DCP and LC-DCP Systems. Dynamic Compression Plates (DCP) and DynamicCompressionPlateswithLimited Bone Contact (LC-DCP).
SurgicalTechnique
ThispublicationisnotintendedfordistributionintheUSA.
Instruments and implantsapprovedbytheAOFoundation.
Imageintensifiercontrol
Thisdescriptionalonedoesnotprovidesufficientbackgroundfordirectuse oftheinstrumentset.Instructionbyasurgeonexperiencedinhandlingtheseinstrumentsishighlyrecommended.
Processing, Reprocessing, Care and MaintenanceForgeneralguidelines,functioncontrolanddismantlingofmulti-partinstruments,aswellasprocessingguidelinesforimplants,pleasecontactyourlocalsalesrepresentativeorreferto:http://emea.depuysynthes.com/hcp/reprocessing-care-maintenanceForgeneralinformationaboutreprocessing,careandmaintenanceofSynthesreusabledevices,instrumenttraysandcases,aswellasprocessingofSynthesnon-sterileimplants,pleaseconsulttheImportantInformationleaflet(SE_023827)orreferto: http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 1
Table of Contents
Introduction DCP and LC-DCP Systems 2
AOPrinciples 4
IntendedUse 5
Indications 6
Surgical Technique Preparation 7
DrillGuidesforDCPandLC-DCP 9
CompressionPlate:SimpleFracture 12
CompressionPlate:MultifragmentaryFracture 15
Buttress Plate 18
Neutralization Plate (Protecting Plate) 20
Product Information Screws,DrillsandTaps 21
MiniFragmentSystem1.5,2.0,2.7 23
CompactHand1.0,1.3,1.5,2.0,2.4 33
CompactHandModule1.0/1.3 33
CompactHandModule1.5 35
CompactHandModule2.0 38
CompactHandModule2.4 41
2 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
mid section
Non-symmetrical holesSomeDynamicCompressionPlatesfeaturenon-symmetricalholeswhichallowtoachievecompressioninonlyonedirection.Theseplatesfeatureamidsectionwhichisplacedatthepositionoffragmentstobecompressed.
Thenon-symmetricalDCPholesareshapedlikeaportionofaninclinedandangledcylinder.Theypossessonecompres-sionpointattheinclinedsideandoneneutralpointinthemiddle.
DynamicCompressionPlatesareavailableindimensionsrangingfrom1.3to4.5mm,LimitedContactDynamicCompressionPlatesrangefrom2.0to4.5mm.
DCP and LC-DCP Systems. Dynamic Compression Plates (DCP) and DynamicCompressionPlateswithLimited Bone Contact (LC-DCP).
Plate hole geometries
Symmetrical holesMost1.3to3.5mmDynamicCompressionPlateshavesym-metricalholessimilartotheLC-DCPhole.Thesymmetricalshapeoftheplateholesenablescompressiontobeachievedinbothdirections,thusplatepositioningisnotrestrictedbythepresenceofamid-section.
SymmetricallyshapedDCPholespossessonecompressionandoneneutralpointonbothsides.Withsomesmallandminiplates,theneutralpointsmeetinthemiddle.
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 3
UndercutsoftheLC-DCPlimitcontactbetweenplateandbone,minimizingtheriskoftissuenecrosisundertheplate.
Non-symmetrical holesTheDCPallowsupto25longitudinaland7transversescrewangulation.
Symmetrical holesTheDCPholeallowsupto50longitudinalscrewangulationforanincreasedrangeofapplications.LC-DCPholesallowevenwiderangulationsupto80.Bothplatetypesallowfor14transversescrewangulation.
Undercuts
Screw angulations
TheuniformstiffnessoftheLC-DCPallowssmoothcontouringoftheplatetothebone.Itprotectstheplatefromlocalizedhighbendingstresses.
Uniform stiffness (LC-DCP only)
LC-DCP
Standard
SymmetricalLC-DCPhole
1
4
2
3
4_Priciples_03.pdf 1 05.07.12 12:08
4 DePuy Synthes Expert Lateral Femoral Nail Surgical Technique
AO PRINCIPLES
In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation1, 2.
1 Mller ME, M Allgwer, R Schneider, H Willenegger. Manual of Internal Fixation. 3rd ed. Berlin Heidelberg New York: Springer. 1991.
2 Redi TP, RE Buckley, CG Moran. AO Principles of Fracture Management. 2nd ed. Stuttgart, New York: Thieme. 2007.
Anatomic reductionFracture reduction and fixation to restore anatomical relationships.
Early, active mobilizationEarly and safe mobilization and rehabilitation of the injured part and the patient as a whole.
Stable fixationFracture fixation providing abso-lute or relative stability, as required by the patient, the injury, and the personality of the fracture.
Preservation of blood supplyPreservation of the blood supply to soft tissues and bone by gentle reduction techniques and careful handling.
4 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
AO Principles
1MllerME,AllgwerM,SchneiderR,WilleneggerH.ManualofInternalFixation. 3rded.Berlin,Heidelberg,NewYork:Springer.1991.
2RediTP,BuckleyRE,MoranCG.AOPrinciplesofFractureManagement.2nd ed. Stuttgart,NewYork:Thieme.2007.
Stable fixationFracturefixationprovidingabsoluteorrelativestability,asrequiredbythepatient,theinjury,andthepersonalityofthefracture.
Anatomic reductionFracturereductionandfixation torestoreanatomicalrelationships.
Early, active mobilizationEarlyandsafemobilizationand rehabilitationoftheinjuredpartandthepatientasawhole.
Preservation of blood supplyPreservationofthebloodsupply tosofttissuesandbonebygentle reductiontechniquesandcarefulhandling.
In1958,theAOformulatedfourbasicprinciples,whichhavebecometheguidelinesforinternalfixation1,2.
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 5
Intended Use
Intended UseDCPandLC-DCPSystemImplantsareintendedfortempo-raryfixation,correctionorstabilizationofbonesinvariousanatomical regions.
6 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Indications
ThistechniqueguideappliestothebelowSynthesDCPandLC-DCPsystemsandplatelines:
Mini Fragment System 1.5, 2.0, 2.7 Fracturesofthemiddleanddistalphalangesandtarsals Fracturesofthemetacarpalsandmetatarsals Osteotomiesandarthrodesesonthehandandfoot Fracturesofthedistalradius(double-platetechnique)
Compact Hand 1.0, 1.3, 1.5, 2.0, 2.4Implantsizes1.0/1.3: Fixationofsmallfragments Fracturesofthedistalandintermediatephalanges Avulsionfractures
Implantsizes1.5: Fracturesofthephalangesandmetacarpals Capturingoffragmentswithlagscrewtechnique
Implantsizes2.0/2.4: Fracturesofthephalangesandmetacarpals Capturingoffragmentswithlagscrewtechnique
Cloverleaf Plates 3.5 Distaltibiaforcomminutedfracturestobuttressitsmedial
side Proximalhumerusforcomminutedfracturesofthehu-meralhead
One-third tubular plate 3.5 Fracturesofsmallersizedbonessuchasfibula,humerus
and ulna.
Low Profile 3.5 Pelvic System PelvicandAcetabularFracturesandOsteotomies
LC-DCP/DCP 3.5 Straight Plate, DCP 3.5 T-Plate
Fracturefixationandfixationafterforexampleosteoto-mies,malunions,nonunionsincludingbutnotlimitedtodistalradius,proximalanddisitaltibia,proximalhumerus,clavicula.
LC-DCP/DCP 4.5 Straight Plate, DCP 4.5 T-Plate/ T-Buttress Plate/L-Plate Fracturesandosteotomiesoflargebonessuchasfemur,tibiaandhumerus
Standard Reconstruction Plate 3.5/4.5 PelvicandAcetabularFracturesandOsteotomies
Semi-Tubular Plate 4.5 Fracturesandosteotomiesofsmallersizedbonessuchashumerus,radius,ulna,clavicula,fibula,tibiaandpelvis
Condylar Buttress Plate 4.5 Buttressingofmultifragmentarydistalfemurfractures Supracondylarfractures Intra-articularandextra-articularcondylarfractures Malunionsandnonunionsofthedistalfemur Periprostheticfractures
Lateral Tibial Head Buttress Plate 4.5 Indicatedforthestabilizationoffracturesoftheproximaltibia.Theseincludeproximalshaftfractures,metaphysealfractures,intra-articularfractures,periprostheticfractures
Proximal Tibial Plate 4.5Intendedfornonunions,malunionsandfracturesoftheproximaltibiaincludingsimple,comminuted,lateralwedge,depression,medialwedge,bicondylarandcombinationsoflateralwedgeanddepressionfractures.
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 7
Preparation
1Plate contouring
Forthetreatmentofjuxta-articularfractures(distaltibia,tibialplateau,distalfemur,distalhumerus,radiusetc.),goodplatecontouringtotheshapeoftheboneisveryimportant.Onlythensatisfactoryreductionandadequatestabilitymaybeachieved.
Puretitaniumhasmechanicalpropertiesdifferingfromstain-lesssteel.Duetoitslowermodulusofelasticity,titaniumismorespringy.Therefore,titaniumplatesshouldbeslightlyover-benttoobtainthedesiredcontour.
ThedesignoftheLC-DCplateensuresuniformrigidity,henceacontinuouscurvatureafterbending.Theplatesshouldnotbebentbeyondthenecessaryextent.
Usebendingpliersorbendingironsforplatecontouring.
Precaution: Avoidrepeatedbending. Sharpindentationsontheplatesurface,especiallyaroundtheplateholes,mayimpairresistancetofatigueandshouldbeavoided.
Reversebendingoruseoftheincorrectinstrumentationforbendingmayweakentheplateandleadtoprematureplatefailure(e.g.breakage).Donotbendtheplatebe-yondwhatisrequiredtomatchtheanatomy.
8 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Reductioninimplantstressbyusingalagscrewthroughtheplate1.
2Use of lag screws to achieve additional stability
Incertaincircumstances,theuseofaplateforfracturecom-pressionmaybesufficient.Inmanyfractures,however,itisadvantageoustoinsertalagscrewthroughtheplatetoin-creasefracturestabilityandtoachieveinterfragmentarycompressioninthefarcortex.Ifafracturegapremains,theplateissubjectedtohighbendingstresses.
Usingalagscrewthroughtheplatereducesimplantstress.1
1KlaueKetal.(1982)DieEntlastungderOsteosyntheseplattedurchinterfragmentrePlattenzugschraube.Helv.Chir.Acta52,1923
Preparation
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 9
a b
DifferentdrillguidetypesareavailabletoperformdrillingforDCPandLC-DCPfixationinbothneutralandcompressionmode.
1Standard drill guides (DCP, sizes 1.3 4.5)
Standarddrillguidesfeatureasimpletubetoprotectsofttissueswhiledrilling.Dependingonthepositioningofthetubewithinthehole,neutraloreccentric(compression)drill-ingcanbeperformed.
Drill Guides for DCP and LC-DCP
Neutral and eccentric drilling
Example
a Drilling in neutral position PositionthetubeinthemiddleoftheDCPhole.
b Drilling in eccentric position compression Positionthetubeinplateholeremotefromthefracture.
10 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
neutral position
inclined position
compression position
buttressposition
2Universal drill guides (DCP and LC-DCP, sizes 1.5 4.5)
Universaldrillguidesfeatureoneendwithaspring-loadedmechanismwhichfacilitatesalltypesofapplications:Neutralposition,compressionposition,buttressposition(LC-DCPonly)andespeciallythepositioningofinclinedlagscrewsthroughtheplate.
a Neutral position Depressthedrillguide.Theupperpartoftheinnersleeveprojects.Positionthedrillguideintheplateholewhichisremotefromthefracture(LC-DCP).WhenusedwithDCplatesthedrillguideautomaticallyslidesintothecorrectmiddlepositionwhendepressed.
b Compression position Donotdepressthedrillguide.Theupperpartisflush.Positionthedrillguideintheplateholeremotefromthefracture.
c Inclined position Thistechniqueisusedforinsertinglagscrewsthroughtheplate.Placethedrillguideintheholeadjacenttothefracture,depress(upperpartprojects),andsetthedesireddrill angle.
d Buttress position (LC-DCP only) Depressthedrillguideasshownforneutralposition(upperpartprojects).Positionthedrillguideintheplateholeadjacenttothefracture.
a c b
d
DrillGuidesforDCPandLC-DCP
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 11
neutral position
buttresspositionarrowpointsawayfromthefracture
compression position
=symbolforafractureline
3LC-DCP drill guides (3.5 and 4.5 LC-DC plates)
TheLC-DCPdrillguidescanbeusedwithLC-DCplatesonly.Theyfeaturededicatedendsforneutralapplication(green)andforapplicationincompressionmode(yellow).
LC-DCPdrillguidescarryanarrowenablingcorrectposition-ingofthescrew. a Neutral position Usethegreendrillguidetoplaceascrewinneutralposition.Thearrowonthegreendrillguidemustpointtowardsthefracture.Compressioncannotbeachievedwiththegreendrillguide.
b Compression Usetheyellowdrillguidetoachievecompression.Thearrowontheyellowdrillguidemustpointtowardsthefracture.
c Buttress position Usethegreendrillguide.Abuttresseffectisachievedwhenthearrowpointsawayfromthefracture.
Pre-drillingininclinedpositionwithLC-DCPdrillguidesisnotrecommendedbecausecorrectpositioningofthescrewcannotbeensured.LC-DCPdrillguidesaredesignedtoonlyfittheholeinamoreorlessverticalposition.Forpre-drillingininclinedpositionusetheuniversaldrillguideinstead (referto2c).
Implant Removal Incasethephysiciandecidestoremovetheimplants,theycanberemovedbyusinggeneralsurgicalinstruments.
green
green yellow
green yellow
a b
c
12 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
1Drill first hole adjacent to fracture
Useanappropriatelysizeddrillbitforthreadedholesanddrillthefirstholeadjacenttothefracture.Usethegreendrillguideinneutralpositionwiththearrowpointingtowardsthefracture.Alternatively,usetheuniversaldrillguideindepressedmode(upperpartprojects)andplaceitintheholeremotefromthefracture.
Determinescrewlength,tapthethread,andinsertthescrew.
Wheneverpossible,thescrewsforaxialcompressionshouldbeplacedinsuchawaythattheapexofthefragmentisdrawnintotheopenwedgebetweenplateandbone.Thisgreatlyreducestheriskofthefragmentslipping.
Alternative:Whenusingashaftscrewwithanunthreadedportionbelowthehead,overdrillthenearcortexusinga tissue protecting sleeve or standard drill guide and an appropriatelysizeddrillbitforglidingholes.
Compression Plate: Simple Fracture
Note: RequireddrillbitsforthreadedandglidingholesandtapsfortheindividualscrewsizescanbefoundinthechapterScrews,DrillsandTaps(refertopage20).
Chooseaplateoftheappropriatelength.Ensurethatthereareenoughplateholesoverbothfragmentsandthatalagscrewcanbeinsertedifnecessary.
Illustrationsshowtheprocedurewiththeneutralandcom-pressiondrillguideoftheLC-DCPdrillguideusinga3.5and4.5LC-DCplate.
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 13
2Drill second hole
Drillthroughbothcorticesintotheoppositefragmentwiththeyellowdrillguideincompressionposition(arrowpointstowardsthefracture).Alternatively,usetheuniversaldrillguideplacingitintheholeremotefromthefracture.Donotdepressit(upperpartstandsflush).
Determinescrewlength,tapthethread,andinsertthescrew.
yellow
Wheneverpossible,thescrewsforaxialcompressionshouldbeplacedinsuchawaythattheapexofthefragmentisdrawnintotheopenwedgebetweenplateandbone.Thisgreatlyreducestheriskofthefragmentslipping.
Alternative: Whenusingashaftscrewwithanunthreadedportionbelowthehead,overdrillthenearcortexusinga tissue protecting sleeve or standard drill guide and an appropriatelysizeddrillbitforglidingholes.
14 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
3Insert interfragmentary lag screw
Toincreasestabilityinthefarcortexandtodecreaseplatewear,insertaninterfragmentarylagscrew.
Drillthroughbothcorticeswithanuniversaldrillguideinde-pressedmode(innersleeveprojects)andanappropriatelysizeddrillbitforthreadedholes.Thehemisphericundersideoftheuniversaldrillguidepermitsidealpositioningofthescrewhead.
Widentheholeinthenearcortexwithadrillbitforglidingholes.Pushthetissueprotectingsleeveupwards,insertthedrillbitintothehole,thenslidethetissueprotectingsleevedownuntilittouchestheplate.Whendrilling,careshouldbetakenthatthecourseoftheglidingholefollowsexactlythatofthepreviousdrillhole.
Asanalternativetoaregularcortexscrewashaftscrew,usedasalagscrew,maybeinserted.Thisensuresefficientglidingofthescrewshaftintheglidingholeresultinginaconsiderablyhighertensioneffect.Likethisinthefarcortextensionisachieved,too.
Intheremainingscrewholesinsertscrewsinneutralpositionapartfromtheholedirectlyabovethefracture.
Implant Removal Incasethephysiciandecidestoremovetheimplants,theycanberemovedbyusinggeneralsurgicalinstruments.
CompressionPlate:SimpleFracture
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 15
Compression Plate: MultifragmentaryFracture
Note: RequireddrillbitsforthreadedandglidingholesandtapsfortheindividualscrewsizescanbefoundinthechapterScrews,DrillsandTaps(refertopage20).
Fracturesshouldbetreatedconsecutively.
1Treat first fracture
Fortreatmentofthefirstfracture,followthepreviouslydescribedexamplestepbystep.
16 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
2Treat second fracture
Treatthesecondfractureusingtheuniversaldrillguide.Drillaholeintothethirdfragmentusingtheuniversaldrillguideincompressionpositionandadrillbitforthreadedholes.Seatthedrillguideatthesideoftheholeremotefromthefracturewithoutdepressingthedrillguide(upperpartisflush).
Drillaglidinghole,measurescrewlengthandtapthethread.
Insertascrewintothehole.Theuseofashaftscrewisrec-ommended.
Nextinsertascrewintothemiddlefragment.Preparethescrewholewithadrillbitforthreadedholesandtheuniver-saldrillguidedepressedforneutralposition(upperpartofinnersleeveprojecting).
CompressionPlate:MultifragmentaryFracture
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 17
Prepareseatingforthelagscrewwiththeuniversaldrillguideandadrillbitforthreadedscrews.Positiontheuniver-saldrillguideadjacenttothefracture,depressthedrillguide(innersleeveprojects),setdrillingangleanddrill.Ifthereistheriskofthedrillbitcollidingwiththescrewinthevicinity,thedrillbithastobeinclined.
Placethescrew.
Byinsertingashaftscrewaslagscrew,additionalstabilityisachieved.Tightenlagandcompressionscrewsalternately.Theremainingscrewholesarefilledwithneutrallyplacedscrews.
Drilltheglidinghole.Widenthenearcortexusinganappro-priatelysizeddrillbitforglidingholesandthetissueprotect-ingsleeve.Measurethescrewlengthandtapthethread.
Implant Removal Incasethephysiciandecidestoremovetheimplants,theycanberemovedbyusinggeneralsurgicalinstruments.
18 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
green
Buttress Plate
Note: RequireddrillbitsforthreadedandglidingholesandtapsfortheindividualscrewsizescanbefoundinthechapterScrews,DrillsandTaps(refertopage20).
Thebuttressplatetechniqueisshownusingtheexampleofashearfractureofthelateralpartofthetibialheadcom-binedwithashortobliquefracture.
Firstthedistalobliquefractureistreatedasinthepreviouslyillustratedexamples.
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 19
Allthescrewholesinthebuttressregionarepreparedwiththeuniversaldrillguideorthegreendrillguide(neutralposi-tion)oftheLC-DCPdrillguide.
Thearrowofthedrillguidemustpointawayfromthefrac-ture.Theproximallypositionedcancellousbonescrewsandcortexscrewsactaslagscrews.Thethreadgripsonlyintheoppositefragment,sothatthereiscompressionbetweenthefragments.Theuseofthegreendrillguidewiththearrowpointingawayfromthefracturepreventsthetibialplateaufragmentandtheplatefromslipping.Inthissituation,thescrewheadsarebuttressedbytheholeedgeadjacenttothefracture.
Implant Removal Incasethephysiciandecidestoremovetheimplants,theycanberemovedbyusinggeneralsurgicalinstruments.
20 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
green
Neutralization Plate (Protecting Plate)
Adaptspiralfracturewithtwoseparatelagscrews.
PositiontheplatetobridgethefractureusingtheLC-DCPdrillguide(3.5and4.5screwsonly)ortheuniversaldrillguide.
WhenusingthegreendrillguideoftheLC-DCPdrillguidethearrowmustpointtowardsthefracture.Whenusingtheuniversaldrillguideseatitattheholeedgeremotefromthefracture,depresstheoutersleevesothattheupperpartprojectsforneutralposition.
Tocompletefracturetreatment,determinescrewlengthsandinsertscrewsafterhavingtappedthethreads.
Implant Removal Incasethephysiciandecidestoremovetheimplants,theycanberemovedbyusinggeneralsurgicalinstruments.
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Surgical Technique DCP and LC-DCP Systems DePuy Synthes 21
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22 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Screws,DrillsandTaps
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 23
Mini Fragment System 1.5, 2.0, 2.7
Cases and Modules
StainlessSteel Titanium
305.500 305.505 GraphicCaseforMiniInstrumentSet,withoutContents
Instruments
310.110 Drill Bit B1.1mm,length60/35mm,2-flute,forQuickCoupling
310.150 DrillBitB1.5mm,length85/60mm,2-flute,forQuickCoupling
310.190 DrillBitB2.0mm,length100/75mm,2-flute,forQuickCoupling
310.260 Drill Bit B2.7mm,length100/75mm,2-flute,forQuickCoupling
310.870 Countersink2.7,length62mm
310.880 Countersink1.5to2.4,length52mm, forMiniQuickCoupling
310.950 HandlewithMiniQuickCoupling
311.010 HandlewithMiniQuickCoupling, Stainless Steel
311.150 TapforCortexScrewsB1.5mm, length50/20mm
311.190 TapforCortexScrewsB2.0mm, length53/24mm
311.260 TapforCortexScrewsB2.7mm, length100/33mm
311.430 HandlewithQuickCoupling, length110mm
312.140 DoubleDrillGuide1.5/1.1,forNo.311.150
312.200 TripleDrillGuide2.0,with3holes
312.220 DoubleDrillGuide2.0/1.5
312.240 DoubleDrillGuide2.7/2.0
314.020 Screwdriver,hexagonal,small, withHoldingSleeve
314.030 ScrewdriverShaft,hexagonal,small, B2.5mm
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
24 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
314.060 HoldingSleeve,forNos.314.020,314.030,314.070,314.550and314.570
314.670 ScrewdriverShaft1.5/2.0,cruciform, withHoldingSleeve,length66mm,blue
319.040 DepthGaugeforScrews,measuringrangeupto50mm
319.110 DepthGaugeforScrewsB1.5and2.0mm,measuringrangeupto26mm
319.390 SharpHook,length155mm
319.970 ScrewForceps,self-holding,length85mm
329.010 BendingIronforPlates1.5and2.0, length130mm
329.120 BendingPliersforPlates1.5to2.7, length140mm
391.820 WireBendingPliers,length155mm, forWiresuptoB1.25mm
391.950 CuttingPliersforPlates1.5to2.7, length256mm
391.970 WireCutter,short,length175mm
392.020 BendingIronforKirschnerWires, forWiresB0.8to1.25mm
398.400 ReductionForcepswithPoints,narrow,ratchetlock,length132mm
398.410 ReductionForceps,withPoints,wide,ratchetlock,length132mm
398.960 StagbeetleForceps,ratchetlock, length125mm
398.990 HoldingForcepsforSmallPlates, ratchetlock,length135mm
399.000 HoldingForcepsforFingerPlates, ratchetlock,length135mm
399.180 BoneLever,small,shortnarrowtip, width6mm,length160mm
399.190 BoneLever,small,shortnarrowtip, width8mm,length160mm
399.450 BoneLever,width15mm,length120mm,endofhandlering-shaped
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
MiniFragmentSystem1.5,2.0,2.7
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 25
399.480 PeriostealElevator,slightlycurvedblade,straightedge,width3mm, length187/87mm
399.970 ReductionForcepswithPoints, ratchetlock,length130mm
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
26 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Plates
StainlessSteel Titanium
246.190 446.190 MiniPlate1.5,straight, 20holes,length100mm
246.230 446.230 MiniT-Plate1.5, head3holes,shaft9holes,length50mm
446.233 MiniT-Plate1.5, shaft8holes,head3holes,length44mm,PureTitanium
446.234 MiniT-Plate1.5, shaft8holes,head4holes,length44mm,PureTitanium
246.240 446.240 MiniT-Plate1.5, head4holes,shaft9holes,length50mm
246.480 446.480 MiniH-Plate1.5,4holes
246.610 MiniCondylarPlate1.5, pinleft,StainlessSteel
246.620 MiniCondylarPlate1.5, pinright,StainlessSteel
446.630 MiniCondylarPlate1.5, shaft6holes,length36mm,pinleft,PureTitanium
446.640 MiniCondylarPlate1.5, shaft6holes,length36mm,pinright,PureTitanium
243.090 MiniAdaptionPlate2.0, 20holes,length100mm
243.130 MiniPlate2.0,straight, 3holes,length17mm
243.140 MiniPlate2.0,straight, 4holes,length23mm
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
MiniFragmentSystem1.5,2.0,2.7
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 27
StainlessSteel Titanium
243.150 MiniPlate2.0,straight, 5holes,length29mm
243.160 MiniPlate2.0,straight, 6holes,length35mm
243.190 443.190 MiniPlate2.0,straight, 20holes,length100mm
243.230 443.230 MiniT-Plate2.0, head3holes,shaft9holes,length50mm
243.240 443.240 MiniT-Plate2.0, head4holes,shaft9holes,length50mm
243.310 MiniL-Plate2.0,left, head2holes,shaft2holes
243.320 MiniL-Plate2.0,right, head2holes,shaft2holes
243.330 MiniL-Plate2.0,oblique,left,head2holes,shaft2holes
243.340 MiniL-Plate2.0,oblique,right,head2holes, shaft2holes
243.410 MiniT-Plate2.0, head2holes,shaft2holes
243.540 443.540 DCP2.0,4holes, length22mm
243.550 443.550 DCP2.0,5holes, length27mm
243.560 443.560 DCP2.0,6holes, length32mm
243.570 443.570 DCP2.0,7holes, length37mm
243.580 443.580 DCP2.0,8holes, length42mm
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
28 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
StainlessSteel Titanium
243.610 443.610 MiniCondylarPlate2.0, pinleft
243.620 443.620 MiniCondylarPlate2.0, pinright
242.030 442.030 QuarterTubularPlate2.7withCollar,3holes,length26mm
242.040 442.040 QuarterTubularPlate2.7withCollar,4holes,length34mm
242.050 442.050 QuarterTubularPlate2.7withCollar,5holes,length42mm
242.060 442.060 QuarterTubularPlate2.7withCollar,6holes,length50mm
242.070 442.070 QuarterTubularPlate2.7withCollar,7holes,length58mm
242.080 442.080 QuarterTubularPlate2.7withCollar,8holes,length66mm
242.310 L-Plate2.7,left,shaft3holes,head2holes
242.320 L-Plate2.7,right,shaft 3holes,head2holes
242.330 442.330 L-Plate2.7,oblique,left, shaft3holes,head2holes
242.340 442.340 L-Plate2.7,oblique,right,shaft3holes,head2holes
242.410 442.410 T-Plate2.7,shaft3holes,head2holes
242.610 442.610 CondylarPlate2.7,6holes,pinleft
242.620 442.620 CondylarPlate2.7,6holes,pinright
244.020 444.020 DCP2.7,2holes, length20mm
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
MiniFragmentSystem1.5,2.0,2.7
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 29
StainlessSteel Titanium
244.030 DCP2.7,3holes, length28mm
244.040 444.040 DCP2.7,4holes, length36mm
244.050 444.050 DCP2.7,5holes, length44mm
244.060 444.060 DCP2.7,6holes, length52mm
244.070 444.070 DCP2.7,7holes, length60mm
244.080 444.080 DCP2.7,8holes, length68mm
244.090 444.090 DCP2.7,9holes, length76mm
244.100 444.100 DCP2.7,10holes, length84mm
244.110 DCP2.7,11holes, length92mm
244.120 444.120 DCP2.7,12holes, length100mm
244.220 444.220 DCP2.7,2holes, length26mm
449.936 LC-DCP2.0,6holes, length36mm
449.938 LC-DCP2.0,8holes, length48mm
449.931 LC-DCP2.0,4holes, length24mm
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
30 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Screws and Washers
Cortex Screw B1.5 mm
Stainless Steel Titanium Length(mm)
210.006 400.006 6
210.007 400.007 7
210.008 400.008 8
210.009 400.009 9
210.010 400.010 10
210.011 400.011 11
210.012 400.012 12
210.014 400.014 14
210.016 400.016 16
210.018 400.018 18
210.020 400.020 20
Cortex Screw B2.0 mm
Stainless Steel Titanium Length(mm)
211.006 401.006 6
211.008 401.008 8
211.010 401.010 10
211.012 401.012 12
211.014 401.014 14
211.016 401.016 16
211.018 401.018 18
211.020 401.020 20
211.022 401.022 22
211.024 401.024 24
211.026 26
211.028 28
211.030 30
211.032 32
211.034 34
211.036 36
211.038 38
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
MiniFragmentSystem1.5,2.0,2.7
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 31
Cortex Screw B2.7 mm
Stainless Steel Titanium Length(mm)
202.006 402.006 6
202.008 402.008 8
202.010 402.010 10
202.012 402.012 12
202.014 402.014 14
202.016 402.016 16
202.018 402.018 18
202.020 402.020 20
202.022 402.022 22
202.024 402.024 24
Washer B7.0/3.6mm
Stainless Steel Titanium
219.980 419.980 forScrewsB2.7to4.0mm
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
32 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Also available (production on request)
243.000.509 DCP2.0,9holes,StainlessSteel
243.000.510 DCP2.0,10holes,length52mm, Stainless Steel
243.000.512 DCP2.0,12holes,length62mm, Stainless Steel
243.880 MiniT-Plate1.5/2.0,shaft4holes, length35mm,StainlessSteel
243.234 T-AdaptionPlate2.0,head3holes, shaft10holes,StainlessSteel
310.511 DrillBitB1.8mm,length100/64mm,2-flute,forJacobsChuck
310.531 DrillBitB2.4mm,length100/64mm,2-flute,forJacobsChuck
Wires
Cerclage Wire
Stainless Steel B (mm) Length(mm)
291.240 0.6 175
291.260 0.8 200
Kirschner WireWith trocar tip, pack of 10 units
Stainless Steel B (mm) Length(mm)
292.060.10 0.6 70
292.080.10 0.8 70
292.100.10 1.0 150
292.120.10 1.25 150
292.160.10 1.6 150
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
MiniFragmentSystem1.5,2.0,2.7
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 33
Compact Hand 1.0, 1.3, 1.5, 2.0, 2.4
Compact Hand Module 1.0/1.3
Module
StainlessSteel Titanium
682.483 682.480 ModuleCompactHand1.0/1.3,withLid,withoutContents,green/yellow
Instruments
310.882 Countersink1.3to2.0,length50mm, forMiniQuickCoupling
312.133 DoubleDrillGuide1.3/1.0
314.413 ScrewdriverShaft1.3,cruciform, withHoldingSleeve,length62mm, forMiniQuickCoupling
314.481 ScrewdriverShaft1.0,cruciform, withHoldingSleeve,length62mm, withMiniQuickCoupling
316.385 DrillBitB0.8mm,length40/16mm,2-flute,forMiniQuickCoupling
513.005 DrillBitB1.0mm,length46/34mm,2-flute,forMiniQuickCoupling
513.035 DrillBitB1.3mm,length46/34mm,2-flute,forMiniQuickCoupling
Plates
StainlessSteel Titanium
221.312 421.312 AdaptionPlate1.3,12holes
221.320 421.320 StrutPlate1.3,oblique- angled,right,8holes
221.321 421.321 StrutPlate1.3,oblique- angled,left,8holes
221.333 421.333 T-AdaptionPlate1.3, head3holes,shaft8holes
221.334 421.334 T-AdaptionPlate1.3, head4holes,shaft8holes
221.335 421.335 Y-AdaptionPlate1.3,11holes
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
34 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Screws
Cortex Screw B1.0 mm, self-tapping
Stainless Steel Titanium Length(mm)
200.526 400.526 6
200.527 400.527 7
200.528 400.528 8
200.529 400.529 9
200.530 400.530 10
200.531 400.531 11
200.532 400.532 12
200.533 400.533 13
200.534 400.534 14
Cortex Screw B1.3 mm, self-tapping
Stainless Steel Titanium Length(mm)
200.686 400.686 6
200.687 400.687 7
200.688 400.688 8
200.689 400.689 9
200.690 400.690 10
200.691 400.691 11
200.692 400.692 12
200.693 400.693 13
200.694 400.694 14
200.695 400.695 15
200.696 400.696 16
200.698 400.698 18
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
CompactHand1.0,1.3,1.5,2.0,2.4CompactHandModule1.0/1.3
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 35
Compact Hand Module 1.5
Module
StainlessSteel Titanium
682.488 682.485 ModuleCompactHand1.5,withLid,withoutContents,red
Instruments
310.880 Countersink1.5to2.4,length52mm, forMiniQuickCoupling
312.140 DoubleDrillGuide1.5/1.1,forNo.311.150
314.667 ScrewdriverShaft1.5,cruciform,withHoldingSleeve,length66mm,withMiniQuickCoupling
513.030 DrillBitB1.1mm,length45/33mm,2-flute,forMiniQuickCoupling
513.080 DrillBitB1.5mm,length52/40mm,2-flute,forMiniQuickCoupling
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
36 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Plates
StainlessSteel Titanium
246.191 446.191 AdaptionPlate1.5,12holes
246.231 446.231 T-AdaptionPlate1.5, head3holes,shaft8holes
246.241 446.241 T-AdaptionPlate1.5, head4holes,shaft8holes
246.242 446.242 Y-AdaptionPlate1.5, 11holes,prebentprofile
246.482 446.482 StrutPlate1.5,oblique- angled,right,8holes, prebentprofile
246.483 446.483 StrutPlate1.5,oblique- angled,left,8holes, prebentprofile
446.612 Y-Plate1.5,shaft8holes,head3holes,length46mm,Pure Titanium
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
CompactHand1.0,1.3,1.5,2.0,2.4CompactHandModule1.5
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 37
Screws
Cortex Screw B1.5 mm, self-tapping
Stainless Steel Titanium Length(mm)
200.806 400.806 6
200.807 400.807 7
200.808 400.808 8
200.809 400.809 9
200.810 400.810 10
200.811 400.811 11
200.812 400.812 12
200.813 400.813 13
200.814 400.814 14
200.816 400.816 16
200.818 400.818 18
200.820 400.820 20
200.822 400.822 22
200.824 400.824 24
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
38 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Compact Hand Module 2.0
Module
StainlessSteel Titanium
682.493 682.490 ModuleCompactHand2.0,withLid,withoutContents,blue
Instruments
310.880 Countersink1.5to2.4,length52mm, forMiniQuickCoupling
312.220 DoubleDrillGuide2.0/1.5
314.672 ScrewdriverShaft2.0,cruciform, withHoldingSleeve,length66mm, withMiniQuickCoupling
323.200 UniversalDrillGuide2.0
513.090 DrillBitB1.5mm,length67/55mm,2-flute,forMiniQuickCoupling
513.140 DrillBitB2.0mm,length67/55mm,2-flute,forMiniQuickCoupling
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
CompactHand1.0,1.3,1.5,2.0,2.4
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 39
Plates
StainlessSteel Titanium
223.588 443.588 LC-DCP2.0,8holes, length51mm
243.091 443.091 AdaptionPlate2.0,12holes
243.231 443.231 T-AdaptionPlate2.0,head3holes,shaft8holes
243.241 443.241 T-AdaptionPlate2.0, head4holes,shaft8holes
243.242 443.242 Y-AdaptionPlate2.0,11holes
243.480 443.480 MiniH-Plate2.0,4holes
243.584 443.584 LC-DCP2.0,4holes, length27mm
243.585 443.585 LC-DCP2.0,5holes, length33mm
243.586 443.586 LC-DCP2.0,6holes, length39mm
243.587 443.587 LC-DCP2.0,7holes,length45mm
447.032 Plate2.0,straight,12holes,length71mm,PureTitanium
447.232 T-Plate2.0,shaft8holes,head2holes,length53mm,Pure Titanium
447.233 T-Plate2.0,shaft8holes,head3holes,length53mm,Pure Titanium
447.612 Y-Plate2.0,3+8holes,length55mm,PureTitanium
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
40 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Screws
Cortex Screw B2.0 mm, self-tapping
Stainless Steel Titanium Length(mm)
201.806 401.806 6
201.807 401.807 7
201.808 401.808 8
201.809 401.809 9
201.810 401.810 10
201.811 401.811 11
201.812 401.812 12
201.813 401.813 13
201.814 401.814 14
201.816 401.816 16
201.818 401.818 18
201.820 401.820 20
201.822 401.822 22
201.824 401.824 24
201.826 401.826 26
201.828 401.828 28
201.830 401.830 30
201.832 401.832 32
201.834 401.834 34
201.836 401.836 36
201.838 401.838 38
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
CompactHand1.0,1.3,1.5,2.0,2.4CompactHandModule2.0
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 41
Compact Hand Module 2.4
Module
StainlessSteel Titanium
682.513 682.510 ModuleCompactHand2.4,withLid,withoutContents,violet
Instruments
310.880 Countersink1.5to2.4,length52mm, forMiniQuickCoupling
312.920 DrillSleeve1.8,withcenteringthread
313.940 Screwdriver,cruciform,withHoldingSleeve,forCortexScrewsB2.4mm
314.672 ScrewdriverShaft2.0,cruciform, withHoldingSleeve,length66mm, withMiniQuickCoupling
317.861 Drill Bit B1.8mm,length80/66mm,2-flute,forMiniQuickCoupling
317.871 Drill Bit B2.4mm,length80/66mm,2-flute,forMiniQuickCoupling
323.202 UniversalDrillGuide2.4
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
42 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Plates
StainlessSteel Titanium
449.906 Plate2.4,straight,6holes, 36mm,PureTitanium
249.912 449.912 AdaptionPlate2.4,12holes,forCompactHand2.4
249.913 449.913 T-AdaptionPlate2.4, head2holes,shaft8holes, forCompactHand2.4
249.914 449.914 T-AdaptionPlate2.4, head3holes,shaft8holes,forCompactHand2.4
249.919 T-AdaptionPlate2.4, head3holes,shaft10holes
249.915 449.915 Y-AdaptionPlate2.4, 11holes,forCompact Hand2.4
249.916 449.916 CondylarPlate2.4,pinright,forCompactHand2.4
249.917 449.917 CondylarPlate2.4,pinleft,forCompactHand2.4
249.924 449.924 LC-DCP2.4,4holes, length35mm,forCompactHand2.4
249.926 449.926 LC-DCP2.4,6holes, length51mm,forCompactHand2.4
249.928 449.928 LC-DCP2.4,8holes, length67mm,forCompactHand2.4
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
CompactHand1.0,1.3,1.5,2.0,2.4CompactHandModule2.4
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 43
Screws and Buttress Pins
Cortex Screw B2.4 mm, self-tapping, for Compact Hand 2.4
Stainless Steel Titanium Length(mm)
201.636 401.636 6
201.637 401.637 7
201.638 401.638 8
201.639 401.639 9
201.640 401.640 10
201.641 401.641 11
201.642 401.642 12
201.643 401.643 13
201.644 401.644 14
201.646 401.646 16
201.648 401.648 18
201.650 401.650 20
201.652 401.652 22
201.654 401.654 24
201.656 401.656 26
201.658 401.658 28
201.660 401.660 30
201.662 401.662 32
201.664 401.664 34
201.666 401.666 36
201.668 401.668 38
201.670 401.670 40
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
44 DePuy Synthes DCP and LC-DCP Systems Surgical Technique
Also available
446.032 Plate1.5,straight,12holes,length59mm,Pure Titanium
446.031 Plate1.5,straight,6holes,length29mm,Pure Titanium
Buttress Pin B1.8 mm
Stainless Steel Titanium Length(mm)
201.962 401.962 12
201.964 401.964 14
201.966 401.966 16
201.968 401.968 18
Availablenonsterileorsterile-packed. AddStocatalognumbertoordersterileproduct.
CompactHand1.0,1.3,1.5,2.0,2.4CompactHandModule2.4
Surgical Technique DCP and LC-DCP Systems DePuy Synthes 45
MRI Information
Torque, Displacement and Image Artifacts according toASTMF2213-06,ASTMF2052-06e1and ASTM F 2119-07Non-clinicaltestingofworstcasescenarioina3TMRI systemdidnotrevealanyrelevanttorqueordisplacement oftheconstructforanexperimentallymeasuredlocalspatialgradientofthemagneticfieldof3.69T/m.Thelargestimageartifactextendedapproximately169mmfromtheconstructwhenscannedusingtheGradientEcho(GE).Testingwasconductedona3TMRIsystem.
Radio-Frequency-(RF-)induced heating according to ASTM F 2182-11aNon-clinicalelectromagneticandthermaltestingofworst casescenarioleadtopeaktemperatureriseof9.5C withanaveragetemperatureriseof6.6C(1.5T)anda peaktemperatureriseof5.9C(3T)underMRIConditionsusingRFCoils(wholebodyaveragedspecificabsorptionrate[SAR]of2W/kgfor6minutes[1.5T]andfor15minutes [3T]).
Precautions:Theabovementionedtestreliesonnon-clini- caltesting.TheactualtemperatureriseinthepatientwilldependonavarietyoffactorsbeyondtheSARandtimeof RFapplication.Thus,itisrecommendedtopayparticularattentiontothefollowingpoints: Itisrecommendedtothoroughlymonitorpatientsunder-goingMRscanningforperceivedtemperatureand/orpainsensations.
PatientswithimpairedthermoregulationortemperaturesensationshouldbeexcludedfromMRscanningproce- dures.
Generally,itisrecommendedtouseaMRsystemwith lowfieldstrengthinthepresenceofconductiveimplants. Theemployedspecificabsorptionrate(SAR)shouldbe reducedasfaraspossible.
Usingtheventilationsystemmayfurthercontributeto reducetemperatureincreaseinthebody.
SynthesGmbHEimattstrasse 34436OberdorfSwitzerlandTel:+41619656111Fax:+41619656600www.depuysynthes.com 0123
Notallproductsarecurrentlyavailableinallmarkets.
ThispublicationisnotintendedfordistributionintheUSA.
AllsurgicaltechniquesareavailableasPDFfilesatwww.depuysynthes.com/ifu
DePuySynthesTraum
a,adivisionofSynthesGmbH
.2016.Allrightsreserved.
036.001.093DSEM/TRM/1115/055605/16
http://www.depuysynthes.com/ifu