Orthopedic - ARIX Wrist System Carpal Fusion Plate
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WRIST SYSTEM CARPAL FUSION PLATE Surgical Technique

Surgical Technique Product Information 2 ARIX Carpal Fusion Plate Surgical Technique

ARIX Carpal Fusion Plate The carpal bones are important for the stability of the carpus and the hand. However, the size and shape of the carpal bones make the application of standard implants difficult. Therefore, the ARIX Carpal Fusion Plate provides a specially designed solution for carpal bone fracture and management. ARIX Carpal Fusion Plate also pursues the pain-free mobility and stability for hand acts in daily living by fixing four-corner bones.

Φ1.1mm K-Wire hole for temporary fixation Center hole for Plate Holder and/or bone graft Low profile design Variable locking hole for both φ2.5mm Locking & Non-Locking Screws Smooth surface and rounded edges for easy tendon movement and less softtissue irritation Features • Cup Type Fusion Plate (6 / 7 screw hole) • Variable locking up to ±15° • Two screw types of Locking & Non-locking Screws available • Low profile Locking Plate • Φ1.1mm K-wire fixation hole • Easy positioning with Plate Holder • Two plate variations with 6 & 7 Hole Plates 4 ARIX Carpal Fusion Plate Su

Features - continued 25-CAFU-007 7 K-wire holes & Locking Screw holes : Width 17 mm, Height 5 mm 25-CAFU-006 6 K-wire holes & Locking Screw holes : Width 16 mm, Height 5 mm ARIX Carpal Fusion Plate 5 ARIX Carpal Fusion Plate Surgical Technique

Features - continued STARIX Screw with T8 • Prevent Cam-out • Allow Higher Torque Application • Self-Retaining function • Locking & Non-Locking Variations available Screw Variation Self-Tapping 2.5 Non-Locking & Locking Screw Variable Locking Interface with Locking Screw • Polyaxial Screw Insertion • Angle range : ±15° • Plate-Screw Locking Interface 6 ARIX Carpal Fusion Plate Surgi

Instrument – Variable Angle Drill Sleeve 1 The Variable Angle Drill Sleeve enables the screw to be inserted at a user preferred angle within ±15° range. 2 The Drill Sleeve Handle allows for ease of insertion of the drill guide and ensures better visibility for targeting. Before positioning the Drill Sleeve, engage it with the Sleeve Handle. After the Drill Guide is fully engaged with the plate, disconnect the Drill Sleeve Handle. The Drill Sleeve Handle is not required when removing the Drill Sleeve. 7 ARIX Carpal Fusion Plate Surgical Techniqu

Features - continued Instrument – Reamer / Plate Holder Optimized reaming angle for ideal plate fitting in reamed recess Ideal reaming depth Plate Holder for easy plate pick-up Plate with Plate Holder 8 ARIX Carpal Fusion Plate Surgical Technique

Anatomic The 3-dimensional plate design is optimized for four-corner and other limited wrist fusion procedures. Choosability Two screw options with the variable locking and the non-locking variations make appropriate screw configuration possible. Easy handling The ARIX Carpal Fusion Plates provide Plate Holder for easy plate positioning on carpal bone. Wide range of adjustable screw insertion angles helps to hold the bone fracture fragments more effectively. Instrumentation The compact and simple set layout enables intuitive selection of appropriate instruments and reduces confusion in the...

Surgical Technique Four Corner Fusion 1. Approach Make a standard dorsal longitudinal incision. Excise Scaphoid Bone 2. Excise Scaphoid Completely excise the scaphoid and debride the midcarpal joint. 3. Temporary Fixation After exposing the capitate, lunate, hamate and triquetrum, denude the cartilage between the four bones involved in the fusion. Temporary fix the bones with 1.1mm K-wires as volar as possible. Suggested order for K-wires : 1 hamate to capitate, 2 triquetrum to lunate, 3 triquetrum to capitate. Required Set ARIX Wrist System Carpal Fusion Plate 10 ARIX Carpal Fusion Plate...

Surgical Technique 4. Carpal Bone Reaming & Bone Grafting Center the Reamer (111-165) over the junction of the four carpals, targeting the center with the guide tip of the Reamer. Under power, ream until the dorsal surface of the carpals is flush with the reamer blade upper plane (see Fig. 1). This is designed to achieve sufficient void depth below the dorsal surface of the carpals. Fill the space between the four bones with bone graft. Ideal reaming depth Required Instruments Reamer 111-165 11 ARIX Carpal Fusion Plate Surgical Technique

Surgical Technique 5. Plate Positioning • Install the Plate Holder (111-169) into the center of the appropriate sized plate with the Driver Shaft (113-HF613). • Pick up the plate using Screw Driver Shaft and place into the depression. • By plate placing, target the hamate with the single screw hole. Ensure that the placement of this first screw adequately facilitates subsequent screw placement in the three other bones. • The plate may be provisionally fixed with a Φ1.1mm Kwire(s) to ensure its position. : The K-wire(s) and Plate Holder provide multiple points of provisional stabilization,...

Surgical Technique 6. Drilling the Lunate Using the Drill Guide (111-080), drill into the lunate at the desired angle. Avoid bi-cortical drilling. Measure screw length using Depth Gauge (111-075) Required Instruments Depth Gauge 111-075 Drill Sleeve(Uni.) Drill Sleeve Handle 111-157 13 ARIX Carpal Fusion Plate Surgical Technique

Surgical Technique 7. Plate Fixation Insert the first screw using the Screw Driver Shaft (113HF-613) attached to the Hand Body (111-010). Note: Do not yet fully tighten the screw to lock. Continue plate fixation by drilling and inserting a second screw in the lunate. (With two screws and a Plate Holder as fixation, the K-wire used for temporary fixation can be removed.) Required Instruments Driver 113-HF-613 Drill Sleeve Handle 111-157 14 ARIX Carpal Fusion Plate Surgical Technique

Surgical Technique 8. Remaining Screw Insertion and Plate Holder and K-wire(s) Removal Drill and insert screws into the remaining holes. Tighten all of the screws to ensure compression of the joint surfaces and promote fusion of the carpals. Remove the Plate Holder with the Driver (113-HF-613) and K-wire(s), allowing autograft to be packed in the central plate hole. Note: Recommended screw insertion order 1) hamate, 2) lunate, 3) capitate, 4) triquetrum. Fill the remaining holes in any order. 9. Closure and Implant Removal Close Incision Use the appropriate method for surgical closure of...