Small Fragment System. Instruments and implants for 2.7 and 3.5 ...

Veterinary

Small Fragment System. Instrumentsand implants for 2.7 and 3.5 platefixation.

Technique Guide

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Small Fragment System Technique Guide Synthes 1

Table of Contents

Introduction

Surgical Technique

Product Information

Small Fragment System 2

Plates 4

Screws 6

Fixation Principles 8

Preparation 11

Reduction and Temporary Plate Placement 13

Screw Insertion 14

Postoperative Treatment and Implant Removal 18

Featured Instruments 19

Set Lists 21

Quick Reference Guide – Instruments 28

Quick Reference Guide – Implants 29

Image intensifier control

WarningThis description alone does not provide sufficient background for direct use ofthe instrument set. Instruction by a surgeon experienced in handling theseinstruments is highly recommended.

Reprocessing, Care and Maintenance of Synthes InstrumentsFor general guidelines, function control and dismantling of multi-part instruments,please contact your local sales representative or refer to:www.synthes.com/reprocessing

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2 Synthes Small Fragment System Technique Guide

Small Fragment System.Instruments and implants for 2.7 and 3.5 plate fixation.

The Small Fragment Standard SystemThe Small Fragment Standard System contains the 2.7, 3.5 and 4.0 implants and related instruments requiredfor standard compression plating.

Features– Equipment for LC-DCP and DCP plating systems– Can be upgraded to LCP system– Cases are organized in general order of use– Compact case sizes fit most tabletop autoclaves– Plate case stores a full range of 2.7, 3.5, and 3.5 Broad

DCP, LC-DCP or LCP plates– Includes auxiliary bins for storing additional equipment

The standard system consists of:– Small Fragment Standard Instrument Set (103.501)– Small Fragment Standard Screw Set (103.518)– Small Fragment DCP Plate Set (103.513)

orSmall Fragment LC-DCP Plate Set (103.514)

The Small Fragment Locking SystemThe Small Fragment Locking System contains the 2.7 and3.5 LCP implants and related instruments required for lockedplating.

Features– Dedicated equipment designed for LCP plating– Locking instruments fit in the Graphic Case for Small

Fragment Instrument Set (690.591) – All cases are organized in general order of use– Compact case sizes fit most tabletop autoclaves

The locking system consists of:– Small Fragment Locking Instrument Set (103.502)– Small Fragment Locking Screw Set (103.517)– Small Fragment LCP Plate Set (103.516)

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LC-DCP

DCP

Bone loss observed beneath afull-contact plate

Reduced bone loss beneath alimited-contact plate

DCP (Dynamic Compression Plate) DCP plate hole – Incorporates an incline in the hole that converts screw

compression into plate translation and compression ofthe bone fracture

– Accepts conventional screws that may be placed in eitherload or neutral positions, depending on whether inter -fragment compression is desired (see using the universaldrill guide on pages 14 and 15 for more detail)

– Allows 25° of longitudinal screw angulation and 7° oftransverse screw angulation

LC-DCP (Limited-Contact Dynamic Compression Plate)Grooved undersurface– Provides limited contact between the plate and bone,

minimizing the chance for temporary porosis under theplate

– Allows periosteal callus formation at the fracture site

LC-DCP plate hole– The Dynamic Compression Unit (DCU) hole is symmetrical

and provides bidirectional compression– Allows 40° of longitudinal screw angulation and 7° of

transverse screw angulation– Accepts conventional screws that may be placed in either

load or neutral positions, depending on whether inter -fragment compression is desired (see using the universaldrill guide on pages 14 and 15 for more detail)

– Centrally located hole at one end for metaphysealfracture repair

– Tapered end for submuscular plate insertion, minimizingtissue trauma

Uniform stiffness– Allows smooth contouring of the plate to the bone– Protects the plate from localized high bending stress,

because of the even distribution of stresses over a longdistance along the plate

Plates


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1

Bibliography1. Gasser, R., and S.M. Perren, "Parametric Numerical Design Optimization of

Internal Fixation Plates", 7th Meeting of the European Society of Biomechanics,Aarhus (Denmark), 1990.

2. Klaue, K. and S.M. Perren. Unconventional Shapes of the Plate Cross-Section inInternal Fixation: The Trapezoid Plate. Long Term Study of Bone Reaction in SheepTibiae. Davos, Switzerland: Laboratory for Experimental Surgery, AO/ASIF, 1990.

LCP (Locking Compression Plate)– Locking screws create a fixed-angle construct, resulting

in angular stability– Tapered end for submuscular plate insertion, minimizing

tissue trauma (1)– Limited-contact plate design reduces plate-to-bone

contact, protecting vascularity– Centrally located hole at one end for metaphyseal fracture

repair

LCP plate holes– Dynamic Compression Unit (DCU) hole allows 40° of

longitudinal screw angulation and 7° of transversescrew angulation

– Combi-holes allow placement of conventional screwson one side or locking screws on the opposite side ofeach holeA. Threaded hole section for locking screwsB. Dynamic Compression Unit (DCU) hole section for

conventional screwsC. Locking screw in threaded side of plate holeD. Cortex screw in compression side of plate holeE. Stacked combi-holes at plate end accepts either cortex,

cancellous or locking screws


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Cortex Screws– For bicortical fixation in diaphyseal bone– Self-tapping screws are standard in all sets– Non-self-tapping screws are also available

Screw Reference Chart

Thread Diameter 2.7 mm 2.7 mm 2.7 mm 3.5 mm 3.5 mm 3.5 mm 4.0 mm

Screw Type Cortex Cortex Locking Cortex Cortex Locking Cancellous

Drill Bit for 2.0 mm 2.0 mm 2.0 mm 2.5 mm 2.5 mm 2.8 mm 2.5 mmThreaded Hole

Tap self-tapping self-tapping self-tapping self-tapping self-tapping self-tapping 4.0 mm

Drive Type 2.5 mm T8 T8 2.5 mm T15 T15 2.5 mm Hexagonal Stardrive Stardrive Hexagonal Stardrive Stardrive Hexagonal

Screws


Cancellous Bone Screws – For fixation in poor quality or metaphyseal bone– Deeper threads and coarser pitch maximizes the surface

area of the threads in contact with the bone, thereby increasing the screw’s holding power in softer bone

Locking Screws– Use with the Locking Compression Plate (LCP)– Conical, double-lead machine thread on the head locks

into the threaded combi-hole or stacked combi-hole in theplate

– Create a fixed-angle construct– Large core diameter provides improved bending and

shear strength– Stardrive recess provides improved torque transmission

to the screw, while retaining the screw without the use ofa holding sleeve

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Screw fixationBicortical cortex screw fixation is the traditional method ofcompressing a plate to the bone. Friction between the plateand bone maintains stability. Therefore, bicortical screws require two cortices of fixation to achieve stability (1).

Locking screws provide stability and load transfer due to thethreaded connection between the plate and screw. There isno compression of the plate to the bone (2).

Note: If a combination of a cortex screw and locking screwsis used, a cortex screw should be inserted first to pull theplate to the bone. If a locking screw is used first, care shouldbe taken to ensure that the plate is held securely to the boneto avoid spinning of the plate about the bone.

Warning:– Synthes implants and instruments are manufactured with

proprietary processes that produce superior products tothose created by conventional manufacturing processes.Though other companies may be able to estimate the Syn-thes general product design, Synthes product dimensionsare proprietary. The precision design of Synthes productsis very important for long-term product function and opti-mal fit between implants.

– Only the finest quality materials are used to manufactureSynthes implants. The metals Synthes uses have been sci-entifically proven to be of the best biocompatibility andquality available today.

– With these features and qualities, the mixing of Synthesimplants with the implants from other companies is notrecommended. The overall performance may be compro-mised due to differences in design, chemical composition,mechanical properties, and quality.

– Given these qualities are trade-secret, no competitor ofSynthes can make a genuine claim “the same as Synthes.”Combining implants from other companies with Synthesimplants could reduce product performance. Conse-quently, it is strongly recommended to not mix parts fromdifferent manufacturers.


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Conventional plating using standard screws

Primary loss of reductionIn conventional plating, even though the bone fragments arecorrectly reduced prior to plate application, fracture disloca-tion will result if the plate contour does not fit the bone (1).In addition, if the lag screw is not seated perpendicular tothe fracture line (e.g., spiral fracture of the distal tibia), shearforces will be introduced. These forces may cause loss of reduction.

Secondary loss of reductionUnder axial load, postoperative, secondary loss of reductionmay occur by toggling of the screws. Since cortex screws donot lock to the plate, the screws cannot oppose the actingforce and may loosen, or be pushed axially through the plateholes (2).

Blood supply to the boneThe periosteum is compressed under the plate area, reducingor even interrupting blood supply to the bone (3). This can delay bone healing due to temporary devasculariza-tion underneath the plate.

Poor-quality boneIn poor-quality bone, screws cannot be tightened sufficientlyto obtain the compression and friction needed to withstandthe loading. This can result in loosening of the screws andloss of stability and reduction.

Standard plating achieves good results in:– Good-quality bone– Fractures which are traditionally fixed with lag screws

to achieve direct bone healing

Fixation Principles


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Bridge/locked plating using locking screws– Screws lock to the plate, forming a fixed-angle construct – Bone healing is achieved indirectly by callus formation

when using locking screws exclusively

Maintenance of primary reductionOnce the locking screws engage the plate, no further tight-ening is possible. Therefore, the implant locks the bone segments in their relative positions regardless of degree ofreduction.

Precontouring the plate minimizes the gap between theplate and the bone, but an exact fit is not necessary for im-plant stability (4). This feature is especially advantageousin minimally or less invasive plating techniques because thesetechniques do not allow exact contouring of the plate tothe bone surface.

Stability under loadBy locking the screws to the plate, the axial force is trans -mitted over the length of the plate. The risk of a secondaryloss of the intraoperative reduction is reduced (5).

Blood supply to the boneLocking the screw into the plate does not generate addi-tional compression. Therefore, the periosteum will be pro-tected and the blood supply to the bone preserved (6).


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Combined internal fixationThe combination of conventional compression plating andlocked plating techniques enhances plate osteosynthesis. Theresult is a combination hole or combi-hole that, dependingon the indication, allows standard compression plating,locked/bridge plating or a combination of both.

Internal fixation using a combination of locking screwsand standard screws

Note: If a combination of standard and locking screws isused, the standard screws should be inserted first to pull theplate to the bone (7).

If locking screws (1) have been used to fix a plate to a frag-ment, subsequent insertion of a standard screw (2) in thesame fragment without loosening and retightening the lock-ing screws is NOT RECOMMENDED (8).

Warning: If a locking screw is used first, care should betaken to ensure that the plate is held securely to the boneto avoid spinning of the plate about the bone.

Dynamic compressionOnce the metaphyseal fragment has been fixed with lockingscrews, the fracture can be dynamically compressed usingstandard screws in the DCU portion of the combi-hole (9).

Locked and standard plating techniques– First, use lag screws to anatomically reconstruct the

bone surfaces– The behavior of a locking screw is not the same as that

of a lag screw. With the locked plating technique, the implant locks the bone segments in their relative positionsregardless of how they are reduced

– A plate used as a locked/bridge plate does not produceany additional compression between the plate and thebone

Fixation Principles


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Preparation

The following techniques apply to any of the Synthes platesystems: LCP, LC-DCP and DCP. For this example, a 3.5 LCPplate was selected since it can accommodate both standardand locking screws.

The surgeon should select the appropriate plate systembased on indication and experience.


1Plate selection

Required sets

103.503 Small Fragment Instrument Set

103.515 Small Fragment Screw Set

103.514 Small Fragment LC-DCP Plate Setor103.516 Small Fragment LCP Plate Set

The plates are available in various lengths. Complete the preoperative radiographic assessment and plan to determineplate length.

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329.890

2Contouring

Instruments

329.040 / Bending Iron for Plates 2.4 to 3.5,329.050 length 145 mm

329.240 Bending Pliers for Plates 4.5, length 250 mm, complete, with Anvils Nos. 329.250 and 329.260

329.870 Bending Template for LC-DCP 3.5 and DCP 3.5, length 87 mmor329.890 Bending Template for LC-DCP 3.5 and DCP 3.5, length 114 mmor329.820 Bending Template for LC-DCP 3.5 and DCP 3.5, length 153 mm

Use the bending templates to determine plate contour. Usethe bending irons or bending pliers to contour the LCP or theLC-DCP plate to the anatomy.

Note: The LCP plate holes have been designed to accept somedegree of deformation. When bending the plate, place thebending irons on two consecutive holes. This ensures thatthe threaded holes will not be distorted. Significant distortionof the locking holes will reduce locking effectiveness. Pleaserefer to the AO Principles of Fracture Management in theDog and Cat,1 AO Principles of Fracture Management,2 andAO Manual of Fracture Management– Internal Fixators.3

1 Johnson. 2 Rüedi. 3 Wagner.

Preparation


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3Reduction and temporary plate placement

Instruments

324.023 Bending Pin for LCP Plates 3.5, with thread, length 100 mm

324.024 Instrument for temporary reduction

398.811 Plate Holding Forceps, with Swivel Foot, size 0or398.812 Holding Forceps with Swivel Foot, for Plates 3.5, speed lock

The plate may be temporarily held in place with standardplate holding forceps or the instrument for temporary reduction.

Note: The middle of the plate should be positioned overthe fracture site if compression of the fracture fragmentsis desired.

The instrument for temporary reduction (1) is designed to temporarily hold the plate to the bone through a plate hole.The device is self-drilling and connects with the Synthesquick connection for power insertion. Insert into near cortexonly. After power insertion, turn the collet clockwise until itpulls the plate securely to the bone.

Note: Care should be taken to avoid inserting this devicein a hole that will be needed immediately for plate fixation.However, the device may be removed and a screw insertedthrough the same plate hole.

A bending pin (2) can also be used as an aid to position theplate, and is particularly useful with minimally invasive plat-ing technique.

Reduction and Temporary Plate Placement


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323.360

Compression (load)

4Screw insertion

Determine whether standard 3.5 mm cortex screws, 4.0 mmcancellous screws or 3.5 mm locking screws will be used forfixation. A combination of all may be used.

Note: If a combination of cortex, cancellous and lockingscrews is used, a standard screw should be used first to pullthe plate to the bone.

Warning: If a locking screw is used first, care should betaken to ensure that the plate is held securely to the boneto avoid spinning of the plate about the bone.

Insertion of a cortex or cancellous bone screw

Instruments

310.250 Drill Bit � 2.5 mm, length 110/85 mm, 2-flute, for Quick Coupling

314.020 Screwdriver, hexagonal, small, with Holding Sleeve

319.010 Depth Gauge for Screws � 2.7 to 4.0 mm, measuring range up to 60 mm

323.360 Universal Drill Guide 3.5

Use the 2.5 mm drill bit through the 3.5 mm universal drillguide to predrill the bone.

Measure for screw length using the depth gauge.

Select and insert the appropriate 3.5 mm cortex screw usingthe small hexagonal screwdriver.

Use the 3.5 mm universal drill guide for an eccentric (compression) or neutral (buttress) insertion of cortex screws.

Note: The 3.5 mm LC-DCP drill guide and the 3.5 mmDCP drill guide are not suitable for use with LCP plates.

Screw Insertion


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Neutral

The universal drill guides are the only drill guides which function in all Synthes plate holes. When a cortex or cancel-lous bone screw is used, a universal drill guide should beused to guide the drill bit. If the screw is intended to achieveinterfragment compression, the universal drill guide shouldbe placed in the load position, as shown. If the screw is intended to hold the plate, the universal drill guide shouldbe placed in the neutral position.

Compression (load) positionCompression is achieved by placing the universal drill guidein the eccentric position, and maintaining the drill guidebody above the plate as shown (1, previous page).

Neutral positionNeutral position is achieved by placing the universal drillguide in the eccentric position, then compressing the drillguide body into the hole, which will shift the drill guideinto the neutral position as shown (2).

Note: For illustrative purposes, a combi-hole has been depicted. The same methodology applies to LC-DCP andDCP holes.


gap

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Screw Insertion

Insertion of 3.5 mm locking screws

Instruments

310.288 Drill Bit � 2.8 mm, length 165 mm, for AO/ASIF Quick Coupling

312.648 LCP Drill Sleeve 3.5, for Drill Bits � 2.8 mm

314.115 Screwdriver Stardrive 3.5, T15

314.116 Screwdriver Shaft Stardrive 3.5, T15, self-holding, for AO/ASIF Quick Coupling

319.010 Depth Gauge for Screws � 2.7 to 4.0 mm, measuring range up to 60 mm

511.773 Torque Limiter, 1.5 Nm, for AO/ASIF Quick Coupling

Note: A locking screw cannot be used as a lag screw. Usestandard screws when requiring a precise anatomical reduction(e.g., joint surfaces) or interfragmentary compression. Beforeinserting the first locking screw, perform anatomical reductionand fix the fracture with lag screws, if necessary. After the insertion of locking screws, further anatomical reduction willno longer be possible.

Screw the LCP drill sleeve into an LCP plate hole until fullyseated (3).

Note: Since the direction of a locking screw is determinedby plate design, final screw position may be verified with aKirschner wire prior to insertion. This becomes especially im-portant when the plate has been contoured or applied inmetaphyseal regions around joint surfaces.

Warning: Do not try to bend the plate using the LCP drillsleeve because damage may occur to the plate hole threads.

Use the 2.8 mm drill bit to drill to the desired depth (4).

Remove the LCP drill sleeve and use the depth gauge to determine screw length (5).


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Insert the locking screw under power using the torque limiterand Stardrive screwdriver shaft (6).

Note: Recheck each locking screw before closing to verifythat the screws are securely locked to the plate. Screwheadsmust be flush with the plate in the locked position beforethey can be considered fully seated.

Warning: Always use a torque limiter when using power toinsert locking screws.

Alternative method of locking screw insertionUse the Stardrive screwdriver to manually insert the appropri-ate length locking screw (7). Carefully tighten the lockingscrew, as excessive force is not necessary to produce effectivescrew-to-plate locking.


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Postoperative Treatment and Implant Removal

Postoperative treatmentPostoperative treatment with locking compression platesdoes not differ from conventional internal fixation proce-dures.

Implant removal

319.390 Sharp Hook, length 155 mm

When removing a screw, first clear the screw drive mecha-nism (hexagonal or Stardrive) of all tissue ingrowth using asharp hook and irrigation. This allows complete engagementof the screwdriver and minimizes the chance of stripping thescrew drive mechanism. See the Universal Screw Removal Setbrochure (036.000.773) for additional instrumentation andtechnique.

When removing locking screws, unlock all screws from theplate; then remove the screws completely from the bone.This prevents simultaneous rotation of the plate when removing the last locking screw.

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Featured Instruments

313.353 Drill Sleeve 2.7, for Aiming Arm No. 313.354, for DHP

The drill sleeve threads into locking plates for correct align-ment of locking screws with plate holes. The drill sleeve cen-ters a drill bit to ensure perpendicular drilling, and permitsproper mating of locking screws to the threaded portion ofthe combi-hole.

312.648 LCP Drill Sleeve 3.5, for Drill Bits � 2.8 mm

Notes:– To prevent cross-threading, turn the LCP drill sleeve coun-

terclockwise until a slight click is noticed, and then turn itclockwise. If properly aligned, threads should engagewithin a quarter-turn.

– The LCP drill sleeve can also be used intraoperatively as areference for visualizing the angle at which the lockingscrews engage in the bone.

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Featured Instruments

324.024 Instrument for temporary reduction – For use with LCP 3.5 plates – Temporarily compresses the plate to the

bone – Can assist bone fragment reduction to

the plate – Self-drilling, self-tapping 2.5 mm thread – Synthes quick coupling connection

Insert into near cortex only. After power insertion, turn thecollet clockwise until it compresses the plate securely to thebone. Take care when inserting this device in a hole that willbe needed for plate fixation. After the device is removed, aconventional screw can be placed in the same hole.

Also available

511.773 Torque Limiter, 1.5 Nm, for AO/ASIF Quick Coupling – For use with 3.5 mm locking screws

511.776 Torque Limiter, 0.8 Nm, with AO/ASIF Quick Coupling – For use with 2.7 mm locking screws

A torque limiter is used to ensure the appropriate amount oftorque is applied to minimize the risks of a locking screwbacking out of the plate.

Note: With titanium implants, this also minimizes the riskof cold welding the screw to the plate. Where steel implantsare used, more torque can be applied by hand tightening thescrew to ensure it is fully seated in the plate.

398.811 Plate Holding Forceps, with Swivel Foot, size 0or398.812 Holding Forceps with Swivel Foot,

for Plates 3.5, speed lock

324.023 Bending Pin for LCP Plates 3.5, with thread, length 100 mm – Facilitates positioning the plate on the

bone

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Shown with both 103.501 and 103.502 set combined

Small Fragment Standard Instrument Set (103.501)

Graphic Case690.591 Graphic Case for Instrument Set Small

Fragments, without Contents

Instruments310.210 Drill Bit � 2.0 mm, length 125/100 mm,

2-flute, for Quick Coupling310.250 Drill Bit � 2.5 mm, length 110/85 mm,



2-flute, for Quick Coupling310.890 Countersink 3.5311.260 Tap for Cortex Screws � 2.7 mm, length 100/33 mm311.320 Tap for Cortex Screws � 3.5 mm, length 110/50 mm311.430 Handle with Quick Coupling, length 110 mm311.440 T-Handle with Quick Coupling312.200 Triple Drill Guide 2.0, with 3 holes312.240 Double Drill Guide 2.7/2.0312.280 Double Drill Guide 3.5/2.5312.300 Drill Sleeve Insert 3.5/2.5, length 42 mm314.020 Screwdriver, hexagonal, small, with Holding Sleeve314.030 Screwdriver Shaft, hexagonal, small, � 2.5 mm319.010 Depth Gauge for Screws � 2.7 to 4.0 mm, measuring range up to 60 mm319.970 Screw Forceps, self-holding, length 85 mm323.260 Universal Drill Guide 2.7323.360 Universal Drill Guide 3.5329.040 / Bending Irons for Plates 2.4 to 3.5,329.050 length 145

For additional information, please refer to package insert.

VW1203.15.10 Kirschner Wire � 1.25 mm with trocar tip, length 150 mm, Stainless Steel, pack of 10 unitsVW2003.15.10 Kirschner Wire � 2.0 mm with trocar tip, length 150 mm, Stainless Steel, pack of 10 units

Note: Small Fragment Instrument Set (103.503) consists ofSmall Fragment Standard Instrument Set (103.501), withgraphic case, and Small Fragment Locking Instrument Set(103.502).

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Lid not shown

Small Fragment Standard Screw Set (103.518)

Screw Rack690.593 Small Fragment Standard Screw Rack

Standard ScrewsCortex Screws � 2.7 mm, self-tapping, 6 each

Length (mm) Length (mm)

VS205.008 8 VS205.016 16

VS205.010 10 VS205.018 18

VS205.012 12 VS205.020 20

VS205.014 14

Cortex Screws � 3.5 mm, self-tapping, 6 each


VS302.012 12 VS302.022 22

VS302.014 14 VS302.024 24

VS302.016 16 VS302.026 26

VS302.018 18 VS302.028 28

VS302.020 20 VS302.030 30

Cancellous Bone Screws � 4.0 mm, fully-threaded, 4 each


VS403.016 16 VS403.024 24

VS403.018 18 VS403.026 26

VS403.020 20 VS403.028 28

VS403.022 22 VS403.030 30

Note: Small Fragment Screw Set (103.515) consists of Small Fragment Standard Screw Set (103.518) and SmallFragment Locking Screw Set (103.517) stored in the optionalGraphic Case for Small Fragment Screw Set (690.515).

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Also AvailableCortex Screws � 2.7 mm, self-tapping(rack will hold 6 each) Length (mm) Length (mm)

VS205.006 6 VS205.038 38*

VS205.022 22 VS205.040 40*

VS205.024 24 VS205.042 42*

VS205.026 26 VS205.044 44*

VS205.028 28 VS205.045 45*

VS205.030 30 VS205.046 46*

VS205.032 32* VS205.048 48*

VS205.034 34* VS205.050 50*

VS205.036 36* VS205.055 55*

Cortex Screws � 3.5 mm, self-tapping (rack will hold 6 each)


VS302.010 10 VS302.055 55

VS302.032 32 VS302.060 60

VS302.034 34 VS302.065 65*

VS302.036 36 VS302.070 70*

VS302.038 38 VS302.075 75*

VS302.040 40 VS302.080 80*

VS302.045 45 VS302.085 85*

VS302.050 50 VS302.090 90*

Cancellous Bone Screws � 4.0 mm, fully threaded (rack willhold four each 10 –40 mm screws, two each 45 mm and 50 mm screws) Length (mm) Length (mm)

VS403.010 10 VS403.040 40

VS403.012 12 VS403.045 45

VS403.014 14 VS403.050 50

VS403.032 32 VS403.055 55*

VS403.036 36 VS403.060 60*

OptionalCortex Screws Stardrive � 2.7 mm, self-tapping(rack will hold 6 each) Length (mm)

VS211.006 – 6 –30

VS211.030

VS211.032 – 32 –60*

VS211.060

Cortex Screws Stardrive � 3.5 mm, self-tapping(rack will hold 6 each) Length (mm)

VS304.010 – 10 –60

VS304.060

VS304.065 65 –90*

VS304.090

Cancellous Bone Screws � 4.0 mm, partially threaded, (rack will hold four each 10 –40 mm screws, two each45 mm and 50 mm screws) Length (mm)

VS404.010 – 10 –50

VS404.050

VS404.055 – 55 –60*

VS404.060

* Do not fit in screw rack

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Small Fragment LC-DCP Plate Set (103.514)

Graphic Case690.511 Graphic Case for Small Fragment Plate Set,

without Contents

ImplantsLC-DCP Plates 2.7

Length Length Holes (mm) Holes (mm)

VP3031.06 6 55 VP3031.10 10 91

VP3031.08 8 73 VP3031.12 12 109

LC-DCP Plates 3.5


VP3041.06 6 80 VP3041.10 10 132

VP3041.08 8 106 VP3041.12 12 158

Broad LC-DCP Plates 3.5


VP3051.08 8 107 VP3051.12 12 159

VP3051.10 10 133 VP3051.14 14 185

Also Available

LC-DCP Plates 2.7


VP3031.04 4 37 VP3031.11 11 100

VP3031.05 5 46 VP3031.14 14 127

VP3031.07 7 64 VP3031.16 16 145

VP3031.09 9 82

LC-DCP Plates 3.5


VP3041.02 2 28 VP3041.14 14 184

VP3041.03 3 41 VP3041.15 15 197

VP3041.04 4 54 VP3041.16 16 210

VP3041.05 5 67 VP3041.18 18 236

VP3041.07 7 93 VP3041.20 20 262

VP3041.09 9 119 VP3041.22* 22 288

VP3041.11 11 145

Lid not shown

Broad LC-DCP Plates 3.5


VP3051.07 7 94 VP3051.16 16 211

VP3051.09 9 120 VP3051.17 17 224

VP3051.11 11 146 VP3051.18 18 237

VP3051.13 13 172 VP3051.20 20 263

VP3051.15 15 198 VP3051.22* 22 289

* Do not fit in case

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310.288

312.648

313.353

314.115

314.116

314.467

314.468

324.023

324.024

VW1605.15


Small Fragment Locking Instrument Set (103.502)

Instruments310.288 Drill Bit � 2.8 mm, length 165 mm, for AO/ASIF Quick Coupling312.648 LCP Drill Sleeve 3.5, for Drill Bits � 2.8 mm313.353 Drill Sleeve 2.7, for Aiming Arm No. 313.354, for DHP314.116 Screwdriver Shaft Stardrive 3.5, T15, self-holding, for AO/ASIF Quick Coupling314.467 Screwdriver Shaft, Stardrive, T8, self-holding324.023 Bending Pin for LCP Plates 3.5, with thread, length 100 mm324.024 Instrument for temporary reduction

Also Available314.115 Screwdriver Stardrive 3.5, T15314.468 Holding Sleeve for Screws Stardrive � 2.4 mm, T8, for Screwdriver Shafts � 3.5 mm, for No. 314.467511.773 Torque Limiter, 1.5 Nm, for AO/ASIF Quick Coupling511.776 Torque Limiter, 0.8 Nm, with AO/ASIF Quick CouplingVW1605.15.10 Kirschner Wire � 1.6 mm with threaded tip, length 150 mm, Stainless Steel, pack of 10 units

Note: Small Fragment Instrument Set (103.503) consists ofSmall Fragment Standard Instrument Set (103.501), withgraphic case, and Small Fragment Locking Instrument Set(103.502).

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Small Fragment Locking Screw Set (103.517)

Lid not shown

* Do not fit in screw rack

Screw Rack690.592 Small Fragment Locking Screw Rack

ImplantsLocking Screws � 2.7 mm, self-tapping, 2 each(rack will hold 6 each)


VS206.012 12 VS206.022 22

VS206.014 14 VS206.024 24

VS206.016 16 VS206.026 26

VS206.018 18 VS206.028 28

VS206.020 20

Locking Screws � 3.5 mm, self-tapping (rack will hold 6 each)

Length Length (mm) Qty. (mm) Qty.

VS303.014 14 2 VS303.030 30 2

VS303.016 16 2 VS303.032 32 2

VS303.018 18 2 VS303.034 34 2

VS303.020 20 2 VS303.036 36 2

VS303.022 22 2 VS303.038 38 2

VS303.024 24 2 VS303.040 40 2

VS303.026 26 2 VS303.045 45 2

VS303.028 28 2 VS303.050 50 1

Also AvailableLocking Screws � 2.7 mm, self-tapping (rack will hold 6 each)


VS206.010 10 VS206.034 34

VS206.030 30 VS206.036 – 36

VS206.032 32 VS206.050 50*

Locking Screws � 3.5 mm, self-tapping (rack will hold 6 each)


VS303.010 10 VS303.055 55

VS303.012 12 VS303.060 60

VS303.042 42 VS303.065* 65

VS303.048 48 VS303.070* 70

VS303.052 52Note: Small Fragment Screw Set (103.515) consists of SmallFragment Standard Screw Set (103.518) and Small FragmentLocking Screw Set (103.517) stored in the optional GraphicCase for Small Fragment Screw Set (690.515).

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LCP Plates 2.7 and lidnot shown

Small Fragment LCP Plate Set (103.516)

* Do not fit in case

Graphic Case690.511 Graphic Case for Small Fragment Plate Set,

without Contents

ImplantsLCP Plates 2.7


VP4031.06 6 54 VP4031.10 10 90

VP4031.08 8 72 VP4031.12 12 108

LCP Plates 3.5


VP4041.06 6 79 VP4041.10 10 131

VP4041.08 8 105 VP4041.12 12 157

Broad LCP Plates 3.5


VP4045.08 8 107 VP4045.12 12 159

VP4045.10 10 133 VP4045.14 14 185

Also Available

LCP Plates 2.7


VP4031.04 4 36 VP4031.09 9 81

VP4031.05 5 45 VP4031.14 14 126

VP4031.07 7 63 VP4031.16 16 144

LCP Plates 3.5


VP4041.02 2 27 VP4041.13 13 170

VP4041.03 3 40 VP4041.14 14 183

VP4041.04 4 53 VP4041.15 15 196

VP4041.05 5 66 VP4041.16 16 209

VP4041.07 7 92 VP4041.18 18 235

VP4041.09 9 118 VP4041.20 20 261

VP4041.11 11 144 VP4041.22* 22 287

Broad LCP Plates 3.5


VP4045.07 7 94 VP4045.16 16 211

VP4045.09 9 120 VP4045.17 17 224

VP4045.11 11 146 VP4045.18 18 237

VP4045.13 13 172 VP4045.20 20 263

VP4045.15 15 198 VP4045.22* 22 289

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Quick Reference Guide – Implants

Small Small Small Small Small Fragment Fragment Fragment Fragment Fragment Standard Locking Screw LC-DCP LCP Screw Set Screw Set Set Plate Set Plate SetPart Number Description (103.518) (103.517) (103.515) (103.514) (103.516)

VS205.008 – Cortex Screw � 2.7 mm, • •VS205.020 self-tapping, lengths 8 –20 mm

VS206.012– Locking Screw Stardrive � 2.7 mm • •VS206.028 (head LCP 2.4), self-tapping, lengths 12–28 mm

VS302.012 – Cortex Screw � 3.5 mm, • •VS302.030 self-tapping, lengths 12 –30 mm

VS303.014 – Locking Screw Stardrive � 3.5 mm, • •VS303.050 self-tapping, lengths 14 –50 mm

VS403.016 – Cancellous Bone Screw � 4.0 mm, • •VS403.030 fully threaded, lengths 16 –30 mm

VP3031.06 LC-DCP 2.7, 6 holes, length 55 mm •








VP3051.08 LC-DCP 3.5, broad, 8 holes, length 107 mm •




VP4031.06 LCP 2.7, 6 holes, length 54 mm •








VP4045.08 LCP 3.5, broad, 8 holes, length 107 mm •




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Small Small Small Small Small Fragment Fragment Fragment Fragment Fragment Standard Locking Screw LC-DCP LCP Screw Set Screw Set Set Plate Set Plate SetPart Number Description (103.518) (103.517) (103.515) (103.514) (103.516)

690.511 Graphic Case for Small Fragment Plate Set, • •without Contents

690.592 Rack for Locking Screws � 2.7 and 3.5 mm, • •self-tapping, without Contents, with Lid

690.593 Rack for Cortex Screws � 2.7 and 3.5 mm and • •Cancellous Bone Screws � 4.0 mm,without Contents, with Lid

690.515 Graphic Case for Screw Set Small Fragments, •without Contents

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Quick Reference Guide – Instruments

Small Small Small Fragment Fragment Fragment Standard Locking Instrument Instrument Instrument Set Set Set Part Number Description (103.501) (103.502) (103.503)

310.210 Drill Bit � 2.0 mm, length 125/100 mm, 2-flute, • • for Quick Coupling




310.890 Countersink 3.5 • •

311.260 Tap for Cortex Screws � 2.7 mm, length 100/33 mm • •

311.320 Tap for Cortex Screws � 3.5 mm, length 110/50 mm • •

311.430 Handle with Quick Coupling, length 110 mm • •

311.440 T-Handle with Quick Coupling • •

312.200 Triple Drill Guide 2.0, with 3 holes • •

312.240 Double Drill Guide 2.7/2.0 • •

312.280 Double Drill Guide 3.5/2.5 • •

312.300 Drill Sleeve Insert 3.5/2.5, length 42 mm • •

314.020 Screwdriver, hexagonal, small, with Holding Sleeve • •

314.030 Screwdriver Shaft, hexagonal, small, � 2.5 mm • •

319.010 Depth Gauge for Screws � 2.7 to 4.0 mm, • • measuring range up to 60 mm

319.970 Screw Forceps, self-holding, length 85 mm • •

323.260 Universal Drill Guide 2.7 • •

323.360 Universal Drill Guide 3.5 • •

329.040 / Bending Iron for Plates 2.4 to 3.5, length 145 mm • •

329.050

VW1203.15.10 Kirschner Wire � 1.25 mm with trocar tip, length 150 mm, • • Stainless Steel, pack of 10 units

VW2003.15.10 Kirschner Wire � 2.0 mm with trocar tip, length 150 mm, • • Stainless Steel, pack of 10 units

310.288 Drill Bit � 2.8 mm, length 165 mm, • • for AO/ASIF Quick Coupling

312.648 LCP Drill Sleeve 3.5, for Drill Bits � 2.8 mm • •

313.353 Drill Sleeve 2.7, for Aiming Arm No. 313.354, for DHP • •

314.116 Screwdriver Shaft Stardrive 3.5, T15, self-holding, • • for AO/ASIF Quick Coupling

314.467 Screwdriver Shaft, Stardrive, T8, self-holding • •

324.023 Bending Pin for LCP Plates 3.5, with thread, length 100 mm • •

324.024 Instrument for temporary reduction • •

690.591 Graphic Case for Instrument Set Small Fragments, without Contents • •

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All technique guides are available as PDF files at www.synthes.com/lit

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Small Fragment System. Instruments and implants for 2.7 and 3.5 ...

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