compression screw. Technique Guide

Introduction Features and Benefits 2 Surgical Technique Hand - Scaphoid 5 Foot - Chevron Osteotomy for Hallux Valgus 14 Using the Optional Drill Guide with Stop 21 Product Information Implants HCS 2.4 23 Image intensifier control This description alone does not provide sufficient background for direct use of the instrument set. Instruction by a surgeon experienced in handling these nstruments is highly recommended Reprocessing, Care and Maintenance of Synthes Instruments For general guidelines, function control and dismantling of multi-part instruments, please refer to: www.synthes.com/reprocessing...

Features and Benefits Tip with self-drilling and selftapping flutes Shorter surgery due to simplified surgical technique Cannulation For minimally invasive technique and guided insertion Head with self-tapping flutes Facilitates countersinking of screw Two different thread lengths of the shaft The optimal implant for every case due to threads available in different lengths P1 P1 Identical pitch of head and shaft threads For controlled closure and compression of the fracture gap Available in steel and titanium All Headless Compression screws from Synthes are available both in stainless implant-grade...

Functional Principle Lag Screw Technique with Compression Sleeve Step 1: Screw insertion nsertion of the screw into the bone with the compression sleeve. Once the tip of the compression sleeve lies on the bone, the fracture gap is closed and compressed by further turn- Once the desired degree of compres- sion is reached, the screw is counter- sunk into the bone with the screwdriver while the compression sleeve is held stationary. During countersinking no additional compression is generated.

Indications – Fixation of intra-articular and extra-articular fractures and non-unions of small bones and small bone fragments – Arthrodeses of small joints – Bunionectomies and osteotomies Examples include, but are not limited to scaphoid and other carpal bones, metacarpals, tarsals, metatarsals, patella, ulnar styloid, capitellum, radial head and radial styloid. 4 Synthes HCS 2.4/3.0 Technique Guide

Hand - Scaphoid The following simplified surgical technique for a scaphoid fracture serves as example for the use of the HCS 2.4 or 3.0 Insert the guide wire 292.623 Guide Wire 01.1 mm with trocar tip, length 150 mm. Stainless Steel 292.622 Guide Wire 01.1 mm with threaded tip, with trocar, length 1 50 mm. Stainless Steel 312.151 Double Drill Guide 2.0/1.1 O While monitoring with the image intensifier, advance the guide wire through the drill guide into the bone until the thread tip is anchored in the far cortex. Note: Do not forcefully insert the guide wire. This may cause

Hand - Scaphoid Option: ream the trapezium 03.226.003 Trapezium Burr, cannulated, for HCS - Headless Compression Screw 03.226.005 Protection Sleeve for HCS - Headless 31 1.430 Handle with Quick Coupling, To facilitate screw insertion, the flank of the trapezium can be removed with the trapezium burr. Slide the trapezium burr with the protection sleeve over the guide wire and carefully ream the trapezium. O Ensure that the trapezium burr does not damage the scaphoid by using image intensification. Note: Do not forcefully insert the trapezium burr since this may damage the guide wire. Synthes HCS...

3 Determine screw and thread length Instruments 03.226.002 Direct Measuring Device for HCS – Headless Compression Screw л 2.4/3.0 mm 292.623 Guide Wire л 1.1 mm with trocar tip, length 150 mm, Stainless Steel or 292.622 Guide Wire л 1.1 mm with threaded tip, with trocar, length 150 mm, Stainless Steel Slide the narrow end of the measuring device over the guide wire to the bone. The measurement on the measuring device shows the depth of the guide wire in the bone in millimeters and directly the appropriate screw length. If the screw is to be countersunk below the surface of the bone, subtract...

Hand - Scaphoid The position of the fracture line determines the thread Correctly selected thread length The shaft thread lies completely within the proximal frag- ment during compression. Fragments can hence be com- Incorrect thread length The shaft thread lies over the fracture gap. Fragments cannot Note: If there is no good bone quality in the distal part of the bone, the distal screw thread can strip-out if too much Synthes HCS 2.4/3.0 Technique Guide

4 Predrilling Instruments 310.221 Drill Bit л 2.0/1.15 mm, cannulated, length 150/48 mm, 3-flute, for Quick Coupling 312.151 Double Drill Guide 2.0/1.1 Predrilling makes it substantially easier to insert the screw in dense bone. Slide the drill guide with the drill bit over the guide wire and pre-drill to the desired depth. Remove the drill guide and verify the effective drilling depth with the image intensifier. Note: Do not drill beyond the tip of the guide wire. Slowly pull the drill bit straight out while running the power tool in “forward mode” to ensure that the guide wire stays in place....

Hand – Scaphoid 5 Pick up screw Instruments For HCS 2.4 03.226.016 Compression Sleeve for HCS – Headless Compression Screw л 2.4 mm For HCS 3.0 03.226.000 Compression Sleeve for HCS – Headless Compression Screw л 3.0 mm Twist the compression sleeve over the head thread of the screw to remove the screw from the screw rack. 10 Synthes HCS 2.4/3.0 Technique Guide

6 Insert screw and compress fragment Instruments 03.226.006 Handle for Compression Sleeve, for HCS – Headless Compression Screw л 1.5–3.0 mm For HCS 2.4 03.226.016 Compression Sleeve for HCS – Headless Compression Screw л 2.4 mm For HCS 3.0 03.226.000 Compression Sleeve for HCS – Headless Compression Screw л 3.0 mm Slide the handle into the selected compression sleeve. Insert the screw into the bone until the fracture gap or the osteotomy is closed and compressed. Notes – Verify the correct position of the shaft thread in the proximal fragment using the image intensifier. If the thread lies over...