Small Fragment LCP Set Implants & Instruments. Objectives Describe the implants found in the Small...

Small Fragment LCP Set

Implants & Instruments

ObjectivesObjectives

• Describe the implants found in the Small Describe the implants found in the Small Fragment Locking Compression Plate (LCP) SetFragment Locking Compression Plate (LCP) Set

• Identify the standard and new instruments that Identify the standard and new instruments that are used with locking screws & platesare used with locking screws & plates

Small Fragment LCP SetSmall Fragment LCP Set

• Used on small bone fractures -- Used on small bone fractures -- ankle, forearm, humerus, pelvisankle, forearm, humerus, pelvis

• Instruments same as standard Instruments same as standard Small Fragment plus moreSmall Fragment plus more

• Available in graphic cases with Available in graphic cases with stainless steel or titanium implants stainless steel or titanium implants

ImplantsImplantsStandard ScrewsStandard Screws

• 3.5mm Cortex3.5mm Cortex• 3.5mm Shaft (Cortex)3.5mm Shaft (Cortex)• 4.0mm Cancellous4.0mm Cancellous

– Fully threadedFully threaded– Partially threadedPartially threaded

• All with standard small All with standard small fragment hex headfragment hex head

• 2.7mm Cortex Screw also 2.7mm Cortex Screw also in set (not shown)in set (not shown)

Screw CharacteristicsScrew Characteristics

Thread

Core

Shaft

Head

Dimensions determine drill bit sizesDimensions determine drill bit sizes

• Core of all screws = 2.5mm drill bitCore of all screws = 2.5mm drill bit• Thread diameter of cortex screws = 3.5mm drill bitThread diameter of cortex screws = 3.5mm drill bit

ImplantsImplants3.5mm Locking Screw

• StarDrive™ recessStarDrive™ recess• Threaded underside of headThreaded underside of head

– Locks screw to locking plate• Small thread pitchSmall thread pitch• Large Large 2.8mm2.8mm core diameter core diameter

ImplantsImplantsStraight PlatesStraight Plates

3.5mm Locking Compression

3.5mm Straight Reconstruction

One Third Tubular

3.5mm Curved Reconstruction

ImplantsImplantsSpecialty PlatesSpecialty Plates

3.5mm T-Plate

3.5mm Oblique T-Plate, L & R

3.5mm Locking Proximal Humeral Plate3.5mm Locking Proximal Humeral Plate

Locking Plate FeaturesLocking Plate FeaturesCombination “Combi” HoleCombination “Combi” Hole

• Smooth side accepts Smooth side accepts cortex, shaft & cancellous cortex, shaft & cancellous screwsscrews

• Threaded side accepts Threaded side accepts locking screwslocking screws

• Plate is contourablePlate is contourable

Standard InstrumentsStandard Instruments

Same as other Small Fragment Sets:Same as other Small Fragment Sets:

– ExposureExposure– ReductionReduction– Screw insertionScrew insertion– Plate bendingPlate bending– Plate applicationPlate application

Exposure InstrumentsExposure Instruments

• Periosteal ElevatorPeriosteal Elevator

• Hohmann Retractors

Reduction InstrumentsReduction Instruments

• ForcepsForceps– With points --

narrow & broad

– Serrated forceps

Screw Insertion Instruments Screw Insertion Instruments

• Drill BitsDrill Bits– 3.5mm– 2.5mm– 2.0mm (not shown)

Screw Insertion InstrumentsScrew Insertion Instruments

• Universal Drill GuideUniversal Drill Guide

– Spring loaded side accepts Spring loaded side accepts 2.5mm drill bit2.5mm drill bit

– Opposite side accepts Opposite side accepts 3.5mm drill bit & taps3.5mm drill bit & taps

– Must be used with locking Must be used with locking platesplates

2.5mm 3.5mm


• 3.5mm Universal Drill Guide3.5mm Universal Drill Guide– Spring loaded end allows precise

placement of screw in non-threaded end of plate hole

– Spring activated = “neutral” position

– Spring not activated = “load” or “compression” position (away from fracture line)


• CountersinkCountersink– Use with quick connect Tap Handle


• Depth GaugeDepth Gauge– Calibrations in 2mm

increments

– Measures to 50mm length screws

– Hook on same side as calibrations


• TapsTaps– 3.5mm cortex

– 4.0mm cancellous

– Used w/QC Tap Handle

– Always pass with Tap Sleeve


• Small Fragment Hex Small Fragment Hex ScrewdriverScrewdriver

• Hints:Hints:– Screw driver shaft + tap handle =

back-up screwdriver– Use holding sleeve to remove

screws from screw rack

3.5mm Cortex Lag Technique3.5mm Cortex Lag TechniqueStepsSteps

• Drill 3.5mmDrill 3.5mm• Drill 2.5mmDrill 2.5mm• CountersinkCountersink• Measure Measure • Tap sometimes – 3.5mmTap sometimes – 3.5mm• Insert 3.5mm Cortex ScrewInsert 3.5mm Cortex Screw

4.0mm Cancellous Lag Technique4.0mm Cancellous Lag TechniqueStepsSteps

• Drill 2.5mmDrill 2.5mm

• MeasureMeasure

• Tap – rarelyTap – rarely

• Insert 4.0mm Cancellous ScrewInsert 4.0mm Cancellous Screw

Plate Bending InstrumentsPlate Bending Instruments

• Bending PliersBending Pliers

• Bending IronsBending Irons

• Bending TemplatesBending Templates

Instruments Instruments for Locking Platesfor Locking Plates

2.8mm Drill Bit2.8mm Drill Bit• Used to drill for 3.5mm Locking ScrewsUsed to drill for 3.5mm Locking Screws

LCP InstrumentsLCP Instruments

2.8mm Threaded Drill Guide2.8mm Threaded Drill Guide

• Ensures proper drilling angleEnsures proper drilling angle

• Not for use as a plate benderNot for use as a plate bender

Correct Incorrect


1.6mm Wire Sleeve1.6mm Wire Sleeve • Inserts into Threaded Drill Guide to accept 1.6mm Inserts into Threaded Drill Guide to accept 1.6mm

Guide WireGuide Wire

• Screw placement can be checked under imageScrew placement can be checked under image


Direct Measuring DeviceDirect Measuring Device• Used over 1.6mm K-wires to measure for Used over 1.6mm K-wires to measure for

locking screw lengthlocking screw length


StarDrive ScrewdriversStarDrive Screwdrivers

• Self-retainingSelf-retaining

• StarDrive Shaft used with Torque Limiting StarDrive Shaft used with Torque Limiting Attachment Attachment


Torque Limiting AttachmentTorque Limiting Attachment

• Allows power insertion of Allows power insertion of

locking screwslocking screws

• No further tightening of screws No further tightening of screws

necessarynecessary


Threaded Plate Holder Threaded Plate Holder • Non-cannulatedNon-cannulated

• Used as handle to position plate and insert plate in Used as handle to position plate and insert plate in percutaneous technique percutaneous technique

• Can be used to bend T-plates and One-third Tubular Can be used to bend T-plates and One-third Tubular Plates when used in pairsPlates when used in pairs


Push-Pull Reduction Device Push-Pull Reduction Device (Whirly-Bird)(Whirly-Bird)

• Secures plate to boneSecures plate to bone

• Guards against “helicopter effect” Guards against “helicopter effect” of the plateof the plate

• Hole can be used for cortex screw Hole can be used for cortex screw insertion (same 2.5mm diameter as insertion (same 2.5mm diameter as drill bit)drill bit)

Care & MaintenanceCare & Maintenance

• Keep drill bits & taps sharpKeep drill bits & taps sharp• Clean cannulationsClean cannulations• Disassemble instrumentsDisassemble instruments• LubricateLubricate


• Tighten screwdriver holding sleeve

• Clean graphic cases


• Inspect threads on Threaded Drill Guides

Quiz QuestionQuiz Question

• True or false? You must remember to pull the True or false? You must remember to pull the Small Fragment locking screw rack in addition Small Fragment locking screw rack in addition to the instrument and plate set.to the instrument and plate set.

• False. Small fragment instruments, plates & False. Small fragment instruments, plates & screws are in the same graphic case.screws are in the same graphic case.

• What is the drill bit size used to drill for the What is the drill bit size used to drill for the core of the 3.5mm cortex screw?core of the 3.5mm cortex screw?

2.5mm2.5mm

• What is the drill bit size used to drill for the What is the drill bit size used to drill for the core of the 3.5mm locking screw?core of the 3.5mm locking screw?

2.8mm2.8mm

• For what types of procedures might you have For what types of procedures might you have the LCP Small Fragment Set in the room?the LCP Small Fragment Set in the room?

• Older patients (osteoporosis)Older patients (osteoporosis)• Re-operation on a non-unionRe-operation on a non-union• Replacing broken hardwareReplacing broken hardware• Other ? Other ?

Now you should be able to:Now you should be able to:

• Describe the implants (screws & plates) Describe the implants (screws & plates) in the LCP Small Fragment Setin the LCP Small Fragment Set

• Identify the instruments that are used with Identify the instruments that are used with standard standard andand locking screws & plates locking screws & plates

Small Fragment LCP Set Implants & Instruments. Objectives Describe the implants found in the Small...

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