Anatomic Talus Plate Module

Size: px

Start display at page:

Download "Anatomic Talus Plate Module"

Amy Bates
6 years ago
Views:

1 Surgical Technique MINI-MOD Small Bone Plating System Anatomic Talus Plate Module

2 Table of Contents Introduction... Indications... Design Features and Benefits...4 System Overview...5 Plates Overview... Screws Overview...7 Surgical Technique...8 Surgical Approach...8 Fracture Reduction...8 Implant Positioning...9 Screw Insertion Technique...0 Catalog Information... Nota Bene The technique description herein is made available to the healthcare professional to illustrate a suggested treatment for the uncomplicated procedure. In the final analysis, the preferred treatment is that which addresses the needs of the patient.

3 Introduction The following technique is for informational and educational purposes only. It is not intended to serve as medical advice. It is the responsibility of treating physicians to determine and utilize the appropriate products and techniques, according to their own clinical judgment, for each of their patients. For more information on the VLP MINI-MOD Talus Plating System, including its indications for use, contraindications, and product safety information, please refer to the product s label and the Instructions for Use packaged with the product. The VLP MINI-MOD Small Bone Plating System is modular in design and is comprised of.5mm,.0mm and.4mm utility and anatomic specific plates and screws. All plates in the system are capable of accepting Non-Locking and Variable Angle Locking Screws to provide the flexibility needed to treat varying anatomy and unpredictable fracture patterns. The VLP MINI-MOD.4mm Anatomic Talus Plate Module features two medial and two lateral low-profile plate options for talus fractures. Each plate hole can accept.4mm Non-Locking Cortical Screws,.4mm Variable Angle Locking Screws and.0mm Osteopenia Screws. Indications The VLP MINI-MOD Talus Plates are indicated for adolescent ( 8 years) and transitional adolescent (8 years) subpopulations and adults, as well as patients with osteopenic bone. The VLP MINI-MOD Talus Plates are indicated for fracture fixation, reconstruction or arthrodesis of small bones, including those in the forefoot, midfoot and hindfoot.

Design Features and Benefits Anatomic, Approach-Specific

Hole Plate Surgical Freedom with Variable-Angle Locking

4 Design Features and Benefits Anatomic, Approach-Specific Plates Anatomic plates are available for both medial and lateral approaches. Multiple approach options allow flexibility in selecting the appropriate implant for each patient. Medial L Plate Medial T Plate Lateral Hole Plate Lateral 4 Hole Plate Surgical Freedom with Variable-Angle Locking Technology Locking and non-locking screws can be used through all of the holes in the plate. Locking screws can be locked up to 5º off-axis, allowing you to position the plate in response to the anatomy and the requirements of the fracture not where the plate fit dictates. 4

System Overview The Talus Plate Module is a supplement to

Description Set VLP MINI-MOD Talus Plate Module 7444-40

Instrument Set 77-40 VLP MINI-MOD Talus Template Module

5 System Overview The Talus Plate Module is a supplement to the VLP MINI-MOD General Instrument and.4mm Instrument and Screw Set. The complementary instruments and screws for the Talus plates are contained within those sets. An overview of those sets can be found below. Description Set VLP MINI-MOD Talus Plate Module VLP MINI-MOD.4mm Instrument Set VLP MINI-MOD.4mm Screw Set VLP MINI-MOD.0mm Osteopenia Screw Set VLP MINI-MOD General Instrument Set VLP MINI-MOD Talus Template Module Note: A Talus Template Module should only be ordered if sterile packaged Talus Plates are required. Talus Plate Module.4mm Instrument and Screw Set General Instrument Tray 5

thickness.4mm Width.mm Width.7mm Length 0.

6 Plates Overview Anatomically contoured Left and right specific Lateral plates available in two different lengths ( and 4 hole) Medial plates available in two shapes ( L and T ) Left Right Left Right Lateral Plate, -Hole Lateral Plate, 4-Hole Plate dimensions Plate dimensions Plate thickness.4mm Plate thickness.4mm Width 5.9mm Width 5.9mm Length.8mm Length 5.mm Number of holes Number of holes 7 Left Right Left Right Medial Plate, L-Shaped Plate dimensions Medial Plate, T-Shaped Plate dimensions Plate thickness.4mm Plate thickness.4mm Width.mm Width.7mm Length 0.4mm Length 0.4mm Number of holes 4 Number of holes 5

7 Screws Overview T7 drive mechanism Low-profile heads reduce soft tissue irritation Standardized.8mm drill bit for all screw types Self Tapping Angulation in Plate Drive Mechanism Thread Outer Diameter Threaded Pitch Core Diameter Drill Diameter Lengths.4mm Cortex Screws Yes 0º T7.4mm.0mm.7mm.8mm 4mm (mm increments) 50mm (mm increments) 55 80mm (5mm increments).4mm Variable Angle Locking Screws Yes 5º T7.4mm.0mm.7mm.8mm 4mm (mm increments) 50mm (mm increments) 55 80mm (5mm increments).0mm Osteopenia Screws No 0º T7.0mm.5mm.7mm.8mm 0mm 50mm (mm increments) 55mm 80mm (5mm increments) Not all screw lengths are available within the standard set configuation but can be available upon request. 7

$Surgical Technique Surgical Approach A two incision technique should be utilized to ensure anatomic reduction of all talar neck and body fractures.$ $Elevate only the soft tissues needed to reduce the fracture. An anterolateral approach can be used for fixation of the lateral plates.$ Start this incision at the tip of the fibula and extend it distally towards the lateral aspect of the talonavicular joint. Care must be taken to protect branches of the superficial peroneal nerve.

Start this incision at the tip of the fibula and extend it distally towards the lateral aspect of the talonavicular joint. Care must be taken to protect branches of the superficial peroneal nerve.

8 Surgical Technique Surgical Approach A two incision technique should be utilized to ensure anatomic reduction of all talar neck and body fractures. An anteromedial approach can be used for fixation of the medial plates. This incision should start at the medial malleolus, extend over the talar neck (medial to the tibialis anterior tendon) and end at the navicular. Elevate only the soft tissues needed to reduce the fracture. An anterolateral approach can be used for fixation of the lateral plates. Start this incision at the tip of the fibula and extend it distally towards the lateral aspect of the talonavicular joint. Care must be taken to protect branches of the superficial peroneal nerve. The extensor digitorum brevis is split in line with its fibers. This incision should be made to gain access to the subtalar joint and lateral talus. Elevate only the soft tissues needed to reduce the fracture. Fracture Reduction Articular fragments must be anatomically reduced prior to plate application and screw insertion. Reduction aids should be placed so as not to interfere with final plate placement. Reduce and provisionally secure bone fragments using Instruments from the VLP MINI-MOD General Instrument set..mm x 50mm K-Wires (7-0) can be used to provisionally fix bone fragments prior to definitive fixation. In addition, Reduction Forceps with Serrated Jaws (77-78) can also be used to assist in fracture reduction. Anteromedial approach Anterolateral approach 8

$Implant Positioning Select the.4mm VLP MINI-MOD Talus plate that best accommodates the patient s anatomy and fracture pattern.$ Plate Placement After choosing the appropriate plate, the VLP.4mm Plate Holder (77-404) can be used to assist in the application of the plate as a provisional fixation tool.

Plate Placement After choosing the appropriate plate, the VLP.4mm Plate Holder (77-404) can be used to assist in the application of the plate as a provisional fixation tool.

9 Implant Positioning Select the.4mm VLP MINI-MOD Talus plate that best accommodates the patient s anatomy and fracture pattern. An acetate template (708-07) is available to assist with preoperative radiographic planning as well as titanium templates (Set Configuration: ). Plate Placement After choosing the appropriate plate, the VLP.4mm Plate Holder (77-404) can be used to assist in the application of the plate as a provisional fixation tool. The plate holder should be twisted into a locking hole in the plate and a.mm K-Wire (7-0) should be inserted through the center of the plate holder to fix the plate and holder to the bone. Once additional fixation has been added to the construct, the plate holder and.mm K-Wire can be removed. If fixation is desired through the hole used for the plate holder device, a.8mm diameter drill (74440 or ) must be used prior to screw insertion. Note: The VLP MINI-MOD.4mm Plate Holder is designed to assist in stabilizing the plate, not to manipulate plate placement in/under soft tissue or to facilitate percutaneous use. If the plate does not properly fit the anatomy, Plate Bending Rods (744-04) from the VLP MINI-MOD General Instrument Set (77-40) can be used to further contour the implant before the plate is fixed to bone. 9

8mm Variable Angle/Fixed Angle Drill Guide (744-40) into the desired screw hole and drill accordingly

10 Screw Insertion Technique The.4mm Talus Plates were designed to accept.4mm Non-Locking Screws,.4mm Variable-Angle Locking Screws and.0mm Osteopenia Screws. Step Insert the.8mm Variable Angle/Fixed Angle Drill Guide (744-40) into the desired screw hole and drill accordingly with the.8mm Short Drill Bit (744-40). Step Measure for screw length by using the.4mm Screw Depth Gauge Short ( ) or Long (77-498). 0

Step Insert the appropriate length.4mm Non-Locking Screw,.

0mm Osteopenia Screw using the Self Retaining T7 Fixed Handle Driver (744-44)/T7 Driver

Note: A moderate amount of downward pressure should be applied through the driver when the

Note: Once locking screw head engagement with the plate is noticed, only a half turn is

11 Step Insert the appropriate length.4mm Non-Locking Screw,.4mm Variable Angle Locking Screw or.0mm Osteopenia Screw using the Self Retaining T7 Fixed Handle Driver (744-44)/T7 Driver Shaft with AO QC (77-497). Fill remaining screw holes as desired. Note: A moderate amount of downward pressure should be applied through the driver when the head of a Locking Screw begins to engage the plate. Note: Once locking screw head engagement with the plate is noticed, only a half turn is necessary to lock the screw. Note: Titanium.4mm Variable Angle Locking screws and locking holes should only be used twice. Final imaging Obtain final radiographic images to confirm optimal screw placement and length prior to closure. Lateral Plate Medial Plate

12 Catalog Information VLP MINI-MOD.4mm Talus Plate Module Set No VLP MINI-MOD Talus Tray VLP MINI-MOD.4mm Talus Plate Medial L Left Sterile VLP MINI-MOD.4mm Talus Plate Medial L Right Sterile VLP MINI-MOD.4mm Talus Plate Medial T Left Sterile VLP MINI-MOD.4mm Talus Plate Medial T Right Sterile VLP MINI-MOD.4mm Talus Plate Lateral 4-Hole Left Sterile VLP MINI-MOD.4mm Talus Plate Lateral 4-Hole Right Sterile VLP MINI-MOD.4mm Talus Plate Lateral -Hole Left Sterile VLP MINI-MOD.4mm Talus Plate Lateral -Hole Right Sterile VLP MINI-MOD General Instrument Set Set No Freer Elevator K-Wire 0.8mm x 70mm Length Trocar Point 7-00 K-Wire.0mm x 50mm Length Trocar Point 7-0 Peri-Loc K-Wire.5mm x 50mm Length Trocar Point 7-0 Peri-Loc K-Wire.mm x 50mm Length Trocar Point Mini Quick Coupling Bulb Handle S/D Small Quick Coupling Handle Sharp Hook Plate Cutting Forceps Hohmann Retractor mm Width Bending Pliers For.5mm &.0mm Plates Wire Cutters 75mm Length VLP MINI-MOD Tray Lid VLP MINI-MOD General Instrument Tray 77-9 Hohmann Retractor Bent 8mm Width Reduction Forceps w/points Broad Reduction Forceps w/serrated Jaw Cannulated AO To Trinkle Adaptor Mini Plate Bending Pliers Jewelers Handle AO QC Termite Forceps mm/.4mm Bending Rod VLP MINI-MOD.4 Instrument Set Set No VLP MINI-MOD.4mm Module Tray VLP MINI-MOD Tray Lid VLP.5mm Plate Holder mm Tap With AO Quick Connect T7 Driver Shaft With AO Quick Connect Depth Gauge For.4mm and.7mm Screws Short Depth Gauge For.4mm and.7mm Screws Countersink for.4mm Screws with AO Quick Connect VLP MINI-MOD.8mm Drill Short AO QC VLP MINI-MOD.8mm Drill Long AO QC mm Provisional Fixation Wire Short mm Provisional Fixation Wire Long VLP MINI-MOD.4mm Overdrill Short AO QC Fixed Handle T7 Driver /.4mm Double Ended Drill Guide Small mm VA Drill Guide Small

13 VLP MINI-MOD.4 Screw Set Set No VLP MINI-MOD.4mm Screw Caddy with Lid Washer for VLP.4mm T7 Screws N VLP Titanium.4mm x mm Cortex Screw T7 Self-Tapping Non-Sterile N VLP Titanium.4mm x 7mm Cortex Screw T7 Self-Tapping Non-Sterile N VLP Titanium.4mm x 8mm Cortex Screw T7 Self-Tapping Non-Sterile N VLP Titanium.4mm x 9mm Cortex Screw T7 Self-Tapping Non-Sterile N VLP Titanium.4mm x 0mm Cortex N VLP Titanium.4mm x mm Cortex N VLP Titanium.4mm x mm Cortex N VLP Titanium.4mm x mm Cortex N VLP Titanium.4mm x 4mm Cortex N VLP Titanium.4mm x 5mm Cortex N VLP Titanium.4mm x mm Cortex N VLP Titanium.4mm x 8mm Cortex N VLP Titanium.4mm x 0mm Cortex N VLP Titanium.4mm x mm Cortex N VLP Titanium.4mm x 4mm Cortex N VLP Titanium.4mm x mm Cortex N VLP Titanium.4mm x 8mm Cortex N VLP Titanium.4mm x 0mm Cortex N VLP Titanium.4mm x mm Cortex N VLP Titanium.4mm x 4mm Cortex N VLP Titanium.4mm x mm Cortex N VLP Titanium.4mm x 8mm Cortex N VLP Titanium.4mm x 40mm Cortex N VLP Titanium.4mm x 4mm Cortex N VLP Titanium.4mm x 44mm Cortex N VLP Titanium.4mm x 4mm Cortex N VLP Titanium.4mm x mm Locking N VLP Titanium.4mm x 7mm Locking N VLP Titanium.4mm x 8mm Locking N VLP Titanium.4mm x 9mm Locking N VLP Titanium.4mm x 0mm Locking 744-4N VLP Titanium.4mm x mm Locking 744-4N VLP Titanium.4mm x mm Locking 744-4N VLP Titanium.4mm x mm Locking N VLP Titanium.4mm x 4mm Locking N VLP Titanium.4mm x 5mm Locking 744-4N VLP Titanium.4mm x mm Locking N VLP Titanium.4mm x 8mm Locking N VLP Titanium.4mm x 0mm Locking 744-4N VLP Titanium.4mm x mm Locking N VLP Titanium.4mm x 4mm Locking 744-4N VLP Titanium.4mm x mm Locking N VLP Titanium.4mm X 8mm Locking N VLP Titanium.4mm x 0mm Locking 744-4N VLP Titanium.4mm x mm Locking *N denotes non-sterile product

14 VLP MINI-MOD.4 Screw Set (continued) Set No N VLP Titanium.4mm x 4mm Locking 744-4N VLP Titanium.4mm x mm Locking N VLP Titanium.4mm x 8mm Locking N VLP Titanium.4mm x 40mm Locking N VLP Titanium.4mm x 4mm Locking N VLP Titanium.4mm x 44mm Locking N VLP Titanium.4mm x 4mm Locking VLP MINI-MOD.0 Screw Set Set No VLP MINI-MOD.0mm Ost Scr Caddy with Lid N VLP Titanium.0mm x 0mm Osteopenia 744-0N VLP Titanium.0mm x mm Osteopenia N VLP Titanium.0mm x 4mm Osteopenia 744-0N VLP Titanium.0mm x mm Osteopenia N VLP Titanium.0mm x 8mm Osteopenia N VLP Titanium.0mm x 0mm Osteopenia 744-0N VLP Titanium.0mm x mm Osteopenia N VLP Titanium.0mm x 4mm Osteopenia 744-0N VLP Titanium.0mm x mm Osteopenia N VLP Titanium.0mm x 8mm Osteopenia N VLP Titanium.0mm x 0mm Osteopenia 744-0N VLP Titanium.0mm x mm Osteopenia N VLP Titanium.0mm x 4mm Osteopenia 744-0N VLP Titanium.0mm x mm Osteopenia N VLP Titanium.0mm x 8mm Osteopenia N VLP Titanium.0mm x 40mm Osteopenia N VLP Titanium.0mm x 4mm Osteopenia N VLP Titanium.0mm x 44mm Osteopenia N VLP Titanium.0mm x 4mm Osteopenia N VLP Titanium.0mm x 48mm Osteopenia *N denotes non-sterile product 4

15 VLP MINI-MOD Ti.4 and.0 Long Screw Set Set No mm Long Screw Caddy VLP Titanium.4mm x 55mm Cortex VLP Titanium.4mm x 0mm Cortex VLP Titanium.4mm x 5mm Cortex VLP Titanium.4mm x 70mm Cortex VLP Titanium.4mm x 75mm Cortex VLP Titanium.4mm x 80mm Cortex VLP Titanium.4mm x 55mm Locking VLP Titanium.4mm x 0mm Locking VLP Titanium.4mm x 5mm Locking VLP Titanium.4mm x 70mm Locking VLP Titanium.4mm x 75mm Locking VLP Titanium.4mm x 80mm Locking VLP Titanium.0mm x 55mm Osteopenia Screw T7 Fully Threaded VLP Titanium.0mm x 0mm Osteopenia Screw T7 Fully Threaded VLP Titanium.0mm x 5mm Osteopenia Screw T7 Fully Threaded VLP Titanium.0mm x 70mm Osteopenia Screw T7 Fully Threaded VLP Titanium.0mm x 75mm Osteopenia Screw T7 Fully Threaded VLP Titanium.0mm x 80mm Osteopenia Screw T7 Fully Threaded *N denotes non-sterile product 5

16 Supporting healthcare professionals for over 50 years Smith & Nephew, Inc. 450 Brooks Road Memphis, TN 8 USA Telephone: Information: Orders/Inquiries: Smith & Nephew, Inc. Trademark of Smith & Nephew. 054 V 7089 REV0 09/

Surgical Technique. Calcaneal Locking Plate

Surgical Technique. Calcaneal Locking Plate Surgical Technique Calcaneal Locking Plate PERI-LOC Locked Plating System Calcaneal Locking Plate Surgical TechniqueCatalog Infor Table of Contents Introduction...2 Indications...3 Plate Features...3 Patient