Implants trauma Cannulated Screws

CAUTION: Federal Law (USA) restricts this device to sale by or on the order of a board certified physician. WARNING: If there is no sufficient bone healing, wrong or incomplete postoperative care, implant might break. Attention: The ITS. cannulated screws - except for the Dens Axis screw - are not suitable for use in the spinal column. The indication range for cannulated screws may vary according to the bone quality and physique of the patient.

1. Introduction P. 5 Preface P. 6 Properties P. 7 Indications P. 8 Equipment P. 10 Contraindications 2. Surgical Technique P. 10 Time of operation P. 11 D=2.7mm cannulated Cortical Screw P. 14 D=3.5mm cannulated Cortical Screw P. 17 D=4.0mm cannulated Cancellous Screw P. 20 D=4.5mm cannulated Cancellous Screw P. 23 D=6.5mm cannulated Cancellous Screw P. 26 D=7.3mm cannulated Cancellous Screw P. 29 Postoperative treatment P. 29 Explantation 3. Information P. 30 Individual tray configuration P. 32 Order list P. 37 Notes P. 38 Reconditioning Manual

Preface ITS. GmbH provides various cannulated screw types with different diameters and lengths covering a wide range of indications for fracture treatment in trauma surgery. Low-profile screw heads with small diameters help minimize soft tissue irritation and are suitable for minimally invasive methods. We offer customized equippping of surgical trays so that users can have trays put together according to their requirements and suggestions.

Properties Properties of the material: • Screw material: TiAl6V4 ELI • Easier removal of the implant after the fracture has healed • Improved fatigue strength of the implant • Reduced risk of inflammation and allergy • Self-drilling & self-tapping • Cannulated for minimally invasive treatment and guided insertion • Flat and curved washers (adapted to the screw head, for optimal contact to the bone surface) • Various thread types for a wide range of indications • * Back-tapping flank for easier explantation

Indications D=4.0mm (Dens Axis) D=6.5mm D=6.5/7.3mm D=2.7mm (distal Radius & Scaphoid Bone) D=3.5/4.0mm D=3.5/4.0/4.5mm D=2.7mm (Tarsal) D=3.5mm (Tarsal, Talus) D=4.0/4.5mm (Talus) D=7.3mm (Calcaneus)

Equipment Guide Wire: • • • • • Trocar with thread Length: 228mm Guide Wire D=1.2mm for D=2.7/3.5mm Guide Wire D=1.6mm for D=4.0/4.5mm Guide Wire D=3.2mm for D=6.5/7.3mm Washers: • Flat and curved version • Adapted to the screw head • For optimal contact to the bone surface

Screwdriver: • Cannulated • Screwdriver, WS 2.5mm for D=2.7/3.5/4.0/4.5mm (Lengths: 120mm and 170mm for Dens Axis Screw) • Screwdriver, WS 5.0mm for D=6.5/7.3mm (Length: 100mm) Surgical Technique

Diaphyseal fractures of long bones In advanced osteoporosis Obesity Lack of patient compliance Time of operation • Primary: Within the first hours after trauma • Secondary: After detumescence, intermediate fixation with external fixation or extension

D=2.7mm cannulated Cortical Screw Indications: • • • • Fractures of the proximal and distal Radius Fractures of the proximal Ulna Fractures of the Scaphoid Bone Fractures of the Tarsal Optionally drilling Predrilling is possible in strong cortical bone with a drill point equal to the core diameter of the screw for easier insertion of the cannulated screw Place the spiral drill, cannulated, D=2.0mm, AO Connector over the guide wire and perform drilling under fluoroscopy. Attention: Do not drill further than the tip of the guide wire as this would impair the firm fixation of the guide wire (drill...

Identification of screw length Place screw depth gauge (59162) over guide wire and insert it through the soft tissue down to the bone. Then read off the required length measurement at the end of the calibrated guide wire. Optional use of washer The use of a washer is recommended in the presence of very osteoporotic bone. Through the additional bone contact surface, the screw load will be distributed across a larger area and reduce countersinking of the screw head into the osteoporotic bone.

Placement of the screw Place the D=2.7mm cannulated Cortical Screw with a short variable or a variable thread (31272-XX/31277-XX) over the guide wire and insert it using the screwdriver, cannulated, WS 2.5, L=120mm (56253-120). Finally, remove the guide wire and confirm correct position under fluoroscopy.

D=3.5mm cannulated Cortical Screw Indications: • Fractures of the Malleolus medialis/ lateralis • Fractures of the proximal and distal Radius and Humerus • Fractures of the proximal Ulna • Fractures of the Patella Fractures of the distal Tibia Fractures of the upper ankle Fractures of the Tarsal Fractures of the Talus Ligament fixation Optionally drilling Predrilling is possible in strong cortical bone with a drill point equal to the core diameter of the screw for easier insertion of the cannulated screw Place the spiral drill, cannulated, D=2.5mm, AO Connector over the guide wire and perform...

Identification of screw length Place screw depth gauge (59162) over guide wire and insert it through the soft tissue down to the bone. Then read off the required length measurement at the end of the calibrated guide wire. Optional use of washer The use of a washer is recommended in the presence of very osteoporotic bone. Through the additional bone contact surface, the screw load will be distributed across a larger area and reduce countersinking of the screw head into the osteoporotic bone.

Placement of the screw Place the D=3.5mm cannulated Cortical Screw with 9mm or variable thread (31352-XX/31357XX) over the guide wire and insert it using the screwdriver, cannulated, WS 2.5, L=120mm (56253-120). Finally, remove the guide wire and confirm correct position under fluoroscopy.

D=4.0mm cannulated Cancellous Screw Indications: • Fractures of the Dens Axis • Fractures of the proximal and distal Radius and Humerus • Fractures of the proximal Ulna • Fractures of the Patella • Fractures of the distal Tibia • Fractures of the Malleolus medialis/ lateralis • Fractures of the Talus • Ligament fixation Access • Reposition manoeuvres can be practised using an external halo fixator or by the corresponding positioning on the operation table • Standard two fluoroscopys (one in the lateral, the other in a.p. path of radiation rays) • Entrance to throat spinal column has to be free...