For Distal Femur Fractures. 95º Condylar Plate. Quick Reference Chart

Transcription

1 For Distal Femur Fractures 95º Condylar Plate Quick Reference Chart

2 95 Condylar Plate. Quick reference chart for distal femur fractures. Insert guide wires Fix condylar fragments with 6.5 mm cancellous lag screws, avoiding the planned insertion site of the blade. Bend the knee to 90 and mark the joint axis with the first Kirschner wire (). Insert the second K-wire () anteriorly over the patellofemoral surface of the condyles to mark the inclination..5 cm.0 cm Mark the entry slot for the plate, as shown. Insert a third K-wire distal to the slot. This third wire (3) must be parallel to the first wire () in the AP view and to the second wire () in the axial view (as shown above). Check position with C-arm. Remove wires () and (). The third wire indicates the direction of insertion of the seating chisel. 3 3 Check the position with the condylar plate guide. Precautions: Poorly defined anteversion or entry point may cause the blade to emerge posteriorly from the femoral neck. Kirschner wires are single-use items, do not re-use. AP view Axial view Note: For complete instructions and indications for use, please refer to package insert. 95 Condylar Plate Quick Reference Chart DePuy Synthes

3 95 Condylar Plate. Quick reference chart for distal femur fractures. continued Insert chisel In dense bone, predrill the channel with a 4.5 mm drill bit. Bevel the proximal rim with the chisel to avoid shattering of the cortex and to improve seating of the plate. Set the chisel guide at 85, to result in 95 placement of the plate. Hammer the seating chisel in parallel to the K-wire in both planes. Check that the flap of the chisel guide is in line with the femoral shaft axis. Control rotation with the slotted hammer. After reaching the desired depth, take off the chisel guide and remove the seating chisel with the slotted hammer. 3 Insert plate Fix the selected plate in the inserter-extractor, ensuring the blade is horizontally aligned with the handle, and tighten the bolt with the open-end wrench. Push the plate into the prepared channel and insert with light hammer blows. Control rotation with the slotted hammer. Remove the inserter-extractor, and use the impactor for final seating of the plate. 95 Condylar Plate Quick Reference Chart DePuy Synthes

4 95 Condylar Plate. Quick reference chart for distal femur fractures. continued 4 Secure plate to distal fragment Predrill with a 3. mm drill bit through the round hole nearest the blade. In dense bone, the near cortex may have to be drilled with a 4.5 mm drill bit, to accept the screwshaft without cracking. Insert the appropriate length 6.5 mm partially threaded cancellous bone screw (to seat the plate and secure the medial fragment). Repeat the steps to insert a second 6.5 mm screw through the second round plate hole. 5 Secure plate to shaft Fix the plate shaft to the bone with a 4.5 mm cortex screw. Note: If axial compression is desired, first use the articulated tension device (ATD). Hook the opened device into the most proximal plate hole and fix to the bone with a short cortex screw. Tighten the bolt of the device to obtain the necessary compression. Insert additional 4.5 mm screws. Remove the ATD to insert the last two 4.5 mm cortex screws. Perform final tightening of screws. Precaution: Achieving medial buttress is essential proximal and distal. 95 Condylar Plate Quick Reference Chart DePuy Synthes 3

5 Osteotomy This description explains the steps for osteotomies. Osteotomy Angled Blade Plates are used with the same instruments as the previously described Angled Blade Plates. Preoperative planning Preoperative planning is of particular importance before performance of corrective osteotomies, because they are the only way the surgeon can check preoperatively the result of the osteotomy as well as the three-dimensional concept of the procedure. The principle of preoperative planning is similar as for fracture treatment. The surgical technique is based on the blade angle, which defines the final varus/valgus correction as the blade is inserted along the axis of the femoral neck in the proximal femur. Depending on the correction, determine the appropriate osteotomy plate by blade length, angle, and displacement. Note: The blade channel is always prepared before the osteotomy is performed. Precaution: The preoperatively predetermined angles must be followed exactly during operation. 95 Condylar Plate Quick Reference Chart DePuy Synthes 4

6 Osteotomy continued Procedure. With a Kirschner wire the anteversion of the neck of the femur is defined. Parallel to the triangular guide plate (eg, 60 ) the Guide Wire is inserted. This wire parallel to the femoral neck axis is indicating the blade direction.. After drilling a -mm hole about 5 mm distal to the site of the planned osteotomy, a Kirschner wire is inserted. Two additional Kirschner wires may be inserted in derotation osteotomies to mark the necessary correction. 3. About 0 mm above the site of the planned osteotomy and far to the front, the cortex is opened with a chisel for insertion of the plate. The seating chisel is then inserted into the center of the neck, parallel to the Guide Wire, to a depth of mm. The flap of the chisel guide is parallel to the femoral shaft. The chisel is then withdrawn 0 0 mm to facilitate later removal Condylar Plate Quick Reference Chart DePuy Synthes 5

7 Osteotomy continued 4. The femur is transected at right angles to the shaft with an oscillating bone saw. 5 5b 5. With the seating chisel as a handle, the proximal fragment is tipped upward. Starting from the middle of the osteotomy, another cut (5b) is made parallel to the seating chisel, and the excised wedge is removed. 6. After removal of the seating chisel the selected plate is inserted into the precut channel. The plate may be clamped to the shaft with a reduction forceps. 7. The tension device is fixed to the femur and tightened to achieve compression The plate is screwed to the femoral shaft. The tension device is removed Condylar Plate Quick Reference Chart DePuy Synthes 6

8 Product Information Instruments mm Kirschner Wire mm Drill Bit mm Drill Bit 34.6 Large Hexagonal Screwdriver, long 3. Articulated Tension Device mm DCP Drill Guide Chisel Guide, with adjustable angle 33. Seating Chisel, 30 mm length 33.6 Inserter- Extractor 33.0 Slotted Hammer 33. Impactor Condylar Plate Guide MR Information The 95º Angled Blade Plates System has not been evaluated for safety and compatibility in the MR environment. It has not been tested for heating, migration or image artifact in the MR environment. The safety of the 95º Angled Blade Plates System in the MR environment is unknown. Scanning a patient who has this device may result in patient injury. Image intensifier control Implants 95 Condylar Plates Blade Blade Length Length Holes (mm) Holes (mm) Available nonsterile or sterile-packed. Add S to catalog number for sterile product. Available nonsterile only. For detailed cleaning and sterilization instructions, please refer to or sterilization instructions, if provided. 95 Condylar Plate Quick Reference Chart DePuy Synthes 7

9 Limited Warranty and Disclaimer: DePuy Synthes products are sold with a limited warranty to the original purchaser against defects in workmanship and materials. Any other express or implied warranties, including warranties of merchantability or fitness, are hereby disclaimed. Please also refer to the package insert(s) or other labeling associated with the devices identified in this quick reference chart for additional information. CAUTION: Federal Law restricts these devices to sale by or on the order of a physician. Some devices listed in this quick reference chart may not have been licensed in accordance with Canadian law and may not be for sale in Canada. Please contact your sales consultant for items approved for sale in Canada. Not all products may currently be available in all markets. Manufactured or distributed by: Synthes USA Products, LLC 30 Wrights Lane East West Chester, PA 9380 Synthes USA, LLC 0 Synthes Avenue Monument, CO 803 To order (USA): To order (Canada): Note: For recognized manufacturer, refer to the product label. DePuy Synthes All rights reserved. DSUS/TRM/6/5 4/7 DV