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Orthopaedic Foot Instruments
0X6.001.030_AA 14.09.09 12:05 Seite Cvr1 Orthopedic Foot Instruments. Dedicated instruments for reconstructive foot surgery. Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite Cvr2 0X6.001.030_AA 14.09.09 12:05 Seite 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 Warning This 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 Instruments For general guidelines, function control and dismantling of multi-part instruments, please refer to: www.synthes.com/reprocessing Synthes 1 0X6.001.030_AA 14.09.09 12:05 Seite 2 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. 2 Synthes Orthopedic Foot Instruments Compression/Distraction Device Set, in modular tray Fields of application – Compression and distraction of joints or bones – Fracture treatment – Arthrodeses (e.g. subtalar arthrodesis) – Osteotomies (e.g. lateral calcaneal lengthening osteotomy) Handling Technique Bone Harvesting Set, in modular tray Fields of application – Bone harvesting (e.g. from the calcaneus, proximal tibia or iliac crest) – Bone biopsies 0X6.001.030_AA 14.09.09 12:05 Seite 3 Features and Benefits Chisel Set, in modular tray Fields of application – Preparation of joints for arthrodeses – Removal of joint cartilage and bone – Removal of exostoses – Removal of osteophytes 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 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 Synthes 3 0X6.001.030_AA 14.09.09 12:05 Seite 4 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 0X6.001.030_AA 14.09.09 12:05 Seite 5 Handling Techniques Compression/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 Synthes 5 0X6.001.030_AA 14.09.09 12:05 Seite 6 Handling Techniques Compression/Distraction Device Set 1 Preparation Expose the indicated area. The approach will depend on the surgical procedure. 2 Prepare 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 threaded fixation 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. 6 Synthes Orthopedic Foot Instruments Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite 7 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. Tips – lock the rotational mechanism first – lock both arms – adjust space between the arms Note: A range of different adjustment approaches may be used. Synthes 7 0X6.001.030_AA 14.09.09 12:05 Seite 8 Handling Techniques Compression/Distraction Device Set 3 Insert 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 sleeves into the bone. 8 Synthes Orthopedic Foot Instruments Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite 9 Finger-tighten the holding sleeves. This will fix the device to the K-wires. If more stability is desired, additional 2.0 mm K-wires can be drilled through the extra K-wire holes of the arms. Synthes 9 0X6.001.030_AA 14.09.09 12:05 Seite 10 Handling Techniques Compression/Distraction Device Set 4 Compress or distract Perform the surgical procedure once the K-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. 5 Remove compression/distraction device Loosen the holding sleeves first, then open the locking clamps. Carefully remove the device. Remove K-wires. 10 Synthes Orthopedic Foot Instruments Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite 11 Synthes 11 0X6.001.030_AA 14.09.09 12:05 Seite 12 Handling Techniques Bone Harvesting Set Set 01.111.477 Bone Harvesting Set for Orthopedic Foot Instruments, with Lid, with Contents Set content 03.111.012 or 03.111.013 Handle, long, 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 12 Orthopedic Foot Instruments Synthes Handle, short, with Quick Coupling Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite 13 387.670 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 the instrument. – Only use instruments with sharp edges. Synthes 13 0X6.001.030_AA 14.09.09 12:05 Seite 14 Handling Techniques Bone Harvesting Set 1 Preparation Expose the indicated area. The approach will depend on the surgical procedure. 2 Place 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 is required. Technique Tip: 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. 14 Synthes Orthopedic Foot Instruments Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite 15 3 Cut bone graft Instruments 03.111.012 or 03.111.013 Handle, long, 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 Handle, short, with Quick Coupling 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. Synthes 15 0X6.001.030_AA 14.09.09 12:05 Seite 16 Handling Techniques Bone Harvesting Set 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. Important: If the bone graft cannot be removed with the trephine, use the bone extraction attachment to remove the bone graft from the bone. This technique is described on page 18. 16 Synthes Orthopedic Foot Instruments Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite 17 4 Remove 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). 1 2 Synthes 17 0X6.001.030_AA 14.09.09 12:05 Seite 18 Handling Techniques Bone Harvesting Set Removal of bone graft with the bone extraction attachment Instruments 03.111.012 or 03.111.013 Handle, long, 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 Handle, short, with Quick Coupling 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. Tips – It is possible to use a hammer in combination with the handles. – Use light, controlled hammer blows. 18 Synthes Orthopedic Foot Instruments Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite 19 Handling Techniques Chisel Set Set 01.111.475 Chisel Set for Orthopedic Foot Instruments, with Lid, with Contents Set content 03.111.012 or 03.111.013 Handle, long, 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 Handle, short, with Quick Coupling 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 the instrument. – Only use instruments with sharp edges. Synthes 19 0X6.001.030_AA 14.09.09 12:05 Seite 20 Handling Techniques Chisel Set 1 Preparation Expose the indicated area. The approach will depend on the surgical procedure. 2 Choose instrument Instruments 03.111.012 or 03.111.013 Handle, long, 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 Handle, short, with Quick Coupling Attach the desired chisel or the cartilage remover to a handle. 20 Synthes Orthopedic Foot Instruments Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite 21 3 Prepare joints and/or bones Tips – It is possible to use a hammer in combination with the handles. – Use light, controlled hammer blows. Synthes 21 0X6.001.030_AA 14.09.09 12:05 Seite 22 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 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 03.111.012 Handle, long, with Quick Coupling *Add suffix "S" to article number to order sterile product. 22 Synthes Orthopedic Foot Instruments Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite 23 03.111.013 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 03.111.030 Shaft for trephine and extraction attachment 02.111.001* Guide Wire ⭋ 3.2 mm with Stop, tip 1.2 mm, Stainless Steel 03.111.031 Stylet for trephine and extraction attachment *Add suffix ”S“ to article to order sterile product. Synthes 23 0X6.001.030_AA 14.09.09 12:05 Seite 24 Instruments 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 24 Orthopedic Foot Instruments Synthes Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite 25 Sets 01.111.476 Compression/Distraction Device Set for Orthopedic Foot Instruments, with Lid, with Contents Art. no. Description 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 Quantity 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 Synthes 25 0X6.001.030_AA 14.09.09 12:05 Seite 26 Sets 01.111.475 Chisel Set for Orthopedic Foot Instruments, with Lid, with Contents Art. no. Description 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 26 Orthopedic Foot Instruments Synthes Quantity Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite 27 01.111.477 Bone Harvesting Set for Orthopedic Foot Instruments, with Lid, with Contents Art. no. Description 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 Module for Bone Harvesting Instruments, for Orthopedic Foot Instruments, without Lid, without Contents 1 68.111.477 Quantity Synthes 27 0X6.001.030_AA 14.09.09 12:05 Seite 28 Replacement Articles 60043900 Spring for Handles 60030145 Spring for Compression/Distraction Device For detailed information ask your Synthes sales representative. 28 Synthes Orthopedic Foot Instruments Handling Technique 0X6.001.030_AA 14.09.09 12:05 Seite Cvr3 SE_239515 AA All technique guides are available as PDF files at www.synthes.com/lit Ö036.001.030öAA<ä 0123 036.001.030 30090038 © 09/2009 Synthes, Inc. or its affiliates All rights reserved Synthes is a trademark of Synthes, Inc. or its affiliates 0X6.001.030_AA 14.09.09 12:05 Seite Cvr4