AxSOS 3 Titanium Tibia Locking Plate System ® Operative technique

AxSOS 3 Titanium | Operative technique AxSOS 3 − ORIF technique Contents Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Indications, precautions and contraindications . . 4 Operative technique . . . . . . . . . . . . . . . . . . . . . . . 6 Pre-operative planning . . . . . . . . . . . . . . . . . . . . . . 6 Patient preparation . . . . . . . . . . . . . . . . . . . . . . . . 7 Bending and non-locking screw fixation . . . . . . . . 8 Locking screw fixation . . . . . . . . . . . . . . . . . . . . . 10 Proximal lateral tibia plate . . . . . . . . . . . . . . . . . 12 Proximal...

AxSOS 3 Titanium | Operative technique Introduction The AxSOS 3 Titanium Locking Plate System is intended for long bone fracture fixation. The system allows for the use of locking and non-locking screws in the metaphysis and the shaft. This operative technique contains a step-by-step procedure for the implantation of tibial plates using the ORIF instrumentation. Plates and Screws used in this Operative Technique Guide: AxSOS 3 Titanium 4.0mm anatomic shaped plates: Proximal lateral tibia Proximal medial tibia AxSOS 3 Titanium screws used with the AxSOS 3 Titanium 4.0mm anatomic shaped plates:...

AxSOS 3 Titanium | Operative technique Indications AxSOS 3 Titanium is intended for long bone fracture fixation. Indications include: • Diaphyseal, metaphyseal, epiphyseal, extra- and intra-articular fractures • Non-unions and malunions • Normal and osteopenic bone • Osteotomies • Periprosthetic fractures of the femur and proximal tibia The AxSOS 3 Titanium Waisted Compression plates are also indicated for fracture fixation of: • Periprosthetic fractures • Diaphyseal and metaphyseal areas of long bones in pediatric patients The 4.0mm waisted compression plate indications also include fixation...

AxSOS 3 Titanium | Operative technique A CAUTION AxSOS 3 Titanium 4.0mm and 5.0mm waisted compression plates should not cross the growth plates of pediatric patients. Intended use AxSOS 3 Titanium is intended for long bone fracture fixation. Contraindications The physician's education, training and professional judgement must be relied upon to choose the most appropriate device and treatment. Conditions presenting an increased risk of failure include: • Any active or suspected latent infection or marked local inflammation in or about the affected area • Compromised vascularity that would inhibit adequate...

AxSOS 3 Titanium | Operative technique Operative technique Pre-operative planning Use of the X-ray template or E-templates can assist in the selection of an appropriately sized implant. Ref 981201 - proximal lateral tibia Ref 981202 - distal medial tibia Ref 981203 - distal anterolateral tibia Ref 981205 - proximal medial tibia NOTICE For conventional templates, the scale is 1:1.15 Which usually matches with analogous X-rays. If digital X-ray images are used, correct magnification has to be verified prior to use. Titanium Locking Plate System Proximal Lateral T?bia Plate ■Vt t n« --r by rr«r.x...

AxSOS 3 Titanium | Operative technique Patient preparation Patient positioning Supine with option to flex the knee. Visualization of the proximal or distal tibia (depending on the indication) using fluoroscopy in both the lateral and AP views is necessary. Surgical approaches Proximal lateral tibia Lateral parapatellar, lateral curved (hockey stick) or straight approach to the proximal tibia. Proximal medial tibia Medial / posteromedial surgical approach to the proximal tibia. Distal medial tibia Medial approach to the distal tibia. Distal anterolateral tibia Anterolateral approach to the distal...

AxSOS 3 Titanium | Operative technique Bending In most cases, the pre-contoured plate will fit without the need for further bending. However, should additional bending of the plate be required the bending irons type 1 and 2 (Ref 705006 and 705007) or the table plate bender (Ref 702900) should be used. The bending irons are designed to be used as a pair. The holes allow the iron to be slid over the shaft of the plate for ease of bending. The open slots of the bending irons are designed to bend the thinner metaphyseal areas of the plate, if needed. A CAUTION Bending of the plate in the region of...

AxSOS 3 Titanium | Operative technique Lag screw technique To seat the 3.5mm non-locking cortex screw or a 3.5mm shaft screw in a lag function, use the dedicated double drill guide for cortical opening: 1. Over-drill the first cortex using the 03.5mm cortical opener (Ref 700353) through the corresponding 03.5mm end of the double drill guide (Ref 705023), (Fig. 4). 2. Then insert the opposite 02.5mm end of the double drill guide (Ref 705023) into the pre-drilled hole until the drill guide comes to a stop on the plate (insertion of about 15mm) (Fig. 5). 3. Drill through the second cortex using...

AxSOS 3 Titanium | Operative technique Locking screw fixation To insert a locking screw - shown here as an example on a distal medial plate, always use the drill sleeve fully inserted into a universal hole. When working in the periarticular area, a drill sleeve may be inserted through the correct aiming block (Fig. 8, 9). If inserting the plate using the handle for plate insertion, place a drill sleeve after the aiming block is attached with the attachment screw to provide more stability (Fig. 8). A 03.1mm drill bit (Ref 705031 short or 705077 medium, depending on the short or medium sleeve chosen)...

AxSOS 3 Titanium | Operative technique Locking screw fixation Final locking with torque limiting attachment 2.5Nm Torque limiter 702760 T-handle assembly Locking screws of appropriate length are inserted into the plate using the T15 screwdriver (Ref 705016). If inserting locking screws under power using the T15 screwdriver bit (Ref 705015), make sure to use a low speed drill setting to avoid damage to the screw plate interface and potential thermal necrosis. In hard bone, it is advised to use the locking tap 04.0mm (Ref 702772) before screw insertion. A CAUTION Always perform final tightening of...