DCP and LC-DCP Systems. Dynamic Compression Plates (DCP ...

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DCP and LC-DCP Systems. Dynamic Compression Plates (DCP) and Dynamic Compression Plates with Limited Bone Contact (LC-DCP). Surgical Technique This publication is not intended for distribution in the USA. Instruments and implants approved by the AO Foundation.

Transcript of DCP and LC-DCP Systems. Dynamic Compression Plates (DCP ...

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DCP and LC-DCP Systems. Dynamic Compression Plates (DCP) and ­Dynamic Compression­Plates­with­Limited Bone Contact (LC-DCP).

Surgical­Technique

This­publication­is­not­intended­for­distribution­in­the­USA.

Instruments and implantsapproved­by­the­AO­Foundation.

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Image­intensifier­control

This­description­alone­does­not­provide­sufficient­background­for­direct­use­ of­the­instrument­set.­Instruction­by­a­surgeon­experienced­in­handling­these­instruments­is­highly­recommended.

Processing, Reprocessing, Care and MaintenanceFor­general­guidelines,­function­control­and­dismantling­of­­multi-part­instruments,­as­well­as­processing­guidelines­for­­implants,­please­contact­your­local­sales­representative­or­refer­to:http://emea.depuysynthes.com/hcp/reprocessing-care-maintenanceFor­general­information­about­reprocessing,­care­and­maintenance­of­Synthes­reusable­devices,­instrument­trays­and­cases,­as­well­as­processing­of­Synthes­non-sterile­implants,­please­consult­the­Important­Information­leaflet­(SE_023827)­or­refer­to:­ http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 1

Table of Contents

Introduction DCP and LC-DCP Systems 2

AO­Principles­­ 4

Intended­Use­­ 5

Indications and Contraindications 6

Surgical Technique Preparation 7

Drill­Guides­for­DCP­and­LC-DCP­­ 9

Compression­Plate:­Simple­Fracture­ 12

Compression­Plate:­Multifragmentary Fracture­ 15

Buttress Plate 18

Neutralization Plate (Protecting Plate) 19

Product Information Screws,­Drills­and­Taps­ 20

Mini­Fragment­System­1.5,­2.0,­2.7­ 22

Compact­Hand­1.0,­1.3,­1.5,­2.0,­2.4­ 32

Compact­Hand­Module­1.0/1.3­ 32

Compact­Hand­Module­1.5­ 34

Compact­Hand­Module­2.0­ 37

Compact­Hand­Module­2.4­ 40

Small­Fragment­Plates­3.5­­ 44

Large­Fragment­Plates­4.5­­­ 45

MRI Information­ 48

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mid section

Non-symmetrical holesSome­Dynamic­Compression­Plates­feature­non-symmetrical­holes­which­allow­to­achieve­compression­in­only­one­­direction.­These­plates­feature­a­mid­section­which­is­placed­at­the­position­of­fragments­to­be­compressed.

The­non-symmetrical­DCP­holes­are­shaped­like­a­portion­of­an­inclined­and­angled­cylinder.­They­possess­one­compres-sion­point­at­the­inclined­side­and­one­neutral­point­in­the­middle.

Dynamic­Compression­Plates­are­available­in­dimensions­ranging­from­1.3­to­4.5­mm,­Limited­Contact­Dynamic­­Compression­Plates­range­from­2.0­to­4.5­mm.

DCP and LC-DCP Systems. Dynamic Compression Plates (DCP) and Dynamic Compression­Plates­with­Limited Bone Contact (LC-DCP).

Plate hole geometries

Symmetrical holesMost­1.3­to­3.5­mm­Dynamic­Compression­Plates­have­sym-metrical­holes­similar­to­the­LC-DCP­hole.­The­symmetrical­shape­of­the­plate­holes­enables­compression­to­be­achieved­in­both­directions,­thus­plate­positioning­is­not­restricted­by­the­presence­of­a­mid-section.

Symmetrically­shaped­DCP­holes­possess­one­compression­and­one­neutral­point­on­both­sides.­With­some­small­and­mini­plates,­the­neutral­points­meet­in­the­middle.

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 3

Undercuts­of­the­LC-DCP­limit­contact­between­plate­and­bone.

Non-symmetrical holesThe­DCP­allows­up­to­25°­longitudinal­and­7°­transverse­screw­angulation.

Symmetrical holesThe­DCP­hole­allows­up­to­50°­longitudinal­screw­angulation­for­an­increased­range­of­applications.­LC-DCP­holes­allow­even­wider­angulations­up­to­80°.­Both­plate­types­allow­for­14°­transverse­screw­angulation.

Undercuts

Screw angulations

The­uniform­stiffness­of­the­LC-DCP­allows­smooth­­contouring­of­the­plate­to­the­bone.­It­may­protect­the­plate­from­localized­high­bending­stresses.

Uniform stiffness (LC-DCP only)

LC-DCP

Standard

Symmetrical­LC-DCP­hole

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4 DePuy Synthes Expert Lateral Femoral Nail Surgical Technique

AO PRINCIPLES

In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation1, 2.

1 Müller ME, M Allgöwer, R Schneider, H Willenegger. Manual of Internal Fixation. 3rd ed. Berlin Heidelberg New York: Springer. 1991.

2 Rüedi TP, RE Buckley, CG Moran. AO Principles of Fracture Management. 2nd ed. Stuttgart, New York: Thieme. 2007.

Anatomic reductionFracture reduction and fixation to restore anatomical relationships.

Early, active mobilizationEarly and safe mobilization and rehabilitation of the injured part and the patient as a whole.

Stable fixationFracture fixation providing abso-lute or relative stability, as required by the patient, the injury, and the personality of the fracture.

Preservation of blood supplyPreservation of the blood supply to soft tissues and bone by gentle reduction techniques and careful handling.

4 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

AO Principles

1­­Müller­ME,­Allgöwer­M,­Schneider­R,­Willenegger­H.­Manual­of­Internal­Fixation.­ 3rd­ed.­Berlin,­Heidelberg,­New­York:­Springer.­1991.­

2­­Rüedi­TP,­Buckley­RE,­Moran­CG.­AO­Principles­of­Fracture­Management.­2nd ed. Stuttgart,­New­York:­Thieme.­2007.

Stable fixationFracture­fixation­providing­absolute­or­relative­stability,­as­required­by­the­­patient,­the­injury,­and­the­personality­of­the­fracture.

Anatomic reductionFracture­reduction­and­fixation­ to­restore­anatomical­relationships.

Early, active mobilizationEarly­and­safe­mobilization­and­ rehabilitation­of­the­injured­part­and­the­patient­as­a­whole.

Preservation of blood supplyPreservation­of­the­blood­supply­ to­soft­tissues­and­bone­by­gentle­ reduction­techniques­and­careful­handling.

In­1958,­the­AO­formulated­four­basic­principles,­which­have­become­the­guidelines­for­internal­fixation1,2.

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Intended Use

Intended UseDCP­and­LC-DCP­System­Implants­are­intended­for­tempo-rary­fixation,­correction­or­stabi­lization­of­bones­in­various­anatomical regions.

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Indications and Contraindications

IndicationsThis­surgical­technique­applies­to­the­below­Synthes­DCP­and­LC-DCP­systems­and­plate­lines:

Mini Fragment System 1.5, 2.0, 2.7 – Fractures­of­the­middle­and­distal­phalanges­and­tarsals – Fractures­of­the­metacarpals­and­metatarsals – Osteotomies­and­arthrodeses­on­the­hand­and­foot – Fractures­of­the­distal­radius­(double-plate­technique)

Compact Hand 1.0, 1.3, 1.5, 2.0, 2.4Implant­sizes­1.0/1.3: – Fixation­of­small­fragments – Fractures­of­the­distal­and­intermediate­phalanges­ – Avulsion­fractures

Implant­sizes­1.5: – Fractures­of­the­phalanges­and­metacarpals – Capturing­of­fragments­with­lag­screw­technique

Implant­sizes­2.0/2.4: – Fractures­of­the­phalanges­and­metacarpals – Capturing­of­fragments­with­lag­screw­technique

Cloverleaf Plates 3.5 – Distal­tibia­for­comminuted­fractures­to­buttress­its­medial­

side – Proximal­humerus­for­comminuted­fractures­of­the­hu-meral­head

One-third tubular plate 3.5 – Fractures­of­smaller­sized­bones­such­as­fibula,­humerus­

and ulna.

ContraindicationsNo­specific­Contraindications.

LC-DCP Plate 3.5, DCP Plate 3.5, T-Plate 3.5 – Fracture­fixation­and­fixation­after­for­example­osteoto-mies,­malunions,­nonunions­including­but­not­­limited­to­distal­radius,­proximal­and­disital­tibia,­­proximal humerus,­and clavicle.

LC-DCP Plate 4.5, DCP Plate 4.5, T-Plate 4.5, T-Buttress Plate 4.5, L-Buttress Plate 4.5 – Fractures­and­osteotomies­of­large­bones­such­as­femur,­tibia­and­humerus

Semi-Tubular Plate 4.5 – Fractures­and­osteotomies­of­smaller­sized­bones­such­as­humerus,­radius,­ulna,­clavicle,­fibula,­tibia­and­pelvis­

Condylar Buttress Plate 4.5 – Buttressing­of­multifragmentary­distal­femur­fractures – Supracondylar­fractures – Intra-articular­and­extra-articular­condylar­fractures – Malunions­and­nonunions­of­the­distal­femur – Periprosthetic­fractures

Lateral Tibial Head Buttress Plate 4.5 – Indicated­for­the­stabilization­of­fractures­of­the­proximal­tibia.­These­include­proximal­shaft­fractures,­metaphyseal­fractures,­­intra-articular­fractures,­periprosthetic­fractures

Proximal Tibial Plate 4.5Indicated­for­nonunions,­malunions­and­fractures­of­the­proximal­tibia­including­simple,­comminuted,­lateral­wedge,­depression,­medial­wedge,­bicondylar­and­combinations­of­lateral­wedge­and­depression­fractures.

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Preparation

1Plate contouring

For­the­treatment­of­juxta-articular­fractures­(distal­tibia,­­tibial­plateau,­distal­femur,­distal­humerus,­radius­etc.),­good­plate­contouring­to­the­shape­of­the­bone­is­very­important.­Only­then­satisfactory­reduction­and­adequate­stability­may­be­achieved.

Pure­titanium­has­mechanical­properties­differing­from­stain-less­steel.­Due­to­its­lower­modulus­of­elasticity,­titanium­is­more­springy.­Therefore,­titanium­plates­should­be­slightly­over-bent­to­obtain­the­desired­contour.

The­design­of­the­LC-DC­Plate­ensures­uniform­rigidity,­hence­a­continuous­curvature­after­bending.­The­plates­should­not­be­bent­beyond­the­necessary­extent.

Use­bending­pliers­or­bending­irons­for­plate­contouring.

Precautions: – Avoid­repeated­bending.­ – Sharp­indentations­on­the­plate­surface,­especially­around­the­plate­holes,­may­impair­resistance­to­fatigue­and­should­be­avoided.

– Reverse­bending­or­use­of­the­incorrect­instrumentation­for­bending­may­weaken­the­plate­and­lead­to­premature­plate­failure­(e.g.­breakage).­Do­not­bend­the­plate­be-yond­what­is­required­to­match­the­anatomy.

– Instruments­and­screws­may­have­sharp­edges­or­moving­joints­that­may­pinch­or­tear­user’s­glove­or­skin.

– Handle­devices­with­care­and­dispose­worn­bone­cutting­instruments­in­an­approved­sharps­container.

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Reduction­in­implant­stress­by­using­a­lag­screw­through­the­plate1.

2Use of lag screws to achieve additional stability

In­certain­circumstances,­the­use­of­a­plate­for­fracture­com-pression­may­be­sufficient.­In­many­fractures,­however,­it­is­advantageous­to­insert­a­lag­screw­through­the­plate­to­in-crease­fracture­stability­and­to­achieve­interfragmentary­compression­in­the­far­cortex.­If­a­fracture­gap­remains,­the­plate­is­subjected­to­high­bending­stresses.

Using­a­lag­screw­through­the­plate­reduces­implant­stress.1

1­­Klaue­K­et­al.­(1982)­Die­Entlastung­der­Osteosyntheseplatte­durch­interfragmentäre­Plattenzugschraube.­Helv.­Chir.­Acta­52,­19–23

Preparation

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a b

Different­drill­guide­types­are­available­to­perform­drilling­for­DCP­and­LC-DCP­fixation­in­both­neutral­and­compression­mode.

1Standard drill guides (DCP, sizes 1.3 – 4.5)

Standard­drill­guides­feature­a­simple­tube­to­protect­soft­­tissues­while­drilling.­Depending­on­the­positioning­of­the­tube­within­the­hole,­neutral­or­eccentric­(compression)­drill-ing­can­be­performed.

Drill Guides for DCP and LC-DCP

Neutral and eccentric drilling

Example

a Drilling in neutral position Position­the­tube­in­the­middle­of­the­DCP­hole.

b Drilling in eccentric position – compression Position­the­tube­in­plate­hole­remote­from­the­fracture.

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neutral position

inclined position

compression position

buttress­position

2Universal drill guides (DCP and LC-DCP, sizes 1.5 – 4.5)

Universal­drill­guides­feature­one­end­with­a­spring-loaded­mechanism­which­facilitates­all­types­of­applications:­Neutral­position,­compression­position,­buttress­position­(LC-DCP­only)­and­especially­the­positioning­of­inclined­lag­screws­through­the­plate.

a Neutral position Depress­the­drill­guide.­The­upper­part­of­the­inner­sleeve­projects.­Position­the­drill­guide­in­the­plate­hole­which­is remote­from­the­fracture­(LC-DCP).­When­used­with­DC­plates­the­drill­guide­automatically­slides­into­the­correct­middle­position­when­depressed.

b Compression position Do­not­depress­the­drill­guide.­The­upper­part­is­flush.­­Position­the­drill­guide­in­the­plate­hole­remote­from­the­fracture.­

c Inclined position This­technique­is­used­for­inserting­lag­screws­through­the­plate.­Place­the­drill­guide­in­the­hole­adjacent­to­the­fracture,­depress­(upper­part­projects),­and­set­the­desired­drill angle.

d Buttress position (LC-DCP only) Depress­the­drill­guide­as­shown­for­neutral­position­­(upper­part­projects).­Position­the­drill­guide­in­the­plate­hole­adjacent­to­the­fracture.

a c b

d

Drill­Guides­for­DCP­and­LC-DCP­

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neutral position

buttress­position:­ arrow­points­away  from­the­fracture

compression position

=­symbol­for­a­fracture­line

arrow­points­towards­the­fracture

3LC-DCP drill guides (3.5 and 4.5 LC-DC plates)

The­LC-DCP­drill­guides­can­be­used­with­LC-DC­plates­only.­They­feature­dedicated­ends­for­neutral­application­(green)­and­for­application­in­compression­mode­(yellow).­

LC-DCP­drill­guides­carry­an­arrow­enabling­correct­position-ing­of­the­screw. a Neutral position Use­the­green­drill­guide­to­place­a­screw­in­neutral­­position.­The­arrow­on­the­green­drill­guide­must­point­­towards­the­fracture.­Compression­cannot­be­achieved­with­the­green­drill­guide.

b Compression Use­the­yellow­drill­guide­to­achieve­compression.­The­­arrow­on­the­yellow­drill­guide­must­point­towards­the­fracture.­

c Buttress position Use­the­green­drill­guide.­A­buttress­effect­is­achieved­when­the­arrow­points­away­from­the­fracture.­

Pre-drilling­in­inclined­position­with­LC-DCP­drill­guides­is­not­recommended­because­correct­positioning­of­the­screw­­cannot­be­ensured.­LC-DCP­drill­guides­are­designed­to­only­fit­the­hole­in­a­more­or­less­vertical­position.­For­pre-drilling­in­inclined­position­use­the­universal­drill­guide­instead­ (refer­to­2c).

Implant Removal In­case­the­physician­decides­to­remove­the­implants,­they­can­be­removed­by­using­general­surgical­instruments.

green

green yellow

green yellow

a b

c

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1Drill first hole adjacent to fracture

Use­an­appropriately­sized­drill­bit­for­threaded­holes­and­drill­the­first­hole­adjacent­to­the­fracture.­Use­the­green­drill­guide­in­neutral­position­with­the­arrow­pointing­towards­the­fracture.­Alternatively,­use­the­universal­drill­guide­in­­depressed­mode­(upper­part­projects)­and­place­it­in­the­hole­remote­from­the­fracture.

Determine­screw­length,­tap­the­thread,­and­insert­the­screw.

Whenever­possible,­the­screws­for­axial­compression­should­be­placed­in­such­a­way­that­the­apex­of­the­fragment­is­drawn­into­the­open­wedge­between­plate­and­bone.­This­greatly­reduces­the­risk­of­the­fragment­slipping.

Alternative:­When­using­a­shaft­screw­with­an­unthreaded­portion­below­the­head,­overdrill­the­near­cortex­using­a­ tissue protecting sleeve or standard drill guide and an appropriately­sized­drill­bit­for­gliding­holes.

Compression Plate: Simple Fracture

Note: Required­drill­bits­for­threaded­and­gliding­holes­and­taps­for­the­individual­screw­sizes­can­be­found­in­the­chapter­“Screws,­Drills­and­Taps”­(refer­to­page­20­and­21).

Choose­a­plate­of­the­appropriate­length.­Ensure­that­there­are­enough­plate­holes­over­both­fragments­and­that­a­lag­screw­can­be­inserted­if­necessary.­

Illustrations­show­the­procedure­with­the­neutral­and­com-pression­drill­guide­of­the­LC-DCP­drill­guide­using­a­3.5­and­4.5­LC-DC­plate.

green

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2Drill second hole

Drill­through­both­cortices­into­the­opposite­fragment­with­the­yellow­drill­guide­in­compression­position­(arrow­points­towards­the­fracture).­Alternatively,­use­the­universal­drill­guide­placing­it­in­the­hole­remote­from­the­fracture.­Do­not­depress­it­(upper­part­stands­flush).

Determine­screw­length,­tap­the­thread,­and­insert­the­screw.

yellow

Whenever­possible,­the­screws­for­axial­compression­should­be­placed­in­such­a­way­that­the­apex­of­the­fragment­is­drawn­into­the­open­wedge­between­plate­and­bone.­This­greatly­reduces­the­risk­of­the­fragment­slipping.

Alternative: When­using­a­shaft­screw­with­an­unthreaded­portion­below­the­head,­overdrill­the­near­cortex­using­a­ tissue protecting sleeve or standard drill guide and an appropriately­sized­drill­bit­for­gliding­holes.

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3Insert interfragmentary lag screw

To­increase­stability­in­the­far­cortex­and­to­decrease­plate­wear,­insert­an­interfragmentary­lag­screw.­

Drill­through­both­cortices­with­an­universal­drill­guide­in­de-pressed­mode­(inner­sleeve­projects)­and­an­appropriately­sized­drill­bit­for­threaded­holes.­The­hemispheric­underside­of­the­universal­drill­guide­permits­ideal­positioning­of­the­screw­head.­

Widen­the­hole­in­the­near­cortex­with­a­drill­bit­for­gliding­holes.­Push­the­tissue­protecting­sleeve­upwards,­insert­the­drill­bit­into­the­hole,­then­slide­the­tissue­protecting­sleeve­down­until­it­touches­the­plate.­When­drilling,­care­should­be­taken­that­the­course­of­the­gliding­hole­follows­exactly­that­of­the­previous­drill­hole.­

As­an­alternative­to­a­regular­cortex­screw­a­shaft­screw,­used­as­a­lag­screw,­may­be­inserted.­This­ensures­efficient­gliding­of­the­screw­shaft­in­the­gliding­hole­resulting­in­a­considerably­higher­tension­effect.­Like­this­in­the­far­cortex­tension­is­achieved,­too.­

In­the­remaining­screw­holes­insert­screws­in­neutral­position­apart­from­the­hole­directly­above­the­fracture.­

Implant Removal In­case­the­physician­decides­to­remove­the­implants,­they­can­be­removed­by­using­general­surgical­instruments.

Compression­Plate:­Simple­Fracture

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Compression Plate: Multifragmentary Fracture

Note: Required­drill­bits­for­threaded­and­gliding­holes­and­taps­for­the­individual­screw­sizes­can­be­found­in­the­chapter­“Screws,­Drills­and­Taps”­(refer­to­page­20­and­21).

Fractures­should­be­treated­consecutively.

1Treat first fracture

For­treatment­of­the­first­fracture,­follow­the­previously­­described­example­step­by­step.­

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2Treat second fracture

Treat­the­second­fracture­using­the­universal­drill­guide.­Drill­a­hole­into­the­third­fragment­using­the­universal­drill­guide­in­compression­position­and­a­drill­bit­for­threaded­holes.­Seat­the­drill­guide­at­the­side­of­the­hole­remote­from­the­fracture­without­depressing­the­drill­guide­(upper­part­is­flush).­

Drill­a­gliding­hole,­measure­screw­length­and­tap­the­thread.

Insert­a­screw­into­the­hole.­The­use­of­a­shaft­screw­is­rec-ommended.

Next­insert­a­screw­into­the­middle­fragment.­Prepare­the­screw­hole­with­a­drill­bit­for­threaded­holes­and­the­univer-sal­drill­guide­depressed­for­neutral­position­(upper­part­of­inner­sleeve­projecting).

Compression­Plate:­Multifragmentary­Fracture

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Prepare­seating­for­the­lag­screw­with­the­universal­drill­guide­and­a­drill­bit­for­threaded­screws.­Position­the­univer-sal­drill­guide­adjacent­to­the­fracture,­depress­the­drill­guide­(inner­sleeve­projects),­set­drilling­angle­and­drill.­If­there­is­the­risk­of­the­drill­bit­colliding­with­the­screw­in­the­vicinity,­the­drill­bit­has­to­be­inclined.­

Place­the­screw.

By­inserting­a­shaft­screw­as­lag­screw,­additional­stability­is­achieved.­Tighten­lag­and­compression­screws­alternately.­The­remaining­screw­holes­are­filled­with­neutrally­placed­screws.

Drill­the­gliding­hole.­Widen­the­near­cortex­using­an­appro-priately­sized­drill­bit­for­gliding­holes­and­the­tissue­protect-ing­sleeve.­Measure­the­screw­length­and­tap­the­thread.

Implant Removal In­case­the­physician­decides­to­remove­the­implants,­they­can­be­removed­by­using­general­surgical­instruments.

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18 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

green

Buttress Plate

Note: Required­drill­bits­for­threaded­and­gliding­holes­and­taps­for­the­individual­screw­sizes­can­be­found­in­the­chapter­“Screws,­Drills­and­Taps”­(refer­to­page­20­and­21).

The­buttress­plate­technique­is­shown­using­the­example­of­a­shear­fracture­of­the­lateral­part­of­the­tibial­head­com-bined­with­a­short­oblique­fracture.­

First­the­distal­oblique­fracture­is­treated­as­in­the­previously­illustrated­examples.­

All­the­screw­holes­in­the­buttress­region­are­prepared­with­the­universal­drill­guide­or­the­green­drill­guide­(neutral­posi-tion)­of­the­LC-DCP­drill­guide.­

The­arrow­of­the­drill­guide­must­point­away­from­the­frac-ture.­The­proximally­positioned­cancellous­bone­screws­and­cortex­screws­act­as­lag­screws.­The­thread­grips­only­in­the­opposite­fragment,­so­that­there­is­compression­between­the­fragments.­The­use­of­the­green­drill­guide­with­the­arrow­pointing­away­from­the­fracture­prevents­the­tibial­plateau­fragment­and­the­plate­from­slipping.­In­this­situation,­the­screw­heads­are­buttressed­by­the­hole­edge­adjacent­to­the­fracture.

Implant Removal In­case­the­physician­decides­to­remove­the­implants,­they­can­be­removed­by­using­general­surgical­instruments.

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 19

green

Neutralization Plate (Protecting Plate)

Adapt­spiral­fracture­with­two­separate­lag­screws.­

Position­the­plate­to­bridge­the­fracture­using­the­LC-DCP­drill­guide­(3.5­and­4.5­screws­only)­or­the­universal­drill­guide.

When­using­the­green­drill­guide­of­the­LC-DCP­drill­guide­the­arrow­must­point­towards­the­fracture.­When­using­the­universal­drill­guide­seat­it­at­the­hole­edge­remote­from­the­fracture,­depress­the­outer­sleeve­so­that­the­upper­part­projects­for­neutral­position.­

To­complete­fracture­treatment,­determine­screw­lengths­and­insert­screws­after­having­tapped­the­threads­for­non-self-tapping­screws.

Implant Removal In­case­the­physician­decides­to­remove­the­implants,­they­can­be­removed­by­using­general­surgical­instruments.

Page 22: DCP and LC-DCP Systems. Dynamic Compression Plates (DCP ...

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21 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

Screws, Drills and Taps

Page 23: DCP and LC-DCP Systems. Dynamic Compression Plates (DCP ...

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0X6.000.343_AB.qxp:0X6.000.343 12.12.2008 9:23 Uhr Seite 1

Surgical Technique DCP and LC-DCP Systems DePuy Synthes 21

Page 24: DCP and LC-DCP Systems. Dynamic Compression Plates (DCP ...

22 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

Mini Fragment System 1.5, 2.0, 2.7

Cases and Modules

for­Stainless­Steel­ for­Titaniumimplants implants

305.500­ ­ 305.505­ ­Graphic­Case­for­Mini­Instrument­Set,­without­Contents

Instruments

311.111 Drill Bit B 1.1­mm,­length­60/35­mm,­2-flute,­for­Quick­Coupling

310.150­ Drill­Bit­B 1.5­mm,­length­85/60­mm,­2-flute,­for­Quick­Coupling

311.191 Drill Bit B 2.0­mm,­length­100/75­mm,­2-flute,­for­Quick­Coupling

311.261 Drill Bit B 2.7­mm,­length­100/75­mm,­2-flute,­for­Quick­Coupling

310.870­ Countersink­2.7,­length­62­mm

310.880­ Countersink­1.5­to­2.4,­length­52­mm,­ for­Mini­Quick­Coupling

310.950­ Handle­with­Mini­Quick­Coupling

311.010­ Handle­with­Mini­Quick­Coupling,­ Stainless Steel

311.150­ Tap­for­Cortex­Screws­B 1.5­mm,­ length­50/20­mm

311.190­ Tap­for­Cortex­Screws­B 2.0­mm,­ length­53/24­mm

311.260­ Tap­for­Cortex­Screws­B 2.7­mm,­ length­100/33­mm

311.430­ Handle­with­Quick­Coupling,­ length­110­mm

312.140­ Double­Drill­Guide­1.5/1.1,­for­No.­311.150

312.200­ Triple­Drill­Guide­2.0,­with­3­holes

312.220­ Double­Drill­Guide­2.0/1.5

312.240­ Double­Drill­Guide­2.7/2.0

314.020­ Screwdriver,­hexagonal,­small,­ with­Holding­Sleeve

314.030­ Screwdriver­Shaft,­hexagonal,­small,­ B 2.5­mm

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 23

314.060­ ­Holding­Sleeve,­for­Nos.­314.020,­314.030,­314.070,­314.550­and­314.570

314.670­ ­Screwdriver­Shaft­1.5/2.0,­cruciform,­ with­Holding­Sleeve,­length­66­mm,­blue

319.040­ Depth­Gauge­for­Screws,­measuring­range­up­to­50­mm

319.110­ Depth­Gauge­for­Screws­B 1.5­and­2.0­mm,­measuring­range­up­to­26­mm

319.390­ Sharp­Hook,­length­155­mm

319.970­ Screw­Forceps,­self-holding,­length­85­mm

329.010­ Bending­Iron­for­Plates­1.5­and­2.0,­ length­130­mm

329.120­ Bending­Pliers­for­Plates­1.5­to­2.7,­ length­140­mm

391.820­ Wire­Bending­Pliers,­length­155­mm,­ for­Wires­up­to­B 1.25­mm

391.950­ Cutting­Pliers­for­Plates­1.5­to­2.7,­ length­256­mm

391.970­ Wire­Cutter,­short,­length­175­mm

392.020­ Bending­Iron­for­Kirschner­Wires,­ for­Wires­B 0.8­to­1.25­mm

398.400­ Reduction­Forceps­with­Points,­narrow,­ratchet­lock,­length­132­mm

398.410­ Reduction­Forceps,­with­Points,­wide,­ratchet­lock,­length­132­mm

398.960­ Stagbeetle­Forceps,­ratchet­lock,­ length­125­mm

398.990­ Holding­Forceps­for­Small­Plates,­ ratchet­lock,­length­135­mm

399.000­ Holding­Forceps­for­Finger­Plates,­ ratchet­lock,­length­135­mm

399.180­ Bone­Lever,­small,­short­narrow­tip,­ width­6­mm,­length­160­mm

399.190­­ Bone­Lever,­small,­short­narrow­tip,­ width­8­mm,­length­160­mm

399.450­ Bone­Lever,­width­15­mm,­length­120­mm,­end­of­handle­ring-shaped

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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24 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

399.480­ ­Periosteal­Elevator,­slightly­curved­blade,­straight­edge,­width­3­mm,­ length­187/87­mm

399.970­ ­Reduction­Forceps­with­Points,­ ratchet­lock,­length­130­mm

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

Mini­Fragment­System­1.5,­2.0,­2.7

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 25

Plates

StainlessSteel

Titanium (TiCP)

246.190 446.190 Mini­Plate­1.5,­straight,­ 20­holes,­length­100­mm

246.230 446.230 Mini­T-Plate­1.5,­ head­3­holes,­shaft­9­holes,­length­50­mm

446.233 Mini­T-Plate­1.5,­ shaft­8­holes,­head­3­holes,­length­44­mm,­Pure­Titanium

446.234 Mini­T-Plate­1.5,­ shaft­8­holes,­head­4­holes,­length­44­mm,­Pure­Titanium

246.240 446.240 Mini­T-Plate­1.5,­ head­4­holes,­shaft­9­holes,­length­50­mm

246.480 446.480 Mini­H-Plate­1.5,­4­holes

246.610 Mini­Condylar­Plate­1.5,­ pin­left,­Stainless­Steel

246.620 Mini­Condylar­Plate­1.5,­ pin­right,­Stainless­Steel

446.630 Mini­Condylar­Plate­1.5,­ shaft­6­holes,­length­36­mm,­pin­left,­Pure­Titanium

446.640 Mini­Condylar­Plate­1.5,­ shaft­6­holes,­length­36­mm,­pin­right,­Pure­Titanium

243.090 Mini­Adaption­Plate­2.0,­ 20­holes,­length­100­mm

243.130 Mini­Plate­2.0,­straight,­ 3­holes,­length­17­mm

243.140 Mini­Plate­2.0,­straight,­ 4­holes,­length­23­mm

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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26 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

StainlessSteel

Titanium (TiCP)

243.150 Mini­Plate­2.0,­straight,­ 5­holes,­length­29­mm

243.160 Mini­Plate­2.0,­straight,­ 6­holes,­length­35­mm

243.190 443.190 Mini­Plate­2.0,­straight,­ 20­holes,­length­100­mm

243.230­ 443.230 Mini­T-Plate­2.0,­ head­3­holes,­shaft­9­holes,­length­50­mm

243.240 443.240 Mini­T-Plate­2.0,­ head­4­holes,­shaft­9­holes,­length­50­mm

243.310 Mini­L-Plate­2.0,­left,­ head­2­holes,­shaft­2­holes

243.320 Mini­L-Plate­2.0,­right,­ head­2­holes,­shaft­2­holes

243.330 Mini­L-Plate­2.0,­oblique,­left,­head­2­holes,­shaft­2­holes

243.340 Mini­L-Plate­2.0,­oblique,­right,­head­2­holes,­ shaft­2­holes

243.410 Mini­T-Plate­2.0,­ head­2­holes,­shaft­2­holes

243.540 443.540 DCP­2.0,­4­holes,­ length­22­mm

243.550 443.550 DCP­2.0,­5­holes,­ length­27­mm

243.560 443.560 DCP­2.0,­6­holes,­ length­32­mm

243.570 443.570 DCP­2.0,­7­holes,­ length­37­mm

243.580 443.580 DCP­2.0,­8­holes,­ length­42­mm

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

Mini­Fragment­System­1.5,­2.0,­2.7

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 27

StainlessSteel

Titanium (TiCP)

243.610 443.610 Mini­Condylar­Plate­2.0,­ pin­left

243.620 443.620 Mini­Condylar­Plate­2.0,­ pin­right

242.030 442.030­ Quarter­Tubular­Plate­2.7­with­Collar,­3­holes,­length­26­mm

242.040 442.040 Quarter­Tubular­Plate­2.7­with­Collar,­4­holes,­length­34­mm

242.050 442.050 Quarter­Tubular­Plate­2.7­with­Collar,­5­holes,­length­42­mm

242.060 442.060 Quarter­Tubular­Plate­2.7­with­Collar,­6­holes,­length­50­mm

242.070 442.070 Quarter­Tubular­Plate­2.7­with­Collar,­7­holes,­length­58­mm

242.080 442.080 Quarter­Tubular­Plate­2.7­with­Collar,­8­holes,­length­66­mm

242.310 L-Plate­2.7,­left,­shaft­3­holes,­head­2­holes

242.320 L-Plate­2.7,­right,­shaft­ 3­holes,­head­2­holes

242.330 442.330 L-Plate­2.7,­oblique,­left,­ shaft­3­holes,­head­2­holes

242.340 442.340 L-Plate­2.7,­oblique,­right,­shaft­3­holes,­head­2­holes

242.410 442.410 T-Plate­2.7,­shaft­3­holes,­head­2­holes

242.610 442.610 Condylar­Plate­2.7,­6­holes,­pin­left

242.620 442.620 Condylar­Plate­2.7,­6­holes,­pin­right

244.020 444.020 DCP­2.7,­2­holes,­ length­20­mm

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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28 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

StainlessSteel

Titanium (TiCP)

244.030 DCP­2.7,­3­holes,­ length­28­mm

244.040 444.040 DCP­2.7,­4­holes,­ length­36­mm

244.050 444.050 DCP­2.7,­5­holes,­ length­44­mm

244.060 444.060 DCP­2.7,­6­holes,­ length­52­mm

244.070 444.070 DCP­2.7,­7­holes,­ length­60­mm

244.080 444.080 DCP­2.7,­8­holes,­ length­68­mm

244.090 444.090 DCP­2.7,­9­holes,­ length­76­mm

244.100 444.100 DCP­2.7,­10­holes,­ length­84­mm

244.110 DCP­2.7,­11­holes,­ length­92­mm

244.120 444.120 DCP­2.7,­12­holes, length­100­mm

244.220 444.220 DCP­2.7,­2­holes, length­26­mm

449.936 LC-DCP­2.0,­6­holes,­ length­36­mm

449.938 LC-DCP­2.0,­8­holes,­ length­48­mm

449.931 LC-DCP­2.0,­4­holes,­ length­24­mm

LC-DCP® 2.7

242.204–242.222­ LC-DCP­2.7,­4­to­12­holes,­ length­41­to­113­mm,­Stainless­Steel*

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.*­Parts­only­available­non-sterile.

Mini­Fragment­System­1.5,­2.0,­2.7

Page 31: DCP and LC-DCP Systems. Dynamic Compression Plates (DCP ...

Surgical Technique DCP and LC-DCP Systems DePuy Synthes 29

Screws and Washers

Cortex Screw B 1.5 mm

Stainless Steel Titanium (TiCP) Length­(mm)

211.116 400.006 6

211.117 400.007 7

211.118 400.008 8

211.119 400.009 9

211.111 400.010 11

211.111 400.011 11

211.112 400.012 12

210.014 400.014 14

211.116 400.016 16

211.118 400.018 18

211.121 400.020 21

Cortex Screw B 2.0 mm

Stainless Steel Titanium (TiCP) Length­(mm)

211.116 401.006 6

211.118 401.008 8

211.111 401.010 11

211.112 401.012 12

211.014 401.014 14

211.116 401.016 16

211.118 401.018 18

211.121 401.020 21

211.122 401.022 22

211.024 401.024 24

211.126 26

211.128 28

211.131 31

211.132 32

211.034 34

211.136 36

211.138 38

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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31 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

Cortex Screw B 2.7 mm

Stainless Steel Titanium (TiCP) Length­(mm)

212.116 402.006 6

212.118 402.008 8

212.111 402.010 11

212.112 402.012 12

202.014 402.014 14

212.116 402.016 16

212.118 402.018 18

212.121 402.020 21

212.122 402.022 22

202.024 402.024 24

Washer B 7.0/3.6 mm

Stainless Steel Titanium (TiCP)

219.981 419.980 for­Screws­B 2.7­to­4.0­mm

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

Mini­Fragment­System­1.5,­2.0,­2.7

Page 33: DCP and LC-DCP Systems. Dynamic Compression Plates (DCP ...

Surgical Technique DCP and LC-DCP Systems DePuy Synthes 31

Also available (production on request)

243.000.509­ DCP­2.0,­9­holes,­Stainless­Steel

243.000.510­ DCP­2.0,­10­holes,­length­52­mm,­ Stainless Steel

243.000.512­ DCP­2.0,­12­holes,­length­62­mm,­ Stainless Steel

243.880­ Mini­T-Plate­1.5/2.0,­shaft­4­holes,­ length­35­mm,­Stainless­Steel

243.234­ T-Adaption­Plate­2.0,­head­3­holes,­ shaft­10­holes,­Stainless­Steel

310.511­ Drill­Bit­B 1.8­mm,­length­100/64­mm,­2-flute,­for­Jacobs­Chuck

310.531­ Drill­Bit­B 2.4­mm,­length­100/64­mm,­2-flute,­for­Jacobs­Chuck

Wires

Cerclage Wire

Stainless Steel B (mm) Length­(mm)

291.240 1.6 175

291.261 1.8 211

Kirschner WireWith trocar tip, pack of 10 units

Stainless Steel B (mm) Length­(mm)

292.161.11 1.6 71

292.181.11 1.8 71

292.111.11 1.1 150

292.121.11 1.25 150

292.161.11 1.6 150

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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32 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

Compact Hand 1.0, 1.3, 1.5, 2.0, 2.4

Compact Hand Module 1.0/1.3

Module

for­Stainless­ Steel implants

for­Titanium­ implants

682.483 682.480 Module­Compact­Hand­1.0/1.3,­with­Lid,­without­Contents,­green/yellow

Instruments

310.882­ Countersink­1.3­to­2.0,­length­50­mm,­ for­Mini­Quick­Coupling

312.133­ Double­Drill­Guide­1.3/1.0

314.413­ Screwdriver­Shaft­1.3,­cruciform,­ with­Holding­Sleeve,­length­62­mm,­ for­Mini­Quick­Coupling

314.481­ Screwdriver­Shaft­1.0,­cruciform,­ with­Holding­Sleeve,­length­62­mm,­ with­Mini­Quick­Coupling

316.385­ Drill­Bit­B 0.8­mm,­length­40/16­mm,­2-flute,­for­Mini­Quick­Coupling

513.005­ Drill­Bit­B 1.0­mm,­length­46/34­mm,­2-flute,­for­Mini­Quick­Coupling

513.035­ Drill­Bit­B 1.3­mm,­length­46/34­mm,­2-flute,­for­Mini­Quick­Coupling

Plates

StainlessSteel

Titanium (TiCP)

221.312 421.312 Adaption­Plate­1.3,­12­holes

221.321 421.320 Strut­Plate­1.3,­oblique- angled,­right,­8­holes

221.321 421.321 Strut­Plate­1.3,­oblique- angled,­left,­8­holes

221.333 421.333 T-Adaption­Plate­1.3,­ head­3­holes,­shaft­8­holes

221.334 421.334 T-Adaption­Plate­1.3,­ head­4­holes,­shaft­8­holes

221.335 421.335 Y-Adaption­Plate­1.3,­11­holes

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 33

Screws

Cortex Screw B 1.0 mm, self-tapping

Stainless Steel Titanium (TiCP) Length­(mm)

200.526 400.526 6

200.527 400.527 7

200.528 400.528 8

200.529 400.529 9

200.530 400.530 11

200.531 400.531 11

200.532 400.532 12

200.533 400.533 13

200.534 400.534 14

Cortex Screw B 1.3 mm, self-tapping

Stainless Steel Titanium (TiCP) Length­(mm)

211.686 400.686 6

211.687 400.687 7

211.688 400.688 8

211.689 400.689 9

211.691 400.690 11

211.691 400.691 11

211.692 400.692 12

211.693 400.693 13

200.694 400.694 14

200.695 400.695 15

211.696 400.696 16

211.698 400.698 18

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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34 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

Compact Hand Module 1.5

Module

for­Stainless­ Steel implants

for­Titanium­ implants

682.488 682.485 Module­Compact­Hand­1.5,­with­Lid,­without­Contents,­red

Instruments

310.880­ Countersink­1.5­to­2.4,­length­52­mm,­ for­Mini­Quick­Coupling

312.140­ Double­Drill­Guide­1.5/1.1,­for­No.­311.150

314.667­ Screwdriver­Shaft­1.5,­cruciform,­with­Holding­Sleeve,­length­66­mm,­with­Mini­Quick­Coupling

513.030­ Drill­Bit­B 1.1­mm,­length­45/33­mm,­2-flute,­for­Mini­Quick­Coupling

513.080­ Drill­Bit­B 1.5­mm,­length­52/40­mm,­2-flute,­for­Mini­Quick­Coupling

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

Compact­Hand­1.0,­1.3,­1.5,­2.0,­2.4

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 35

Plates

StainlessSteel

Titanium (TiCP)

246.191 446.191 Adaption­Plate­1.5,­12­holes

246.231 446.231 T-Adaption­Plate­1.5,­ head­3­holes,­shaft­8­holes

246.241 446.241 T-Adaption­Plate­1.5,­ head­4­holes,­shaft­8­holes

246.242 446.242 Y-Adaption­Plate­1.5,­ 11­holes,­prebent­profile

246.482 446.482 Strut­Plate­1.5,­oblique- angled,­right,­8­holes,­ prebent­profile

246.483 446.483 Strut­Plate­1.5,­oblique- angled,­left,­8­holes,­ prebent­profile

446.612 Y-Plate­1.5,­shaft­8­holes,­head­3­holes,­length­46­mm,­Pure Titanium

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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36 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

Screws

Cortex Screw B 1.5 mm, self-tapping

Stainless Steel Titanium alloy (TAN)

Length­(mm)

211.816 400.806 6

Stainless Steel Titanium (TiCP) Length­(mm)

211.817 400.807 7

211.818 400.808 8

211.819 400.809 9

211.811 400.810 11

211.811 400.811 11

211.812 400.812 12

211.813 400.813 13

200.814 400.814 14

211.816 400.816 16

211.818 400.818 18

211.821 400.820 21

211.822 400.822 22

200.824 400.824 24

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

Compact­Hand­1.0,­1.3,­1.5,­2.0,­2.4Compact­Hand­Module­1.5

Page 39: DCP and LC-DCP Systems. Dynamic Compression Plates (DCP ...

Surgical Technique DCP and LC-DCP Systems DePuy Synthes 37

Compact Hand Module 2.0

Module

for­Stainless­ Steel implants

for­Titanium­ implants

682.493 682.490 Module­Compact­Hand­2.0,­with­Lid,­without­Contents,­blue

Instruments

310.880­ Countersink­1.5­to­2.4,­length­52­mm,­ for­Mini­Quick­Coupling

312.220­ Double­Drill­Guide­2.0/1.5

314.672­­ Screwdriver­Shaft­2.0,­cruciform,­ with­Holding­Sleeve,­length­66­mm,­ with­Mini­Quick­Coupling

323.200­ Universal­Drill­Guide­2.0

513.090­ Drill­Bit­B 1.5­mm,­length­67/55­mm,­2-flute,­for­Mini­Quick­Coupling

513.140­­ Drill­Bit­B 2.0­mm,­length­67/55­mm,­2-flute,­for­Mini­Quick­Coupling

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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38 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

Plates

StainlessSteel

Titanium (TiCP)

223.588 443.588 LC-DCP­2.0,­8­holes,­ length­51­mm

243.091 443.091 Adaption­Plate­2.0,­12­holes

243.231 443.231 T-Adaption­Plate­2.0,­head­3­holes,­shaft­8­holes

243.241 443.241 T-Adaption­Plate­2.0,­ head­4­holes,­shaft­8­holes

243.242 443.242 Y-Adaption­Plate­2.0,­11­holes

243.480 443.480 Mini­H-Plate­2.0,­4­holes

243.584 443.584 LC-DCP­2.0,­4­holes,­ length­27­mm

243.585 443.585 LC-DCP­2.0,­5­holes,­ length­33­mm

243.586 443.586 LC-DCP­2.0,­6­holes,­ length­39­mm

243.587 443.587 LC-DCP­2.0,­7­holes,length­45­mm

447.032 Plate­2.0,­straight,­12­holes,­length­71­mm,­Pure­Titanium

447.232 T-Plate­2.0,­shaft­8­holes,­head­2­holes,­length­53­mm,­Pure Titanium

447.233 T-Plate­2.0,­shaft­8­holes,­head­3­holes,­length­53­mm,­Pure Titanium

447.612 Y-Plate­2.0,­3­+­8­holes,­length­55­mm,­Pure­Titanium

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

Compact­Hand­1.0,­1.3,­1.5,­2.0,­2.4Compact­Hand­Module­2.0

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 39

Screws

Cortex Screw B 2.0 mm, self-tapping

Stainless Steel Titanium alloy­(TAN)

Length­(mm)

211.816 401.806 6

211.817 401.807 7

211.818 401.808 8

211.819 401.809 9

211.811 401.810 11

211.811 401.811 11

211.812 401.812 12

211.813 401.813 13

201.814 401.814 14

211.816 401.816 16

211.818 401.818 18

211.821 401.820 21

211.822 401.822 22

201.824 401.824 24

211.826 401.826 26

211.828 401.828 28

211.831 401.830 31

211.832 401.832 32

201.834 401.834 34

211.836 401.836 36

211.838 401.838 38

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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41 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

Compact Hand Module 2.4

Module

for­Stainless­ Steel implants

for­Titanium­ implants

682.513 682.510 Module­Compact­Hand­2.4,­with­Lid,­without­Contents,­violet

Instruments

310.880­ Countersink­1.5­to­2.4,­length­52­mm,­ for­Mini­Quick­Coupling

312.920­ Drill­Sleeve­1.8,­with­centering­thread

313.940­ Screwdriver,­cruciform,­with­Holding­Sleeve,­for­Cortex­Screws­B 2.4­mm

314.672­ Screwdriver­Shaft­2.0,­cruciform,­ with­Holding­Sleeve,­length­66­mm,­ with­Mini­Quick­Coupling

317.861 Drill Bit B 1.8­mm,­length­80/66­mm,­2-flute,­for­Mini­Quick­Coupling

317.871 Drill Bit B 2.4­mm,­length­80/66­mm,­2-flute,­for­Mini­Quick­Coupling

323.202­ Universal­Drill­Guide­2.4

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

Compact­Hand­1.0,­1.3,­1.5,­2.0,­2.4

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 41

Plates

StainlessSteel

Titanium (TiCP)

449.906 Plate­2.4,­straight,­6­holes,­ 36­mm,­Pure­Titanium

249.912 449.912 Adaption­Plate­2.4,­12­holes,­for­Compact­Hand­2.4

249.913 449.913 T-Adaption­Plate­2.4,­ head­2­holes,­shaft­8­holes,­ for­Compact­Hand­2.4

249.914 449.914 T-Adaption­Plate­2.4,­ head­3­holes,­shaft­8­holes,­for­Compact­Hand­2.4

249.919 T-Adaption­Plate­2.4,­ head­3­holes,­shaft­10­holes

249.915 449.915 Y-Adaption­Plate­2.4,­ 11­holes,­for­Compact­ Hand­2.4

249.916 449.916 Condylar­Plate­2.4,­pin­right,­for­Compact­Hand­2.4

249.917 449.917 Condylar­Plate­2.4,­pin­left,­for­Compact­Hand­2.4

249.924 449.924 LC-DCP­2.4,­4­holes,­ length­35­mm,­for­Compact­Hand­2.4

249.926 449.926 LC-DCP­2.4,­6­holes,­ length­51­mm,­for­Compact­Hand­2.4

249.928 449.928 LC-DCP­2.4,­8­holes,­ length­67­mm,­for­Compact­Hand­2.4

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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42 DePuy Synthes DCP and LC-DCP Systems Surgical Technique Surgical Technique DCP and LC-DCP Systems DePuy Synthes 42

Screws and Buttress Pins

Cortex Screw B 2.4 mm, self-tapping, for Compact Hand 2.4

Stainless Steel Titanium alloy­(TAN)

Length­(mm)

211.636 401.636 6

211.637 401.637 7

211.638 401.638 8

211.639 401.639 9

201.640 401.640 11

201.641 401.641 11

201.642 401.642 12

201.643 401.643 13

201.644 401.644 14

201.646 401.646 16

201.648 401.648 18

201.650 401.650 21

201.652 401.652 22

201.654 401.654 24

201.656 401.656 26

201.658 401.658 28

211.661 401.660 31

211.662 401.662 32

201.664 401.664 34

211.666 401.666 36

211.668 401.668 38

211.671 401.670 40

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

Compact­Hand­1.0,­1.3,­1.5,­2.0,­2.4Compact­Hand­Module­2.4

Page 45: DCP and LC-DCP Systems. Dynamic Compression Plates (DCP ...

Surgical Technique DCP and LC-DCP Systems DePuy Synthes 43

Also available

446.032­ Plate­1.5,­straight,­12­holes,­length­59­mm,­Pure Titanium

446.031­ Plate­1.5,­straight,­6­holes,­length­29­mm,­Pure Titanium

Buttress Pin B 1.8 mm

Stainless Steel Titanium (TiCP)

Length­(mm)

211.962 401.962 12

201.964 401.964 14

211.966 401.966 16

211.968 401.968 18

Available­nonsterile­or­sterile-packed. Add­“S”­to­catalog­number­to­order­sterile­product.

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44 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

Cloverleaf Plate 3.5

241.830–241.860­ Cloverleaf­Plate­3.5,­shaft­3­to­6­holes,­ length­88­to­136­mm,­Stainless­Steel

441.830–441.860­ Cloverleaf­Plate­3.5,­shaft­3­to­6­holes,­ length­88­to­136­mm,­Pure­Titanium

One-third Tubular Plate 3.5 with Collar

241.320–241.420­ One-third­Tubular­Plate­3.5­with­Collar,­ 2­to­12­holes,­length­28­to­148­mm,­Stainless Steel

441.320–441.420­ One-third­Tubular­Plate­3.5­with­Collar,­2­to­12­holes,­length­28­to­148­mm,­Pure­Titanium

LC-DCP® Plate 3.5

223.520–223.640­ LC-DCP-Plate­3.5,­2­to­14­holes,­ length­25­to­181­mm,­Stainless­Steel

423.520–423.620­ LC-DCP-Plate­3.5,­2­to­12­holes,­ length­25­to­155­mm,­Pure­Titanium

DCP® Plate 3.5

248.020–248.160­ DCP-Plate­3.5,­­2­to­16­holes,­ length­26­to­194­mm,­Stainless­Steel

T-Plate 3.5

241.130–241.160­ T-Plate­3.5,­right-angled,­shaft­3­to­6­holes,­head­3­to­4­holes,­length­50­to­78­mm,­Stainless Steel

441.130–441.160­ T-Plate­3.5,­right-angled,­shaft­3­to­6­holes,­head­3­to­4­holes,­length­50­to­78­mm,­Pure Titanium

241.230–241.250­ T-Plate­3.5,­oblique-angled,­shaft­3­to­5­holes,­head­3­holes,­length­52­to­74­mm,­Stainless Steel

441.230–441.250­ T-Plate­3.5,­oblique-angled,­ shaft­3­to­5­holes,­head­3­holes,­ length­52­to­74­mm,­Pure­Titanium­

Compact­Hand­1.0,­1.3,­1.5,­2.0,­2.4

All­parts­above­are­available­non-sterile­or­sterile-packed.­Add­“S”­to­catalog­number­to­order­sterile­product.­

Small Fragment Plates 3.5

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 45

Large Fragment Plates 4.5

LC-DCP® 4.5

224.520–224.660­ LC-DCP­4.5,­narrow,­2­to­16­holes,­ length­34­to­286­mm,­Stainless­Steel­

424.520–424.660­ LC-DCP­4.5,­narrow,­2­to­16­holes,­ length­34­to­286­mm,­Pure­Titanium­

226.560–226.680­ LC-DCP­4.5,­broad,­6­to­18­holes,­ length­106­to­322­mm,­Stainless­Steel­

426.560–426.680­ LC-DCP­4.5,­broad,­6­to­18­holes,­ length­106­to­322­mm,­Pure­Titanium

DCP® 4.5

224.020–224.180­ DCP­4.5,­narrow,­2­to­18­holes,­ length­39­to­295­mm,­Stainless­Steel

226.060–226.180­ DCP­4.5,­broad,­6­to­18­holes,­ length­103­to­295­mm,­Stainless­Steel

T-Plate 4.5

240.110–240.190­ T-Plate­4.5,­shaft­3­to­11­holes,­ length­68­to­196­mm,­Stainless­Steel

440.130–440.180­ T-Plate­4.5,­3­to­8­holes,­ length­68­to­148­mm,­Pure­Titanium

T-Buttress Plate 4.5

240.340–240.360­ T-Buttress­Plate­4.5,­shaft­4­to­6­holes,­length­81­to­112­mm,­Stainless­Steel­

440.340-440.360­ T-Buttress­Plate­4.5,­shaft­4­to­6­holes,­length­81­to­112­mm,­Pure­Titanium*­

All­parts­above­are­available­non-sterile­or­sterile-packed.­ Add­"S"­to­catalog­number­to­order­sterile­product.­*­Parts­only­available­non-sterile.

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46 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

L-Buttress Plate 4.5

240.403–240.440­ L-Buttress­Plate­4.5,­right,­left-angled,­ shaft­3­to­6­holes,­length­69­to­117­mm,­Stainless Steel

440.440­ L-Buttress­Plate­4.5,­right,­left-angled,­ shaft­4­holes,­length­85­mm,­Pure­Titanium

240.503–240.540­ L-Buttress­Plate­4.5,­left,­right-angled,­ shaft­3­to­6­holes,­length­69­to­117­mm,­­Stainless Steel

440.540­ L-Buttress­Plate­4.5,­left,­right-angled,­ shaft­4­holes,­length­85­mm,­Pure­Titanium

Semi-Tubular Plate 4.5

222.020–222.120­ Semi-Tubular­Plate­4.5,­2­to­12­holes,­length­39­to­199­mm,­Stainless­Steel­

422.020–422.100­ Semi-Tubular­Plate­4.5,­2­to­10­holes,­length­39­to­167­mm,­Pure­Titanium

Condylar Buttress Plate 4.5

240.700–240.720­ Condylar­Buttress­Plate­4.5,­left,­ shaft­11­to­15­holes,­Stainless­Steel­

240.920–240.930­ Condylar­Buttress­Plate­4.5,­left,­ shaft­7­to­9­holes,­Stainless­Steel­

440.567–440.575­ Condylar­Buttress­Plate­4.5,­left,­ shaft­7­to­15­holes,­Pure­Titanium*­

240.730–240.750­ Condylar­Buttress­Plate­4.5,­right,­ shaft­11­to­15­holes,­Stainless­Steel

240.940–240.950­ Condylar­Buttress­Plate­4.5,­right,­ shaft­7­to­9­holes,­Stainless­Steel­

440.547–440.555­ Condylar­Buttress­Plate­4.5,­right,­ shaft­7­to­15­holes,­Pure­Titanium*­

All­parts­above­are­available­non-sterile­or­sterile-packed.­ Add­"S"­to­catalog­number­to­order­sterile­product.­*­Parts­only­available­non-sterile.

Compact­Hand­1.0,­1.3,­1.5,­2.0,­2.4Large­Fragment­Plates­4.5­­

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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 47

Lateral Tibial Head Buttress Plate 4.5

240.460–240.500­ Lateral­Tibial­Head­Buttress­Plate­4.5,­right,­shaft­5­to­13­holes,­length­118­to­246­mm,­Stainless Steel

440.515–440.523­ Lateral­Tibial­Head­Buttress­Plate­4.5,­right,­shaft­5­to­13­holes,­length­130­to­274­mm,­Pure Titanium

240.560–240.600­ Lateral­Tibial­Head­Buttress­Plate­4.5,­left,­shaft­5­to­13­holes,­length­118­to­246­mm,­Stainless Steel

440.525–440.533­ Lateral­Tibial­Head­Buttress­Plate­4.5,­left,­shaft­5­to­13­holes,­length­130­to­274­mm,­Pure Titanium

Proximal Tibial Plate 4.5

240.004­ Proximal­Tibial­Plate­4.5­right,­4­holes/ L­73­mm,­Stainless­Steel*

240.005­ Proximal­Tibial­Plate­4.5­left,­4­holes/ L­73­mm,­Stainless­Steel*

240.008­ Proximal­Tibial­Plate­4.5­right,­8­holes/ L­145­mm,­Stainless­Steel*

240.009­ Proximal­Tibial­Plate­4.5­left,­8­holes/ L­145­mm,­Stainless­Steel*

240.012­ Proximal­Tibial­Plate­4.5­right,­12­holes/ L­217­mm,­Stainless­Steel*

240.013­ Proximal­Tibial­Plate­4.5­left,­12­holes/ L­217­mm,­Stainless­Steel*

All­parts­above­are­available­non-sterile­or­sterile-packed.­ Add­"S"­to­catalog­number­to­order­sterile­product.­*­Parts­only­available­non-sterile.

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48 DePuy Synthes DCP and LC-DCP Systems Surgical Technique

MRI Information

Torque, Displacement and Image Artifacts according to ASTM F 2213-06, ASTM F 2052-06e1 and  ASTM F 2119-07Non-clinical­testing­of­worst­case­scenario­in­a­3 T­MRI­ system­did­not­reveal­any­relevant­torque­or­displacement­ of­the­construct­for­an­experimentally­measured­local­spatial­gradient­of­the­magnetic­field­of­3.69 T/m.­The­largest­image­­artifact­extended­approximately­169 mm­from­the­construct­when­scanned­using­the­Gradient­Echo­(GE).­Testing­was­­conducted­on­a­3 T­MRI­system.

Radio-Frequency-(RF-)induced heating according to ASTM F 2182-11aNon-clinical­electromagnetic­and­thermal­testing­of­worst­ case­scenario­lead­to­peak­temperature­rise­of­9.5 °C­ with­an­average­temperature­rise­of­6.6 °C­(1.5 T)­and­a­ peak­temperature­rise­of­5.9 °C­(3 T)­under­MRI­Conditions­­using­RF­Coils­(whole­body­averaged­specific­absorption­rate­[SAR]­of­2 W/kg­for­6 minutes­[1.5 T]­and­for­15 minutes­ [3 T]).

Precautions:­The­above­mentioned­test­relies­on­non-clini­- cal­testing.­The­actual­temperature­rise­in­the­patient­will­­depend­on­a­variety­of­factors­beyond­the­SAR­and­time­of­ RF­application.­Thus,­it­is­recommended­to­pay­particular­­attention­to­the­following­points: – It­is­recommended­to­thoroughly­monitor­patients­under-going­MR­scanning­for­perceived­temperature­and/or­pain­sensations.

– Patients­with­impaired­thermoregulation­or­temperature­­sensation­should­be­excluded­from­MR­scanning­proce­- dures.

– Generally,­it­is­recommended­to­use­a­MR­system­with­ low­field­strength­in­the­presence­of­conductive­implants.­ The­employed­specific­absorption­rate­(SAR)­should­be­ reduced­as­far­as­possible.

– Using­the­ventilation­system­may­further­contribute­to­ reduce­temperature­increase­in­the­body.

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