plate in position
when inserting the most proximal
cortex screw.
DJ8675-A
7. Insert lag screw
Overdrill the near cortex using the
2.7 mm universal drill guide and the
2.7 mm drill bit.
Drill the threaded hole using the 2.0
mm end of the 2.7 mm universal drill
guide and the 2.0 mm drill bit.
Measure the screw length using the
depth gauge.
Insert appropriate 2.7 mm cortex
screw.
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8. Insert locking screws
Insert the threaded drill guide into the
most distal locking hole until fully seated.
Using the 2.0 mm drill bit, drill to the
desired depth.
Measure the screw length by using the
scale on the drill guide or with the depth
gauge.
Note: In especially hard bone, the use of
the tap for 2.7 mm locking screws may
be necessary.
Insert the appropriate 2.7 mm locking
screw.
Repeat with additional locking screws as
needed.
DJ8675-A
Surgical Technique:
For a transverse (90°) osteotomy
DJ8675-A
Technique: Approach
1. Preparation and Patient
Postitioning
Place the patient in a supine position
with the forearm positioned on a
hand table in full supination and the
shoulder in 90° abduction. The use
of a tourniquet and magnifying loops
is recommended.
Make a longitudinal incision to
approach the volar side of the ulna.
Plate placement: between distal and
middle third of ulna, just proximal to
pronator quadratus muscle.
DJ8675-A
2. Position and fix drill template
Choose the drill template according
to the intended amount of
shortening. The shape of the drill
template is identical to the shape of
the short LCP Ulna Osteotomy Plate
2.7.
Fix the Drill Template on the bone
with the two different lengths KWires available (bicortical fixation).
The position of the drill template
corresponds to the later plate
position (short plate). The drill
template should fit properly to the
bone, if not plate contouring is
necessary.
DJ8675-A
3. Apply compression/distraction
instrument
Position the compression/distraction
instrument with the 100 mm 2.0 mm
Kirschner wires (02.111.902.01) in the
inner part of the clamps. Tighten clamps
clockwise to retain the Kirschner wires.
For additional support, insert the 150 mm
2.0 mm Kirschner wires (02.111.903.01)
into the outer part of the clamps.
Note:
–
Both tips of the compression/distraction
instrument should be in contact with the
bone
–
Be sure Kirschner wires do not collide
DJ8675-A
Select parallel saw blade
Choose a transverse (90°) cut saw
blade indicated for the desired
amount of shortening.
DJ8675-A
4. Perform transverse osteotomy
With the drill template in contact with
the bone and the parallel saw blade
in motion, create the osteotomy.
Remember to irrigate during sawing
to avoid excessive heating.
Once cut is complete, turn the spindle
on the compression/distraction
instrument clockwise to reduce the
osteotomy.
DJ8675-A
5. Remove drill template and place
plate
After complete osteotomy, remove
drill template and place the plate
over the K-Wires.
Always include the oblong holes
with the most proximal and the most
distal K-Wire.
DJ8675-A
6. Insert cortex screws
Remove the K-Wire distal to the
osteotomy, measure with depth
gauge, and insert the appropriate
2.7 mm cortex screw.
Repeat with second distal k-wire
and proximal k-wire.
Note: The holding forceps with ball
tip can be placed in the proximal
locking hole to keep plate in position
when inserting the most proximal
cortex screw.
DJ8675-A
8. Insert locking screws
Insert the threaded drill guide into the
most distal locking hole until fully seated.
Using the 2.0 mm drill bit, drill to the
desired depth.
Measure the screw length by using the
scale on the drill guide or with the depth
gauge.
Note: In especially hard bone, the use of
the tap for 2.7 mm locking screws may
be necessary.
Insert the appropriate 2.7 mm locking
screw.
Repeat with additional locking screws as
needed.
DJ8675-A
Thank you

2.7 mm LCP Ulna Osteotomy System Powerpoint

Transcription

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