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LCP Wrist Fusion

LCP Wrist Fusion
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0X6.000.700_AA.qxp 02.12.2008 9:42 Uhr Seite Cvr1 LCP Wrist Fusion Set. Anatomic plates for total wrist fusion. Technique Guide

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Introduction LCP Wrist Fusion System 2 Surgical Technique Preoperative Planning 6 Prepare Joint and Optional Bone Void Filler Insertion 8 Insert Distal Cortex Screws 9 Insert Distal Locking Screws 11 Insert Proximal Cortex Screws 13 Insert Proximal Locking Screws 1 5 Close and Optional Implant Removal 17 Product Information Screws 18 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...

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0X6.000.700_AA.qxp 02.12.2008 9:42 Uhr Seite 2 LCP Wrist Fusion System The LCP Wrist Fusion System consists of plates, locking screws and cortex screws. Implants are available in stainless steel and titanium. Plates – Standard bend plates for average-sized individuals – Short bend plates for small-stature individuals or patients with previous proximal row carpectomy – Straight plate for patients with unusual anatomy or a severely deformed wrist joint – Precontoured plates reduce the need for intraoperative bending – Low-profile plates minimize plate prominence – Limited-contact design...

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- Self-tapping for easy insertion - Self-retaining Stardrive recess provides improved torque transmission and increased resistance to stripping - Locking screws with threaded head are used in Combi holes to create a fixed-angle construct, particularly advantageous to osteopenic bone 2.7 mm Locking Screw 3.5 mm Locking Screw 2.4 mm Cortex Screw 2.7 mm Cortex Screw 3.5 mm Cortex Screw * Distal holes accept 2.4 mm cortex screws also

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0X6.000.700_AA.qxp 02.12.2008 9:43 Uhr Seite 4 AO Principles In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation.1 These principles as applied to the LCP Wrist Fusion System, are: Anatomic reduction The LCP Wrist Fusion System consists of implants designed to restore the anatomy of the wrist after fusion. Stable fixation The implants in the LCP Wrist Fusion System use locking compression plate (LCP) technology. Locking the screw to the plate creates a fixed-angle construct that is stronger compared to a similar nonlocking plate and screw...

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0X6.000.700_AA.qxp 02.12.2008 9:43 Uhr Seite 5 Indications The LCP Wrist Fusion System is indicated for wrist arthrodesis and fractures of other small bones of the carpus. Specific indications include: – Posttraumatic arthrosis of the joints of the wrist – Rheumatoid wrist deformities requiring restoration – Complex carpal instability – Postseptic arthritis of the wrist – Severe unremitting wrist pain related to motion – Brachial plexus nerve palsies – Tumor resection – Spastic deformities Synthes 5

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0X6.000.700_AA.qxp 02.12.2008 9:43 Uhr Seite 6 Preoperative Planning Evaluate the condition of the soft tissues. Compare the standard bend, short bend and straight plates to the patient's wrist, and determine which plate to use for fusion. The standard bend plate is used for medium to large wrist fixation. The short bend plate is used for smaller wrist fixation and for fusion following proximal row carpectomy. The straight plate is used for wrist fixation when the standard and short bend plates do not fit the anatomy. This plate can be contoured to the anatomy of the patient's wrist. 6...

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0X6.000.700_AA.qxp 02.12.2008 9:43 Uhr Seite 7 Approach 1 Approach Place the patient in the supine position with the hand and arm on a hand table. Make a longitudinal incision from the radial aspect of the third metacarpal across Lister's tubercle to the dorsum of the distal radius. Open the third dorsal compartment, and transpose the extensor pollicis longus (EPL) radially. Retract the digital extensors of the index and middle fingers to expose the dorsal aspect of the third metacarpal. Make an incision through the wrist capsule and extend it proximally to the radius along its dorsal...

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0X6.000.700_AA.qxp 02.12.2008 9:43 Uhr Seite 8 Prepare Joint and Optional Bone Void Filler Insertion 2 Prepare joint Expose and decorticate the joint surfaces to be included in the fusion. These include the scaphocapitate joint, capitolunate joint, radioscaphoid joint and radiolunate joint. In some cases, the ulnar midcarpal, lunotriquetral and second and third carpometacarpal joints may be included. Remove Lister's tubercle and the dorsal distal aspect of the radius with an osteotome. Decorticate the dorsal surfaces of the scaphoid, lunate, and capitate. The dorsal shavings can be saved...

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Insert Distal Cortex Screws Insert distal 2.4 or 2.7 mm cortex screws 31 1.430 Handle with Quick Coupling, 314.467 Screwdriver Shaft, Stardrive, T8, 319.005 Depth Gauge for Screws 0 2.0 and 319.010 Depth Gauge for Screws 0 2.7 to 4.0 mm, 310.509 Drill Bit 0 1.8 mm, with marking, 310.534 Drill Bit 0 2.0 mm, with marking, 323.202 Universal Drill Guide 2.4 323.260 Universal Drill Guide 2.7 Fix the plate to the third metacarpal and then to the radius. nsert screws in the sequence shown. Position the plate directly over the dorsal aspect of the third metacarpal. Note: Screw sequence may vary...

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0X6.000.700_AA.qxp 02.12.2008 9:43 Uhr Seite 10 Insert Distal Cortex Screws Remove the drill and drill guide. Use the depth gauge to measure for screw length. Insert the cortex screw, using the self-retaining StarDrive screwdriver shaft and handle, and tighten carefully. Alternative technique: Insert distal locking screw A unicortical locking screw can be inserted in the threaded portion of the distal hole instead of the cortex screw. This unicortical locking screw can limit fracture propagation at the end of the plate. The technique for inserting a locking screw is described on page 11. 10...

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0X6.000.700_AA.qxp 02.12.2008 9:43 Uhr Seite 11 Insert Distal Locking Screws 4 Insert distal 2.7 mm locking screws 2.7 mm 1 Instruments 311.430 LCP Drill Sleeve for LCP Screws л 2.7 mm (head LCP 2.4), with Scale up to 30 mm, for Drill Bits л 2.0 mm 4 6 5 7 8 Screwdriver Shaft, Stardrive, T8, self-holding 323.033 2 Handle with Quick Coupling, length 110 mm 314.467 3 3.5 mm 310.534 Drill Bit л 2.0 mm, with marking, length 110/85 mm, 2-flute 511.776 Sequence of screw placement Torque Limiter, 0.8 Nm, for AO/ASIF Quick Coupling Insert locking screw in the sequence shown (2, 3, 4). Screw the...

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