Small Fragment & Large Fragment Application Notes for ...
of 32
/32
Embed Size (px)
Transcript of Small Fragment & Large Fragment Application Notes for ...
Layout 1Locking Compression Technology by aap
1
Disclaimer
This surgical technique is exclusively intended for medical professionals, especially physicians, and the-
refore may not be regarded as a source of information for non-medical persons. The description of this
surgical technique does not constitute medical advice or medical recommendations nor does it convey
any diagnostic or therapeutic information on individual cases. Therefore, the attending physician is
fully responsible for providing medical advice to the patient and obtaining the informed consent of the
patient which this surgical technique does not supersede.
The description of this surgical technique has been compiled by medical experts and trained staff of
aap mplantate AG with utmost diligence and to the best of their knowledge. However, aap Implantate
AG excludes any liability for the completeness, accuracy, currentness, and quality of the information
as well as for material or immaterial damages arising from the use of this information.
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
2
Application Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 • Preoperative planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
• Preparing the plate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
• Insertion of cortical screws (gold) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
• Insertion of locking compression screws (red) without compression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
• Insertion of locking compression screws (red) with compression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
• Insertion of locking screws (blue) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Explantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Case Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
3Application Notes Small Fragment & Large Fragment
Content
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
4
Introduction
Since 1990, aap has been committed to providing innovative, high-quality and cost-effective solutions to meaningfully
improve daily experience of orthopedic surgeons and contribute to better patient outcomes.
LOQTEQ® anatomical locking plating system
combines the principles of bridging plate osteo-
synthesis and angle-stable interfragmentary
of a cone and a thread, which allows for angle-
stable interfragmentary fracture compression
step. The screw is gliding during tightening and
automatically safe locked in the plate hole.
In biomechanical testing against a leading com-
petitor, LOQTEQ® screw achieved double com-
pressive force and 2mm fracture compression
in a single screw hole.
LOQTEQ® plates have been engineered to provide stable mechanical fi-
xation, low hardware prominence and feature highly polished surface
for reduced soft-tissue ingrowth and ease of explantation.
LOQTEQ® system has been engineered with following features to faci-
litate surgeons comfort and improve the efficiency in the OR:
• Self-retaining screws
• Set modularity
The straight plates feature minor contact undercuts to minimize the
contact surface and thereby may reduce the damage to the perio-
steum.
thread
cone
250%
200%
150%
100%
50%
0
2,5
2,0
1,5
1,0
0,5
0
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
5Application Notes Small Fragment & Large Fragment
Introduction
Material
The LOQTEQ® implants and instruments are manufactured using high-quality materials, which have been proven to be
successful in medical technology for decades. The anatomical plates and bone screws are made of titanium alloy.
All materials employed comply with national and international standards. They are characterized by good biocompatibility,
a high degree of safety against allergic reactions and good mechanical properties.
LOQTEQ® implants show an excellent highly polished surface.
Indications/Contraindications
Indications
LOQTEQ® Straight Plate 3.5 / LOQTEQ® Reconstruction Plate 3.5 / LOQTEQ® ¹³ Tubular Plate 3.5
• Fixation of fractures, osteotomies, and non-unions of the scapula, olecranon, humerus, radius, ulna,
distal tibia, and fibula, particularly in osteopenic bone.
LOQTEQ® Narrow Plate 4.5 / LOQTEQ® Broad Plate 4.5
• Fixation of various long bones, such as the humerus, femur and tibia. It is also for use in fixation
of osteopenic bone and fixation of non-unions or malunions.
Contraindications
• Acute and chronic osteomylitis at or close to the surgical field
• Infection or inflammation (localized or systemic);
• Allergies against the implant material;
• High anesthesia risk patients;
• Insufficient soft tissue coverage;
• Fractures in children and adolescents with epiphyseal plates not yet ossified
In addition, the success of the operation may also be compromised by:
• Patients not cooperating and those with neurological disorders who
do not wish to or cannot follow instructions given by their physician;
• Allergies against the implant material;
• Past history of medical disorders of or surgery on the extremity in question;
• Severe chronic or acute comorbidity (such as arthritis; osteoporosis; neurogenic and vascular disorders; etc.)
• Patients not able to adhere to the rehabilitation protocol and patients for whom
the success of the procedure seems unlikely (for instance, in case of dementia);
• Simple fractures of non-osteoporotic bone.
Please refer to the instructions for use for detailed information on contraindications.
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
6
Introduction
The implants are supplied sterile and non-sterile.
Implants and instruments that are supplied in non-sterile condition must be sterilized before use.
For this purpose, please refer to the Instructions for Use that are enclosed with the plates, instruments, and trays.
Do not use (sterile) implants from damaged or open inner packaging.
Implant components that have come or might have come into contact with infectious fluids (e.g. blood) must not be
resterilized and reused in another surgery. They must be returned to the manufacturer. Resterilization is prohibited
under any circumstances (see Instructions for Use).
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
7Application Notes Small Fragment & Large Fragment
Introduction
titanium-grey
blue
blue
self-tapping
red
T15
self-tapping
blue
T15
Do not use in locking-
compression hole!
gl id
in g-
lo ck
in g
ho le
ro un
d- lo
ck in
g ho
1/3 Tubular Plate 3.5 round locking hole
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
8
Introduction
titanium-grey
titanium-grey
Implants (Large Fragment 4.5)
angle stable
without compression
Twist drill (no marking): ø3.2
gl id
in g-
lo ck
in g
ho le
gl id
in g-
lo ck
in g
ho le
9Application Notes Small Fragment & Large Fragment
Application Notes
The LOQTEQ® System includes many different plate types and can be used for treatment of a wide number of fracture
types. The primary focus of this surgical technique is the application of straight plates and does not deal with any
specific fracture type. Please refer to special literature for more specific fracture treatment options.
The novel combination of angular stability and compression in the straight plates and in the diaphyseal area of the
anatomical plates offers various fixation options to users:
• Interfragmentary compression with a locking screw
• Interfragmentary compression with a cortical screw
• Compression-free locking with a locking screw
• Compression-free fixation with a cortical screw
Surgical Technique
Preoperative planning • Evaluate the fracture type on the basis of the X-rays / CT and select
the appropriate plate length and screw positions.
Preparing the Plate • The straight plates may be contoured to individual patient anatomy.
The reconstruction plates feature bending elements to facilitate
the bending process. Use bending irons to contour the plates as
needed.
CauTION:
Observe the following while bending the plates:
• avoid repeatedly or excessively bending the plates
as it may result in implant failure.
• Bend the plate between the holes to prevent the loss of
locking function.
• avoid any sharp-edged damage by the instruments.
Reduction and primary fixation • For reduction and temporary fixation of the fragments place
K-wires or reduction forceps. Ensure that the K-wires will not
interfere with later plate positioning. If necessary, use lag screws
to secure intraarticular fragments.
INSTRUMENTS SMALL FRAGMENT ART.-NO. Bending iron 1 for small fragment plates, closed IP 8405-00 Bending iron 2 for small fragment plates, closed IP 8405-50 Drill guide for gliding hole LOQTEQ® 3.5, I-ø 2.8, red IU 8166-10 Reduction sleeve for K-wire ø1.6 IU 8166-16 K-wire with trocar point, ø1.6, L 180 NK 0016-18
INSTRUMENTS LARGE FRAGMENT ART.-NO. Drill guide for gliding hole LOQTEQ® 4.5, ID 3.9, red IU 8167-10 Reduction sleeve for K-wire ø2.0 IU 8167-15 K-wire with trocar point, ø2.0, L 250 NK 0020-25
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
10
• For inserting a non-locking cortical screw (gold) in a locking hole,
use the double drill guide in a neutral position, i.e. center in the
plate hole by applying slight pressure on the adjustable part. Drill
using a twist drill, determine the length of the screw using the depth
gauge, and insert a non locking cortical screw (gold) of the appro-
priate length.
locking compression screws (red) is used, non-locking cortical
screws (gold) must be inserted first.
• Check plate position using fluoroscopy and adjust if required.
Insertion of cortical screws (gold)
Application Notes
INSTRUMENTS SMALL FRAGMENT ART.-NO. Double drill guide, ø 2.7/3.5, with spring aided centering IU 8116-60 Twist drill ø2.7, L 150, coil 50, quick coupling IU 7427-15 Depth gauge for screws ø3.5 - 4.0, up to L 90 IS 7904-20 Screwdriver Duo, T15, quick coupling IU 7825-56
INSTRUMENTS LARGE FRAGMENT ART.-NO. Double drill guide ø3.2/4.5, with spring aided centering IU 8117-50 Twist drill ø3.2, L 195, coil 50, quick coupling IU 7432-30 Depth gauge for screws ø4.5 - 6.5, up to L 100 IS 7905-20 Handle with quick coupling, with torque limiter 3.5 Nm IU 7707-35
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
11Application Notes Small Fragment & Large Fragment
• Screw the drill guide (red) for gliding-locking holes into a plate
hole. Drill with the twist drill (blue / red) and remove the drill guide.
With the depth gauge, measure the screw length, insert a locking
compression screw (red) of the appropriate length and finally
tighten the screw with the torque limiter.
For this purpose, use only the enclosed screwdriver and finally
tighten the screw with the torque limiter. Optimal fixation is
reached once an audible click is heard.
NOTE:
as soon as the head of the screw reaches the plate hole it is
compulsory to switch to the torque limiter. In cases of very hard
bone in the diaphysis it is necessary to make sure that the screw
head is flush to the plate. Therefore, it is permissible in excep-
tionally hard bone of the diaphysis to finish the screw without
the torque limiter.
• For an optimal plate-to-screw connection, it is necessary to use
the drill guide (red) for gliding hole LOQTEQ® for the insertion of
locking screws. If the locking screw is inserted obliquely, the angu-
lar stability may be reduced.
NOTE:
locking screws with small heads (blue) ONLY in the intended
round locking holes (without compression).
For anatomical locking plates, please refer to the respective
surgical techniques.
Application Notes
INSTRUMENTS SMALL FRAGMENT ART.-NO. Twist drill ø 2.7, L 150, coil 50, quick coupling IU 7427-15 Drill guide for gliding hole LOQTEQ® 3.5, I-ø 2.8, red IU 8166-10 Depth gauge for screws ø3.5 - 4.0, up to L 90 IS 7904-20 Handle with quick coupling, with torque limiter 2.0 Nm IU 7707-20 Screwdriver Duo, T15, quick coupling IU 7825-56
INSTRUMENTS LARGE FRAGMENT ART.-NO. Twist drill ø3.8, L 180, coil 50, quick coupling IU 7438-18 Depth gauge for screws ø4.5 - 6.5, up to L 100 IS 7905-20 Handle with quick coupling, with torque limiter 3.5 Nm IU 7707-35 Screwdriver Duo, T25, quick coupling IU 7835-56
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
12
Application Notes
INSTRUMENTS SMALL FRAGMENT ART.-NO. Basic insert for load drill guide LOQTEQ® 3.5 IU 8166-05 Load drill guide LOQTEQ® 3.5, compression 1mm IU 8166-01 Load drill guide LOQTEQ® 3.5, compression 2mm IU 8166-02 Load drill guide LOQTEQ® 3.5, adjustable up to 2mm IU 8166-03
INSTRUMENTS LARGE FRAGMENT ART.-NO. Basic Insert for Load Drill Guide LOQTEQ® 4.5 IU 8167-05 Load Drill guide LOQTEQ® 4.5, compression 1mm IU 8167-01 Load Drill guide LOQTEQ® 4.5, compression 2mm IU 8167-02 Load Drill guide LOQTEQ® 4.5, adjustable up to 2mm IU 8167-03
• For combined shaft fractures, the required fracture compression
can be achieved by inserting a non-locking cortical screw or
LOQTEQ® locking compression screw into the compression position.
• Screw the basic insert for load drill guide into a shaft hole near the
fracture line or, if necessary, above the fracture line. Choose a load
drill guide in accordance with the compression distance (1mm or
2mm) and position on the basic insert away from the fracture gap.
• Alternatively, the adjustable load drill guide can be used. The frac-
ture gap serves as orientation in setting the compression distance
(max. 2mm). For this purpose, turn the wheel of the load drill guide
until an appropriate gap forms in the upper part of the instrument
and position the drill guide on the basic insert for load drill guide
away from the fracture gap.
• Drill to the desired depth using a twist drill
and determine the depth with the depth
gauge.
13
Application Notes
INSTRUMENTS SMALL FRAGMENT ART.-NO. Twist drill ø2.7, L 150, coil 50, quick coupling IU 7427-15 Depth gauge for screws ø3.5 - 4.0, up to L 90 IS 7904-20 Screwdriver Duo, T15, quick coupling IU 7825-56 Handle with quick coupling, with torque limiter 2.0Nm IU 7707-20 Large handle, cannulated, quick coupling IU 7706-00
Application Notes Small Fragment & Large Fragment
INSTRUMENTS LARGE FRAGMENT ART.-NO. Twist drill ø3.8, L 250, coil 50, quick coupling IU 7438-25 Depth gauge for screws ø4.5 - 6.5, up to L 100 IS 7905-20 Screwdriver Dou, T25,quick coupling IU 7835-56 Handle with quick coupling, with torque limiter 3.5 Nm IU 7707-35 Large handle, cannulated, quick coupling IU 7706-00
• Loosely insert a LOQTEQ® locking compression screw of the appro-
priate length with screwdriver and finally tighten the screw with
the torque limiter. Optimal fixation is achieved when an audible
click is heard.
Care should be taken to select the proper compression distance
(1 or 2mm). If the fracture gap is too small and the bone very
hard, excessive compression may prevent full locking of the
angle stable screw.
NOTE:
as soon as the head of the screw reaches the plate hole it is
compulsory to switch to the torque limiter. In cases of very hard
bone in the diaphysis it is necessary to make sure that the screw
head is flush to the plate. Therefore, it is permissible in excep-
tionally hard bone of the diaphysis to finish the screw without
the torque limiter.
• Alternatively, a non-locking cortical screw (gold) can be placed as a
compression screw. For this purpose, use the double drill guide in
offset position (do not apply pressure on the drill guide) and drill
using a twist drill.
• When all required screws have been inserted, perform final check
using fluoroscopy, AP and lateral, and close the wound.
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
14
Application Notes
INSTRUMENTS ART.-NO. Twist drill ø2.7, L 150, coil 50, quick coupling IU 7427-15 Drill guide for round hole LOQTEQ® 3.5, I-ø 2.8, blue IU 8166-20 Screwdriver Duo, T15, quick coupling IU 7825-56 Handle with quick coupling, with torque limiter 2.0Nm IU 7707-20 Depth gauge for screws ø3.5 - 4.0, up to L 90 IS 7904-20 Double drill guide, ø 2.7/3.5, with spring aided centering IU 8116-60
• Screw the drill guide (blue) for the round holes into a plate hole.
Drill with the twist drill (blue/red) and remove the drill guide.
Measure screw length using the depth gauge. Insert a round
locking hole screw (blue) using a screwdriver and a handle with
torque limiter.
only for Reconstruction Plate 3.5 and 1/3 Tubular Plate 3.5
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
15Application Notes Small Fragment & Large Fragment
NOTE:
removal. The explantation screwdrivers are not self-holding and
allow for higher torque transmission during screw removal. They
should be ordered separately.
The screwdriver in the set are self-holding and should not be
used for screw explantation.
• Place an incision on the old scar. Manually undo all screws and
sequentially remove them.
performed using a power tool.
Explantation
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
16
• The load drill guide facilitates setting a variable compression path.
It can be disassembled and reassembled in only a few steps.
N NOTE:
(Iu 8166-03/Iu 8167-03), please add a screwdriver hexagonal
2.5 (Iu 7825-00) together with your order.
• Remove screws (item 4.1 and 4.2) using a
hexagonal screwdriver 2.5
• Pull the compression block apart (items 1 and 2)
• Fit together the compression block (items 1 and 2)
• Insert the set screw (item 3) into the compression block,
middle hole
using a hexagonal srewdriver 2.5
Disassembly
assembly
17Application Notes Small Fragment & Large Fragment
Implants & Instruments Small Fragment 3.5
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
18
LOQTEQ® Straight Plate 3.5
HOLES LENGTH (mm)
4 60 PG 3555-04-2 5 73 PG 3555-05-2 6 86 PG 3555-06-2 7 99 PG 3555-07-2 8 112 PG 3555-08-2 9 125 PG 3555-09-2 10 138 PG 3555-10-2 11 151 PG 3555-11-2 12 164 PG 3555-12-2
LOQTEQ® Reconstruction Plate 3.5
HOLES LENGTH (mm)
5 58 PR 3550-05-2 6 70 PR 3550-06-2 7 82 PR 3550-07-2 8 94 PR 3550-08-2 9 106 PR 3550-09-2 10 118 PR 3550-10-2 12 142 PR 3550-12-2 14 166 PR 3550-14-2 16 190 PR 3550-16-2 18 214 PR 3550-18-2
LOQTEQ® ¹⁄³ Tubular Plate 3.5
HOLES LENGTH (mm)
3 40 PG 3553-03-2 4 52 PG 3553-04-2 5 64 PG 3553-05-2 6 76 PG 3553-06-2 7 88 PG 3553-07-2 8 100 PG 3553-08-2 9 112 PG 3553-09-2 10 124 PG 3553-10-2 11 136 PG 3553-11-2 12 148 PG 3553-12-2
For ordering of the sterile plates please add „S“ to the article number, e.g. PG 3555-04-2S
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
19Application Notes Small Fragment & Large Fragment
Small Fragment 3.5 Screws Implants
LOQTEQ® Cortical Screw 3.5, small head, T15, self-tapping
L 12 SK 3526-12-2 L 14 SK 3526-14-2 L 16 SK 3526-16-2 L 18 SK 3526-18-2 L 20 SK 3526-20-2 L 22 SK 3526-22-2 L 24 SK 3526-24-2 L 26 SK 3526-26-2 L 28 SK 3526-28-2 L 30 SK 3526-30-2 L 32 SK 3526-32-2 L 34 SK 3526-34-2 L 36 SK 3526-36-2 L 38 SK 3526-38-2 L 40 SK 3526-40-2 L 42 SK 3526-42-2 L 45 SK 3526-45-2 L 50 SK 3526-50-2 L 55 SK 3526-55-2 L 60 SK 3526-60-2 L 65 SK 3526-65-2 L 70 SK 3526-70-2 L 75 SK 3526-75-2 L 80 SK 3526-80-2 L 85 SK 3526-85-2
LOQTEQ® Cortical Screw 3.5, T15, self-tapping
L 12 SK 3525-12-2 L 14 SK 3525-14-2 L 16 SK 3525-16-2 L 18 SK 3525-18-2 L 20 SK 3525-20-2 L 22 SK 3525-22-2 L 24 SK 3525-24-2 L 26 SK 3525-26-2 L 28 SK 3525-28-2 L 30 SK 3525-30-2 L 32 SK 3525-32-2 L 34 SK 3525-34-2 L 36 SK 3525-36-2 L 38 SK 3525-38-2 L 40 SK 3525-40-2 L 42 SK 3525-42-2 L 45 SK 3525-45-2 L 50 SK 3525-50-2 L 55 SK 3525-55-2 L 60 SK 3525-60-2 L 65 SK 3525-65-2 L 70 SK 3525-70-2 - - - - - -
Cortical Screw 3.5, T15, self-tapping
L 12 SK 3514-12-2 L 14 SK 3514-14-2 L 16 SK 3514-16-2 L 18 SK 3514-18-2 L 20 SK 3514-20-2 L 22 SK 3514-22-2 L 24 SK 3514-24-2 L 26 SK 3514-26-2 L 28 SK 3514-28-2 L 30 SK 3514-30-2 L 32 SK 3514-32-2 L 34 SK 3514-34-2 L 36 SK 3514-36-2 L 38 SK 3514-38-2 L 40 SK 3514-40-2 L 42 SK 3514-42-2 L 45 SK 3514-45-2 L 50 SK 3514-50-2 L 55 SK 3514-55-2 L 60 SK 3514-60-2 L 65 SK 3514-65-2 L 70 SK 3514-70-2 L 75 SK 3514-75-2 L 80 SK 3514-80-2 L 85 SK 3514-85-2
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
20
Instruments Small Fragment 3.5
Bending iron 1 for small fragment plates, closed IP 8405-00 Bending iron 2 for small fragment plates, closed IP 8405-50
Depth gauge for screws ø3.5 - 4.0, up to L 90 IS 7904-20
Large handle, cannulated, quick coupling IU 7706-00
Handle with quick coupling, with torque limiter 2.0Nm IU 7707-20
Screwdriver Duo, T15, quick coupling IU 7825-56
Twist drill ø2.7, L 150, coil 50, quick coupling IU 7427-15* Twist drill ø2.7, L 220, coil 50, quick coupling IU 7427-22* Twist drill ø3.5, L 110, coil 50, quick coupling IU 7435-00*
* For ordering single use drills please add „-1u“ to the article number (e.g. Iu 7427-15-1u)
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
21Application Notes Small Fragment & Large Fragment
Instruments Small Fragment 3.5
Load Drill guide LOQTEQ® 3.5, compression 1mm IU 8166-01 Load Drill guide LOQTEQ® 3.5, compression 2mm IU 8166-02 Load Drill guide LOQTEQ® 3.5, adjustable up to 2mm IU 8166-03 Basic insert for load drill guide LOQTEQ® 3.5 IU 8166-05
Double drill guide ø2.7/3.5, with spring aided centering IU 8116-60
Drill guide for gliding hole LOQTEQ® 3.5, I-ø 2.8, red IU 8166-10
Reduction sleeve for K-wire ø1.6 IU 8166-16
Drill guide for round hole LOQTEQ® 3.5, I-ø 2.8, blue IU 8166-20
K-wire with trocar point, ø1.6, L 180 NK 0016-18
Screw forceps, self-holding IU 8004-00
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
23Application Notes Small Fragment & Large Fragment
Implants & Instruments Large Fragment 4.5
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
24
Plates Large Fragment 4.5 Implants
For ordering of the sterile plates please add „S“ to the article number, e.g. PG 4555-04-2S
LOQTEQ® Narrow Plate 4.5
HOLES LENGTH (mm)
4 72 PG 4555-04-2 5 90 PG 4555-05-2 6 108 PG 4555-06-2 7 126 PG 4555-07-2 8 144 PG 4555-08-2 9 162 PG 4555-09-2 10 180 PG 4555-10-2 11 198 PG 4555-11-2 12 216 PG 4555-12-2 14 252 PG 4555-14-2 16 288 PG 4555-16-2
LOQTEQ® Broad Plate 4.5
HOLES LENGTH (mm)
6 115 PG 4556-06-2 7 133 PG 4556-07-2 8 150 PG 4556-08-2 9 168 PG 4556-09-2 10 186 PG 4556-10-2 11 204 PG 4556-11-2 12 222 PG 4556-12-2 14 257 PG 4556-14-2 16 293 PG 4556-16-2 18 328 PG 4556-18-2
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
25Application Notes Small Fragment & Large Fragment
Large Fragment 4.5 Screws Implants
LOQTEQ® Cortical Screw 4.5, T25, self-tapping
L 12 SK 4525-12-2 L 14 SK 4525-14-2 L 16 SK 4525-16-2 L 18 SK 4525-18-2 L 20 SK 4525-20-2 L 22 SK 4525-22-2 L 24 SK 4525-24-2 L 26 SK 4525-26-2 L 28 SK 4525-28-2 L 30 SK 4525-30-2 L 32 SK 4525-32-2 L 34 SK 4525-34-2 L 36 SK 4525-36-2 L 38 SK 4525-38-2 L 40 SK 4525-40-2 L 42 SK 4525-42-2 L 45 SK 4525-45-2 L 50 SK 4525-50-2 L 55 SK 4525-55-2 L 60 SK 4525-60-2 L 65 SK 4525-65-2 L 70 SK 4525-70-2 L 75 SK 4525-75-2 L 80 SK 4525-80-2 L 85 SK 4525-85-2 L 90 SK 4525-90-2
Cortical Screw 4.5, T25, self-tapping
L 12 SK 4514-12-2 L 14 SK 4514-14-2 L 16 SK 4514-16-2 L 18 SK 4514-18-2 L 20 SK 4514-20-2 L 22 SK 4514-22-2 L 24 SK 4514-24-2 L 26 SK 4514-26-2 L 28 SK 4514-28-2 L 30 SK 4514-30-2 L 32 SK 4514-32-2 L 34 SK 4514-34-2 L 36 SK 4514-36-2 L 38 SK 4514-38-2 L 40 SK 4514-40-2 L 42 SK 4514-42-2 L 45 SK 4514-45-2 L 50 SK 4514-50-2 L 55 SK 4514-55-2 L 60 SK 4514-60-2 L 65 SK 4514-65-2 L 70 SK 4514-70-2 L 75 SK 4514-75-2 L 80 SK 4514-80-2 L 85 SK 4514-85-2 L 90 SK 4514-90-2
For ordering of the sterile screws please add „S“ to the article number, e.g. SK 4525-12-2S
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
26
Instruments Large Fragment 4.5
Depth gauge for screws ø4.5 - 6.5, up to L 100 IS 7905-20
Large handle, cannulated, quick coupling IU 7706-00
Handle with quick coupling, with torque limiter 3.5Nm IU 7707-35
Tap for cortical screws ø4.5, L 125 / 70 IU 7745-00
Screw forceps, self-holding IU 8004-00
Twist drill ø3.2, L 195, coil 50, quick coupling IU 7432-30* Twist drill ø3.8, L 180, coil 50, quick coupling IU 7438-18* Twist drill ø3.8, L 250, coil 50, quick coupling IU 7438-25* Twist drill ø4.5, L 145, coil 50, quick coupling IU 7445-00*
* For ordering single use drills please add „-1u“ to the article number (e.g. Iu 7432-30-1u)
Screwdriver Duo, T25, quick coupling IU 7835-56
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
27Application Notes Small Fragment & Large Fragment
Instruments Large Fragment 4.5
Load drill guide LOQTEQ® 4.5, compression 1mm IU 8167-01 Load drill guide LOQTEQ® 4.5, compression 2mm IU 8167-02 Load drill guide LOQTEQ® 4.5, adjustable up to 2mm IU 8167-03 Basic insert for load drill guide LOQTEQ® 4.5 IU 8167-05
Double drill guide ø3.2/4.5, with spring aided centering IU 8117-50
Drill guide for gliding hole LOQTEQ® 4.5, I-ø 3.9, red IU 8167-10
Reduction sleeve for K-wire ø2.0 IU 8167-15
K-wire with trocar point, ø2.0, L 250 NK 0020-25
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
28
Ulna shortening osteotomy
Preoperative Postoperative
Clinical case and CT images with the kind permission of Asklepios Clinic Weißenfels, Germany
Clinical case and CT images with the kind permission of University Hospital Gießen and Marburg, Germany
Preoperative Postoperative
Layout, typesetting: deSIGN graphic - Wolfram Passlack
Illustrations: Karen Hilberg
[email protected] www.aap.de
[email protected] www.aap.de (0
1) 04 04 24 09 36 48 53 (1 0) 16 08
W P 4A H 01 0 EN
/1 60 8
1
Disclaimer
This surgical technique is exclusively intended for medical professionals, especially physicians, and the-
refore may not be regarded as a source of information for non-medical persons. The description of this
surgical technique does not constitute medical advice or medical recommendations nor does it convey
any diagnostic or therapeutic information on individual cases. Therefore, the attending physician is
fully responsible for providing medical advice to the patient and obtaining the informed consent of the
patient which this surgical technique does not supersede.
The description of this surgical technique has been compiled by medical experts and trained staff of
aap mplantate AG with utmost diligence and to the best of their knowledge. However, aap Implantate
AG excludes any liability for the completeness, accuracy, currentness, and quality of the information
as well as for material or immaterial damages arising from the use of this information.
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
2
Application Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 • Preoperative planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
• Preparing the plate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
• Insertion of cortical screws (gold) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
• Insertion of locking compression screws (red) without compression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
• Insertion of locking compression screws (red) with compression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
• Insertion of locking screws (blue) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Explantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15
Case Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
3Application Notes Small Fragment & Large Fragment
Content
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
4
Introduction
Since 1990, aap has been committed to providing innovative, high-quality and cost-effective solutions to meaningfully
improve daily experience of orthopedic surgeons and contribute to better patient outcomes.
LOQTEQ® anatomical locking plating system
combines the principles of bridging plate osteo-
synthesis and angle-stable interfragmentary
of a cone and a thread, which allows for angle-
stable interfragmentary fracture compression
step. The screw is gliding during tightening and
automatically safe locked in the plate hole.
In biomechanical testing against a leading com-
petitor, LOQTEQ® screw achieved double com-
pressive force and 2mm fracture compression
in a single screw hole.
LOQTEQ® plates have been engineered to provide stable mechanical fi-
xation, low hardware prominence and feature highly polished surface
for reduced soft-tissue ingrowth and ease of explantation.
LOQTEQ® system has been engineered with following features to faci-
litate surgeons comfort and improve the efficiency in the OR:
• Self-retaining screws
• Set modularity
The straight plates feature minor contact undercuts to minimize the
contact surface and thereby may reduce the damage to the perio-
steum.
thread
cone
250%
200%
150%
100%
50%
0
2,5
2,0
1,5
1,0
0,5
0
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
5Application Notes Small Fragment & Large Fragment
Introduction
Material
The LOQTEQ® implants and instruments are manufactured using high-quality materials, which have been proven to be
successful in medical technology for decades. The anatomical plates and bone screws are made of titanium alloy.
All materials employed comply with national and international standards. They are characterized by good biocompatibility,
a high degree of safety against allergic reactions and good mechanical properties.
LOQTEQ® implants show an excellent highly polished surface.
Indications/Contraindications
Indications
LOQTEQ® Straight Plate 3.5 / LOQTEQ® Reconstruction Plate 3.5 / LOQTEQ® ¹³ Tubular Plate 3.5
• Fixation of fractures, osteotomies, and non-unions of the scapula, olecranon, humerus, radius, ulna,
distal tibia, and fibula, particularly in osteopenic bone.
LOQTEQ® Narrow Plate 4.5 / LOQTEQ® Broad Plate 4.5
• Fixation of various long bones, such as the humerus, femur and tibia. It is also for use in fixation
of osteopenic bone and fixation of non-unions or malunions.
Contraindications
• Acute and chronic osteomylitis at or close to the surgical field
• Infection or inflammation (localized or systemic);
• Allergies against the implant material;
• High anesthesia risk patients;
• Insufficient soft tissue coverage;
• Fractures in children and adolescents with epiphyseal plates not yet ossified
In addition, the success of the operation may also be compromised by:
• Patients not cooperating and those with neurological disorders who
do not wish to or cannot follow instructions given by their physician;
• Allergies against the implant material;
• Past history of medical disorders of or surgery on the extremity in question;
• Severe chronic or acute comorbidity (such as arthritis; osteoporosis; neurogenic and vascular disorders; etc.)
• Patients not able to adhere to the rehabilitation protocol and patients for whom
the success of the procedure seems unlikely (for instance, in case of dementia);
• Simple fractures of non-osteoporotic bone.
Please refer to the instructions for use for detailed information on contraindications.
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
6
Introduction
The implants are supplied sterile and non-sterile.
Implants and instruments that are supplied in non-sterile condition must be sterilized before use.
For this purpose, please refer to the Instructions for Use that are enclosed with the plates, instruments, and trays.
Do not use (sterile) implants from damaged or open inner packaging.
Implant components that have come or might have come into contact with infectious fluids (e.g. blood) must not be
resterilized and reused in another surgery. They must be returned to the manufacturer. Resterilization is prohibited
under any circumstances (see Instructions for Use).
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
7Application Notes Small Fragment & Large Fragment
Introduction
titanium-grey
blue
blue
self-tapping
red
T15
self-tapping
blue
T15
Do not use in locking-
compression hole!
gl id
in g-
lo ck
in g
ho le
ro un
d- lo
ck in
g ho
1/3 Tubular Plate 3.5 round locking hole
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
8
Introduction
titanium-grey
titanium-grey
Implants (Large Fragment 4.5)
angle stable
without compression
Twist drill (no marking): ø3.2
gl id
in g-
lo ck
in g
ho le
gl id
in g-
lo ck
in g
ho le
9Application Notes Small Fragment & Large Fragment
Application Notes
The LOQTEQ® System includes many different plate types and can be used for treatment of a wide number of fracture
types. The primary focus of this surgical technique is the application of straight plates and does not deal with any
specific fracture type. Please refer to special literature for more specific fracture treatment options.
The novel combination of angular stability and compression in the straight plates and in the diaphyseal area of the
anatomical plates offers various fixation options to users:
• Interfragmentary compression with a locking screw
• Interfragmentary compression with a cortical screw
• Compression-free locking with a locking screw
• Compression-free fixation with a cortical screw
Surgical Technique
Preoperative planning • Evaluate the fracture type on the basis of the X-rays / CT and select
the appropriate plate length and screw positions.
Preparing the Plate • The straight plates may be contoured to individual patient anatomy.
The reconstruction plates feature bending elements to facilitate
the bending process. Use bending irons to contour the plates as
needed.
CauTION:
Observe the following while bending the plates:
• avoid repeatedly or excessively bending the plates
as it may result in implant failure.
• Bend the plate between the holes to prevent the loss of
locking function.
• avoid any sharp-edged damage by the instruments.
Reduction and primary fixation • For reduction and temporary fixation of the fragments place
K-wires or reduction forceps. Ensure that the K-wires will not
interfere with later plate positioning. If necessary, use lag screws
to secure intraarticular fragments.
INSTRUMENTS SMALL FRAGMENT ART.-NO. Bending iron 1 for small fragment plates, closed IP 8405-00 Bending iron 2 for small fragment plates, closed IP 8405-50 Drill guide for gliding hole LOQTEQ® 3.5, I-ø 2.8, red IU 8166-10 Reduction sleeve for K-wire ø1.6 IU 8166-16 K-wire with trocar point, ø1.6, L 180 NK 0016-18
INSTRUMENTS LARGE FRAGMENT ART.-NO. Drill guide for gliding hole LOQTEQ® 4.5, ID 3.9, red IU 8167-10 Reduction sleeve for K-wire ø2.0 IU 8167-15 K-wire with trocar point, ø2.0, L 250 NK 0020-25
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
10
• For inserting a non-locking cortical screw (gold) in a locking hole,
use the double drill guide in a neutral position, i.e. center in the
plate hole by applying slight pressure on the adjustable part. Drill
using a twist drill, determine the length of the screw using the depth
gauge, and insert a non locking cortical screw (gold) of the appro-
priate length.
locking compression screws (red) is used, non-locking cortical
screws (gold) must be inserted first.
• Check plate position using fluoroscopy and adjust if required.
Insertion of cortical screws (gold)
Application Notes
INSTRUMENTS SMALL FRAGMENT ART.-NO. Double drill guide, ø 2.7/3.5, with spring aided centering IU 8116-60 Twist drill ø2.7, L 150, coil 50, quick coupling IU 7427-15 Depth gauge for screws ø3.5 - 4.0, up to L 90 IS 7904-20 Screwdriver Duo, T15, quick coupling IU 7825-56
INSTRUMENTS LARGE FRAGMENT ART.-NO. Double drill guide ø3.2/4.5, with spring aided centering IU 8117-50 Twist drill ø3.2, L 195, coil 50, quick coupling IU 7432-30 Depth gauge for screws ø4.5 - 6.5, up to L 100 IS 7905-20 Handle with quick coupling, with torque limiter 3.5 Nm IU 7707-35
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
11Application Notes Small Fragment & Large Fragment
• Screw the drill guide (red) for gliding-locking holes into a plate
hole. Drill with the twist drill (blue / red) and remove the drill guide.
With the depth gauge, measure the screw length, insert a locking
compression screw (red) of the appropriate length and finally
tighten the screw with the torque limiter.
For this purpose, use only the enclosed screwdriver and finally
tighten the screw with the torque limiter. Optimal fixation is
reached once an audible click is heard.
NOTE:
as soon as the head of the screw reaches the plate hole it is
compulsory to switch to the torque limiter. In cases of very hard
bone in the diaphysis it is necessary to make sure that the screw
head is flush to the plate. Therefore, it is permissible in excep-
tionally hard bone of the diaphysis to finish the screw without
the torque limiter.
• For an optimal plate-to-screw connection, it is necessary to use
the drill guide (red) for gliding hole LOQTEQ® for the insertion of
locking screws. If the locking screw is inserted obliquely, the angu-
lar stability may be reduced.
NOTE:
locking screws with small heads (blue) ONLY in the intended
round locking holes (without compression).
For anatomical locking plates, please refer to the respective
surgical techniques.
Application Notes
INSTRUMENTS SMALL FRAGMENT ART.-NO. Twist drill ø 2.7, L 150, coil 50, quick coupling IU 7427-15 Drill guide for gliding hole LOQTEQ® 3.5, I-ø 2.8, red IU 8166-10 Depth gauge for screws ø3.5 - 4.0, up to L 90 IS 7904-20 Handle with quick coupling, with torque limiter 2.0 Nm IU 7707-20 Screwdriver Duo, T15, quick coupling IU 7825-56
INSTRUMENTS LARGE FRAGMENT ART.-NO. Twist drill ø3.8, L 180, coil 50, quick coupling IU 7438-18 Depth gauge for screws ø4.5 - 6.5, up to L 100 IS 7905-20 Handle with quick coupling, with torque limiter 3.5 Nm IU 7707-35 Screwdriver Duo, T25, quick coupling IU 7835-56
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
12
Application Notes
INSTRUMENTS SMALL FRAGMENT ART.-NO. Basic insert for load drill guide LOQTEQ® 3.5 IU 8166-05 Load drill guide LOQTEQ® 3.5, compression 1mm IU 8166-01 Load drill guide LOQTEQ® 3.5, compression 2mm IU 8166-02 Load drill guide LOQTEQ® 3.5, adjustable up to 2mm IU 8166-03
INSTRUMENTS LARGE FRAGMENT ART.-NO. Basic Insert for Load Drill Guide LOQTEQ® 4.5 IU 8167-05 Load Drill guide LOQTEQ® 4.5, compression 1mm IU 8167-01 Load Drill guide LOQTEQ® 4.5, compression 2mm IU 8167-02 Load Drill guide LOQTEQ® 4.5, adjustable up to 2mm IU 8167-03
• For combined shaft fractures, the required fracture compression
can be achieved by inserting a non-locking cortical screw or
LOQTEQ® locking compression screw into the compression position.
• Screw the basic insert for load drill guide into a shaft hole near the
fracture line or, if necessary, above the fracture line. Choose a load
drill guide in accordance with the compression distance (1mm or
2mm) and position on the basic insert away from the fracture gap.
• Alternatively, the adjustable load drill guide can be used. The frac-
ture gap serves as orientation in setting the compression distance
(max. 2mm). For this purpose, turn the wheel of the load drill guide
until an appropriate gap forms in the upper part of the instrument
and position the drill guide on the basic insert for load drill guide
away from the fracture gap.
• Drill to the desired depth using a twist drill
and determine the depth with the depth
gauge.
13
Application Notes
INSTRUMENTS SMALL FRAGMENT ART.-NO. Twist drill ø2.7, L 150, coil 50, quick coupling IU 7427-15 Depth gauge for screws ø3.5 - 4.0, up to L 90 IS 7904-20 Screwdriver Duo, T15, quick coupling IU 7825-56 Handle with quick coupling, with torque limiter 2.0Nm IU 7707-20 Large handle, cannulated, quick coupling IU 7706-00
Application Notes Small Fragment & Large Fragment
INSTRUMENTS LARGE FRAGMENT ART.-NO. Twist drill ø3.8, L 250, coil 50, quick coupling IU 7438-25 Depth gauge for screws ø4.5 - 6.5, up to L 100 IS 7905-20 Screwdriver Dou, T25,quick coupling IU 7835-56 Handle with quick coupling, with torque limiter 3.5 Nm IU 7707-35 Large handle, cannulated, quick coupling IU 7706-00
• Loosely insert a LOQTEQ® locking compression screw of the appro-
priate length with screwdriver and finally tighten the screw with
the torque limiter. Optimal fixation is achieved when an audible
click is heard.
Care should be taken to select the proper compression distance
(1 or 2mm). If the fracture gap is too small and the bone very
hard, excessive compression may prevent full locking of the
angle stable screw.
NOTE:
as soon as the head of the screw reaches the plate hole it is
compulsory to switch to the torque limiter. In cases of very hard
bone in the diaphysis it is necessary to make sure that the screw
head is flush to the plate. Therefore, it is permissible in excep-
tionally hard bone of the diaphysis to finish the screw without
the torque limiter.
• Alternatively, a non-locking cortical screw (gold) can be placed as a
compression screw. For this purpose, use the double drill guide in
offset position (do not apply pressure on the drill guide) and drill
using a twist drill.
• When all required screws have been inserted, perform final check
using fluoroscopy, AP and lateral, and close the wound.
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
14
Application Notes
INSTRUMENTS ART.-NO. Twist drill ø2.7, L 150, coil 50, quick coupling IU 7427-15 Drill guide for round hole LOQTEQ® 3.5, I-ø 2.8, blue IU 8166-20 Screwdriver Duo, T15, quick coupling IU 7825-56 Handle with quick coupling, with torque limiter 2.0Nm IU 7707-20 Depth gauge for screws ø3.5 - 4.0, up to L 90 IS 7904-20 Double drill guide, ø 2.7/3.5, with spring aided centering IU 8116-60
• Screw the drill guide (blue) for the round holes into a plate hole.
Drill with the twist drill (blue/red) and remove the drill guide.
Measure screw length using the depth gauge. Insert a round
locking hole screw (blue) using a screwdriver and a handle with
torque limiter.
only for Reconstruction Plate 3.5 and 1/3 Tubular Plate 3.5
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
15Application Notes Small Fragment & Large Fragment
NOTE:
removal. The explantation screwdrivers are not self-holding and
allow for higher torque transmission during screw removal. They
should be ordered separately.
The screwdriver in the set are self-holding and should not be
used for screw explantation.
• Place an incision on the old scar. Manually undo all screws and
sequentially remove them.
performed using a power tool.
Explantation
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
16
• The load drill guide facilitates setting a variable compression path.
It can be disassembled and reassembled in only a few steps.
N NOTE:
(Iu 8166-03/Iu 8167-03), please add a screwdriver hexagonal
2.5 (Iu 7825-00) together with your order.
• Remove screws (item 4.1 and 4.2) using a
hexagonal screwdriver 2.5
• Pull the compression block apart (items 1 and 2)
• Fit together the compression block (items 1 and 2)
• Insert the set screw (item 3) into the compression block,
middle hole
using a hexagonal srewdriver 2.5
Disassembly
assembly
17Application Notes Small Fragment & Large Fragment
Implants & Instruments Small Fragment 3.5
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
18
LOQTEQ® Straight Plate 3.5
HOLES LENGTH (mm)
4 60 PG 3555-04-2 5 73 PG 3555-05-2 6 86 PG 3555-06-2 7 99 PG 3555-07-2 8 112 PG 3555-08-2 9 125 PG 3555-09-2 10 138 PG 3555-10-2 11 151 PG 3555-11-2 12 164 PG 3555-12-2
LOQTEQ® Reconstruction Plate 3.5
HOLES LENGTH (mm)
5 58 PR 3550-05-2 6 70 PR 3550-06-2 7 82 PR 3550-07-2 8 94 PR 3550-08-2 9 106 PR 3550-09-2 10 118 PR 3550-10-2 12 142 PR 3550-12-2 14 166 PR 3550-14-2 16 190 PR 3550-16-2 18 214 PR 3550-18-2
LOQTEQ® ¹⁄³ Tubular Plate 3.5
HOLES LENGTH (mm)
3 40 PG 3553-03-2 4 52 PG 3553-04-2 5 64 PG 3553-05-2 6 76 PG 3553-06-2 7 88 PG 3553-07-2 8 100 PG 3553-08-2 9 112 PG 3553-09-2 10 124 PG 3553-10-2 11 136 PG 3553-11-2 12 148 PG 3553-12-2
For ordering of the sterile plates please add „S“ to the article number, e.g. PG 3555-04-2S
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
19Application Notes Small Fragment & Large Fragment
Small Fragment 3.5 Screws Implants
LOQTEQ® Cortical Screw 3.5, small head, T15, self-tapping
L 12 SK 3526-12-2 L 14 SK 3526-14-2 L 16 SK 3526-16-2 L 18 SK 3526-18-2 L 20 SK 3526-20-2 L 22 SK 3526-22-2 L 24 SK 3526-24-2 L 26 SK 3526-26-2 L 28 SK 3526-28-2 L 30 SK 3526-30-2 L 32 SK 3526-32-2 L 34 SK 3526-34-2 L 36 SK 3526-36-2 L 38 SK 3526-38-2 L 40 SK 3526-40-2 L 42 SK 3526-42-2 L 45 SK 3526-45-2 L 50 SK 3526-50-2 L 55 SK 3526-55-2 L 60 SK 3526-60-2 L 65 SK 3526-65-2 L 70 SK 3526-70-2 L 75 SK 3526-75-2 L 80 SK 3526-80-2 L 85 SK 3526-85-2
LOQTEQ® Cortical Screw 3.5, T15, self-tapping
L 12 SK 3525-12-2 L 14 SK 3525-14-2 L 16 SK 3525-16-2 L 18 SK 3525-18-2 L 20 SK 3525-20-2 L 22 SK 3525-22-2 L 24 SK 3525-24-2 L 26 SK 3525-26-2 L 28 SK 3525-28-2 L 30 SK 3525-30-2 L 32 SK 3525-32-2 L 34 SK 3525-34-2 L 36 SK 3525-36-2 L 38 SK 3525-38-2 L 40 SK 3525-40-2 L 42 SK 3525-42-2 L 45 SK 3525-45-2 L 50 SK 3525-50-2 L 55 SK 3525-55-2 L 60 SK 3525-60-2 L 65 SK 3525-65-2 L 70 SK 3525-70-2 - - - - - -
Cortical Screw 3.5, T15, self-tapping
L 12 SK 3514-12-2 L 14 SK 3514-14-2 L 16 SK 3514-16-2 L 18 SK 3514-18-2 L 20 SK 3514-20-2 L 22 SK 3514-22-2 L 24 SK 3514-24-2 L 26 SK 3514-26-2 L 28 SK 3514-28-2 L 30 SK 3514-30-2 L 32 SK 3514-32-2 L 34 SK 3514-34-2 L 36 SK 3514-36-2 L 38 SK 3514-38-2 L 40 SK 3514-40-2 L 42 SK 3514-42-2 L 45 SK 3514-45-2 L 50 SK 3514-50-2 L 55 SK 3514-55-2 L 60 SK 3514-60-2 L 65 SK 3514-65-2 L 70 SK 3514-70-2 L 75 SK 3514-75-2 L 80 SK 3514-80-2 L 85 SK 3514-85-2
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
20
Instruments Small Fragment 3.5
Bending iron 1 for small fragment plates, closed IP 8405-00 Bending iron 2 for small fragment plates, closed IP 8405-50
Depth gauge for screws ø3.5 - 4.0, up to L 90 IS 7904-20
Large handle, cannulated, quick coupling IU 7706-00
Handle with quick coupling, with torque limiter 2.0Nm IU 7707-20
Screwdriver Duo, T15, quick coupling IU 7825-56
Twist drill ø2.7, L 150, coil 50, quick coupling IU 7427-15* Twist drill ø2.7, L 220, coil 50, quick coupling IU 7427-22* Twist drill ø3.5, L 110, coil 50, quick coupling IU 7435-00*
* For ordering single use drills please add „-1u“ to the article number (e.g. Iu 7427-15-1u)
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
21Application Notes Small Fragment & Large Fragment
Instruments Small Fragment 3.5
Load Drill guide LOQTEQ® 3.5, compression 1mm IU 8166-01 Load Drill guide LOQTEQ® 3.5, compression 2mm IU 8166-02 Load Drill guide LOQTEQ® 3.5, adjustable up to 2mm IU 8166-03 Basic insert for load drill guide LOQTEQ® 3.5 IU 8166-05
Double drill guide ø2.7/3.5, with spring aided centering IU 8116-60
Drill guide for gliding hole LOQTEQ® 3.5, I-ø 2.8, red IU 8166-10
Reduction sleeve for K-wire ø1.6 IU 8166-16
Drill guide for round hole LOQTEQ® 3.5, I-ø 2.8, blue IU 8166-20
K-wire with trocar point, ø1.6, L 180 NK 0016-18
Screw forceps, self-holding IU 8004-00
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
23Application Notes Small Fragment & Large Fragment
Implants & Instruments Large Fragment 4.5
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
24
Plates Large Fragment 4.5 Implants
For ordering of the sterile plates please add „S“ to the article number, e.g. PG 4555-04-2S
LOQTEQ® Narrow Plate 4.5
HOLES LENGTH (mm)
4 72 PG 4555-04-2 5 90 PG 4555-05-2 6 108 PG 4555-06-2 7 126 PG 4555-07-2 8 144 PG 4555-08-2 9 162 PG 4555-09-2 10 180 PG 4555-10-2 11 198 PG 4555-11-2 12 216 PG 4555-12-2 14 252 PG 4555-14-2 16 288 PG 4555-16-2
LOQTEQ® Broad Plate 4.5
HOLES LENGTH (mm)
6 115 PG 4556-06-2 7 133 PG 4556-07-2 8 150 PG 4556-08-2 9 168 PG 4556-09-2 10 186 PG 4556-10-2 11 204 PG 4556-11-2 12 222 PG 4556-12-2 14 257 PG 4556-14-2 16 293 PG 4556-16-2 18 328 PG 4556-18-2
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
25Application Notes Small Fragment & Large Fragment
Large Fragment 4.5 Screws Implants
LOQTEQ® Cortical Screw 4.5, T25, self-tapping
L 12 SK 4525-12-2 L 14 SK 4525-14-2 L 16 SK 4525-16-2 L 18 SK 4525-18-2 L 20 SK 4525-20-2 L 22 SK 4525-22-2 L 24 SK 4525-24-2 L 26 SK 4525-26-2 L 28 SK 4525-28-2 L 30 SK 4525-30-2 L 32 SK 4525-32-2 L 34 SK 4525-34-2 L 36 SK 4525-36-2 L 38 SK 4525-38-2 L 40 SK 4525-40-2 L 42 SK 4525-42-2 L 45 SK 4525-45-2 L 50 SK 4525-50-2 L 55 SK 4525-55-2 L 60 SK 4525-60-2 L 65 SK 4525-65-2 L 70 SK 4525-70-2 L 75 SK 4525-75-2 L 80 SK 4525-80-2 L 85 SK 4525-85-2 L 90 SK 4525-90-2
Cortical Screw 4.5, T25, self-tapping
L 12 SK 4514-12-2 L 14 SK 4514-14-2 L 16 SK 4514-16-2 L 18 SK 4514-18-2 L 20 SK 4514-20-2 L 22 SK 4514-22-2 L 24 SK 4514-24-2 L 26 SK 4514-26-2 L 28 SK 4514-28-2 L 30 SK 4514-30-2 L 32 SK 4514-32-2 L 34 SK 4514-34-2 L 36 SK 4514-36-2 L 38 SK 4514-38-2 L 40 SK 4514-40-2 L 42 SK 4514-42-2 L 45 SK 4514-45-2 L 50 SK 4514-50-2 L 55 SK 4514-55-2 L 60 SK 4514-60-2 L 65 SK 4514-65-2 L 70 SK 4514-70-2 L 75 SK 4514-75-2 L 80 SK 4514-80-2 L 85 SK 4514-85-2 L 90 SK 4514-90-2
For ordering of the sterile screws please add „S“ to the article number, e.g. SK 4525-12-2S
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
26
Instruments Large Fragment 4.5
Depth gauge for screws ø4.5 - 6.5, up to L 100 IS 7905-20
Large handle, cannulated, quick coupling IU 7706-00
Handle with quick coupling, with torque limiter 3.5Nm IU 7707-35
Tap for cortical screws ø4.5, L 125 / 70 IU 7745-00
Screw forceps, self-holding IU 8004-00
Twist drill ø3.2, L 195, coil 50, quick coupling IU 7432-30* Twist drill ø3.8, L 180, coil 50, quick coupling IU 7438-18* Twist drill ø3.8, L 250, coil 50, quick coupling IU 7438-25* Twist drill ø4.5, L 145, coil 50, quick coupling IU 7445-00*
* For ordering single use drills please add „-1u“ to the article number (e.g. Iu 7432-30-1u)
Screwdriver Duo, T25, quick coupling IU 7835-56
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
27Application Notes Small Fragment & Large Fragment
Instruments Large Fragment 4.5
Load drill guide LOQTEQ® 4.5, compression 1mm IU 8167-01 Load drill guide LOQTEQ® 4.5, compression 2mm IU 8167-02 Load drill guide LOQTEQ® 4.5, adjustable up to 2mm IU 8167-03 Basic insert for load drill guide LOQTEQ® 4.5 IU 8167-05
Double drill guide ø3.2/4.5, with spring aided centering IU 8117-50
Drill guide for gliding hole LOQTEQ® 4.5, I-ø 3.9, red IU 8167-10
Reduction sleeve for K-wire ø2.0 IU 8167-15
K-wire with trocar point, ø2.0, L 250 NK 0020-25
Application Notes Small Fragment & Large Fragment
aap Implantate AG Lorenzweg 5 • 12099 Berlin • Germany
28
Ulna shortening osteotomy
Preoperative Postoperative
Clinical case and CT images with the kind permission of Asklepios Clinic Weißenfels, Germany
Clinical case and CT images with the kind permission of University Hospital Gießen and Marburg, Germany
Preoperative Postoperative
Layout, typesetting: deSIGN graphic - Wolfram Passlack
Illustrations: Karen Hilberg
[email protected] www.aap.de
[email protected] www.aap.de (0
1) 04 04 24 09 36 48 53 (1 0) 16 08
W P 4A H 01 0 EN
/1 60 8
