EXTERNAL FIXATION SYSTEM

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1. DJD II Body2. Humeral Guide3. Pin Insertion Guides4. Hoffmann® II Compact™ Instruments5. Hoffmann® II Compact™ Components and Apex® Pins

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The DJD II is a Dynamic Elbow Joint Distractor which extends

the range of the Hoffmann® II Compact™ System to treat post-

traumatic elbow stiffness as well as some acute elbow trauma

cases. Plus, it provides the same advantages as the Hoffmann II

Compact System in terms of ease of use, versatility and patient

comfort.

The two principal goals of the DJD II are to allow active or passive

motion of the elbow and to protect the elbow articular surfaces and

the collateral ligaments. Motion is allowed by a hinge which

replicates the elbow axis of rotation, while an integrated distraction

mechanism prevents the articular surfaces from damaging each other.

The DJD II may be used in either a monolateral or bilateral

configuration. This allows a great deal of flexibility in use and

indications.

Whatever the indications, the DJD II allows mobilization of the elbow

providing for earlier rehabilitation, facilitating the patient’s daily tasks

and increasing his/her comfort.

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Overview

IndicationsTrauma indicationsWhen protection of the articular surfaces is required:

– Coronoid fracture with or without fixation;

– Olecranon fracture with tenuous fixation;

– Distal humerus articular fractures;

– Unstable ulnohumeral joint after acute collateral ligamentdisruption;

– Combination of instability with any of the above fractures(complex instability).

Reconstruction indicationsAs an adjunct for individuals undergoing release of stiff elbow. This ismost common in the post-traumatic condition, but occasionally isused with inflammatory stiffness. The use of distraction is generallyindicated in these circumstances:

– There has been a significant amount of dissection suggestingthat maintaining the intraoperative motion will be difficult.

– If the pathology has modified the joint contour requiringrefashioning of the joint surface, with or without an interpositionmembrane.

– When an interposition procedure is performed.

– If the collateral ligament has been reconstructed or repaired inassociation with the release.

Contraindications– Inexperience with the use of external fixation devices is

considered a relative contraindication. Application of the DJD IIis technically demanding and requires accurate placement of theskeletal pins.

– If uncertainty exists with regard to the anatomic location of theneurovascular structures due to post-traumatic destruction of thejoint, the DJD II should be used only with extreme caution. Thepins, under these circumstances, may be inserted under directvision.

– Local sepsis is a relative contraindication to the application ofthe DJD II.

– The presence of some internal fracture fixation devices in thedistal humerus or proximal ulna.

– Pre-emptive medical condition, e.g. severe osteoporosis.

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Indications / Contraindications

• Simplified frame construction (only 1 major component)

• Most compact elbow external fixator

• Integrated hinge to replicate the elbow’s natural axis of rotation

• Integrated joint distraction mechanism

• Unilateral or bilateral frame configurations

• Highly versatile system

• Independent pin placement reduces the potential ofneurovascular injury

• Compatible with Hoffmann® II Compact™ couplings

• Compatible with Apex® pins

• Enters in the concept of a “unique external fixation family”

• Limited risk of elbow joint infection due to removable referencepin after frame positioning

• Simple, user friendly instrumentation

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Features & Benefits

The DJD II body has been specifically designed to provide

strength, reduce bulkiness and weight and simplify use.

• The DJD II body is composed of two 5mm diameter stainless

steel rods linked together by a hinge which includes an

integrated distraction mechanism to distract the elbow joint.

These elements cannot be disassembled from each other, which

contributes to the simplicity of the system.

• The DJD II body’s ulnar and humeral rods are compatible with

the Hoffmann® II Compact™ couplings. The complex anatomy of

the elbow makes independent pin placement a crucial advantage

in reducing the potential of neurovascular injury.

• The DJD II body bored hinge allows the positioning of the DJD II

body over the 3mm Apex® reference pin which has to be

previously inserted into the axis of rotation of the elbow (see

operative technique). Therefore, the DJD II body hinge is

designed to replicate the anatomical axis of rotation and allows

natural mobilization of the elbow. The removal of the reference

pin at the end of the surgery limits potential risk of elbow joint

infection.

N.B.: In case of bilateral frame configuration, the 3mm Apex

reference pin is replaced by a 3mm smooth transfixing pin, over

which the DJD II bodies are applied to both lateral and medial

sides. Once the frames are secured, the smooth transfixing pin

which replicates the elbow axis of rotation for both of the frames

is removed, thus reducing the risk of joint infection.

• The DJD II body distraction mechanism allows distraction up to

10mm (typically 2-3mm distraction is sufficient to accomplish the

goals of the procedure) without any additional components.

• The DJD II body distraction mechanism includes a graduated

scale to allow controlled distraction. Its 5mm square head screw

is identical to the 5mm square head screws of the Hoffmann II

Compact couplings allowing the use of the same wrench.

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DJD II Body

HumeralRod

DistractionScrew

UlnarRod

Hinge

Graduatedmillimeter scaleallows precisedistraction

Independent pin placement is a key factor to successful elbow

surgery where complex anatomy dictates the pin insertion

areas. The Hoffmann® II Compact™ pin-to-rod coupling has been

specifically designed to provide the freedom of single pin

placement with ease of use.

• Designed to accept 3 & 4mm Apex® pins and 5mm rods

• Integrated spring loaded snap-fit mechanism allows easy

assembly and temporary fixation during adjustment procedures

• Lateral entries with a “click” effect of the pin / rod

• Radially serrated tooth design provides excellent locking and

rotational stability

• Easy access top locking via a 5mm square head screw

The Hoffmann® II Compact™ rod-to-rod coupling connects two

5mm rods to each other. Thus, a 5mm rod can be placed between

the proximal humeral rod and the distal ulnar rod of the DJD II by

using two Hoffmann® II Compact™ rod-to-rod couplings. Such a

frame may be used to lock the joint in order to minimise elbow

joint movement during the first 24 hours after the surgery (see

operative technique).

• Designed to accept 5mm rods

• Integrated spring loaded snap-fit mechanism allows easy

assembly and temporary fixation during adjustment procedures

• Lateral entries with a “click” effect of the rods

• Radially serrated tooth design provides excellent locking and

rotational stability

• Easy access top locking via a 5mm square head screw

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Pin-to-Rod Coupling

Rod-to-Rod Coupling

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DJD II Frames Reference Guide

A B C

DJD II body 1 2 1(Cat No 5195-0-010)

Pin-to-rod coupling 4 8 4(Cat No 4940-1-020)

Apex® pins 4 8 4

A. Unilateral frame (Lateral) B. Bilateral frame

C. Unilateral frame (Medial)

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Components

Pre-operative X-ray Post-operative Post-operative Frame removalROM: 60° X-ray frame at 6 weeks

ROM: 120°

Case 1: Heterotopic bone formation after neurotrauma causing completeankylosis of the joint.

19 year old man

Case 2: Post-traumatic stiffness after supracondylar fracture.45 year old man

Pre-operative X-ray Post-operative Post-operative Frame removalRange of Motion (ROM): 0° X-ray frame at 6 weeks

ROM: 135°

Case 3: Fascia lata arthroplasty.Rheumatoid arthritis: right elbow joint ankylosis since 14 years.

52 year old woman

Pre-operative X-ray Post-operative Post-operative Frame removal at 6 weeksROM: 0° X-ray frame ROM: 85°

Pre-operative X-ray Post-operative Post-operative Frame removalROM: 60° X-ray frame at 6 weeks

ROM: 120°

Components

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Cat. No Description

DJD II component

5195-0-010 DJD II body

Hoffmann® II couplings

4940-1-010 Hoffmann® II Compact™ rod-to-rod coupling

4940-1-020 Hoffmann® II Compact™ pin-to-rod coupling

Recommended Hoffmann® II Compact™ rod

5049-5-250 Stainless Steel connecting rod 5mm x 250mm

5049-5-525 Carbon connecting rod 5mm x 250mm

Recommended Apex® 3 & 4mm pins

Self Drilling/Self Tapping

5038-5-080 Pin diameter 3mm, length 80mm, thread length 20mm

5038-2-110 Pin diameter 3mm, length 110mm, thread length 25mm

5023-2-090 Pin diameter 4mm, length 90mm, thread length 20mm

5023-3-120 Pin diameter 4mm, length 120mm, thread length 30mm

5023-5-150 Pin diameter 4mm, length 150mm, thread length 40mm

Blunt

5036-2-080 Pin diameter 3mm, length 80mm, thread length 20mm

5036-2-110 Pin diameter 3mm, length 110mm, thread length 25mm

5027-2-090 Pin diameter 4mm, length 90mm, thread length 20mm

5027-3-120 Pin diameter 4mm, length 120mm, thread length 30mm

5027-4-150 Pin diameter 4mm, length 150mm, thread length 40mm

Smooth transfixing pin (bilateral frame construction)

5045-5-200 Smooth transfixing diameter 3mm, length 200mm

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Instruments

Cat. No Description

DJD II specific instruments

5195-1-010 Humeral guide

5195-1-020 3mm pin insertion guide

5195-1-030 4mm pin insertion guide

Hoffmann® II Compact™ standard instruments

4940-9-030 5mm wrench / 3 & 4mm pin driver

5150-9-005 5mm spanner wrench

4940-9-010 Stabilization / reduction wrench

4920-9-020 Thumbwheel

Tray

5195-9-100 Storage and sterilization case

Stryker®, Hoffmann®, Hoffmann® II, Apex®, Monotube®, Triax™, Compact™ and Tenxor™are trademarks of Stryker Corporation.

Hoffmann®II Swiss Patent Application: 01-709/94-3. Other Patents Pending. * Patents: EU 385,929; 374,093;Canada 1,193,506; U.S. 5,160,335 and 5,207,676. ** Swiss Patent Application: 02-709/94-3. Other Patents Pending.*** Patents: EU 230,856; Swiss CH 671,150; U.S. 4,978,350.†Data on file at Stryker® Howmedica Osteonics USA.

Manufacturing location5 chemin des AulxCH-1228 Plan-les-OuatesGeneva, SwitzerlandTel: 00 41 22 884 0111Fax:00 41 22 884 0199

Cat. No: 5075-3-500

© 2001 Stryker Corporation. All rights reserved.0701

MANUFACTURER:

Unilateral frame system designed to handle a wide variety of fracturesand limb-lengthening applications. This simple, colour-coded systemoffers both dynamic and carbon tubes for individualised performanceand economy. True simplicity, versatility, and economy.

Modular frames which allow for true independent pin placement.Completely compatible with Original Hoffmann® components, thisnew system improves flexibility and ease-of-use, while enhancingframe economics through minimal componentry. It’s external fixationwith a “snap.”

Designed to complement the anatomy of the distal radius by allowing independentmovement of its clamps in multiple planes. Standard unilateral or bi-lateral bridgingframes for intra-articular fractures and peri-articular non-bridging frames for extra-articular fractures. Fully compatible with the Hoffmann® II System, based on aspring-loaded snap-fit mechanism that improves flexibility and ease-of-use.

The DJD II is a Dynamic Elbow Joint Distractor. Fully compatible withthe Hoffmann® II Compact™ System, it is designed to treat post-traumatic elbow stiffness as well as acute elbow trauma cases.

The Tenxor™ System is a hybrid system providing advanced technologyand ease of application. Fully compatible with Hoffmann® II andMonotube® Triax™, based on a spring-loaded, snap-fit mechanism thatimproves flexibility and ease of use.

Every Fixator incorporates the high quality pin-to-bone interfaceprovided by Apex® Pins. The Apex® Pin cuts more sharply with lesstorque, friction and heat upon insertion improving purchase whileminimising the risk of pin tract problems.† Available in self-drilling andblunt tip designs, only from Stryker® Howmedica Osteonics!

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™CompactEXTERNAL FIXATION SYSTEM

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E X T E R N A L F I X A T I O N S Y S T E M

onotube® TRIAX™