4.5/6.7 mm Low Profile Screw System

Surgical Technique

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6.5 mm AO Screw

Designed in conjunction with foot and ankle surgeons, the Arthrex Cannulated Low Profile 6.7 mm Screw is the ideal tool for hindfoot fixation. Larger diameter and longer length threads are designed to provide greater pull-out and compression than other screws designed for hip fractures. Lower profile heads decrease the need for removal in areas where minimal soft tissue and direct weight-bearing are considerations.

•18 mm thread length and 28 mm thread length – Longer threads are ideal for the foot and ankle

• Deeper threads – Using a 2.4 mm Guide Pin allows threads to be deeper than standard A0 Screw

•Larger Thread Height –Maximizespurchasefor30% more pull-out than a standard screw

• Lower Profile Head – 1 mm lower than a standard screw

•2.4 mm Guide Pin – Enabling accurate placement

• Self-Drilling/Self-Tapping – Quick and easy insertion, reverse cutting flutes

• 3.5 mm Hex – Strong drive for confident placement

• Best material on the market –TypeIIAnodizedTitanium

actual sizes

Arthrex 6.7 mm Lag Screw - 18 mm thread

Arthrex 6.7 mm Lag Screw - 28 mm thread

Arthrex 6.7 mm2.3 mm core-to-thread differential

AO 6.5 mm1.7 mm core-to-thread differential

Arthrex 6.7 mm Screwhas a 1 mm lower profile than AO Screw

16 mm

18 mm

Pull-out Strength Comparison*

*data on file

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Comparison between AO 6.5 mm Screw and the Arthrex 6.7 mm Screw

Arthrex 6.7 mm Lag Screw

6.5 mm AO Screw

This is a Foot Screw – Not a Hip Screw

Arthrex

AO

1. Medializing Calcaneal Osteotomy (MCO) Technique, 6.7 mm LPS Screw

Countersink, if desired. Measure pin depth with the Depth Device (inset).

Cut the calcaneus 2 cm from the posterior edge. Shift medially 1 cm.

Maintain the correction with two 2.4 mm Guide Pins at the desired location of the screws. If desired, use a parallel pin guide. Always drive the pin through the longer leg of the guide.

Repair is complete.Fix with two 6.7 mm cannulated LPS Screws. Screws are self-drilling, but in very hard bone predrilling may be required. Screws may be inserted by hand or power, but final tightening should be done by hand.

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2. Subtalar Arthrodesis Technique, 6.7 mm LPS Screw

Prepare subtalar joint by thoroughly removing all cartilage. Roughen bony surfaces by drilling, “fish scaling” or other means. Pack the joint with graft material.

Insert two 2.4 mm Guide Pins at the desired location of the screws. If desired, use parallel pin guide. Always drive pin through the longer leg of the guide.

Countersink, if desired. Measure the pin depth with the Depth Device.

Fix with two 6.7 mm cannulated LPS Screws. The screws are self-drilling, but in very hard bone predrilling may be required.

Screws may be inserted by hand or power, but final tightening should be done by hand. Screws may be inserted in divergent directions, if desired.

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Guidewires must be placed diagonally prior to screw insertion.

3. Triple Arthrodesis Technique Options, 4.5 mm LPS Screw

Ankle Arthrodesis, 6.7 mm LPS Screw and the use of Biologics

Option: H-Plate fixation of Talonavicular and Calcaneocuboidal Joints

Final Fixation.

Surgical Technique

In consideration of the above procedures the use of Biologics could be employed to aid in promoting osseous regeneration across fusion site voids with JRF Stimublast.

•JRFStimuBlastisademineralizedbonematrix(DBM) that provides osteoinductive and osteoconductive properties•TheReverse Phase Medium (RPM) carrier provides superior handling characteristics – Material is flowable at room temperature and thickens to become more viscous at body temperature – RPM allows the DBM graft to be moldable and packedintoanydefectsize – JRF StimuBlast will resist irrigation and can be used in a fluid environment without the fear of graft migration•Thisis a ready-to-use, off-the-shelf product that requires no thawing or premixing preparation•JRFStimuBlastisterminallysterilizedusingelectronbeam, which does not harm the DBM or its bioactivity

This description of technique is provided as an educational tool and clinical aid to assist properly licensed medical professionals in the usage of specific Arthrex products. As part of this professional usage, the medical professional must use their professional judgment in making any final determinations in product usage and technique. In doing so, the medical professional should

rely on their own training and experience and should conduct a thorough review of pertinent medical literature and the product’s directions for use.

Developed in conjunction with Ned Amendola, M.D., University of Iowa, IA; Paul Shurnas, M.D., Columbia Orthopaedic Group, MO; Troy Watson, M.D., Desert Orthopaedic Center, NV.

U.S. PATENT PENDING©2011, Arthrex Inc. All rights reserved. LT0432F

AO 6.5 mm1.7 mm core-to-thread differential

Ordering Information

4.5 mm Screw System

Screws and Washer:

Cannulated Lag Screws, 4.5 mm x 20 — 80 mm (partially threaded) AR-8945-20PT — 80PTLow Profile Screws, 4.5 mm x 20 — 80 mm (fully threaded) AR-8945-20FT — 80FTSolid Lag Screws, 5.5 mm x 40 — 65 mm AR-8955-40PT — 65PT Washer, 10 mm AR-8945W

4.5 mm Instruments:

Cannulated Depth Device, 3 /4.5 mm AR-8944DG Driver, 3.5 mm Hex, Cannulated (Mini Hudson) AR-8967D Cannulated Drill Bit, 3 mm (Mini Hudson) AR-8945-30C Cannulated Drill Bit, 4.5 mm (Mini Hudson) AR-8945-45C Countersink (Mini Hudson) AR-8945CSFixed Handle Cannulated Countersink, 4.5 mm AR-8945CSF Drill Guide, 3/4.5 mm (Trim-iT) AR-4164G Tap, cannulated, 4.5 mm (Mini Hudson) AR-8945TCGuidewire, .062”, 1.6 mm AR-8941KGuidewire, .062”, 1.6 mm, threaded AR-8941KT

6.7 mm Screw System

Screws and Washer:

Cannulated Lag Screws, 6.7 mm x 40 — 120 mm 18 mm thread length AR-8967-1840 — 18120Cannulated Lag Screws, 6.7 mm x 40 — 120 mm 28 mm thread length AR-8967-2840 — 28120 6.7 mm Low Profile Screw System Tenodesis Module AR-8967SWasher, 13 mm AR-8967W

6.7 mm Instruments:

Parallel Pin Guide, adjustable AR-8967PG C-Ring Pin Guide AR-8967CG Cannulated Depth Device, 6.7 mm AR-8967DG Drill Guide, 4 mm/6.7 mm AR-8967G Drill Bit, 4 mm, cannulated AR-8967-40C Drill Bit, 6.7 mm, cannulated AR-8967-67C Cannulated Countersink, 4.5 mm/6.7 AR-8945CS Fixed Handle Cannulated Countersink, 6.7 mm AR-8967CSF Cannulated Tap, 6.7 mm AR-8967TC Driver, 3.5 mm Hex, cannulated AR-8967D Ratcheting Screwdriver Handle AR-1999Tear Drop Handle AR-2001 Low Profile Screw System Instrumentation Case AR-8946C Guidewire, .094” AR-8967KGuidewire w/Trocar Tip, nonthreaded, 12”, qty. 6 AR-8967K-12Guidewire w/Trocar Tip, threaded, 12”, qty. 6 AR-8967KT-12Guidewire w/Trocar Tip, threaded, 8”, qty. 6 AR-8967KT