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LCP Distal Fibula Plates. Part of the Synthes locking compression plate (LCP) Technique Guide
Abrir o catálogo na página 1Introduction LCP Distal Fibula Plates 2 Surgical Technique Preoperative Planning 6 Patient Positioning and Approach 8 Product Information Plates 20 This description alone does not provide sufficient background for direct use of the instrument set. Instruction by a surgeon experienced in handling these instruments is highly recommended Reprocessing, Care and Maintenance of Synthes Instruments For general guidelines, function control and dismantling of multi-part instruments, please refer to: www.synthes.com/reprocessing
Abrir o catálogo na página 30X6.001.085_AA 05.03.10 13:03 Seite 2 LCP Distal Fibula Plates. Part of the Synthes locking compression plate (LCP) system. The LCP Distal Fibula Plates are part of the Synthes locking compression plate system that merges locking screw technology with conventional plating techniques. The plates are available in stainless steel and titanium. The plates feature an anatomic shape and profile, both distally and along the fibular shaft. The combi-holes in the LCP plate shaft combine a dynamic compression unit (DCU) hole with a locking screw hole. Combi-holes provide maximum flexibility with the...
Abrir o catálogo na página 40X6.001.085_AA 05.03.10 13:03 Seite 3 LCP Lateral Distal Fibula Plate Combi-holes in shaft accept 3.5 mm locking screws, 3.5 mm cortex screws, and 4.0 mm cancellous bone screws Five coaxial distal holes accept 2.4 mm and 2.7 mm locking and cortex screws to provide multiple screw options Preshaped design Recesses for screwheads in coaxial holes minimize screw prominence to create a lowprofile construct Four Kirschner wire holes in the head accept 2.0 mm Kirschner wires LCP Posterolateral Distal Fibula Plate Combi-holes in shaft accept 3.5 mm locking screws, 3.5 mm cortex screws, and 4.0 mm...
Abrir o catálogo na página 50X6.001.085_AA 05.03.10 13:03 Seite 4 AO Principles In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation.1, 2 Those principles, as applied to the LCP Distal Fibula Plates are: Anatomic reduction The anatomic plate profile assists with reduction of the distal fibula to the diaphysis and assessment of length, rotation and alignment of the distal fibula. Multiple distal screws at the distal fibula allow maintenance of the articular reduction and stabilization of the distal segment relative to the fibular shaft. Stable fixation The combination...
Abrir o catálogo na página 60X6.001.085_AA 05.03.10 13:03 Seite 5 Indications The LCP Distal Fibula Plates are intended for fixation of fractures, osteotomies and non-unions of the metaphyseal and diaphyseal region of the distal fibula, especially in osteopenic bone. Synthes 5
Abrir o catálogo na página 7Preoperative Planning Note: The techniques for implanting the lateral and postero- lateral distal fibula plates are similar. The following describes implantation of a lateral plate. O Complete the preoperative radiographic assessment and pre- pare the preoperative plan. Determine plate length and distal screw locations to ensure proper plate selection and position, and screw placement in the distal fibula. Required sets LCP Lateral Distal Fibula Plates Set 01.112.072 LCP Lateral Distal Fibula Plates (Stainless Steel), in Modular Tray, Vario Case System 01.112.074 LCP Lateral Distal Fibula...
Abrir o catálogo na página 80X6.001.085_AA 05.03.10 13:03 Seite 7 Modular screw rack All screws are available in a modular screw rack which can be arranged as needed. 68.122.020 or 68.122.060 Modular Insert 2/3, for Modular Screw Rack for Screws 3.5/4.0 mm Modular Insert 1/3, for Modular Screw Rack for Screws 3.5 mm 68.122.021 Modular Insert 1/3, for Modular Screw Rack for Screws 2.7/2.4 mm 68.000.113 Screw Rack, size 1/2, for Modular Insert Optional modular small fragment instrument trays 68.122.019 Modular Tray for Small Fragment Bending Instruments 68.122.014 Modular Tray for Small Fragment Reduction Instruments...
Abrir o catálogo na página 90X6.001.085_AA 05.03.10 13:03 Seite 8 Patient Positioning and Approach 1 Position patient Position the patient supine with a sandbag (bump) underneath the buttock of the affected side. This allows the foot to lie in a neutral position and prevents the normal external rotation of the leg. Elevate the leg on a padded rest with the knee slightly flexed to assist placement in a neutral position. Visualization of the distal fibula under image intensification in both the lateral and AP views is recommended. Note: The direction of the locking screws is determined by the design of the plate, based...
Abrir o catálogo na página 100X6.001.085_AA 05.03.10 13:03 Seite 9 2 Approach Make a straight lateral or posterolateral surgical incision to expose the fibular fracture, the distal fibula, and the fibular diaphysis. A lateral incision directly over the fibula can accentuate plate prominence and the wound closure will be directly over the implant. Alternatively, the incision can be placed along the posterolateral border of the fibula where there is improved soft tissue coverage. Be careful not to damage the superficial peroneal nerve proximally and anteriorly, or the sural nerve posteriorly. Deep dissection allows...
Abrir o catálogo na página 110X6.001.085_AA 05.03.10 13:03 Seite 10 Implantation 1 Reduce fracture Expose and clean the fracture site and reduce the fracture. It is critical that fibular length, alignment and rotation are accurately restored. In spiral or oblique fracture patterns, a clamp can be applied for reduction. Provisional reduction can be maintained with pointed reduction forceps or Kirschner wires. Alternatively, in some fracture patterns, the plate can be used to assist and guide the reduction. This may be especially important in comminuted fractures where a bridging technique is used. Technique tip:...
Abrir o catálogo na página 120X6.001.085_AA 05.03.10 13:03 Seite 11 2 Insert plate Expose the fibula proximally as needed for plate application. In the majority of circumstances, an open approach for plate application will be performed. Occasionally, a sub muscular plate insertion will be performed using a minimally invasive technique. The LCP Lateral Distal Fibula Plate can be slid along the lateral fibular shaft and positioned with the distal end of the plate approximately 5 mm from the tip of the fibula. Note: The LCP Posterolateral Distal Fibula Plate is typically positioned 8 – 10 mm from the tip of the fibula. 3...
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