Patient Charge/Inventory Control Sheet TraumaOne™...Lorenz ® Plating System TraumaOne Mandible 2.0/2.3mm Trauma One /634& 5&$) (please ˜ll in the blank) /".& %"5& %&-7&3:50-0$"50

Items not to scale 00-Form33713 • Rev 0-1311

Patient Charge/Inventory Control Sheet

Midface 1.5mmLorenz® Plating System TraumaOne™

TraumaOne™

NURSE/TECH (please fill in the blank)

NAME:

DATE:

DELIVERY TO LOCATION: SURGERY800.874.7711 • 904.741.4400Fax: 904.741.3059www.biometmicrofixation.com

P.O. #:

Patient Data – For charge use

DescriptionPart #

Orbital Floor Plates - GoldQty

Small Orbital Floor

Medium Orbital Floor

Large Orbital Floor

N.O.E. Plate

01-7106

01-7107

01-7108

01-7109

DescriptionPart #

Regular Plates - SilverQty

Straight Plates

Double Y Plates

Rectangle Plates

L Plates, 100º

Curved Plates

RegularX-Long

4-hole

4-hole, Long

6-hole

16-hole

01-7040

01-7047

01-7050

01-7066

01-7110

01-7114

2 x 3-hole

2 x 4-hole

01-7136

01-7137

Left, Med, 3x3

Right, Med, 3x3

Left, X-Long, 3x3

Right, X-Long, 3x3

Left, 4x6

Right, 4x6

01-7032

01-7033

01-7036

01-7037

01-7038

01-7039

6-hole

10-hole

01-7126

01-7130

DescriptionPart #

Orbital Plates (green)Qty

Curved Plates

4-hole

6-hole

18-hole

01-7123

01-7121

01-7122

Straight Plates

6-holeSP-2371

4-hole

8-hole

20-hole

01-8664

01-8662

01-8670

Rigid Plates - Gold

Straight Plates

14-hole01-8689

Curved Plates

Left, 2x2

Right, 2x2

Left, Med, 3x3

Right, Med, 3x3

Left, Long, 3x3

Right, Long, 3x3

Left, 4x6

Right, 4x6

01-8678

01-8679

SP-2575

SP-2576

01-8636

01-8637

01-8680

01-8681

L Plates

Y Plate01-8604

Y Plates

DescriptionPart #Qty



Midface 1.5mmLorenz® Plating System TraumaOne™

TraumaOne™


NAME:

DATE:


P.O. #:


LengthPart #

1.5mm Self-Tapping Screw - GoldQty

3.5mm

4mm

5mm

6mm

7mm

8mm

9mm

11mm

13mm

15mm

91-1503

91-1504

91-1505

91-1506

91-1507

91-1508

91-1509

91-1511

91-1513

91-1515

LengthPart #

1.8mm Self-Tapping Screws - MagentaQty

3.5mm

5mm

7mm

9mm

91-1803

91-1805

91-1807

91-1809

LengthPart #

1.5mm Self-Drilling Screws - GreenQty

3.5mm

4mm

1.65 x 5mm

6mm

7mm

91-6103

91-6104

91-6105x

91-6106

91-6107

QTY PART # DESCRIPTION

Additional

DescriptionPart #

MeshQty

Small Grid Panel

0.6mm

0.3mm

01-7182

01-7185

Hex Panel

0.2mm01-7340

Orbital Floor Mesh

0.2mmSP-1865

DescriptionPart #

Drills/BladesQty

Drills

1.1x50mm, 5mm Stop

1.1x50mm, 7mm Stop

1.1x50mm, 9mm Stop

1.1x50mm, 15mm Stop

01-7142

01-7144

01-7146

01-7148

Blades

1.5mm HT X-Lock Blade

1.5mm HT X-Lock Blade, Long

2.0x7mm Bone Reduction Blade

2.5x6mm Bone Reduction Blade

15-1194

15-1196

SP-1889

SP-2032

* iQ Drills can be found on a separate page at the end of this document



Mandible 2.0/2.3mmLorenz® Plating System TraumaOne™

TraumaOne™


NAME:

DATE:


P.O. #:


DescriptionPart #

1.0mm Thick Plates - SilverQty

Straight Plates

4-hole

4-hole w/gap

4-hole, Long gap

4-hole, X-Long gap

7-hole

16-hole

10-hole

SP-2284

42-1004

SP-2375

SP-2376

42-1007

42-1016

SP-2256

Curved Plates

7-hole42-1003

Matrix Plates

Straight 2x7

Curved 2x7

42-1005

42-1006

Y Plates

Long

Double Y

42-1002

SP-2665

DescriptionPart #

1.6mm Thick Plates - GoldQty

Straight Plates

4-hole

4-hole w/gap

7-hole

16-hole

43-1005

43-1004

43-1007

43-1016

Curved Plates

7-hole43-1008

Matrix Plates

Straight 2x7

Curved 2x7

SP-2630

SP-2631

Y Plates

LongSP-2465

Angled Plates

Small43-1001

DescriptionPart #

2.0mm Thick Plates - BlueQty

Straight Plates

4-hole w/gap

6-hole

6-hole w/gap

12-hole

24-hole

SP-2292

SP-2566

SP-2377

44-1012

44-1024

Angle Plates

Large

Large, Straight

44-1001

44-1021

Double Angle Plates

Small, Prebent

Medium, Prebent

Small, Straight

Medium. Straight

44-1002

44-1003

44-1018

44-1022

DescriptionPart #

2.6mm Thick Plates - MagentaQty

Straight Plates

7-hole

16-hole

SP-2468

SP-2469

Curved Plates

7-holeSP-2470

Double Angle Plates

Small, Straight

Large, Straight

SP-2276

SP-2277

Angle Plates

Large, Prebent

Large, Straight

Small, Straight

44-1005

44-1023

SP-2467



Mandible 2.0/2.3mmLorenz® Plating System TraumaOne™

TraumaOne™


NAME:

DATE:


P.O. #:


DescriptionPart #

TemplatesQty

Straight Plate

24-hole46-1024T

Double Angle Plate

Small, Prebent

Medium, Prebent

Small, Straight

Medium, Straight

46-1002T

46-1003T

46-1018T

46-1022T

Angle Plate

Large, Prebent

Large, Straight

46-1001T

46-1021T

DescriptionPart #

Drills/BladesQty

Drills

1.5x50mm, 5mm stop

1.5x50mm, 7mm stop

1.8x50mm, 26mm Stop

1.8x115mm, 26mm Stop

1.6x50mm, 22mm Stop

1.6x115mm, 26mm Stop

01-9192

01-9193

24-2050

46-1004

46-1006

46-1007

Blades

Mandibular Screwdriver Blade

IMF blade

46-1005

46-0011 TRAUMAONE IMF BLADE

DescriptionPart #

Add-On CondyleQty

Left

Right

01-2691

01-2692

5mm

6mm

8mm

10mm

12mm

14mm

16mm

18 mm

41-2305

41-2306

41-2308

41-2310

41-2312

41-2314

41-2316

41-2318

2.3mm X-DriveNon-Locking Screws - GoldQty DescriptionPart #

6mm

8mm

10mm

12mm

14mm

16mm

18mm

41-2406

41-2408

41-2410

41-2412

41-2414

41-2416

41-2418

2.3mm X-DriveLocking Screws - GoldQty DescriptionPart #

8mm

10 mm

12 mm

14 mm

16 mm

18 mm

41-2708

41-2710

41-2712

41-2714

41-2716

41-2718

2.7mm X-DriveNon-Locking Screws - MagentaQty DescriptionPart #

7mm

9mm

11mm

91-5607

91-5609

91-5611

2.0mm Self-DrillingIMF ScrewsQty DescriptionPart #

DescriptionPart #

Additional ItemsQty

Plate, 4-hole, Straight, 0.6mm

Plate, 4-hole, Compression, 1.6mm

Plate, Large, Angle, 2.8mm

Plate, 9-hole, Wide, 1.2mm

Plate, Deburr, J-Notch

2.3mm Bone Tap

SP-2585

SP-2194

SP-2623

SP-2402

01-2788

SP-2258

23 241 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

6

5

4

3

2

1

12 3 194 5 6 7 8 9 10 11 12 13 14 15 16 17 18

10 11 12 13 14 1516

65

43

21

1

23

4

17

21

25

2423

22

65

43

21

56

7 89 18

19 20

Tipand

Bottom

5mm

7mm

5mm

6mm

8mm

10mm

12mm

14mm

16mm

18 mm

41-2205

41-2207

41-2005

41-2006

41-2008

41-2010

41-2012

41-2014

41-2016

41-2018

2.0mm X-Drive Non-LockingScrews - Blue/SilverQty DescriptionPart #

6mm

8mm

10mm

12mm

14mm

16mm

18 mm

41-2106

41-2108

41-2110

41-2112

41-2114

41-2116

41-2118

2.0mm X-DriveLocking Screws - SilverQty DescriptionPart #

* iQ Drills can be found on a separate page at the end of this document



DrillsiQ™ Intelligent System

iQ Drills


NAME:

DATE:


P.O. #:


DescriptionPart #

Midface DrillsQty

Drills

1.1mm drill w/ 5mm stop




72-2030

72-2034

72-2038

72-2042






72-2049

72-2052

72-2055

72-2057

72-2060

Mandible Drills

Percutaneous Drills




72-2019

72-2021

72-2023

72-1010

iQ™ Driver Battery

iQ™ Driver Battery

Documents

Patient Charge/Inventory Control Sheet TraumaOne™...Lorenz ® Plating System TraumaOne Mandible 2.0/2.3mm Trauma One /634& 5&$) (please ˜ll in the blank) /".& %"5& %&-*7&3:50-0$"5*0

Patient Charge/Inventory Control Sheet TraumaOne™...Lorenz ® Plating System TraumaOne Mandible 2.0/2.3mm Trauma One /634& 5&$) (please ˜ll in the blank) /".& %"5& %&-7&3:50-0$"50