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Before using the intramedullary. please ensure that it is functioning properly and free of any defects. In addition, please follow these instructions, including the information regarding repair as wellas the safety information. This will be ensure that no damage results from incorrect assembly or operration, which are not covered by guarantee and for which the manufacturer shall not be liable. The intramedullary is not be operated and used only by persons who have the necessary training and technical knowledge to do so. We reserve the right to modify our products and their technical specifications without prior notice. Please keep these instructions for future reference. They must be available to operating room personnel Table of contents 1. Description 2. Purpose 3. Mode of operation 4. Hazards and warnings 5. Putting into operation 6. Preparation 7. Functional test 8. Operation 9. Cleaning, disinfection, sterilization 9.1 Cleaning / disinfection 9.2 Sterilization 10. Troubleshooting list 11. Technical service 12. Technical data 13. Accessories 14. Indications 15. Contraindications 1. Description: 1 Drill head 2 Flexible drill shank 3 Shank 2. Purpose The purpose of the intramedullary is to drill an intramedullary socket prior to the insertion of implants ( e.g. intramedullary nails, hip endoprostheses ). 3. Mode of operation The intramedullary is used to drill intramedullary sockets in a stepwise manner until the desired final diameter is reached. 4. Hazards and warnings There is a little risk to personal safty incurred, trough the use of the intramedullary. Nervertheless, incorrect operation or misuse can be hazardous: for the user for the patient for the unit All persons who operate this tool should read carefully the following information regarding safe use. Your safety is at stake. 4.1 For the user Injuries, as well as irreparable damage to the can result if it is operated in a counter-clockwise (left-hand) direction. The intramedullary should only be operated in a clockwise (right-hand) direction. The use of the guide spindle that is excessively curved or warped, and/or excessive bending of the intramedullary, can lead to increased friction and thereby to unintentional removal of material from the guide spindle and thereby to binding of the drill. Only guide spindles and intramedullary s should be used whose surfaces are undamaged and free of defects and whose shanks are not warped. Page 1 of 5

The intramedullary is delivered unsterilized. It must therefore also be sterilized prior to initial use (see section 9). In order to avoid accidental operation of the intramedullary, it should only be connected with the motor switched off and the system safety lock activated. Failure to do this can lead to damage to the drill and to injuries. When operating the motor drive unit, be sure to follow the instructions carefully. In order to avoid a high thermal load bursts of forward movement and overloading the motor drive system, use only sharpened intramedullary s that are free of defects. In order to prevent the flexible drill shank 2 from warping, avoid kinking the intramedullary during use or while cleaning. Damaged intramedullary s should be set aside and not used. 4.2 For the patient In order to achieve optimal results and avoid thermal damage to bones and tissues (necrosis), drilling should be performed using constant forward pressure. Working with sharp-edged tools can give rise to taers or perforations in surgical gloves. This can in turn give rise to contamination and infection. Therefore, avoid touching the cutting edges of tools when using or changing them. 4.3 For the unit In order to operate the unit safety, and in the interest of preventing injuries, only use intramedullary s whose cutting edges 1 and flexible drill shanks 2 show no sign of damage. Only use the intramedullary if its functions have been tested as described in (see section 7) and if no damage or defects are found. The intramedullary should only be sterilized with steam. Sterilization should be carried out via an approved sterilization procedure. (see section 9.2) 5. Putting into operation Attachement configurations that are not specified in the instructions for use may only be used if they have no negativ impact on the performance and safety parameters of the intended applications. In order to operate the intramedullary, a compatible motor drive is needed. The motor drive must have sufficient torque (>700 Ncm), a compatible number of rpm s (150-300 rpm), as well as the correct shank adapter (DIN 58809-Aesculap, AO, Hudson, Zimmer or Trinkle). 6. Preperation Only use the intramedullary if the cutting edge of it s drill head 1 and the shank 2 show no signs of damage. Connect the intramedullary with a suitable shank profile (Aesculap, AO, Hudson, Zimmer or Trinkle) to the adapter of the respective motor drive. Follow the instructions that accompany the respective handpiece. Both injuries and irreparable damage to the drill can result if it is operated in a counter-clockwise (lefthand) direction. The intramedullary should only be operated in a clockwise (righthand) direction. The intramedullary is delivered unsterilized. It must therefore also be sterilized prior to initial use (see section 9). In order to avoid accidental operation of the intramedullary, it should only be connected with the motor switched off and the system safety lock activated. Failure to do so can lead to damage to the drill and to injuries. Page 2 of 5

When operating the motor drive unit, be sure to follow the instructions carefully. 7. Functional test Before each use, both the motor drive and intramedullary that is to be used should be inspected. Be sure that neither flexible drill shank 2 nor the cutting edges are damaged. Ensure that the intramedullary is seated securely in the motor drive adapter. When doing this, hold the motor drive firmly in one hand and pull in a forward direction on the intramedullary with the other. If the intramedullary is firmly seated, it will remain in the in the handpiece adapter when you pull on it. Ensure that the guide spindle and intramedullary configuration to be used for drilling is a correct one. At the same time, push the guide spin-through the longitudinal boring of the intramedullary. The guide spindle should move smoothly in the boring. In order to avoid hazards arising from wearing away spindle material during use, watch out for crimped or abraded guide spindles, and set them aside. The use of either a guide spindle that is excessivly curved or warped, or a crimped intramedullary (or both) can lead to increased friction and thereby to unintended removal of material and to binding of the drill. Only guide spindles and intramedullary s should be used whose surfaces are not damaged and whose shanks are free of defects and are not warped. Working with sharp-edged tools can give rise to tears or perforations in surgical gloves. This can in turn give rise to contamination and infection. Therefore, avoid touching the cutting edge of tools when using or changing them. In order to operate the unit safely and in the interest of preventing injuries, only use intramedullary s whose cutting edges 1 and flexible shanks 2 are free of defects. Only use the intramedullary if its functions have been tested as described in (see section 7) and if no damage or defects are found. 8. Operation The intramedullary should only be used in conjunction with a compatible guide spindle. The choice of guide spindle is determined by the diameter of the guide of the intramedullary. The guide spindle is first used to align the section of bone on the correct axis, and should be guided only with the hand, which should be positioned on the special handle. The drill is guided by means of the inserted guide spindle. Begin the smallest diameter appropriate to the diagnostic procedure and increase by increments of 0.5-1.0 mm until the desired end diameter is achieved. For information pertaining to operation of the motor drive, please refer to the motor drive instruction manual. The use of either a guide spindle that is excessively curved or warped, or a crimped intramedullary (or both) can lead to increased friction and thereby to unintended removal of material and to binding of the drill. Only guide spindles and intramedullary s should be used whose surfaces are undamaged and free of defects and whose shanks are not warped. Injuries, as well as irreparable damage to the drill can result if it is operated in a counter-clockwise (left-hand) direction. The intramedullary should only be operated in a clockwise (right-hand) direction. In order to achieve optimal results and avoid thermal damage to bones and tissues (necrosis), drilling should be performed using constant forward pressure. In order to avoid a high thermal load bursts of forward movement and overloading the motor drive system, use only sharpened intramedullary s that are free of defects. In order to prevent the flexible drill shank 2 from warping, avoid kinking the intramedullary during operation or cleaning. Damaged intramedullary s should be set aside and not used! 9. Cleaning, disinfection, sterilization Minimum criteria for cleaning and disinfecting solutions: These are to be determined by national government regulations. 9.1 Cleaning / disinfection Following use, immerse the intramedullary in an active cleaning disinfection solution. The manufacturer s instructions with reard to dilution ratios, action time, etc. must be observed. Page 3 of 5

Then clean the intramedullary inside and out by holding it under running water. While doing this, bend the flexible drill shank 2 slightly in order to remove any encrusted material, useing, if necessary, a soft brush. To clean the inside, a guide spindle or narrow round brush can also be used. Final cleaning of the flexible drill shank 2 should be carried out by gently and carefully bending and twisting it while exposing it to ultrasonic. Finally, rinse and the intramedullary thoroughly, and then dry it. When cleaning the guide spindle, watch out for surfaces that are damaged, i.e. that are excessively scratched, abraded, or worn. Damaged guide spindles should be set aside and not used. During preperations for each use, the intramedullary should be inspected for damage to its cutting edges 1 and on the flexible drill shank 2. Damaged intramedullary s should be set aside and not used. Working with sharp-edged tools can give rise to tears or perforations in surgical gloves. This can in turn give rise to contamination and infection. Therefore, avoid touching the cutting edge of tools when using or changing them. Please no In order to prevent the flexible drill shank from warping, avoid excessive bending of the intramedullary during operation or cleaning. Damaged intramedullary s should be set aside and not used. 9.2 Sterilization Sterilization should be carried out by a validated steam sterilization method (e.g. sterilizer according to EN 285 and and validated according to EN 554 ). Autoclave: Autoclave: steam autoclave, Temperature = 121 to 123 celsius, pressure 1 1,2 bar (15-17psi), at least 30 minutes in packed condition. At temperature of 131 up to 135 celsius, 1-1,2 bar (15-17psi) the pressure is reduced to approximately 20 minutes. autoclave with backing pressure: during the backing pressure cycle the air is evacuated from the chamber before steam is let in. Standard sterilization time for packed instruments, 135 celsius at 2-3 bar (27-30psi) minium 4 to 10 minutes. The intramedullary should only be steam sterilized! 10. Troubleshooting list Fault Cause Fault detection Rectification The intramedullary doesn t turn The motor drive is not attached The motor drive is malfunctioning The motor drive fails to Engage the The motor drive fails to turn The motor drive is not correctly attached Consult motor drive instructions for use Instrument fails to cut properly Bone material in the flutes or drilling canal Dull cutting edge Bursts of forward Movement, overheating Take the intramedullary out of the motor drive and remove bone material Replace intramedullary ; service have to be by origin manufacturer Intramedullary fails to achieve desired socket depth Warped guide spindle or Intramedullary Intramedullary is Difficult to center with the Guide spindle or cannot be Cenered at all Replace guide spindle and intramedullary For further information regarding technical problems, please consult the appropriate instructions for use. 11. Technical service Maintenance/repairs Sharpening of the intramedullary should only be carried out by origin MANUFACTURER. Contact MANUFACTURER technical service department even if only minor technical problems arise. In so doing, more problems or breakdown of the intramedullary will be prevented from occurring. Replace any dull or damaged intramedullary s. For information pertaining to maintenance of the motor drive, please consult the instruction manual. The MANUFACTURER shall be held responsible for the safety, reliability and performance of this product only if any installation, additions, adjustments, service, repairs or changes with regard to this product are carried out solely by the manufacturer and if the product is used in accordance with the instructions accompanying it Only original MANUFACTURER replacement parts might be used for repairs. The user must obtain from the company that has carried out any repairs a document specifying the type and and extent of the work performed ; this document should bear the company stamp, date and authorized signature. Page 4 of 5

12. Technical data Intramedullary diameter: Motor drive rpm: Compatible shank adapters: Ø 6.0 mm up to Ø 18 mm 150 300 rpm with max. torque for shaft = 10Nm DIN 58809-Aesculap AO-Synthes Hudson Zimmer Trinkle 13. Accessories The compatible handles and guide spindles for drilling with intramedullary s are: Guide spindles with round head ( olive ), made of implant material DIN ISO 5832-1 Guide spindle diameter 2.0 mm for intramedullary : diameter 6.0 mm up to 7.5 mm Guide spindle diameter 3.0 mm for intramedullary : diameter 8.0 mm up to 18 mm Guide spindle length: 900 mm RECOMMENDED HANDLE: JAKOBS CHUCK WITH T HANDLE 14. Indikationen Flexible s are intended to open and widen the medulla (cavity) of tubular bones, femoral, tbia- and humeral. 15.Contraindications Acute and chronic infections; muscle, nerve or vascular diseases that endanger the affected extremity; a lack of bony tissue or poor bone quality (e.g. severe osteoporosis); local bone tumours. Systemic diseases and metabolic disorders; infections and falls; drug dependence In the event of failure to comply with these guidelines or if it can be proven that these guidelines were breached is unable to accept any claims for compensation. CATALOGUE NUMBER CAUTION BATCH CODE MANUFACTURING DATE SEE INSTRUCTION FOR USE AS MEDIZINTECHNIK GMBH DOES NOT ACCEPT RESPONSIBILITY IF THIS CUSTOMER INFORMATION HAS BEEN VIOLATED PROVABLY. Page 5 of 5