Post on 16-Mar-2018
2.4 mm/2.7 mm Variable Angle LCPForefoot/Midfoot System.Procedure-specific plates for osteotomies,fusions and fractures of the foot.
Technique Guide
Introduction
System Features
Table of Contents
Indications 3
2.4 mm/2.7 mm Variable Angle LCP 5Forefoot/Midfoot System
Compression System 6
2.4 mm/2.7 mm Variable Angle LCP Technology 7
Proximal and Distal Reamers 8
First MTP (Metatarsophalangeal) Fusion Plates 9
Opening Wedge Osteotomy Plates 10
First TMT (Tarsometatarsal) Fusion Plates 11
TMT Fusion Plates 12
T-, L-, Cloverleaf Fusion Plates 13
X- and Straight Fusion Plates 14
Navicular and Cuboid Plates 15
Mesh Plates 16
Modular Sets 17
Image intensifier control
Synthes
2 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Surgical Technique
Product Information
Table of Contents
Compression System Technique 19
2.4 mm/2.7 mm Variable Angle Locking Technique 23
Proximal and Distal Reamers Technique for 37First MTP Fusion
First MTP Fusion 41
Opening Wedge Osteotomy for Correction 45of Hallux Valgus
First TMT Fusion for Correction of Hallux Valgus 51
Second or Third TMT Fusion 55
Navicular and Cuboid Features 59
T-, L-, Cloverleaf, X-, Straight, and Mesh Plates 63
Set Configurations 71
Indications
Indications
The Synthes 2.4 mm/2.7 mm Variable Angle LCPForefoot /Midfoot System is indicated for fixation of osteotomies, fusions, fractures, nonunions, malunions andreplantations of small bones and small bone fragments inadult and adolescent (12–21 years) patients, including thefoot and ankle, and particularly in osteopenic bone.
Synthes 3
System Features
2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System.Procedure-specific plates for osteotomies, fusions and fractures of the foot.
The system consists of anatomic- andprocedure-specific plates, variable anglelocking and cortex screws, and a com-pression feature, to aid in reconstructivefoot surgery. The implants are availablein stainless steel and titanium alloy.
Synthes 5
Compression System
Features– Tactile compression – Designed within the plate to
minimize additional soft tissuedissection
– Allows final screw fixation aftercompression is achieved
6 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Compressionwire slot
Compressionwire hole
Compression Wires – 1.6 mm diameter, 150 mm overall
length – Thread lengths from 10 mm to
40 mm in 5 mm increments – Stop feature allows quick and easy
preliminarily fixation of the plate tothe bone, eliminating the need forplate holding forceps
– Material: Cobalt chromium alloythat is stiffer than conventionalstainless steel
Compression Forceps – Spherical recess matches the
spherical stops on the compressionwires, to ensure the forceps willgrasp the stop, regardless of thewire insertion angle
– Locking ratchet mechanism holdscompression during screw insertion
– Lightweight device does not requiresupport during screw insertion
The spherical stop is designed to sit above thecompression wire hole or compression slot, and insidevariable angle LCP holes. It allows off-axis insertion ofthe wire, while maintaining compression capability.
2.4 mm/2.7 mm Variable Angle LCP Technology
Synthes 7
Plates feature variable angle lockingholes, with or without the dynamic compression portion. Four columns ofthreads in the variable angle locking holeprovide four points of threaded lockingbetween the plate and the variable anglelocking screw, to create a fixed-angleconstruct at the desired screw angle.– Plate holes accept 2.4 mm and 2.7 mm
variable angle locking screws – Using 2.4 mm or 2.7 mm variable
angle locking screws allows a fixed-angle construct, 15° off-nominal-axis,or variable angulation within a 30° coneof angulation
– Holes are compatible with existing 2.4 mm and 2.7 mm locking screws.However, these screws can only beused coaxially, not off-angle.
– 2.4 mm and 2.7 mm cortex screwscan be used in the locking holes andplate positioning slots for traditionalcompression and fixation
Variable Angle Locking Drill Guide, cone Variable Angle Locking Drill Guide, coaxial
Proximal and Distal Reamers
8 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Proximal Reamers – Concave shape to form a sphere
on the joint surface – Leading-edge radius to prevent
soft tissue damage
Distal Reamers – Convex shape to form a pocket
in the joint surface – Tapered to prevent damage to
the metatarsal head
Features– Used to prepare articulating joint
surfaces for fusion—specifically, between metatarsals and phalanges
– Cannulated for use over a K-wire,for better control
– 14 mm–24 mm reamers accept 1.6 mm K-wires
– 6 mm–12 mm reamers accept 1.25 mm K-wires
– Quick coupling
First MTP (Metatarsophalangeal) Fusion Plates
Synthes 9
0°
5°
10°
Features– Anatomic, low-profile plates
designed specifically for first MTParthrodesis
– 10° of valgus integrated into all firstMTP fusion plates
– Left and right plate designs – Small and medium plates with 3
different dorsiflexion angles: 0°, 5°, 10° – Large plates with 5° dorsiflexion – Revision plates with 0° dorsiflexion and
an extra variable angle locking hole tosecure a bone block
– Each plate is etched with a line indicating the fusion site to ensureproper plate placement
– Include compression feature– Compression wire holes allow
preliminary fixation of the plate to the bone
– Plantar side undercut allows contouringaround medial phalangeal eminence
Opening Wedge MeasuringInstrument – Thin tip slides into osteotomy site
and opens the wedge for the desired correction
– Ratchet mechanism holds osteotomy open
– Measurement scale indicates the appropriate size wedge for the desired opening
Opening Wedge Osteotomy Plates
Features– Anatomic, low-profile plates designed
specifically for metatarsal openingwedge osteotomy for hallux valgus correction
– 6 plates with varying spacer lengths:0 mm, 3 mm, 4 mm, 5 mm, 6 mmand 7 mm spacing
– Spacer includes a tapered tip for eas-ier insertion into the osteotomy site
– Compression wire holes allow for preliminary fixation of the plateto the bone
10 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
First TMT (Tarsometatarsal) Fusion Plates
Synthes 11
Features– Anatomic, low-profile plates specifi-
cally designed for first TMTarthrodesis (e.g., Lapidus procedure)
– Standard and large sizes – Designed to be placed dorsomedial
on the medial cuneiform and firstmetatarsal
– Precontoured for slight valgus orplantar positioning of the firstmetatarsal depending on plateplacement
– Include compression feature – Compression wire holes allow
preliminary fixation of the plate to the bone
TMT Fusion Plates
Features– Anatomic, low-profile plate for
fusions of the second and thirdtarsal and metatarsal joints
– Precontoured to fit anatomy – Includes compression feature – Compression wire holes allow
preliminary fixation of the plate tothe bone
12 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
T-, L- and Cloverleaf Fusion Plates
Synthes 13
Features– Anatomic, low-profile plates for
a variety of fusions, osteotomies and fractures
– Long T-plate with 3-hole head formore flexibility
– Include compression feature – Compression wire holes allow
preliminary fixation of the plate tothe bone
X- and Straight Fusion Plates
Features– Low-profile plates designed for
a variety of fusions, osteotomies and fractures
– X-plates available in extra small,small, medium and large
– Straight plates available in 2-holeand 4-hole versions
– Include compression feature – Compression wire holes allow
preliminary fixation of the plate tothe bone
14 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Synthes 15
Features– Low-profile plates designed specifi-
cally for fixation of navicular andcuboid fractures
– Contourable – May be cut to length
Navicular and Cuboid Plates
Mesh Plate
Features– Low-profile plate – Contourable – May be cut to length
16 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Modular Sets
Features– Modularity allows customized selection of implants – Reduces inventory and overall costs by eliminating
seldom-used implants
Synthes 17
Compression System Technique
Compression System Technique
1Insert compression wires
Instruments
03.211.410– 1.6 mm Compression Wires, 150 mm 03.211.440 length, 10 mm – 40 mm thread lengths
Place the plate on the bone, ensuring that the plate is placedappropriately according to the specific procedure.
Estimate the appropriate thread length needed for the plateand bone combination.
Note: Bicortical fixation is recommended.
Using a wire driver, insert the compression wire through thecompression wire hole (or compression slot) and through thebone.
To minimize stripping of the bone threads, slow wire insertionwhen the spherical stop nears the plate. Control the insertionfor tactile confirmation of compression between the wire,the plate and the bone.
There should be sufficient force holding the plate to thebone.
For plates with a compression slot, insert a second compressionwire into the far side of the slot (or compression hole).
Synthes 19
Compression System Technique
2 Compress
Instrument
03.211.400 Compression Forceps
Move the ratchet mechanism to engage as the forceps close,preventing the spring from opening the forceps.
Place the compression forceps into position, with the tipsaround the compression wire spheres.
Compress by squeezing the handles. Do not overcompress,as this may cause the compression wires to strip out of thebone.
If the ratcheting mechanism is in the correct position, hands-free compression can be maintained during radiographic verification of compression and the insertion of screws for final fixation.
After stable fixation is achieved, remove the compressionwires.
20 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Instruments
03.211.400 Compression Forceps
1.6 mm Compression Wires, 150 mm length
03.211.410 10 mm thread
03.211.415 15 mm thread
03.211.420 20 mm thread
03.211.425 25 mm thread
03.211.430 30 mm thread
03.211.435 35 mm thread
03.211.440 40 mm thread
Synthes 21
2.4 mm/2.7 mm Variable Angle Locking Technique
2.4 mm/2.7 mm Variable Angle Locking Technique
1Variable angle locking screw insertion—conical(off-nominal-axis)
Instruments
For 2.4 mm variable angle locking screws
03.110.023 1.8 mm Variable Angle Locking Drill Guide,cone
310.509 1.8 mm Drill Bit with depth mark, quick coupling, 110 mm
319.006 Depth Gauge, for 2.0 mm and 2.4 mmcortex screws
For 2.7 mm variable angle locking screws
03.211.003 2.0 mm Variable Angle Locking Drill Guide,variable
319.01 Depth Gauge, for small screws
323.062 2.0 mm Drill Bit with depth mark, quick coupling, 140 mm
To insert the variable angle locking screw off the nominalaxis, insert the cone-shaped drill guide in the desired variableangle locking screw hole in the plate.
The drill guide cone will self-retain in the hole.
Synthes 23
2.4 mm/2.7 mm Variable Angle Locking Technique
1. Variable angle locking screw insertion—conical (off-nominal-axis) continued
The funnel of the drill guide allows a drilling angle within a30° cone.
When drilling off-axis, the drill guide should remain in placeand the drill bit may be aimed in any direction within the cone.
Verify the drill bit angle and depth under radiographic imagingto ensure the desired angle has been achieved. If necessary,drill at a different angle and verify again under imaging.
Use the depth gauge to measure for the correct screw length.
24 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
2Variable angle locking screw insertion—coaxial (fixed angle)
Instrument
For 2.4 mm locking and VA locking screws
03.110.024 1.8 mm Variable Angle Locking Drill Guide,coaxial
For 2.7 mm locking and VA locking screws
03.211.004 2.0 mm Variable Angle Locking Drill Guide,coaxial
Variable angle and standard locking screws can be insertedinto the plate in line with the predefined screw trajectory.
The coaxial drill guide will self-retain in the hole.
Drill to the desired depth. Verify the drill bit depth under radiographic imaging.
Use the depth gauge to measure for the correct screwlength.
Synthes 25
2.4 mm/2.7 mm Variable Angle Locking Technique
3Preliminary screw placement
Instruments
03.111.038/ Handle with quick coupling311.43
314.467 StarDrive Screwdriver Shaft T8, 105 mm
Insert the correct length variable angle locking screw manually,using a self-retaining T8 StarDrive screwdriver shaft andquick coupling handle. Insert the screw until the screwheadis seated in the variable angle locking hole. Do not overtightenthe screw. Insert additional screws as needed.
Confirm proper alignment, screw placement and screwlength with multiple views under radiographic imaging.
Note: Ensure a screw is inserted on each side of the osteotomy/fusion site before removing the compression forceps.
Remove the compression wires.
26 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Synthes 27
4Lock variable angle screws
Instruments
03.110.002 Torque Limiting Attachment, 1.2 Nm
03.110.005 Handle for Torque Limiting Attachment
314.453 StarDrive Screwdriver Shaft, T8, 55 mm
Alternative instruments
03.111.038 Handle, with quick coupling
314.467 StarDrive Screwdriver Shaft, T8, 105 mm
511.776 Torque Limiting Attachment, 0.8 Nm
Use the 1.2 Nm torque limiting attachment (TLA) to finaltighten variable angle locking screws. Assemble the torquelimiting attachment to the T8 StarDrive screwdriver shaft andthe handle for torque limiting attachment.
After appropriate screw angle and length have been deter-mined, manually insert the screw using the TLA assembly.
Use of the TLA is mandatory when inserting the screws intovariable angle locking holes to ensure the minimal amount oftorque is applied.
03.110.002 03.110.005
2.4 mm/2.7 mm Variable Angle LCP Technology
28 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Alternative instrument
314.468 Holding Sleeve for StarDrive ScrewdriverShaft
Reduce the plate to the bone using the holding sleeve withvariable angle locking screws.
Slide the holding sleeve onto the screwdriver shaft. Engagethe variable angle locking screw, ensuring the holding sleevecovers the threads on the head of the screw. Insert thescrew.
Once the desired reduction is achieved, slide the holdingsleeve back to expose the screwhead threads. Insert thescrew until the screwhead is seated in the variable anglelocking hole. Do not overtighten the screw.
Screws Used with the 2.4 mm/2.7 mm VA-LCP Forefoot/Midfoot SystemStainless Steel and Titanium
Synthes 29
2.4 mm Variable Angle Locking Screws– Threaded, rounded head locks securely into the variable
angle locking holes – Locked screws allow unicortical screw fixation and load
transfer to the near cortex – Color coded for easier identification – T8 StarDrive recess– Self-tapping tip– 10 mm to 60 mm lengths (2 mm increments)
2.4 mm Cortex Screws– For use in round or Combi holes – Low-profile head – Used to provide compression or neutral fixation – Self-tapping tip – 10 mm to 60 mm lengths (2 mm increments)
2.4 mm Locking Screws– Only for axial insertion in the variable angle locking holes – Threaded, conical head locks securely into the variable
angle locking holes – T8 StarDrive recess– Self-tapping tip – 10 mm to 30 mm lengths (2 mm increments)
All screws are available in implant-quality 316L stainless steel or titanium alloy (Ti-6AI-7Nb)
2.7 mm Variable Angle Locking Screws– Threaded, rounded head locks securely into the variable
angle locking holes – Locked screws allow unicortical screw fixation and load
transfer to the near cortex – Color coded for easier identification – T8 StarDrive recess– Self-tapping tip – 10 mm to 60 mm lengths (2 mm increments)
2.7 mm Cortex Screws– For use in round or Combi holes – Used to provide compression or neutral fixation – Low-profile head – Self-tapping tip – 10 mm to 50 mm lengths (2 mm increments), 55 mm
and 60 mm
2.7 mm Locking Screws– Only for axial insertion in the variable angle locking holes – Threaded, conical head locks securely into the variable
angle locking holes – T8 StarDrive recess– Self-tapping tip – 10 mm to 50 mm lengths (2 mm increments), 55 mm
and 60 mm
Screws for the 2.4 mm/2.7 mm VA-LCP Forefoot/Midfoot System Stainless Steel and Titanium
30 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Instruments for the 2.4 mm/2.7 mm VA-LCP and Cortex Screws
Synthes 31
2.4 mm Instruments
03.110.000 1.8 mm Universal Variable Angle LockingDrill Guide
03.110.023 1.8 mm Variable Angle Locking Drill Guide,cone
03.110.024 1.8 mm Variable Angle Locking Drill Guide,coaxial
310.509 1.8 mm Drill Bit with depth mark, quickcoupling, 110 mm
310.530 2.4 mm Drill Bit, quick coupling, 100 mm
310.972 Countersink, for 2.0 mm and 2.4 mmscrews
312.18 2.4 mm/1.8 mm Double Drill Sleeve
319.006 Depth Gauge, for 2.0 mm and 2.4 mmcortex screws
323.202 2.4 mm Universal Drill Guide
Instruments for the 2.4 mm/2.7 mm VA-LCP and Cortex Screws
32 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Synthes 33
2.7 mm Instruments
03.211.002 2.0 mm Universal Variable Angle LockingDrill Guide
03.211.003 2.0 mm Variable Angle Locking Drill Guide,variable
03.211.004 2.0 mm Variable Angle Locking Drill Guide,coaxial
310.26 2.7 mm Drill Bit, quick coupling, 100 mm
310.87 Countersink, for 2.7 mm cortex screws
312.24 2.7 mm/2.0 mm Double Drill Sleeve
319.01 Depth Gauge, for small screws
323.062 2.0 mm Drill Bit with depth mark, quickcoupling, 140 mm
323.26 2.7 mm Universal Drill Guide
Instruments for the 2.4 mm/2.7 mm VA-LCP and Cortex Screws
34 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Synthes 35
Common Instruments
03.110.002 Torque Limiting Attachment, 1.2 Nm
03.110.005 Handle for Torque Limiting Attachment
311.43 Handle with quick coupling
03.211.001 2.4 mm/2.7 mm Variable Angle LCP PlateHolding Pins
314.453 Short StarDrive Screwdriver Shaft, T8, 55 mm
314.467 StarDrive Screwdriver Shaft, T8, 105 mm
314.468 Holding Sleeve, for StarDrive ScrewdriverShaft, T8
Proximal and Distal ReamersTechnique for First MTP Fusion
Proximal and Distal Reamers Technique for First MTP Fusion
1 Approach
Make a dorsomedial incision extending from the proximal interphalangeal joint of the hallux to the middle of the firstmetatarsal. This incision should be medial to the extensorhallucis longus tendon. Isolate and retract the superficial nerveand vessel. Make a linear capsular incision to expose the firstmetatarsal head and proximal phalanx base.
Dissect down to the joint. Plantar flex the phalanx down toexpose the joint.
2Insert K-wire
Instrument
292.56 1.6 mm Kirschner Wire, 150 mm, trocarpoints on both ends
Plantar flex the hallux and insert the 1.6 mm K-wire into thehead of the first metatarsal. Ensure the wire is centered inthe canal.
A chielectomy may be necessary, to remove impinging boneand create a flat surface for the plate.
Synthes 37
Proximal and Distal Reamers Technique for First MTP Fusion
3 Proximal reaming
Instrument
03.211.114– Cannulated Reamers, proximal,03.211.124 14 mm–24 mm
Select the appropriate reamer. Always start with a larger sizeand work down to a smaller size.
Slide the proximal reamer over the K-wire. Ream to removecartilage from the joint.
Important: When preparing the joint, it is possible to removetoo much bone, causing shortening. Ream only enough toremove the cartilage and expose the bone surface for fusion.
38 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
4 Distal reaming
Instruments
03.211.014– Cannulated Reamers, distal,03.211.024 14 mm–24 mm
292.56 1.6 mm Kirschner Wire, trocar points onboth ends
Bend the toe down to expose the phalanx.
Remove the K-wire from the metatarsal. Insert a K-wire intothe center of the phalanx.
Slide the corresponding distal reamer over the K-wire. Reamto remove cartilage from the joint.
Important: When preparing the joint, it is possible to removetoo much bone, causing shortening. Ream only enough toremove the cartilage and expose the bone surface for fusion.
Remove the reamer and K-wire.
Synthes 39
Instruments
Cannulated Reamers, for 1.25 mm K-wires
Proximal Distal Diameter (mm)
03.211.106 03.211.006 6
03.211.108 03.211.008 8
03.211.110 03.211.010 10
03.211.112 03.211.012 12
Cannulated Reamers, for 1.6 mm K-wires
Proximal Distal Diameter (mm)
03.211.114 03.211.014 14
03.211.116 03.211.016 16
03.211.118 03.211.018 18
03.211.120 03.211.020 20
03.211.122 03.211.022 22
03.211.124 03.211.024 24
40 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
First MTP Fusion
First MTP Fusion
Required sets
01.210.110 2.4 mm Variable Angle Locking and CortexScrew Instrument Module
01.210.210/ 2.4 mm Variable Angle Locking and Cortex01.210.410 Screw Module
or
01.211.111 2.7 mm Variable Angle Locking and CortexScrew Instrument Module
01.211.211/ 2.7 mm Variable Angle Locking and Cortex01.211.411 Screw Module
1Select and position plate
Select the plate that allows the desired level of correction.
A sterile flat surface can be placed on the bottom of the footto measure the desired amount of toe dorsiflexion. The platemay be contoured slightly to achieve the desired outcome.
Place the plate on the joint surface, using the etched line asa guide to ensure proper plate position.
Synthes 41
3Insert locking screws
For final fixation, insert the appropriate screws according tothe screw insertion technique described in the Variable AngleLocking Technique.
Variable angle locking screws allow manipulation around theindependent lag screw.
Remove the compression wires.
First MTP Fusion
2 Compress
Instruments
03.211.400 Compression Forceps
03.211.410– 1.6 mm Compression Wires03.211.440 10 mm–40 mm thread
It is recommended to insert an independent lag screw to aidin compression and stabilization. Insert the screw startingmedial and distal to the joint on the phalanx, crossing thejoint and ending in the lateral side of the metatarsal head.
Compression may also be achieved as described in the Compression System Technique.
42 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Implants
Synthes 43
2.4 mm/2.7mm Variable Angle LCP First MTP Fusion Plates,small, 42 mm
Stainless Steel Titanium Right /Left Dorsiflexion
02.211.230 04.211.230 right 0°
02.211.231 04.211.231 left 0°
02.211.232 04.211.232 right 5°
02.211.233 04.211.233 left 5°
02.211.234 04.211.234 right 10°
02.211.235 04.211.235 left 10°
0°
5°
10°
0°
5°
10°
2.4 mm/2.7mm Variable Angle LCP First MTP Fusion Plates,medium, 52 mm
Stainless Steel Titanium Right /Left Dorsiflexion
02.211.236 04.211.236 right 0°
02.211.237 04.211.237 left 0°
02.211.238 04.211.238 right 5°
02.211.239 04.211.239 left 5°
02.211.240 04.211.240 right 10°
02.211.241 04.211.241 left 10°
Implants
44 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
0°
5°
10°
2.4 mm/2.7mm Variable Angle LCP First MTP Fusion Plates,large, 57 mm
Stainless Steel Titanium Right /Left Dorsiflexion
02.211.242 04.211.242 right 5°
02.211.243 04.211.243 left 5°
2.4 mm/2.7mm Variable Angle LCP First MTP Fusion Plates,revision, 53 mm
Stainless Steel Titanium Right /Left Dorsiflexion
02.211.244 04.211.244 right 0°
02.211.245 04.211.245 left 0°
Opening Wedge Osteotomy forCorrection of Hallux Valgus
Opening Wedge Osteotomy for Correction of Hallux Valgus
Required sets
01.210.110 2.4 mm Variable Angle Locking and CortexScrew Instrument Module
01.210.210/ 2.4 mm Variable Angle Locking and Cortex01.210.410 Screw Module (stainless steel or titanium)
or
01.211.111 2.7 mm Variable Angle Locking and CortexScrew Instrument Module
01.211.211/ 2.7 mm Variable Angle Locking and Cortex01.211.411 Screw Module (stainless steel or titanium)
1 Approach
Make a 3 to 4 cm dorsomedial incision from the first tarsalmetatarsal (TMT) joint, distally along the midline of the firstmetatarsal.
Dissect down to the bone and isolate the medial branch ofthe superficial peroneal nerve.
Synthes 45
Opening Wedge Osteotomy for Correction of Hallux Valgus
2Create osteotomy
Identify a point medial on the metatarsal, approximately 1.5 cm distal to the TMT joint. Create an osteotomy startingfrom the medial side of the metatarsal but do not cutthrough the bone. Leave the lateral cortex intact, to act as a hinge point for opening the wedge.
46 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
3 Open and measure
Instrument
03.211.009 Opening Wedge Measuring Instrument
Open the osteotomy using osteotomes or the opening wedgemeasuring instrument. Slide the tip of the opening wedgeinstrument into the osteotomy. Open the osteotomy bysqueezing the handle until the desired correction is achieved.
The measuring instrument should be placed in the final implant position to ensure correct alignment and measurement.
Use radiographic imaging to confirm that the desired correctionhas been achieved.
Read the measurement on the back of the instrument to determine the appropriate spacer size.
Remove the measuring instrument.
Synthes 47
Opening Wedge Osteotomy for Correction of Hallux Valgus
4 Position opening wedge plate
Instruments
03.211.410– 1.6 mm Compression Wires03.211.440 10 mm–40 mm thread
Position the plate with the top of the T proximal to the osteotomy.
Insert the plate into the osteotomy. The tip of the spacer has a lead-in design to aid in inserting the wedge into theosteotomy.
Insert the compression wire (as described in the CompressionSystem Technique) through one of the wire holes for prelimi-nary plate fixation.
48 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
5 Insert variable angle locking screws
Insert the variable angle locking screws (as described in VariableAngle Locking Technique) starting with a screw in the sideopposite to the compression wire. Insert another lockingscrew in an open locking hole on the same side as the com-pression wire. Remove the compression wire and insert theremaining locking screws.
Pack bone graft into the osteotomy site, as appropriate.
Synthes 49
Product Information
Implants
2.4 mm/ 2.7mm Variable Angle Locking Opening WedgeOsteotomy Plates
Stainless Steel Titanium Spacer (mm)
02.211.210 04.211.210 0
02.211.211 04.211.211 3
02.211.212 04.211.212 4
02.211.213 04.211.213 5
02.211.214 04.211.214 6
02.211.215 04.211.215 7
Instrument
03.211.009 Opening Wedge Measuring Instrument
50 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
First TMT Fusion for Correction of Hallux Valgus
First TMT Fusion for Correction of Hallux Valgus
Required sets
01.210.110 2.4 mm Variable Angle Locking and CortexScrew Instrument Module
01.210.210/ 2.4 mm Variable Angle Locking and Cortex01.210.410 Screw Module (stainless steel or titanium)
or
01.211.111 2.7 mm Variable Angle Locking and CortexScrew Instrument Module
01.211.211/ 2.7 mm Variable Angle Locking and Cortex01.211.411 Screw Module (stainless steel or titanium)
1Approach
Make a dorsomedial incision medial to the extensor hallucislongus tendon (lateral to the tibialis anterior tendon). The incision should extend from the medial cuneiform to mid-shaft of the first metatarsal.
Dissect down to bone and isolate the medial branch of thesuperficial peroneal nerve.
Synthes 51
2Prepare joint surface
Remove the cartilage and prepare the joint surface for fusion.The surface of the joint can be manipulated to achieve thedesired correction.
Take care to minimize joint surface removal to prevent short-ening of the first ray.
4 Compress
It is recommended to insert an independent lag screw to aidin compression and stabilization. Insert the screw obliquelyacross the TMT joint.
Compression may also be achieved as described in the Compression System Technique.
First TMT Fusion for Correction of Hallux Valgus
3Position plate
Instruments
03.211.400 Compression Forceps
03.211.410– 1.6 mm Compression Wires03.211.440 10 mm–40 mm thread
Select the appropriate size plate and place it over the jointsurface with the compression slot proximal to the joint.
Place the plate dorsomedial on the bone.
The plate is precontoured to help prevent medialization ofthe first metatarsal.
A compression wire can be used to hold the plate in position.
Alternatively, the plate can be placed dorsally; additional contouring may be needed.
52 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Synthes 53
5Insert variable angle locking screws
For final fixation, insert the appropriate screws according tothe screw insertion technique described in the Variable AngleLocking Technique.
Variable angle locking screws allow manipulation around theindependent lag screw.
Remove the compression wires.
Second or Third TMT Fusion
Second or Third TMT Fusion
Required sets
01.210.110 2.4 mm Variable Angle Locking and CortexScrew Instrument Module
01.210.210/ 2.4 mm Variable Angle Locking and Cortex01.210.410 Screw Module (stainless steel or titanium)
or
01.211.111 2.7 mm Variable Angle Locking and CortexScrew Instrument Module
01.211.211/ 2.7 mm Variable Angle Locking and Cortex01.211.411 Screw Module (stainless steel or titanium)
1 Approach
Make a long dorsal incision over the third metatarsal starting,at the navicular and extending to the midshaft of themetatarsal. Identify and retract the dorsalis pedis artery andnerve. Dissect down to the bone.
2Prepare joint surface
Remove the cartilage and prepare the joint surface for fusion.The surface of the joint can be manipulated to achieve thedesired correction.
Take care to minimize joint surface removal to prevent short-ening of the second and third rays.
Synthes 55
4Compress
If necessary, compression across the joint can be achieved using the compression wires and forceps as described in theCompression System Technique.
Second or Third TMT Fusion
3 Place plate
Instruments
03.211.400 Compression Forceps
03.211.410– 1.6 mm Compression Wires03.211.440 10 mm–40 mm thread
Place the plate dorsally over the joint surface with the com-pression slot distal to the joint.
The plate is precontoured for an anatomic fit.
A compression wire can be used to hold the plate in position.
56 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
5Insert variable angle locking screws
For final fixation, insert the appropriate screws according tothe screw insertion technique described in the Variable AngleLocking Technique.
Remove the compression wires.
Synthes 57
Implants
2.4 mm/2.7mm Variable Angle LCP First TMT Fusion Plates
Stainless Steel Titanium Size Length (mm)
02.211.246 04.211.246 Standard 39
02.211.247 04.211.247 Long 48
2.4 mm/2.7mm Variable Angle LCP TMT Fusion Plates 43 mm
Stainless Steel Titanium
02.211.266 04.211.266
58 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Navicular and Cuboid Fractures
Navicular and Cuboid Fractures
Required sets
01.210.110 2.4 mm Variable Angle Locking and CortexScrew Instrument Module
01.210.210/ 2.4 mm Variable Angle Locking and Cortex01.210.410 Screw Module (stainless steel or titanium)
or
01.211.111 2.7 mm Variable Angle Locking and CortexScrew Instrument Module
01.211.211/ 2.7 mm Variable Angle Locking and Cortex01.211.411 Screw Module (stainless steel or titanium)
1 Approach
Option A: NavicularMake a dorsal longitudinal incision from the midneck of thetalus toward the base of the second metatarsal. It is impor-tant to preserve neurovascular and tendinous structures.
It may be necessary to open the talonavicular joint capsule toallow visualization of the joint. To minimize the potential forvascular damage, strip only a small segment of the capsulefrom the navicular bone.
Option B: Cuboid Make a linear dorsolateral incision starting at the sinu tarsiand extending to the base of the fourth metatarsal.
Warning: This incision may run parallel to, or directly over,the sural nerve and cross the peroneous tertius. Take care toavoid injuring these structures.
One of the main objectives of cuboid fracture managementis restoration of the lateral column length and articular surface.
Synthes 59
Navicular and Cuboid Fractures
2Contour plate
Instruments
03.211.001 2.4 mm/2.7 mm Variable Angle LCPHolding Pin (2 required)
03.211.005 2.4 mm/ 2.7 mm Variable Angle LCPBending Plier (2 required)
Option A: NavicularApply K-wires and independent lag screws for provisionalbone fixation and stabilization.
The plate is designed to fit the navicular bone, as shown.
Two bending pliers can be used to contour the plate to fitthe navicular. A holding pin can be used to aid in contouring.
The plates can be cut to length for the specific fracture patternor patient anatomy.
Option B: CuboidApply K-wires and independent lag screws for provisionalbone fixation and stabilization.
The plates are designated left and right, however, they canbe used on either left or right foot. By using the oppositeplate on the foot, an extra variable angle locking hole maybe positioned in the lateral cuneiform.
Two bending pliers can be used to contour the plate to fitthe cuboid. A holding pin can be used to aid in contouring.
60 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
3 Insert variable angle locking screws
For final fixation, insert the variable angle locking screws asdescribed in the Variable Angle Locking Technique.
Synthes 61
Implants
2.4 mm/2.7 mm Variable Angle Locking Navicular Plate
Stainless Steel Titanium
02.211.220 04.211.220
2.4 mm/2.7 mm Variable Angle Locking Cuboid Plates
Stainless Steel Titanium Left /Right
02.211.221 04.211.221 left
02.211.222 04.211.222 right
62 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
T-, L-, Cloverleaf, X-, Straight, andMesh Plates
T-, L-, Cloverleaf, X-, Straight, and Mesh Plates
Required sets
01.210.110 2.4 mm Variable Angle Locking and CortexScrew Instrument Module
01.210.210/ 2.4 mm Variable Angle Locking and Cortex01.210.410 Screw Module (stainless steel or titanium)
or
01.211.111 2.7 mm Variable Angle Locking and CortexScrew Instrument Module
01.211.211/ 2.7 mm Variable Angle Locking and Cortex01.211.411 Screw Module (stainless steel or titanium)
1 Cut plate (mesh only)
Instruments
03.211.007 Mesh Plate Cutters
391.906 Cable Cutter, large
Cut the plate to fit patient anatomy. To cut multiple rows,use the large cable cutter.
A minimum of two rows and two columns are necessary toensure structural integrity.
The mesh plate cutters can be used for finer cuts around thescrew holes. To prevent sharp edges from causing soft tissueirritation, place the mesh plate bottom side down on themesh plate cutter platen.
Synthes 63
T-, L-, Cloverleaf, X-, Straight, and Mesh Plates
2Contour plate
Instruments
03.211.001 2.4 mm/2.7 mm Variable Angle LCP PlateHolding Pins (2 required)
03.211.005 2.4 mm/2.7 mm Variable Angle LCPBending Pliers (2 required)
Contour the plate to fit the specific anatomy and fixation options.
The bending pliers are designed to protect the variable angleholes during contouring by aligning the cloverleaf protrusionon the pliers with the cloverleaf design in the plate. Use twopliers to contour the plate.
Two holding pins can also be used for fine contouring of theplates by placing them in different variable angle holes. Muchlike the bending pliers, the holding pins are designed to protectthe variable angle holes when bending. If significant contour-ing is required, or the plate is too stiff, use the bending pliersfor contouring.
64 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
3 Compress (optional)
Instruments
03.211.400 Compression Forceps
03.211.410– 1.6 mm Compression Wires03.211.440 10 mm–40 mm thread
If needed, compression can be achieved using the compressionwires and forceps as described in the Compression SystemTechnique.
Synthes 65
T-, L-, Cloverleaf, X-, Straight, and Mesh Plates
4 Insert variable angle locking screws
For final fixation, insert the variable angle locking screws asdescribed in the Variable Angle Locking Technique.
Remove the compression wires.
66 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Implants
2.4 mm/2.7mm Variable Angle LCP Cloverleaf Fusion PlatesStainless Steel Titanium Size Length (mm)
02.211.250 04.211.250 Short 38
02.211.251 04.211.251 Standard 45
02.211.252 04.211.252 Long 64
2.4 mm/2.7mm Variable Angle LCP T-Fusion PlatesStainless Steel Titanium Size Length (mm)
02.211.253 04.211.253 Short 35
02.211.254 04.211.254 Standard 42
02.211.255 04.211.255 Long 61
02.211.265 04.211.265 Long 92
Synthes 67
Implants
2.4 mm/2.7mm Variable Angle LCP L-Fusion Plates, leftStainless Steel Titanium Size Length (mm)
02.211.257 04.211.257 Short 37
02.211.259 04.211.259 Standard 44
02.211.261 04.211.261 Long 62
2.4 mm/2.7mm Variable Angle LCP L-Fusion Plates, right
Stainless Steel Titanium Size Length (mm)
02.211.256 04.211.256 Short 37
02.211.258 04.211.258 Standard 44
02.211.260 04.211.260 Long 62
68 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
2.4 mm/2.7 mm Variable Angle Locking X-Plates
Stainless Steel Titanium Size Length (mm)
02.211.201 04.211.201 extra small 24
02.211.202 04.211.202 small 27
02.211.203 04.211.203 medium 32
02.211.204 04.211.204 large 36
2.4 mm/2.7 mm Variable Angle Locking Straight Fusion Plates
Stainless Steel Titanium Size Length (mm)
02.211.262 04.211.262 2 hole 27
02.211.263 04.211.263 4 hole 40
2.4 mm/2.7 mm Variable Angle Locking Mesh Plate, 5 x 12 holes
Stainless Steel Titanium
02.211.224 04.211.224
Synthes 69
Instruments
03.211.005 2.4 mm/2.7 mm Variable Angle LCP Bending Pliers
– Protects variable angle holes when bending – Cuts 1.6 mm and 2.0 mm K-wires – Integrated file to soften sharp edges
03.211.007 Mesh Plate Cutters
– Allows fine cutting of Mesh Plate
70 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Set Configurations
2.4 mm Variable Angle LCP Forefoot/Midfoot Instrument and Implant Set Stainless Steel (01.211.219)
Graphic Cases 60.116.004 Graphic Case, 2/3 length, 4 bay
60.116.007 Auxiliary Tray, 2/3 length, 1/2 width
60.116.203 Auxiliary Bin, 1/2 length, 1/2 height
60.211.011 2.4 mm/2.7 mm Variable Angle LCPForefoot/Midfoot Label Pack
Instruments 03.211.005 2.4 mm/2.7 mm Variable Angle LCP
Bending Pliers, 2 ea.
03.211.007 Mesh Plate Cutters
Sets01.210.110 2.4 mm Variable Angle Locking and Cortex
Screw Instrument Set
01.210.210 2.4 mm Variable Angle Locking and CortexScrew Set
01.211.112 Proximal and Distal Reamers Set, 14 mm–24 mm
01.211.214 Compression Instruments, X- and StraightPlate Set
01.211.215 TMT Fusion Plate Set
01.211.216 First MTP Fusion Plates Set
01.211.217 Opening Wedge Plates and Instrument Set
01.211.218 Tarsal and Mesh Plates Set
Synthes 71
Note: For additional information, please refer to package insert. For detailed cleaning and sterilization instructions, please refer tohttp://us.synthes.com/Medical+Community/Cleaning+and+Sterilization.htmor to the below listed inserts, which will be included in the shipping container:– Processing Synthes Reusable Medical Devices—Instruments, Instrument Trays
and Graphic Cases—DJ1305– Processing Non-sterile Synthes Implants—DJ1304
72 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
2.4 mm Variable Angle LCP Forefoot/Midfoot Instrument and Implant Set Titanium (01.211.419)
Graphic Cases 60.116.004 Graphic Case, 2/3 Length, 4 bay
60.116.007 Auxiliary Tray, 2/3 length, 1/2 width
60.116.203 Auxiliary Bin, 1/2 length, 1/2 height
60.211.011 2.4 mm/2.7 mm Variable Angle LCPForefoot/Midfoot Label Pack
Instruments
03.211.005 2.4 mm/2.7 mm Variable Angle LCP Bending Pliers, 2 ea.
03.211.007 Mesh Plate Cutters
Sets 01.210.110 2.4 mm Variable Angle Locking and
Cortex Screw Instrument Set
01.210.410 Titanium 2.4 mm Variable Angle Locking andCortex Screw Set
01.211.112 Proximal and Distal Reamers Set, 14 mm– 24 mm
01.211.414 Titanium Compression Instruments, X- and Straight Plate Set
01.211.415 Titanium TMT Fusion Plate Set
01.211.416 Titanium First MTP Fusion Plates Set
01.211.417 Titanium Opening Wedge Plates andInstrument Set
01.211.418 Titanium Tarsal and Mesh Plates Set
2.7 mm Variable Angle LCP Forefoot/Midfoot Instrument and Implant Set Stainless Steel (01.211.220)
Graphic Cases 60.116.004 Graphic Case, 2/3 length, 4 bay
60.116.007 Auxiliary Tray, 2/3 length, 1/2 width
60.116.203 Auxiliary Bin, 1/2 length, 1/2 height
60.211.011 2.4 mm/2.7 mm Variable Angle LCPForefoot/Midfoot Label Pack
Instruments 03.211.005 2.4 mm/2.7 mm Variable Angle LCP
Bending Pliers, 2 ea.
03.211.007 Mesh Plate Cutters
Sets01.211.111 2.7 mm Variable Angle Locking and
Cortex Screw Instrument Set
01.211.112 Proximal and Distal Reamers Set, 14 mm– 24 mm
01.211.211 2.7 mm Variable Angle Locking and CortexScrew Set
01.211.214 Compression Instruments, X- and StraightPlate Set
01.211.215 TMT Fusion Plate Set
01.211.216 First MTP Fusion Plates Set
01.211.217 Opening Wedge Plates and Instrument Set
01.211.218 Tarsal and Mesh Plates Set
Synthes 73
2.7 mm Variable Angle LCP Forefoot/Midfoot Instrument and Implant Set Titanium (01.211.420)
Graphic Cases 60.116.004 Graphic Case, 2/3 Length, 4 bay
60.116.007 Auxiliary Tray, 2/3 length, 1/2 width
60.116.203 Auxiliary Bin, 1/2 length, 1/2 height
60.211.011 2.4 mm/2.7 mm Variable Angle LCPForefoot/Midfoot Label Pack
Instruments 03.211.005 2.4 mm/2.7 mm Variable Angle LCP Bending
Pliers, 2 ea.
03.211.007 Mesh Plate Cutters
Sets01.211.111 2.7 mm Variable Angle Locking and Cortex
Screw Instrument Set
01.211.112 Proximal and Distal Reamers Set, 14 mm– 24 mm
01.211.411 Titanium 2.7 mm Variable Angle Locking andCortex Screw Set
01.211.414 Titanium Compression Instruments, X- andStraight Plate Set
01.211.415 Titanium TMT Fusion Plate Set
01.211.416 Titanium First MTP Fusion Plates Set
01.211.417 Titanium Opening Wedge Plates andInstrument Set
01.211.418 Titanium Tarsal and Mesh Plates Set
74 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
2.4 mm Variable Angle Locking and Cortex Screw Set Stainless Steel (01.210.210) and Titanium (01.210.410)
Graphic Cases 60.116.050 Screw Module Shell
60.116.058 2.4 Screw Block
60.116.071 2.4 Flip-Up Screw Rack, 2 ea.
60.116.452 Screw Type Push Pin, Blank
60.116.507 Screw Type Push Pin, Cortex
60.116.521 Screw Type Push Pin, VA Locking
60.116.554 Label Pack for 2.4 mm screws andinstruments
01.116.534 Length Market Push Pin Set
Implants 2.4 mm Variable Angle Locking Screws, self-tapping, with T8StarDrive recess
Stainless LengthSteel Titanium (mm) Qty
02.210.110 04.210.110 10 5
02.210.112 04.210.112 12 5
02.210.114 04.210.114 14 5
02.210.116 04.210.116 16 5
02.210.118 04.210.118 18 5
02.210.120 04.210.120 20 5
02.210.122 04.210.122 22 5
02.210.124 04.210.124 24 5
02.210.126 04.210.126 26 5
02.210.128 04.210.128 28 5
02.210.130 04.210.130 30 4
02.210.132 04.210.132 32 4
02.210.134 04.210.134 34 4
02.210.136 04.210.136 36 4
02.210.138 04.210.138 38 4
02.210.140 04.210.140 40 4
02.210.142 04.210.142 42 4
02.210.144 04.210.144 44 4
02.210.146 04.210.146 46 4
02.210.148 04.210.148 48 4
02.210.150 04.210.150 50 4
02.210.152 04.210.152 52 4
02.210.154 04.210.154 54 4
02.210.156 04.210.156 56 4
Synthes 75
2.4 mm Variable Angle Locking and Cortex Screw Set Stainless Steel (01.210.210) and Titanium (01.210.410)
Implants continued
2.4 mm Cortex Screws, self-tapping, with T8 StarDrive recess
Stainless LengthSteel Titanium (mm) Qty
201.760 401.760 10 5
201.762 401.762 12 5
201.764 401.764 14 5
201.766 401.766 16 5
201.768 401.768 18 5
201.770 401.770 20 5
201.772 401.772 22 5
201.774 401.774 24 5
201.776 401.776 26 5
201.778 401.778 28 5
201.780 401.780 30 4
201.782 401.782 32 4
201.784 401.784 34 4
201.786 401.786 36 4
201.788 401.788 38 4
201.790 401.790 40 4
02.210.942 04.210.942 42 4
02.210.944 04.210.944 44 4
02.210.946 04.210.946 46 4
02.210.948 04.210.948 48 4
02.210.950 04.210.950 50 4
02.210.952 04.210.952 52 4
02.210.954 04.210.954 54 4
02.210.956 04.210.956 56 4
76 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
2.4 mm Variable Angle Locking and Cortex Screw Instrument Set (01.210.110)
Graphic Case 60.210.003 2.4mm Variable Angle Locking and Cortex
Screw Instrument Module Case
Instruments 03.110.000 1.8 mm Universal Variable Angle Locking
Drill Guide
03.110.002 Torque Limiting Attachment, 1.2 Nm
03.110.005 Handle for Torque Limiting Attachment
03.110.023 1.8 mm Variable Angle Locking Drill Guide,cone
03.110.024 1.8 mm Variable Angle Locking Drill Guide,coaxial
03.111.038 Handle with quick coupling
03.211.001 2.4 mm/2.7 mm Variable Angle LCP PlateHolding Pins, 2 ea.
310.509 1.8 mm Drill Bit with depth mark, quickcoupling, 2 ea
310.530 2.4 mm Drill Bit, quick coupling, 100 mm,2 ea.
310.972 Countersink, for 2.0 mm and 2.4 mmscrews
312.18 2.4 mm/1.8 mm Double Drill Sleeve
314.453 Short StarDrive Screwdriver Shaft, T8, 55 mm, 2 ea.
314.467 StarDrive Screwdriver Shaft, T8, 105 mm,2 ea.
314.468 Holding Sleeve, for StarDrive ScrewdriverShaft, T8
319.006 Depth Gauge, for 2.0 mm and 2.4 mmscrews
323.202 2.4 mm Universal Drill Guide
Also Available 03.111.005 Depth Gauge, for 2.4 mm and 2.7 mm
screws
310.162 1.8 mm Drill Bit with Depth Mark, StrykerJ-latch, 110 mm
311.43 Handle with quick coupling
317.872 2.4 mm Drill Bit, Stryker J-Latch, 90 mm
511.776 Torque Limiting Attachment, 0.8 Nm,quick coupling
Synthes 77
2.7 mm Variable Angle Locking and Cortex Screw Set Stainless Steel (01.211.211) and Titanium (01.211.411)
Graphic Cases 60.116.050 Screw Module Shell
60.116.059 2.7 mm Screw Block
60.116.072 2.7 mm Flip-Up Screw Rack, 2 ea.
60.116.452 Screw Type Push Pin, Blank
60.116.507 Screw Type Push Pin, Cortex
60.116.521 Screw Type Push Pin, VA Locking
60.116.555 Label Pack for 2.7 mm screws andinstruments
01.116.534 Length Market Push Pin Set
Implants 2.7 mm Variable Angle Locking Screws, self-tapping, with T8StarDrive recess
Stainless LengthSteel Titanium (mm) Qty
02.211.010 04.211.010 10 4
02.211.012 04.211.012 12 4
02.211.014 04.211.014 14 4
02.211.016 04.211.016 16 4
02.211.018 04.211.018 18 4
02.211.020 04.211.020 20 4
02.211.022 04.211.022 22 4
02.211.024 04.211.024 24 4
02.211.026 04.211.026 26 4
02.211.028 04.211.028 28 4
02.211.030 04.211.030 30 3
02.211.032 04.211.032 32 3
02.211.034 04.211.034 34 3
02.211.036 04.211.036 36 3
02.211.038 04.211.038 38 3
02.211.040 04.211.040 40 3
02.211.042 04.211.042 42 3
02.211.044 04.211.044 44 3
02.211.046 04.211.046 46 3
02.211.048 04.211.048 48 3
02.211.050 04.211.050 50 3
02.211.052 04.211.052 52 3
02.211.054 04.211.054 54 3
02.211.056 04.211.056 56 3
78 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
2.7 mm Cortex Screws, self-tapping, with T8 StarDrive recess
Stainless LengthSteel Titanium (mm) Qty
202.870 402.870 10 4
202.872 402.872 12 4
202.874 402.874 14 4
202.876 402.876 16 4
202.878 402.878 18 4
202.880 402.880 20 4
202.882 402.882 22 4
202.884 402.884 24 4
202.886 402.886 26 4
202.888 402.888 28 4
202.890 402.890 30 3
202.892 402.892 32 3
202.894 402.894 34 3
202.896 402.896 36 3
202.898 402.898 38 3
202.900 402.900 40 3
202.962 402.962 42 3
202.963 402.963 44 3
202.965 402.965 46 3
202.966 402.966 48 3
202.967 402.967 50 3
202.968 402.968 55 3
202.969 402.969 60 3
Synthes 79
2.7 mm Variable Angle Locking and Cortex Screw Instrument Set (01.211.111)
Graphic Case 60.211.003 2.7 mm Variable Angle Locking and Cortex
Screw Instrument Module Case
Instruments 03.110.002 Torque Limiting Attachment, 1.2 Nm
03.110.005 Handle for Torque Limiting Attachment
03.111.038 Handle with quick coupling
03.211.001 2.4 mm/2.7 mm Variable Angle LCP PlateHolding Pins, 2 ea.
03.211.002 2.0 mm Universal Variable Angle LockingDrill Guide
03.211.003 2.0 mm Variable Angle Locking Drill Guide,variable
03.211.004 2.0 mm Variable Angle Locking Drill Guide,coaxial
310.26 2.7 mm Drill Bit, quick coupling, 100 mm,2 ea.
310.87 Countersink, for 2.7 mm cortex screws
312.24 2.7 mm/2.0 mm Double Drill Sleeve
314.453 Short StarDrive Screwdriver Shaft, T8, 55 mm, 2 ea.
314.467 StarDrive Screwdriver Shaft, T8, 105 mm,2 ea.
314.468 Holding Sleeve, for StarDrive ScrewdriverShaft, T8
319.01 Depth Gauge, for small screws
323.062 2.0 mm Drill Bit with depth mark, quickcoupling, 140 mm
323.26 2.7 mm Universal Drill Guide
Also Available 311.43 Handle with quick coupling
511.776 Torque Limiting Attachment, 0.8 Nm
80 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
Compression Instruments, X- and Straight Plate Set Stainless Steel (01.211.214) and Titanium (01.211.414)
Graphic Cases60.116.052 Module Shell
60.211.008 Compression Wires and Forceps Module Bin
Implants2.4 mm/2.7 mm Variable Angle Locking X-Plates◊
Stainless Steel Titanium Size
02.211.201 04.211.201 extra small
02.211.202 04.211.202 small
02.211.203 04.211.203 medium
02.211.204 04.211.204 large
2.4 mm/2.7 mm Variable Angle Locking Straight FusionPlates◊
Stainless Steel Titanium Size
02.211.262 04.211.262 2 hole
02.211.263 04.211.263 4 hole
Instruments 03.211.400 Compression Forceps
1.6 mm Compression Wires, 150 mm, 6 ea.
Thread Length (mm)
03.211.410 10
03.211.415 15
03.211.420 20
03.211.425 25
03.211.430 30
03.211.435 35
03.211.440 40
Synthes 81
◊ Available nonsterile or sterile-packed Add “S” to catalog number to order sterile product
TMT Fusion Plate Set Stainless Steel (01.211.215) and Titanium (01.211.415)
Graphic Case 60.211.006 TMT, First TMT, Cloverleaf, Plate Module Bin
Implants2.4 mm/2.7 mm Variable Angle LCP First TMT Fusion Plates◊
Stainless Steel Titanium Size Length (mm)
02.211.246 04.211.246 standard 39
02.211.247 04.211.247 long 48
2.4 mm/2.7 mm Variable Angle LCP TMT Fusion Plates, 43 mm◊
Stainless Steel Titanium
02.211.266 04.211.266
2.4 mm/2.7 mm Variable Angle LCP Cloverleaf Fusion Plates◊
Stainless Steel Titanium Size Length (mm)
02.211.250 04.211.250 short 38
02.211.251 04.211.251 standard 45
02.211.252 04.211.252 long 64
2.4 mm/2.7 mm Variable Angle LCP L-Fusion Plates, right◊
Stainless Steel Titanium Size Length (mm)
02.211.256 04.211.256 short 37
02.211.258 04.211.258 standard 44
02.211.260 04.211.260 long 62
2.4 mm/2.7 mm Variable Angle LCP L-Fusion Plates, left◊
Stainless Steel Titanium Size Length (mm)
02.211.257 04.211.257 short 37
02.211.259 04.211.259 standard 44
02.211.261 04.211.261 long 62
2.4 mm/2.7 mm Variable Angle LCP T-Fusion Plates◊
Stainless Steel Titanium Holes Size LengthHead (mm)
02.211.253 04.211.253 2 short 35
02.211.254 04.211.254 2 standard 42
02.211.255 04.211.255 2 long 61
02.211.265 04.211.265 3 extra long 92
82 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
◊ Available nonsterile or sterile-packed Add “S” to catalog number to order sterile product
Proximal and Distal Reamers Set, 14 mm–24 mm (01.211.112)
Graphic Cases 60.116.052 Module Shell
60.211.009 Proximal and Distal Reamers Module Bin 1
Implant 292.56 1.6 mm Kirschner Wire, 150 mm, trocar
points on both ends, 10/pkg.
Instruments Cannulated Reamers (for 1.6 mm K-Wires)
Proximal Distal Diameter (mm)
03.211.114 03.211.014 14
03.211.116 03.211.016 16
03.211.118 03.211.018 18
03.211.120 03.211.020 20
03.211.122 03.211.022 22
03.211.124 03.211.024 24
Also Available 01.211.113 6 mm–12 mm Proximal and Distal Reamer
Set
Graphic Case 60.211.010 Proximal and Distal Reamers Module Bin 2
Implant 292.52 1.25 mm Kirschner Wire, 150 mm, trocar
points on both ends, 10/pkg.
Instruments Cannulated Reamers (for 1.25 mm K-Wires)
Proximal Distal Diameter (mm)
03.211.106 03.211.006 6
03.211.108 03.211.008 8
03.211.110 03.211.010 10
03.211.112 03.211.012 12
Synthes 83
First MTP Fusion Plates Sets Stainless Steel (01.211.216) and Titanium (01.211.416)
Graphic Case 60.211.001 First MTP Fusion Module Bin
Implants 2.4 mm/2.7 mm Variable Angle LCP First MTP Fusion Plates,small, 42 mm◊
Stainless Steel Titanium Left/Right Dorsiflexion
02.211.230 04.211.230 right 0°
02.211.231 04.211.231 left 0°
02.211.232 04.211.232 right 5°
02.211.233 04.211.233 left 5°
02.211.234 04.211.234 right 10°
02.211.235 04.211.235 left 10°
2.4 mm/2.7 mm Variable Angle LCP First MTP Fusion Plates,medium, 52 mm◊
Stainless Steel Titanium Left/Right Dorsiflexion
02.211.236 04.211.236 right 0°
02.211.237 04.211.237 left 0°
02.211.238 04.211.238 right 5°
02.211.239 04.211.239 left 5°
02.211.240 04.211.240 right 10°
02.211.241 04.211.241 left 10°
2.4 mm/2.7 mm Variable Angle LCP First MTP Fusion Plates,large, 57 mm◊
Stainless Steel Titanium Left/Right Dorsiflexion
02.211.242 04.211.242 right 5°
02.211.243 04.211.243 left 5°
2.4 mm/2.7 mm Variable Angle LCP First MTP Fusion Plates,revision, 53 mm◊
Stainless Steel Titanium Left/Right Dorsiflexion
02.211.244 04.211.244 right 0°
02.211.245 04.211.245 left 0°
84 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
◊ Available nonsterile or sterile-packed Add “S” to catalog number to order sterile product
Opening Wedge Plates and Instrument Set Stainless Steel (01.211.217) and Titanium (01.211.417)
Graphic Cases 60.116.052 Module Shell
60.211.007 Opening Wedge Plate and InstrumentModule Bin
Implants 2.4 mm/2.7 mm Variable Angle Locking Opening WedgePlates◊
Stainless Steel Titanium Spacer (mm)
02.211.210 04.211.210 0
02.211.211 04.211.211 3
02.211.212 04.211.212 4
02.211.213 04.211.213 5
02.211.214 04.211.214 6
02.211.215 04.211.215 7
Instrument
03.211.009 Opening Wedge Measuring Instrument
Synthes 85
◊ Available nonsterile or sterile-packed Add “S” to catalog number to order sterile product
Tarsal and Mesh Plates Set Stainless Steel (01.211.218) and Titanium (01.211.418)
Graphic Case 60.211.005 Tarsal and Mesh Plate Module Bin
Implants2.4 mm/2.7 mm Variable Angle Locking Navicular Plate◊
Stainless Steel Titanium
02.211.220 04.211.220
2.4 mm/2.7 mm Variable Angle Locking Cuboid Plates◊
Stainless Steel Titanium Left/Right
02.211.221 04.211.221 left
02.211.222 04.211.222 right
2.4 mm/2.7 mm Variable Angle Locking Mesh Plate, 5 x 12holes◊
Stainless Steel Titanium
02.211.224 04.211.224
86 Synthes 2.4 mm/2.7 mm Variable Angle LCP Forefoot/Midfoot System Technique Guide
◊ Available nonsterile or sterile-packed Add “S” to catalog number to order sterile product
Synthes (USA)1302 Wrights Lane EastWest Chester, PA 19380Telephone: (610) 719-5000To order: (800) 523-0322Fax: (610) 251-9056
Synthes (Canada) Ltd.2566 Meadowpine BoulevardMississauga, Ontario L5N 6P9Telephone: (905) 567-0440To order: (800) 668-1119Fax: (905) 567-3185
© 2010 Synthes, Inc. or its affiliates. All rights reserved. Combi, LCP and Synthes are trademarks of Synthes, Inc. or its affiliates. Printed in U.S.A. 3/11 J9980-B
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