CrossTIE. PIP Arthrodesis Implant. surgical technique ordering information PEEK IMPLANTS PEEK IMPLANTS ALLOGRAFT IMPLANTS CROSSTIE INSERTER

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ordering information x x 0o 1443-3301 1444-3300 x x 10o 1443-3311 1444-3310 2.5mm x 2.5mm x 0o 1443-2501 1444-2500 2.5mm x 2.5mm x 10o 1443-2511 1444-2510 ALLOGRAFT IMPLANTS * Sterile Packaged in Saline, No Need to Re-Hydrate x x 0 4200-3300 x x 10o 4200-3310 2.5mm x 2.5mm x 0 o UNIVERSAL INSERTER Universal Inserter, Sterile Packed 4200-0001 4200-2500 CROSSTIE INSERTER CrossTIE Inserter, Sterile Packed 4200-0000 choosing the correct reamer The CrossTIE Implant relies on a press fit in the prepared bone tunnel for fixation. Additional fixation is available at the surgeon s discretion using the optional tie-in technique. The chart below is for reference and the final decision as to which reamer is most appropriate should be made by the surgeon based on their medical judgement and the patient s bone quality. Suggested Reamer Standard CrossTIE Implant 2.7mm diameter Cat. No. 1400-1027 2.5mm Mini CrossTIE Implant Allograft CrossTIE Implant diameter Cat. No. 1400-1030 2.5mm Allograft CrossTIE Implant Note Bene: These technique guidelines are for informational purposes only. Proper surgical procedures are the responsibility of the surgeon, who must evaluate the appropriateness of the procedures described based upon his/her own medical training, experience, and the needs of the individual patient. Prior to the use of these products, the surgeon should refer to the product instruction for use (IFU) for complete indications, warnings, precautions and contra indications. IFU s are also available by contacting CrossRoads Extremity Systems. CrossTIE PIP Arthrodesis Implant 6055 Primacy Parkway, Suite 140 Memphis, TN 38119 crextremity.com 901. 221. 8406 LA0075 Rev C LA0075 Rev C CrossTIE Brochure.indd 1

CrossTIE PIP Arthrodesis Systems Designed to aid in the correction of hammertoe deformity. The CrossTIE System is available in either PEEK material or as a machined cortical allograft. Both styles feature a unique distal cross hole which allows the surgeon the option to tie in the implant thus aiding in reduction and compression of the joint surfaces. Exposure and Joint Preparation Exposure of the PIP joint can be achieved using a standard dorsal incision and soft tissue dissection. Resect the head of the proximal phalanx and base of the middle phalanx being mindful to avoid over-resection. Using provided reamer, drill the proximal phalanx until the cutting flutes are buried. Drill the middle phalanx to the laser mark on the cutting flutes. Manually reduce the middle phalanx over the distal end of the CrossTIE Implant. Compress until the joint is fully reduced and bone-to-bone contact is achieved. Implantation Implantation, continued The CrossTIE implant and inserter are packaged sterile and ready to use. Use caution during insertion to prevent MP Joint sublaxation Stabilize the proximal phalanx using a phalangeal clamp. Once stabilized, insert the exposed portion of the CrossTIE implant into the proximal phalanx. During implantation force and grip should be applied to the proximal portion of the inserter. Once inserted proximally, gently remove the inserter. Especially useful in revision cases, the CrossTIE implant tie in feature minimizes pistoning of the implant due to enlargement of the intramedullary canal. Available in standard size of diameter and in a mini size of, the CrossTIE PEEK s are available in both straight and 10o angled configurations. CrossTIE Allograft Implants are available in standard size of diameter, in both straight and 10o angled configurations. A mini size of is available in straight only. CrossTIE Allograft implants are provided sterile packed in saline so rehydrating at time of surgery is not required. The allograft implant utilizes the Universal Inserter, also provided sterile packed. product overview Note: Do not apply force to distal end of inserter. Manufactured from PEEK or machined cortical allograft Note: The CrossTIE inserter is laser marked to ensure proper dorsal orientation of the implant. Distal hole allows surgeon to tie in the implant and reattach the extensor tendon Tie-In technique Implants and instruments are delivered sterile packaged Inserters can be sold back to CrossRoads via the EcoSMART Instrument Recovery Program* *Patent Pending Suture Hole Preparation An optional suture tunnel can be drilled approximately 3-4mm from the proximal edge of the middle phalanx. Recommended suture tunnel can be drilled using either a 1.6mm or 1.1mm k-wire. Suture Introduction Suture is introduced through the tunnel in the middle phalanx, then passed through the hole in the distal portion of the CrossTIE Implant and back through the tunnel in the middle phalanx. Closure Using the suture as leverage, the middle phalanx is manually reduced over the distal end of the CrossTIE implant until the joint is fully reduced and bone-to-bone contact is achieved. Once the joint is fully reduced, the suture may be used to reattach the extensor tendon, or removed. NOTE : Suture must be on a PS1 or PS2 needle in order to pass through the CrossTIE implant. LA0075 Rev C CrossTIE Brochure.indd 2

CrossTIE PIP Arthrodesis Systems Designed to aid in the correction of hammertoe deformity. The CrossTIE System is available in either PEEK material or as a machined cortical allograft. Both styles feature a unique distal cross hole which allows the surgeon the option to tie in the implant thus aiding in reduction and compression of the joint surfaces. Exposure and Joint Preparation Exposure of the PIP joint can be achieved using a standard dorsal incision and soft tissue dissection. Resect the head of the proximal phalanx and base of the middle phalanx being mindful to avoid over-resection. Using provided reamer, drill the proximal phalanx until the cutting flutes are buried. Drill the middle phalanx to the laser mark on the cutting flutes. Manually reduce the middle phalanx over the distal end of the CrossTIE Implant. Compress until the joint is fully reduced and bone-to-bone contact is achieved. Implantation Implantation, continued The CrossTIE implant and inserter are packaged sterile and ready to use. Use caution during insertion to prevent MP Joint sublaxation Stabilize the proximal phalanx using a phalangeal clamp. Once stabilized, insert the exposed portion of the CrossTIE implant into the proximal phalanx. During implantation force and grip should be applied to the proximal portion of the inserter. Once inserted proximally, gently remove the inserter. Especially useful in revision cases, the CrossTIE implant tie in feature minimizes pistoning of the implant due to enlargement of the intramedullary canal. Available in standard size of diameter and in a mini size of, the CrossTIE PEEK s are available in both straight and 10o angled configurations. CrossTIE Allograft Implants are available in standard size of diameter, in both straight and 10o angled configurations. A mini size of is available in straight only. CrossTIE Allograft implants are provided sterile packed in saline so rehydrating at time of surgery is not required. The allograft implant utilizes the Universal Inserter, also provided sterile packed. product overview Note: Do not apply force to distal end of inserter. Manufactured from PEEK or machined cortical allograft Note: The CrossTIE inserter is laser marked to ensure proper dorsal orientation of the implant. Distal hole allows surgeon to tie in the implant and reattach the extensor tendon Tie-In technique Implants and instruments are delivered sterile packaged Inserters can be sold back to CrossRoads via the EcoSMART Instrument Recovery Program* *Patent Pending Suture Hole Preparation An optional suture tunnel can be drilled approximately 3-4mm from the proximal edge of the middle phalanx. Recommended suture tunnel can be drilled using either a 1.6mm or 1.1mm k-wire. Suture Introduction Suture is introduced through the tunnel in the middle phalanx, then passed through the hole in the distal portion of the CrossTIE Implant and back through the tunnel in the middle phalanx. Closure Using the suture as leverage, the middle phalanx is manually reduced over the distal end of the CrossTIE implant until the joint is fully reduced and bone-to-bone contact is achieved. Once the joint is fully reduced, the suture may be used to reattach the extensor tendon, or removed. NOTE : Suture must be on a PS1 or PS2 needle in order to pass through the CrossTIE implant. LA0075 Rev C CrossTIE Brochure.indd 2

CrossTIE PIP Arthrodesis Systems Designed to aid in the correction of hammertoe deformity. The CrossTIE System is available in either PEEK material or as a machined cortical allograft. Both styles feature a unique distal cross hole which allows the surgeon the option to tie in the implant thus aiding in reduction and compression of the joint surfaces. Exposure and Joint Preparation Exposure of the PIP joint can be achieved using a standard dorsal incision and soft tissue dissection. Resect the head of the proximal phalanx and base of the middle phalanx being mindful to avoid over-resection. Using provided reamer, drill the proximal phalanx until the cutting flutes are buried. Drill the middle phalanx to the laser mark on the cutting flutes. Manually reduce the middle phalanx over the distal end of the CrossTIE Implant. Compress until the joint is fully reduced and bone-to-bone contact is achieved. Implantation Implantation, continued The CrossTIE implant and inserter are packaged sterile and ready to use. Use caution during insertion to prevent MP Joint sublaxation Stabilize the proximal phalanx using a phalangeal clamp. Once stabilized, insert the exposed portion of the CrossTIE implant into the proximal phalanx. During implantation force and grip should be applied to the proximal portion of the inserter. Once inserted proximally, gently remove the inserter. Especially useful in revision cases, the CrossTIE implant tie in feature minimizes pistoning of the implant due to enlargement of the intramedullary canal. Available in standard size of diameter and in a mini size of, the CrossTIE PEEK s are available in both straight and 10o angled configurations. CrossTIE Allograft Implants are available in standard size of diameter, in both straight and 10o angled configurations. A mini size of is available in straight only. CrossTIE Allograft implants are provided sterile packed in saline so rehydrating at time of surgery is not required. The allograft implant utilizes the Universal Inserter, also provided sterile packed. product overview Note: Do not apply force to distal end of inserter. Manufactured from PEEK or machined cortical allograft Note: The CrossTIE inserter is laser marked to ensure proper dorsal orientation of the implant. Distal hole allows surgeon to tie in the implant and reattach the extensor tendon Tie-In technique Implants and instruments are delivered sterile packaged Inserters can be sold back to CrossRoads via the EcoSMART Instrument Recovery Program* *Patent Pending Suture Hole Preparation An optional suture tunnel can be drilled approximately 3-4mm from the proximal edge of the middle phalanx. Recommended suture tunnel can be drilled using either a 1.6mm or 1.1mm k-wire. Suture Introduction Suture is introduced through the tunnel in the middle phalanx, then passed through the hole in the distal portion of the CrossTIE Implant and back through the tunnel in the middle phalanx. Closure Using the suture as leverage, the middle phalanx is manually reduced over the distal end of the CrossTIE implant until the joint is fully reduced and bone-to-bone contact is achieved. Once the joint is fully reduced, the suture may be used to reattach the extensor tendon, or removed. NOTE : Suture must be on a PS1 or PS2 needle in order to pass through the CrossTIE implant. LA0075 Rev C CrossTIE Brochure.indd 2

ordering information x x 0o 1443-3301 1444-3300 x x 10o 1443-3311 1444-3310 2.5mm x 2.5mm x 0o 1443-2501 1444-2500 2.5mm x 2.5mm x 10o 1443-2511 1444-2510 ALLOGRAFT IMPLANTS * Sterile Packaged in Saline, No Need to Re-Hydrate x x 0 4200-3300 x x 10o 4200-3310 2.5mm x 2.5mm x 0 o UNIVERSAL INSERTER Universal Inserter, Sterile Packed 4200-0001 4200-2500 CROSSTIE INSERTER CrossTIE Inserter, Sterile Packed 4200-0000 choosing the correct reamer The CrossTIE Implant relies on a press fit in the prepared bone tunnel for fixation. Additional fixation is available at the surgeon s discretion using the optional tie-in technique. The chart below is for reference and the final decision as to which reamer is most appropriate should be made by the surgeon based on their medical judgement and the patient s bone quality. Suggested Reamer Standard CrossTIE Implant 2.7mm diameter Cat. No. 1400-1027 2.5mm Mini CrossTIE Implant Allograft CrossTIE Implant diameter Cat. No. 1400-1030 2.5mm Allograft CrossTIE Implant Note Bene: These technique guidelines are for informational purposes only. Proper surgical procedures are the responsibility of the surgeon, who must evaluate the appropriateness of the procedures described based upon his/her own medical training, experience, and the needs of the individual patient. Prior to the use of these products, the surgeon should refer to the product instruction for use (IFU) for complete indications, warnings, precautions and contra indications. IFU s are also available by contacting CrossRoads Extremity Systems. CrossTIE PIP Arthrodesis Implant 6055 Primacy Parkway, Suite 140 Memphis, TN 38119 crextremity.com 901. 221. 8406 LA0075 Rev C LA0075 Rev C CrossTIE Brochure.indd 1

ordering information x x 0o 1443-3301 1444-3300 x x 10o 1443-3311 1444-3310 2.5mm x 2.5mm x 0o 1443-2501 1444-2500 2.5mm x 2.5mm x 10o 1443-2511 1444-2510 ALLOGRAFT IMPLANTS * Sterile Packaged in Saline, No Need to Re-Hydrate x x 0 4200-3300 x x 10o 4200-3310 2.5mm x 2.5mm x 0 o UNIVERSAL INSERTER Universal Inserter, Sterile Packed 4200-0001 4200-2500 CROSSTIE INSERTER CrossTIE Inserter, Sterile Packed 4200-0000 choosing the correct reamer The CrossTIE Implant relies on a press fit in the prepared bone tunnel for fixation. Additional fixation is available at the surgeon s discretion using the optional tie-in technique. The chart below is for reference and the final decision as to which reamer is most appropriate should be made by the surgeon based on their medical judgement and the patient s bone quality. Suggested Reamer Standard CrossTIE Implant 2.7mm diameter Cat. No. 1400-1027 2.5mm Mini CrossTIE Implant Allograft CrossTIE Implant diameter Cat. No. 1400-1030 2.5mm Allograft CrossTIE Implant Note Bene: These technique guidelines are for informational purposes only. Proper surgical procedures are the responsibility of the surgeon, who must evaluate the appropriateness of the procedures described based upon his/her own medical training, experience, and the needs of the individual patient. Prior to the use of these products, the surgeon should refer to the product instruction for use (IFU) for complete indications, warnings, precautions and contra indications. IFU s are also available by contacting CrossRoads Extremity Systems. CrossTIE PIP Arthrodesis Implant 6055 Primacy Parkway, Suite 140 Memphis, TN 38119 crextremity.com 901. 221. 8406 LA0075 Rev C LA0075 Rev C CrossTIE Brochure.indd 1