1.5 mm LCP Modular Mini Fragment System TGsynthes.vo.llnwd.net/o16/LLNWMB8/US Mobile/Synthes North Americ… · Use the AO preoperative planner template for the 1.5 mm LCP Modular

1.5 mm LCP Modular Mini FragmentSystem. 1.5 mm instrument andimplant modules.

Technique Guide

Introduction

Surgical Technique

Product Information

Table of Contents

1.5 mm LCP Modular Mini Fragment System 2

AO Principles 4

Indications 5

Preoperative Planning and Reduction 6

Insert Plate 7

Insert Screws 10

Implant Removal 16

Implants 17

Instruments 20

Set Lists 21

Image intensifier control

Synthes

IMPORTANT: This device has not been evaluated for safetyand compatibility in the MR environment. This device has notbeen tested for heating or migration in the MR environment.

1.5 mm LCP Modular Mini Fragment System. 1.5 mm instrument and implantmodules.

The 1.5 mm LCP Modular Mini FragmentSystem consists of 1.5 mm lockingcompression plate (LCP) instrumentand implant module sets.

2 Synthes 1.5 mm LCP Modular Mini Fragment System Technique Guide

Plates– Low profile to minimize soft tissue

irritation

– Cut-to-length feature minimizes inventory

– Coaxial Combi holes allow the use of a locking screw or a cortex screwin the same round conical plate hole

– Available with or without shortthreaded drill guides preassembled to the plate

– Combi holes in the LCP plates allowuse of a cortex screw in the compres-sion side of the hole or a locking screwin the threaded side of the hole

Locking screws– Self-tapping tip facilitates insertion

– Self-retaining StarDrive recess allowsimproved torque transmission and increased resistance to stripping

– Threaded head profile used with LCP plates creates a fixed-angle construct, particularly advantageousin osteopenic bone

– Low-profile head sits flush with the plate

– Available in stainless steel or titanium

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Cortex screws– Self-tapping tip facilitates insertion

– Self-retaining StarDrive recess allowsimproved torque transmission and increased resistance to stripping

– Used for compression

– Low-profile head sits flush with the plate

– Available in stainless steel or titanium

Coaxial Combi holes allow the use of a locking screw or a cortex screw in thesame round conical plate hole

Available with or without short threadeddrill guides preassembled to the plate

preassembledplate

Cut-to-length feature minimizes inventory

AO Principles

In 1958, the AO formulated four basic principles, which havebecome the guidelines for internal fixation.1 Those principles,as applied to the 1.5 mm LCP Modular Mini Fragment System, are:

Anatomic reductionFracture reduction and fixation to restore anatomical relationships.

Stable fixationLocking screws create a fixed-angle construct, providing angular stability.

Preservation of blood supplyTapered end may facilitate submuscular plate insertion. Sub-muscular plate insertion may help to preserve tissue viability.Limited-contact plate design minimizes disruption of soft tissue and preserves vascular blood flow for bone healing.

Early, active mobilizationEarly mobilization per standard AO technique creates an environment for bone healing, expediting a return to optimal function.

1. M. E. Müller, M. Allgöwer, R. Schneider, and H. Willenegger. Manual ofInternal Fixation, 3rd Edition. Berlin: Springer-Verlag. 1991.


Indications

The Synthes 1.5 mm LCP Modular Mini Fragment System con-sists of plates and screws and is intended for fixation of smallbones and small bone fragments; osteotomies, arthrodeses,replantations, and reconstructions of small bones and smallbone fragments, particularly in osteopenic bone.

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Preoperative Planning and Reduction

Preoperative planning

Use the AO preoperative planner template for the 1.5 mmLCP Modular Mini Fragment System.

Required sets

01.114.001/ 1.5 mm LCP Modular Mini Fragment 01.114.002 Instrument and Implant Set

(stainless steel or titanium)or01.114.501/ 1.5 mm LCP Modular Mini Fragment 01.114.502 Instrument and Implant Set, with Drill

Guides (stainless steel or titanium)

105.200/ Modular Hand System 145.200 (stainless steel or titanium)or01.111.120/ Modular Mini Fragment LCP Instrument01.111.140 and Implant Set (stainless steel or titanium)

1Reduce fracture

Instruments

292.10/ 1.0 mm Kirschner Wire, trocar point492.10 (stainless steel or titanium)or292.50* 1.0 mm Kirschner Wire, trocar points on

both ends (stainless steel)

399.97 Reduction Forceps, with points

Reduce the fracture under imaging and, if necessary, fix withKirschner wires or reduction forceps.

* Also available

Insert Plate

2Trim plate

Instrument

391.98* Plate Cutter, for 1.0 mm–2.0 mm plates

The plate cutter can be used on a preassembled plate withoutremoval of the short threaded drill guides.

Optional instrument

391.962 Bending/Cutting Pliers

If the bending/cutting pliers are used on a plate preassembledwith drill guides, the drill guides must first be removed fromthe plate.

Trim the plate to the desired length using the cutters and remove the burrs.

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* Also available

Insert Plate

3Contour plate (optional)

Instrument

03.114.003 Threaded Bending Pin, for 1.5 mm LCP Plates

If necessary, use threaded bending pins to contour the plateto fit the patient’s anatomy. The bending pins can be insertedover the short threaded drill guides or threaded into thescrew holes. The threaded bending pins should be used toprevent deformation of the threaded holes while bending.

Optional instruments

391.962 Bending/Cutting Pliers

391.963 Universal Bending Pliers

The non-preassembled plates can also be bent using the flat-nosed pliers.

Note: If possible, bend LCP plates between the Combi holes.Do not deform the Combi holes during bending or over-bend the plates as this may adversely affect insertion of locking screws.


4Position plate

Instruments

292.10/ 1.0 mm Kirschner Wire, trocar point492.10 (stainless steel or titanium)or292.50* 1.0 mm Kirschner Wire, trocar points on both

ends (stainless steel)

398.819 Plate Holding Forceps with swivel foot, 150 mm

399.97 Reduction Forceps, with points

Position the plate over the reduced fracture using forcepsand fix provisionally with Kirschner wires or reduction forceps, if necessary.

Note: If using a preassembled plate, the short threaded drillguides must be removed from surrounding holes to allow plateholding forceps to sit flush on the plate. The point of pointedreduction forceps can be inserted in the cannulation of theshort threaded drill guides to secure the plate to the bone.

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* Also available

5Determine screw type

Depending on the individual case, cortex screws and/or locking screws may be inserted. Determine where lockingscrews will be used. Locking or cortex screws can be used inany of the screw holes, with the exception of the nonthreadedelongated hole, which only accepts 1.5 mm cortex screws. If a combination of locking and cortex screws is planned, a cortex screw should be inserted first to pull the plate to thebone. If a locking screw is inserted first, ensure that the plateis held securely to the bone, to avoid spinning of the plate as the screw is locked into the plate.

Insert Screws


6Insert screws in plate head

Instruments

03.114.009 StarDrive Screwdriver Shaft, with HoldingSleeve, T4, 66 mm

311.01 Handle, with mini quick coupling

319.004 Depth Gauge, for 1.3 mm and 1.5 mm screws

Alternative instrument

03.114.002 Screwdriver Shaft, T4, 42 mm, self-retaining

for use with 1.5 mm locking screws

03.114.007 1.1 mm Drill Bit, mini quick coupling, 75 mm

for use with 1.5 mm cortex screws


310.141 1.5 mm Drill Bit, mini quick coupling, 65 mm

312.14 1.5 mm/1.1 mm Double Drill Sleeve

A 1.5 mm cortex screw can be inserted in the nonthreadedelongated hole. Adjust the plate as necessary and tightenthe screw.

Note: The fracture pattern will dictate the optimal screwplacement.

Insert 1.5 mm cortex or locking screws in the head of theplate. If a cortex screw will be inserted normal to the plate,the short threaded drill guide can be used. If a cortex screwwill be angled or inserted using a lag technique, use thedouble drill sleeve. Use the 1.1 mm drill bit for the threadedhole and the 1.5 mm drill bit for the gliding hole. Determinethe screw length using the depth gauge.

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Insert Screws

6. Insert screws in plate head continued

Notes:If using a preassembled plate, the shortthreaded drill guide must be removedfrom the hole before using the double drill sleeve.

If measuring through the short threadeddrill guide, subtract 5 mm from thereading, to account for the drill guide.

Drill for a 1.5 mm locking screw usingthe short threaded drill guide preassem-bled in the plate, and the 1.1 mm drillbit. Measure for screw length using thedepth gauge.

Note: If measuring through the shortthreaded drill guide, subtract 5 mmfrom the reading, to account for thedrill guide.

Alternative technique

Instrument

03.114.001 1.1 mm LCP ThreadedDrill Guide

On non-preassembled plates, threadthe 1.1 mm threaded drill guide intothe hole and drill.

Note: Remove the 1.1 mm LCP threadeddrill guide before measuring.



7Insert screws in plate shaft

Instruments



319.004 Depth Gauge, for 1.3 mm and 1.5 mm screws



for use with 1.5 mm locking screws


for use with 1.5 mm cortex screws



312.14 1.5 mm/1.1 mm Double Drill Sleeve

A 1.5 mm cortex screw can be inserted in the nonthreadedelongated hole. Adjust the plate as necessary and tightenthe screw.

Note: The fracture pattern will dictate the optimal screwplacement.

Insert 1.5 mm cortex or locking screws in the plate shaft. If a cortex screw will be inserted normal to the plate, the shortthreaded drill guide can be used. If a cortex screw will be angled or inserted using a lag technique, use the double drillsleeve. Use the 1.1 mm drill bit for the threaded hole and the1.5 mm drill bit for the gliding hole. Determine the screwlength using the depth gauge.

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Insert Screws

7. Insert screws in plate shaft continued

Notes:If using a preassembled plate, the shortthreaded drill guide must be removedfrom the hole before using the double drill sleeve.

If measuring through the short threadeddrill guide, subtract 5 mm from thereading, to account for the drill guide.

Drill for a 1.5 mm locking screw usingthe short threaded drill guide pre-assembled in the plate, and the 1.1 mmdrill bit. Measure for screw length usingthe depth gauge.

Note: If measuring through the shortthreaded drill guide, subtract 5 mmfrom the reading, to account for thedrill guide.


Instrument

03.114.001 1.1 mm LCP ThreadedDrill Guide

On non-preassembled plates, threadthe 1.1 mm threaded drill guide intothe hole and drill.

Note: Remove the 1.1 mm LCP threadeddrill guide before measuring.


8Remove short threaded drill guides

Instruments





Be sure to remove all short threaded drill guides when usingpreassembled plates. The removable tray located in the bottom of the module can serve as a tool to help remove the short drill guides from the screwdriver shaft. It is recom-mended to count the short threaded drill guides, to ensurethey are all removed before closure.

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Implant Removal

Implant removal

Instruments





Loosen all locking screws first, to prevent the plate from rotating during removal of the last locking screw. Remove all screws in a second step. If the screw threads are stripped,a stripped screw extractor can be used. An extraction bolt or hollow reamer can be used to engage shaft threads for removal.


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1.5 mm Cortex Screws, self-tapping, with T4 StarDriverecess– Used to provide compression or neutral fixation

– Low-profile head sits flush in the plate holes

– StarDrive recess mates with self-retaining screwdriver and provides improved torque transmission

– 6 mm to 24 mm lengths

1.5 mm Locking Screws, self-tapping, with T4 StarDriverecess– Threaded, conical head locks securely in Combi holes of

the plate, to provide angular stability

– Locked screws allow unicortical screw fixation and loadtransfer to the near cortex

– StarDrive recess mates with self-retaining screwdriver and provides improved torque transmission

– 6 mm to 24 mm lengths

Note: For information on fixation principles using conventionaland locked plating techniques, please refer to the Small Fragment Locking Compression Plate (LCP) Technique Guide.

Implants

Screws are made of implant-quality 316L stainless steel or titanium alloy (Ti-6AI-7Nb)

1.5 mm LCP PlatesStainless Steel Titanium Holes Length (mm)02.114.002 04.114.002 4 2302.114.004 04.114.004 6 36

1.5 mm LCP Adaption PlatesStainless Steel Titanium Holes Length (mm)02.114.003 04.114.003 6 2902.114.005 04.114.005 12 59

1.5 mm LCP T-PlatesStainless Steel Titanium Description02.114.006 04.114.006 3 holes head,

8 holes shaft02.114.007 04.114.007 4 holes head,

8 holes shaft

1.5 mm LCP Extended H-PlatesStainless Steel Titanium Description02.114.010 04.114.010 right02.114.009 04.114.009 left

1.5 mm LCP Y-PlateStainless Steel Titanium Description02.114.013 04.114.013 3 holes head,

8 holes shaft

1.5 mm LCP Condylar PlateStainless Steel Titanium Description02.114.014 04.114.014 6 holes shaft


Implants

Plates are made of implant-quality 316L stainless steel or commercially pure (CP) titanium

Plates, assembled with short threaded drill guides1.5 mm LCP PlatesStainless Steel Titanium Holes Length (mm)02.114.502 04.114.502 4 2302.114.504 04.114.504 6 36

1.5 mm LCP Adaption PlatesStainless Steel Titanium Holes Length (mm)02.114.503 04.114.503 6 2902.114.505 04.114.505 12 59

1.5 mm LCP T-PlatesStainless Steel Titanium Description02.114.506 04.114.506 3 holes head,

8 holes shaft02.114.507 04.114.507 4 holes head,

8 holes shaft

1.5 mm LCP Extended H-PlatesStainless Steel Titanium Description02.114.509 04.114.509 left02.114.510 04.114.510 right

1.5 mm LCP Y-PlateStainless Steel Titanium Description02.114.513 04.114.513 3 holes head,

8 holes shaft

1.5 mm LCP Condylar PlateStainless Steel Titanium Description02.114.514 04.114.514 6 holes shaft

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Instruments

03.114.001 1.1 mm LCP Threaded Drill Guide, for 1.5 mmLCP Plates

03.114.002 StarDrive Screwdriver Shaft, T4, 42 mm, self-retaining

03.114.003 Threaded Bending Pin, for 1.5 mm LCP plates



310.971 Countersink, for 1.3 mm and 1.5 mm screws



1.5 mm LCP Modular Mini Fragment Instrument and Implant Sets Stainless Steel (01.114.001) and Titanium (01.114.002)

Module60.114.001 1.5 mm LCP Module Case306.667.96 Screw Length Marker Kit

Instruments03.114.001 1.1 mm LCP Threaded Drill Guide, for 1.5 mm

LCP Plates, 2 ea.03.114.002 StarDrive Screwdriver Shaft, T4, 42 mm,

self-retaining03.114.003 Threaded Bending Pin, for 1.5 mm LCP plates,

2 ea.03.114.007 1.1 mm Drill Bit, mini quick coupling, 75 mm,

2 ea.03.114.009 StarDrive Screwdriver Shaft, with Holding

Sleeve, T4, 66 mm310.141 1.5 mm Drill Bit, mini quick coupling, 65 mm,

2 ea.310.971 Countersink, for 1.3 mm and 1.5 mm screws

Implants1.5 mm Locking Screws, self-tapping, with T4 StarDrive recess

Length Stainless Steel Titanium (mm) Qty.

02.214.006 04.214.006 6 602.214.007 04.214.007 7 602.214.008 04.214.008 8 602.214.009 04.214.009 9 602.214.010 04.214.010 10 602.214.011 04.214.011 11 602.214.012 04.214.012 12 602.214.013 04.214.013 13 602.214.014 04.214.014 14 602.214.015 04.214.015 15 602.214.016 04.214.016 16 402.214.018 04.214.018 18 402.214.020 04.214.020 20 402.214.022 04.214.022 22 402.214.024 04.214.024 24 4

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1.5 mm Cortex Screws, self-tapping, with T4 StarDrive recessLength

Stainless Steel Titanium (mm) Qty.

02.214.106 04.214.106 6 602.214.107 04.214.107 7 602.214.108 04.214.108 8 602.214.109 04.214.109 9 602.214.110 04.214.110 10 602.214.111 04.214.111 11 602.214.112 04.214.112 12 602.214.113 04.214.113 13 602.214.114 04.214.114 14 602.214.115 04.214.115 15 602.214.116 04.214.116 16 402.214.118 04.214.118 18 402.214.120 04.214.120 20 402.214.122 04.214.122 22 402.214.124 04.214.124 24 4

Note: For additional information, please refer to package insert.

For detailed cleaning and sterilization instructions, please refer tohttp://www.synthes.com/sites/NA/MedicalCommunity/Pages/Cleaning_and_Sterilization.aspxor to the below listed inserts which will be included in the shipping container:—Processing Synthes Reusable Medical Devices—Instruments, Instrument Trays and Graphic

Cases—DJ1305—Processing Non-sterile Synthes Implants—DJ1304

1.5 mm LCP Modular Mini Fragment Instrument and Implant SetsStainless Steel (01.114.001) and Titanium (01.114.002)


Implants continuedWithout Short Threaded Drill Guides

1.5 mm LCP Plates, 2 ea.

Stainless Steel Titanium Holes Length (mm)

02.114.002 04.114.002 4 2302.114.004 04.114.004 6 36

1.5 mm LCP Adaption Plates, 2 ea.

Stainless Steel Titanium Holes Length (mm)

02.114.003 04.114.003 6 2902.114.005 04.114.005 12 59

1.5 mm LCP T-Plates, 2 ea.

Stainless Steel Titanium Description

02.114.006 04.114.006 3 holes head, 8 holes shaft02.114.007 04.114.007 4 holes head, 8 holes shaft

1.5 mm LCP Extended H-Plates, 2 ea.


02.114.009 04.114.009 left02.114.010 04.114.010 right

1.5 mm LCP Y-Plate, 2 ea.


02.114.013 04.114.013 3 holes head, 8 holes shaft

1.5 mm LCP Condylar Plate, 2 ea.


02.114.014 04.114.014 6 holes shaft

1.5 mm LCP Modular Mini Fragment Instrument and Implant Sets with Drill Guides Stainless Steel (01.114.501) and Titanium (01.114.502)

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Module60.114.001 1.5 mm LCP Module Case306.667.96 Screw Length Marker Kit

Instruments03.114.001 1.1 mm LCP Threaded Drill Guide, for 1.5 mm

LCP Plates, 2 ea.03.114.002 StarDrive Screwdriver Shaft, T4, 42 mm,

self-retaining03.114.003 Threaded Bending Pin, for 1.5 mm LCP

plates, 2 ea.03.114.007 1.1 mm Drill Bit, mini quick coupling, 75 mm,

2 ea.03.114.009 StarDrive Screwdriver Shaft, with Holding

Sleeve, T4, 66 mm310.141 1.5 mm Drill Bit, mini quick coupling, 65 mm,

2 ea.310.971 Countersink, for 1.3 mm and 1.5 mm screws

Implants1.5 mm Locking Screws, self-tapping, with T4 StarDrive recess

Length Stainless Steel Titanium (mm) Qty.

02.214.006 04.214.006 6 602.214.007 04.214.007 7 602.214.008 04.214.008 8 602.214.009 04.214.009 9 602.214.010 04.214.010 10 602.214.011 04.214.011 11 602.214.012 04.214.012 12 602.214.013 04.214.013 13 602.214.014 04.214.014 14 602.214.015 04.214.015 15 602.214.016 04.214.016 16 402.214.018 04.214.018 18 402.214.020 04.214.020 20 402.214.022 04.214.022 22 402.214.024 04.214.024 24 4

1.5 mm Cortex Screws, self-tapping, with T4 StarDrive recessLength

Stainless Steel Titanium (mm) Qty.

02.214.106 04.214.106 6 602.214.107 04.214.107 7 602.214.108 04.214.108 8 602.214.109 04.214.109 9 602.214.110 04.214.110 10 602.214.111 04.214.111 11 602.214.112 04.214.112 12 602.214.113 04.214.113 13 602.214.114 04.214.114 14 602.214.115 04.214.115 15 602.214.116 04.214.116 16 402.214.118 04.214.118 18 402.214.120 04.214.120 20 402.214.122 04.214.122 22 402.214.124 04.214.124 24 4

1.5 mm LCP Modular Mini Fragment Instrument and Implant Sets with Drill Guides Stainless Steel (01.114.501) and Titanium (01.114.502)


Implants continuedWith Short Threaded Drill Guides

1.5 mm LCP PlatesStainless Steel Titanium Holes Length (mm)

02.114.502 04.114.502 4 2302.114.504 04.114.504 6 36

1.5 mm LCP Adaption PlatesStainless Steel Titanium Holes Length (mm)

02.114.503 04.114.503 6 2902.114.505 04.114.505 12 59

1.5 mm LCP T-PlatesStainless Steel Titanium Description

02.114.506 04.114.506 3 holes head, 8 holes shaft02.114.507 04.114.507 4 holes head, 8 holes shaft

1.5 mm LCP Extended H-PlatesStainless Steel Titanium Description

02.114.509 04.114.509 left02.114.510 04.114.510 right

1.5 mm LCP Y-PlateStainless Steel Titanium Description

02.114.513 04.114.513 3 holes head, 8 holes shaft

1.5 mm LCP Condylar PlateStainless Steel Titanium Description

02.114.514 04.114.514 6 holes shaft

Also Available

Synthes

Required Set01.111.120/ Modular Mini Fragment LCP Instrument 01.111.140 and Implant Set (stainless steel or titanium)

or

105.200/ Modular Hand System145.200 (stainless steel or titanium)

Instruments03.114.008 1.1 mm Drill Bit, Stryker J-latch, 85 mm03.114.010 StarDrive Screwdriver Shaft, T4, 66 mm391.98 Plate Cutter, for 1.0 mm–2.0 mm plates292.50 1.0 mm Kirschner Wire, trocar points on

both ends

Lid and Tray60.114.003 Lid for 1.5 mm LCP Module Case60.114.004 Tray for Small Threaded Drill Guides,

for 1.5 mm module

Synthes (USA)1302 Wrights Lane EastWest Chester, PA 19380Telephone: (610) 719-5000To order: (800) 523-0322Fax: (610) 251-9056

Synthes (Canada) Ltd.2566 Meadowpine BoulevardMississauga, Ontario L5N 6P9Telephone: (905) 567-0440To order: (800) 668-1119Fax: (905) 567-3185

© 2009 Synthes, Inc. or its affiliates. All rights reserved. Combi, LCP and Synthes are trademarks of Synthes, Inc. or its affiliates. Printed in U.S.A. 8/11 J9076-D

www.synthes.com

Documents

1.5 mm LCP Modular Mini Fragment System TGsynthes.vo.llnwd.net/o16/LLNWMB8/US Mobile/Synthes North Americ… · Use the AO preoperative planner template for the 1.5 mm LCP Modular