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A.L.P.S.®

A.L.P.S.®
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A.L.P.S.®

Product catalog summary
Overview of the A.L.P.S. Distal Tibia Plating System
The A.L.P.S. Distal Tibia Plating System is designed for distal tibia procedures, offering a low-profile, anatomically contoured solution to minimize discomfort and soft tissue irritation. It includes anterolateral and medial plates made from Type 2 Anodized Titanium Alloy, available in various sizes to accommodate different patient anatomies.
F.A.S.T. Guide and F.A.S.T. Tabs Technologies
The system incorporates F.A.S.T. Guide and F.A.S.T. Tabs technologies to enhance surgical efficiency. F.A.S.T. Guide facilitates accurate drilling with pre-loaded, disposable guides, while F.A.S.T. Tabs allow for easy contouring to the bone and provide stability through threaded holes that lock screws to the plate.
Screw Options
The system offers locking, non-locking, and multi-directional screw options. Locking screws provide a fixed angle construct for strong fixation, while multi-directional screws allow for up to 15 degrees of angulation. Non-locking screws can be used in various modes, including compression and buttress.
Plate Specifications
Anterolateral Plate: Available in wide and narrow widths, with specifications including head width (39 mm or 34 mm), head thickness (3 mm), and shaft width (12 mm).
Medial Plate: Features include a head width of 23 mm, head thickness of 3 mm, and shaft width of 12 mm. Both plates are available in lengths of 6H, 9H, 12H, and 15H.
Surgical Approaches
Three surgical approaches are outlined: Antero-Medial, Standard Anterior, and Lateral Böhler. Each approach provides different levels of access and visualization, with specific considerations for incision placement to avoid complications.
Staged Protocol and Internal Fixation
A staged protocol is recommended, starting with the application of a spanning external fixator. Internal fixation of the fibula and malleolus should follow CT scan evaluation to determine incision locations.
Conclusion
The A.L.P.S. Distal Tibia Plating System offers a versatile and robust solution for distal tibia fractures, combining advanced technologies and materials to support effective surgical outcomes.
Introduction
This document provides detailed surgical procedures and guidelines for the reconstruction of the distal tibia and fibula using the A.L.P.S. Distal Tibia Plating System. It includes approaches for exposure, reconstruction techniques, and the application of plates and screws.
Anterior Approach
The anterior approach involves making an incision in line with the skin to expose the anterior tibial (AT) and extensor hallucis longus (EHL) tendons. The anterior tibial artery and deep peroneal nerve are located and protected. This approach allows excellent visualization of the medial and anterior tibial plafond but limits lateral tibial plafond visualization.
Lateral Approach
The lateral approach starts proximal to the ankle joint and extends distally. It involves identifying and protecting the superficial peroneal nerve and exposing the extensor retinaculum and tendons. This approach provides excellent visualization of the lateral articular surface of the tibia but does not allow for medial plate application.
Fibula and Posterior Malleolar Reconstruction
Reconstruction of the fibular shaft and lateral malleolus is performed using standard fibular plating techniques. If the posterior malleolus is free-floating, it must be fixed during fibula fixation to ensure joint stability.
Tibial Reconstruction
For tibial reconstruction, axial alignment and anatomic reconstruction of the joint surface are crucial. The articular surface is approached first, using ligamentotaxis and K-wires for reduction. The metaphysis is evaluated for impaction fractures, which may require a cancellous bone graft.
Plate Selection and Application
Plate selection depends on the fracture's stability and comminution. Anterolateral plates are recommended for lateral comminution, while medial plates are used for medial comminution. Plates are applied using a midline incision for combined comminution. The Anterolateral Distal Tibial Plate and Medial Tibial Plate are low-profile, anatomically contoured plates designed for minimal discomfort and soft tissue irritation.
Screw Insertion
Screw insertion involves using a calibrated drill bit and measuring drill sleeve for accurate placement. Locking screws are inserted using a torque-limiting screwdriver, and multi-directional screws allow for angulation within a 15-degree arc.
Conclusion
The document provides comprehensive guidelines for the surgical reconstruction of the distal tibia and fibula, emphasizing the importance of proper exposure, alignment, and fixation techniques to ensure successful outcomes.
Specifications and Procedures
The document outlines the use of different drill bits and guides, such as the 2.7 mm Calibrated Drill Bit and the 2.5 mm ACP Drill Guide, for precise drilling and measurement. It specifies the use of locking and non-locking screws, including their sizes and corresponding catalog numbers. Step-by-step instructions are provided for drilling through cortices, measuring depth, and inserting screws.
Recommendations
The document advises on the correct orientation of drill guides and the importance of taking accurate depth measurements to ensure effective screw placement. It also highlights the use of specific tools for different types of screws and plate configurations.
Ordering Information
A comprehensive list of instruments, implants, and disposables is provided, including order codes and descriptions for each item. This section ensures that users can accurately order the necessary components for the A.L.P.S. Distal Tibia Plating System.
Critical Information
The document stresses the importance of using the correct drill guide orientation and depth measurement techniques to avoid improper screw placement. It also provides detailed ordering information to facilitate the procurement of the correct surgical tools and implants.
Specifications of Cancellous Screws
The document provides detailed ordering information and specifications for various types of cancellous screws used in orthopedic surgeries, including non-locking, locking, lag, cannulated lag, and multi-directional locking screws, along with their respective sizes and sterile/non-sterile options.
Indications for Use
  • Medial Locking Plate: Suitable for pilon fractures, high medial malleolar fractures, and low boot type rotational distal extra-articular shaft fractures.
  • Anterolateral Locking Plate: Indicated for distal intra-articular tibia fractures, proximal tibia fractures, and proximal and distal humerus fractures.
Contraindications
  • Active infections or conditions that retard healing.
  • Insufficient bone quality or quantity for stabilization.
  • Patient's inability to follow postoperative instructions.
  • Foreign body sensitivity.
  • Cases involving malignant tumors without supplemental fixation.
Legal and Usage Information
The document emphasizes that the technique is intended for surgeons and not laypersons, highlighting the importance of professional medical judgment. It also notes that the device is restricted to sale by or on the order of a surgeon, and all content is protected by intellectual property rights.
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Catalog excerpts

A.L.P.S.®-1

A.L.P.S.® Distal Tibia Plating System Surgical Technique

 Open the catalog to page 1
A.L.P.S.®-5

A.L.P.S. Distal Tibia Plating System Low Profile Anatomically Contoured The Distal Tibia Locking Plate System • A low-profile designed to help minimize potential discomfort and soft tissue irritation Contoured plates mimic the anatomy of the distal tibia Anterolateral plate is available in wide and narrow widths to suit patient size Bullet tip designed to minimize soft tissue disruption during insertion Plate insertion handle simplifies submuscular application For distal tibia procedures that often involve complex fractures and minimal tissue coverage, the Distal Tibia Plating System provides...

 Open the catalog to page 5
A.L.P.S.®-7

A.L.P.S. Distal Tibia Plating System Fast, Accurate Surgeries F.A.S.T. Guide ® and F.A.S.T. Tabs ® Technologies F.A.S.T. Guide • Facilitates accurate drilling • Pre-loaded and disposable • Saves time in the OR since no intraoperative assembly is required • Color-coded guides make identification easy: Red guide=Right, Lime guide=Left F.A.S.T. Tabs • Distal tabs of the Anterolateral Plate easily contour to conform to the bone • Threaded holes in the tabs of the Anterolateral Plate allow screws to lock to the plate, providing stability and support • Interlocking alignment of distal screws can create...

 Open the catalog to page 7
A.L.P.S.®-9

A.L.P.S. Distal Tibia Plating System Versatility in construct Locking, non-locking, and multi-directional screw options • Choose Locking, Non-Locking, or Multi-Directional Screws according to need • All options available in each construct • Tapered, threaded screws lock into position when tightened to establish a fixed angle construct for strong fixation or when optimal screw purchase is required • Locking Multi-Directional Screws (MDS) allow for up to 15 degrees of angulation from center • Non-Locking Screws can be positioned and used in compression, neutral, and buttress modes Particularly...

 Open the catalog to page 9
A.L.P.S.®-11

The Zimmer Biomet A.L.P.S. Distal Tibia Plating System represents the next generation in anatomic plate design. It combines the benefits of low-profile titanium plate metallurgy with the advantages of multiplanar locked screw technology. These features allow the formation of a three dimensional matrix of fixed and variable angle screws to create a true subchondral scaffold that can provide strong fixation in comminuted fractures or osteopenic bone. The Medial Locking Plate is indicated for: The Zimmer Biomet A.L.P.S. Distal Tibia Plating System features Type 2 Anodized Titanium Alloy low-profile,...

 Open the catalog to page 11
A.L.P.S.®-12

A.L.P.S. Distal Tibia Plating System Anterolateral Distal Tibia Locking Plate Proximal bullet tip facilitates submuscular plate insertion Type 2 Anodized Titanium Alloy for strength and biocompatibility Threaded holes for Locking 3.5 mm, 4.0 mm, and 3.5 mm Multi-Directional Screws Low-profile, anatomically contoured plate design to minimize soft tissue irritation Compression holes in the shaft of the plate for 3.5 mm and 4.0 mm Non-Locking Screws F.A.S.T. Guide inserts for easy drilling 3.5 mm Multi-Directional Locking Screws allow for up to 15 degrees of angulation from center Versatile anatomic...

 Open the catalog to page 12
A.L.P.S.®-13

Anterolateral Plate Specifications Anterolateral Plate Wide Narrow Head Width 39 mm 34 mm Head Thickness 3 mm 3 mm Tab Thickness 3 mm 3 mm Shaft Width 12 mm 12 mm Shaft Thickness 3 mm 3 mm Distance between center holes of shaft Left / Right Left / Right 3.5 mm Locking Cortical Screw: 3.5 mm Locking Multi-Directional Screw: • Large core diameter and shallow thread pitch for bending and shear strength • Cobalt-Chrome screw with large core diameter • elf-tapping tip minimizes the need for pre-tapping and S eases screw insertion • apered screw head helps ensure alignment T of the screw head into...

 Open the catalog to page 13
A.L.P.S.®-14

A.L.P.S. Distal Tibia Plating System Medial Distal Tibia Locking Plate Proximal bullet tip facilitates submuscular plate insertion Type 2 Anodized Titanium Alloy for strength and biocompatibility Threaded holes for locking 3.5 mm, 4.0 mm, and 3.5 mm Multi-Directional Screws Low-profile, anatomically contoured plate design to minimize soft tissue irritation Compression holes in the shaft of the plate for 3.5 mm and 4.0 mm Non-Locking Screws F.A.S.T. Guide inserts for easy drilling 3.5 mm Multi-Directional Locking Screws allow for up to 15 degrees of angulation from center Distal tab for 3.5 mm...

 Open the catalog to page 14
A.L.P.S.®-15

Medial Plate Specifications Medial Plate Head Width Average Head Thickness Shaft Width Shaft Thickness Distance between center holes of shaft Left / Right 3.5 mm Locking Cortical Screw: 3.5 mm Locking Multi-Directional Screw: • arge core diameter and shallow thread pitch for L bending and shear strength • Cobalt-Chrome screw with large core diameter • elf-tapping tip minimizes the need for pre-tapping and S eases screw insertion • apered screw head helps ensure alignment T of the screw head into the plate hole • apered threaded head minimizes screw back-out and T construct pullout • ulti-directional...

 Open the catalog to page 15
A.L.P.S.®-16

A.L.P.S. Distal Tibia Plating System Figure 1 When planning to treat a distal tibia fracture surgically using plates, application of a spanning external fixator should be performed as soon as possible. Staged Protocol Suggested by Surgeon Design Team Portable Traction When planning to treat a distal tibia fracture surgically using plates, application of a spanning external fixator should be performed as soon as possible (Figure 1). Pin placement distally is dependent on the type of frame employed. Proximally placed tibial pins should be away from planned incisions to avoid pin tracts possibly...

 Open the catalog to page 16
A.L.P.S.®-17

Figure 2 One of three surgical approaches can be used. An example of an Antero-Medial approach. Surgical Approaches Approaches include an antero-medial incision, a standard anterior incision, or the lateral Böhler approach. When plating the fibula through a standard lateral approach, the surgeon should identify the tibial incision first to avoid narrow skin bridges between the two incisions. Begin at the level of the distal shaft of the tibia, just lateral to the anterior crest, and continue distally as far as needed, staying medial to the anterior tibial tendon. Take the skin together with the...

 Open the catalog to page 17

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