LCP Low Bend Medial Distal Tibia Plates 3.5 mm. Anatomic plates with low profile head for intra- and extraarticular fractures. Technique Guide

Introduction LCP Low Bend Medial Distal Tibia Plates 3.5 mm 2 Surgical Technique Preparation 6 Product Information Set Lists 17 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 nstrument is highly recommended Reprocessing, Care and Maintenance of Synthes Instruments For general guidelines, function control and dismantling of multipart instruments please refer to: www.synthes.com/reprocessing

LCP Low Bend Medial Distal Tibia Plates 3.5 mm The LCP Low Bend Medial Distal Tibia Plate 3.5 mm is part of the Synthes Small Fragment LCP system that merges locking screw technology with conventional plating techniques. The combi-holes in the LCP plate shaft combine a dynamic compression unit (DCU) hole with a locking screw hole. Combi-holes provide the flexibility of axial compression and locking capability throughout the length of the plate shaft. Fixation with the 3.5 mm LCP Low Bend Medial Distal Tibia Plate has many similarities to traditional plate fixation methods, with a few important...

Plate features – Head of plate is low profile for minimal prominence on medial malleolus – 3.5 mm cortex and 4.0 mm cancellous bone screws sit flush with plate in the nonlocking portion of distal combiholes to minimize screw prominence – Rounded edges to minimize soft tissue irritation – Limited-contact shaft profile – Available in stainless steel or titanium Combi-holes in the shaft and head accept the following: – 3.5 mm cortex screws – 3.5 mm locking screws – 4.0 mm cancellous bone screws Three distal locking screws diverge across subchondral bone and are parallel to joint Six round locking...

AO Principles In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation.1,2 Those principles, as applied to the 3.5 mm LCP Low Bend Medial Distal Tibia Plate, are: Anatomic reduction Precontoured plate assists reduction of metaphysis to diaphysis and facilitates restoration of the articular surface by exact screw placement. Stable fixation Locking screws create a fixed-angle construct, providing angular stability. Preservation of blood supply Tapered end allows submuscular plate insertion, preserving tissue viability. Limited-contact plate design...

Indications The Synthes LCP Low Bend Medial Distal Tibia Plates are intended for fixation of complex intra- and extra-articular fractures and osteotomies of the distal tibia, as a part of the Synthes Small Fragment LCP System. Synthes 5

Complete the preoperative radiographic assessment and prepare the preoperative plan. Determine plate length and Position the patient supine on a radiolucent operating table. 3.5 mm LCP Low Bend Medial Distal Tibia Plates set 01.1 12.062 Tray for LCP Medial Distal Tibial Plate 3.5, low bend (TAN), for Vario Case, without Lid, with Contents 01.1 12.063 Tray for LCP Medial Distal Tibial Plate 3.5, low bend (Stainless Steel), for Vario Case, without Lid, with Contents Modular small fragment instrument trays* 68.122.013 Modular Small Fragment Basic Instrument Tray 68.122.015 Modular Small Fragment...

Reduction Reduce articular surface Approach An open or a percutaneous approach may be used depending on the fracture. Reduction Technique tip: Application of an external fixator or large distractor may facilitate visualization and reduction of the joint. Reduce the fracture fragments and confirm reduction using image intensification. Methods of stabilizing reduction include the following: – Independent Kirschner wires – K-wires through the plate – Independent lag screws – Lag screws through the plate – Locking screws through the plate Locking screws do not provide interfragment compression; therefore,...

Plate Insertion Insert plate Percutaneous insertion For a percutaneous approach, make an incision to access the medial malleolus and slide the plate under the soft tissue. Technique tip: Thread a bending pin or LCP drill guide into one of the distal holes as a handle for percutaneous inser- Open insertion Open the area as necessary to expose the joint. Carefully push the plate under the soft tissue for placement on the Center the plate on the medial malleolus. Important: When choosing a percutaneous approach take care not to damage the saphenous nerve or saphenous vein. Saphenous vein (blue)...

2 Position plate and fix provisionally After plate insertion, check alignment on the bone using fluoroscopy. Make any adjustments before inserting screws. Note: This locking plate is precontoured to fit the medial distal tibia. If the plate contour is changed, it is important to check the position of the screws relative to the joint, using the screw placement verification technique. Optional instrument 324.024 Instrument for temporary reduction The plate may be temporarily held in place using any of the following options: – Instrument for temporary reduction (push-pull reduction device) – 4.0...

Plate Insertion Optional technique: Screw placement verification with threaded tip, length 1 50/5 mm 310.284 LCP Drill Bit 0 2.8 mm with Stop, 323.027 LCP Drill Sleeve 3.5, for Drill Bits 0 2.8 mm 323.055 Centering Sleeve for Kirschner Wire 323.060 PHILOS Direct Measuring Device Since the direction of the locking screw depends on the con- tour of the plate, final screw position may be verified with a K-wire before insertion. This becomes especially important when the plate has been manually contoured or applied near Synthes LCP Low Bend Medial Distal Tibia Plates 3.5 mm Technique Guide

Thread a 3.5 mm LCP drill sleeve into the desired locking hole and insert the 1.6 mm centering sleeve for Kirschner wire into the drill guide. nsert a 1.6 mm threaded K-wire through the centering sleeve and drill to the desired depth. O Verify K-wire placement under image intensification to deter- mine if final screw placement will be acceptable. Important: The K-wire position represents the final position of the locking screw. Confirm that the K-wire does not enter