Implants trauma Pelvic Reconstruction System

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, plate might break. All ITS plates are preformed anatomically as a matter of principle. If adjustment of the plate to the shape of the bone is required, this is possible by carefully bending gently in one direction once. Particular care is required when bending in the region of a plate hole, as deformation of the plate may lead to a failure of the locking mechanism. The plate must not be buckled or bent...

1. Introduction P. 5 Preface P. 6 Screws P. 7 Properties P. 8 Indications & Contraindications P. 8 Time of operation 2. Surgical Technique P. 10 Instruments P. 12 Application of Acetabular Plate P. 13 Reconstruction of Anterior Pelvic Ring using Reconstruction Plate P. 14 Application of Symphysis Plate P. 15 Application of SIJ Plate P. 16 Ilio-Iliac Distance Osteosynthesis P. 17 SIJ Screw Fixation P. 18 Postoperative treatment P. 18 Explantation 3. Information P. 19 Notes P. 21 Locking P. 21 Dotize® P. 22 Order list P. 26 Reconditioning Manual

Preface The Pelvic Reconstruction System is a proven osteosynthesis system for various fractures of the pelvis. The special feature of this implant is the free choice of screw placement. The user is able to set any desired screw in any hole (either locking or non-locking screw). The free choice of screw angulation (+/- 15°, see page 21) provides an advantage in fracture treatment, especially in the case of complex fractures.

Cancellous Screw, locking, D=5.9mm Spiral Drill, D=3.5mm, L=110/280mm, AO Connector Screwdriver Shank, PRS, Solid, WS 3.5, L=90/230mm, AO Connector Spiral Drill, D=3.5mm, L=110/280mm, AO Connector Screwdriver Shank, PRS, Solid, WS 3.5, L=90/230mm, AO Connector Spiral Drill, D=3.2mm, L=145/225mm, AO Connector Screwdriver Shank, PRS, Solid, WS 3.5, L=90/230mm, AO Connector Cortical Screw, locking, D=4.5mm Spiral Drill, D=3.2mm, L=145/225mm, AO Connector Screwdriver Shank, PRS, Solid, WS 3.5, L=90/230mm, AO Connector

♦ Plate material: Titanium ♦ Easier removal of the implant after the ♦ Improved fatigue strength of the ♦ Reduced risk of cold welding ♦ Reduced risk of inflammation and ♦ Can be anatomically shaped (with bending pliers and setting instruments) ♦ Curved plate in 2 different degrees R88 ♦ Bending templates (to avoid repeated in situ attachment and readjustment) ♦ Plate profile of the Straight Plate, ♦ Plate profile of the SIJ Plate (L-Shape & Closed), Curved Plate (R88 & RI08): Note: Plates for right and left side. !■ ■■[■■■■[■■■■I IIIIIIIIIIII ■[■■■■[■■■■I ■■■ !■ ■[■■■■[■■■■I IIIIIIIIIIIII ■!...

Indications, Contraindications & Time of operation Indications: • All pelvic injuries Existing infections in the fracture zone and operation area Common situations that do not allow osteosynthesis Obesity Lack of patient compliance Time of operation: • Immediately after trauma or delayed

Surgical Technique

Instruments Spike: • For fixation of the plate to bone fragments where screw fixation is not possible because of the anatomic situation PRS Extension System: • Especially complex fractures can therefore be treated more simply • The PRS Extension System expands the range of indications, due to the fact that any PRS plate can be combined with one or more plates

Bending Forceps: • For fine-adjustment of the radius of the curved plate Bending Iron: • To form the plate to the respective pelvic region

Application of Acetabular Plate • Access by means of Kocher-Langenbeck approach, possibly using trochanter-flip osteotomy and surgical luxation • Reduction and temporary fixation using a K-wire • Shaping of the bending template • Appropriate final adjustment of the plate • Application of the plate and temporary fixation using spikes and fluoroscopic or X-ray inspection • Finally, insertion of cortical or cancellous screws (either locking or non-locking) into the holes of the plate • Fluoroscopic or X-ray inspection • Drainage of the area and layered closure of the wound (refixation of greater...

Reconstr. of Anterior Pelvic Ring using Reconstr. Plate • Ilio-inguinal approach or possibly Stoppa approach • Reduction using Weber or Jungbluth forceps, Schanz screw and temporary K-wire fixation if required • Attachment and adjustment of appropriate bending template, with fluoroscopic or X-ray inspection if required • Adjustment and setting of reconstruction plate on the bending template using setting instruments or bending pliers • Attachement of the plate and temporary fixation using spikes and fluoroscopic or X-ray inspection • Finally, insertion of cortical or cancellous screws (either...

Application of Symphysis Plate • Lower medial laparotomy (emergency) or Pfannenstiel incision • Extra-peritoneal opening of the pelvis minor in the linea alba • Notch the muscle attachment of the muscle rectus abdominis from inside, if possible do not sever laterally • Resection using pointed reduction or pelvic reduction forceps • Positioning of 4 or 6-hole plate superiorly (adjust using setting instruments if required) • Temporary fixation using spikes and fluoroscopic or X-ray inspection • Finally, insertion of cortical or cancellous screws (either locking or non-locking) • Drainage of retropubic...

Antero-lateral approach or first window in the context of an ilio-inguinal approach Adjustment of sacroiliac joint with Hohmann retractors Resection using pointed reduction or pelvic reduction forceps Adjustment of a double-hole plate or double L-plates Temporary fixation using spikes, fluoroscopy or X-ray inspection Finally, insertion of cortical or cancellous screws (either locking or non-locking) Drainage, closure of wound SIJ Plate L-Shape SIJ Plate Closed