c2433 lag screw op-tec broch - stryker 2 - lag screw technical guide... · guide pin insertion 10...

OPERATIVE TECHNIQUE

CONTENTS

Introduction 4

Features & Benefits 5

Indications & Contraindications 6

Preoperative Planning 7

Patient Positioning 8

Lag Screw & Hip Plate Assembly Technique

Skin Incision 9

Guide Pin Insertion 10

Femoral Head / Neck Reaming 14

Lag Screw Insertion 16

One-Step Insertion 18

Plate Attachment 19

Lag Screw Removal 22

Instrument Assembly Instructions

Combination Reamer Assembly 23

Lag Screw Assembly 24

Ordering Information

Instruments 26

Implants 27

4

The Omega™ 2 Compression Hip Screw System is a unique and innovative

system reflecting the long experience of Stryker Trauma

in the treatment of proximal hip fractures.

This modular system offers the surgeon a wide choice of slimlined hip plates

combined with a unique option of cephalic implants,

and state of the art instrumentation.

This system provides a simple and easy-to-use solution for all

surgeons facing hip fractures. All implants are delivered sterile

for traceability and inventory reduction.

INTRODUCTION

5

FEATURES & BENEFITS

HANSSON™ Twin HookMinimized disruption

• The smooth profile of the implant allows theHansson™ Twin Hook to slide into place withoutturning or hammering, minimizing dislocation.

Preserved bone integrity• Minimum disruption to cancellous bone.• Full bone / implant surface contact for better stability.

Reduced invasive surgery• The complete procedure can be carried out

through a 5 to 7cm skin incision. This can reducebleeding, tissue destruction, operative time, and may help to limit post-operative pain and rehabilitation time.

Simpler and atraumatic removal procedure• The Hansson™ Twin Hook can be removed

through a 10mm skin incision without needto remove the plate, reducing the traumafor the patient.

Low Profile Hip Plate Range• Available in both Standard Barrel

(38mm) and Short Barrel (25mm)styles and a full range of sizes (2 to 14 holes) and angles.

• Hip Plate barrel accepts Omega™ Plus Lag Screws orHansson™ Twin Hook.

• Bi-directional hole design from SPS system

• All sideplate holes accept 6.5mmcancellous or ASNIS III 6.5mmcannulated screws for additionalstabilization of a medial fragment.

• Fully threaded Low Profilecompression screw

State of the artinstrumentationAccurate angle guides:• Radiolucency of the angle guide

body to precisely position the instrument, and therefore the guide pin.

• Multiple guide pin holes for accurateplacement of the guide pin withoutneed to move the instrument.

• Variable angle guide with“freehand” technique option.

• Stiffer CoCr guide pin for reduced deflection.

• SPS instruments for bone screw placement.

• Layout of the trays sequencedaccording to the surgical technique.

Omega™ Plus Lag Screws13mm Standard Lag Screw

• Leading edge of the cutting threadengages quickly, with or withouttapping, and provides tactile controlduring final positioning and seating.

15mm Super Lag Screw• Provide superior resistance to

migration in case of osteoporotic bone.

CEPHALIC IMPLANT OPTION:

6

INDICATIONS / CONTRAINDICATIONS

Indications

The Omega™ 2 Compression Hip Screw is indicated for fractures of the Proximal Femur which may include:

• Intertrochanteric Fractures

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 blood supply to the fracture or the operative site.

• Bone stock compromised by disease, infection or prior implantation that can not provideadequate support and/or fixation of the devices.

• Material sensitivity, documented or suspected.

• Obesity. An overweight or obese patient can produce loads on the implant that can lead to failure of the fixation of the device or to failure of the device itself.

• Patients having inadequate tissue coverage over the operative site.

• Implant utilization that would interfere with anatomical structures or physiological performance.

• Any mental or neuromuscular disorder which would create an unacceptable risk of fixationfailure or complications in postoperative care.

• Other medical or surgical conditions which would preclude the potential benefit of surgery.

• Intracapsular and Basal Neck fracturesNOTE: Due to rotational instability, it is highly

recommended that an Asnis III 6.5mmCannulated screw or Hansson™ Pinbe added to stabilize the fracture.

7

PREOPERATIVE PLANNING

Review the frontal and lateral X-Rays of the pelvis andinjured femur prior to surgery to assess fracture stability,bone quality, as well as neck-shaft angle and to estimateplate length required.

Use templates preoperatively to plan plate angle, plate length,barrel length and Lag Screw length.

The Lag Screw should be centered in the head within 10 millimeters of subchondral bone, and the plate shouldallow for fixation of four bone screws below the fracture line.Application of the template to an X-Ray of the uninvolvedhip may help simulate reduction of the fractured hip.

8

PATIENT POSITIONING

The patient is placed supine on the fracture table. Satisfactory access to the hip with the C-arm in the frontal and lateral planes are verified.

The fracture is reduced by flexion, longitudinal traction, abduction and internal rotation on a fracture table. In unstable fractures, guide pins can be placed, in order to stabilize the reduced fragments.

9

SKIN INCISION

A 10 to 15 centimetre incision is made,starting at the tip of the greater trochanterand continuing straight distally.

The incision is continued through thesubcutaneous tissue and tensor fascia latain line with the skin incision. The vastuslateralis is split longitudinally andreflected upward to allow palpation of thefracture line and inferior neck anteriorly.

By utilising one or more of the following visuallandmarks, correct positioning of the guide pin can be achieved.

With the guide pin placed at 135° angle, the pin crossesthe lateral cortex at the level of the lesser trochanter; at the insertion of the gluteus maximus at theposterolateral edge of the femur; or two fingerbreadths(2.5 to 3.5cm) below the crest of the greater trochanter at the origin of the vastus lateralis.

Correct positioning of the guide pin is achievedreferencing anatomical and visual landmarks, as shown in the figure below.

For each 5° change in hip plate angle, the guide pin insertion point will be movedapproximately 5mm distally (for increased angle) or proximally (for decreased angle).

There are two types of angle guides for the placementof the guide pin:

• A Fixed Angle Guide which is corresponding to the 135° barrel plate angle (angle most commonly indicated).

• A Variable Angle Guide in conjunction with an Elastosil® T-Handle can be used to insert the guide pin at 130°, 135°, 140°, 145° and 150°.

NOTE: The angle guides are radiolucent to help thecorrect positioning of the angle guide and the guide pin under image intensifier (helpful when a reduced skin incision is performed and direct visibility of the site is therefore reduced).

10

GUIDE PIN INSERTION

ORIENTATION AND PLACEMENT OF THE GUIDE PIN IS ONE OF THE MOST CRITICAL STEPS IN THIS PROCEDURE.

Crest of the GreaterTrochanter

Insertion of gluteus maximus

135°

Lesser Trochanter

11

GUIDE PIN INSERTION CONTINUED

Using image intensification, the guide pin is advanced untilit reaches the subchondral bone in the center of the femoralhead in both frontal and lateral views.

While holding firmly the appropriate angle guide on the femoral shaft, the 2.8mm guide pin is inserted in the central hole of the angle guide and advanced into the femoral head under image intensification.

If the guide pin is not positioned correctly, an additional pincould be inserted 5mm above or below the central positionin the frontal plane, and 5mm anteriorly or posteriorly to the central position in the lateral plane, without removingthe first guide pin.

NOTE: To insert a second pin near the first one, use a QuickCoupling Chuck for 2.8mm guide pin (REF. 704027)together with a 2.8mm guide pin with quick couplingfitting (REF. 704012S), otherwise there is a risk thatthe power drill chuck will touch the first guide pin.

“Freehand” technique for guide pin placement:

Place a 2.8mm guide pin anterior to the neck of the femurand align it in the center of the head against the medialcortex by using image intensification.

A 3.2mm drill bit can be used to make an opening in thelateral cortex, allowing for easy insertion of the guide pin.Using image intensification, the guide pin is advanced untilit reaches the subchondral bone in the femoral head. After confirming appropriate tip position of the guide pin on both frontal and lateral views, verify the appropriateplate angle by using the Variable Angle Guide. To unlockthe mechanism, pull the cylinder of the guide (1) and turn it by 90° (2).

Slide the Variable Angle Guide over the guide pin andadjust it down to the lateral aspect of the femur (make surethat all the spikes are in contact with the bone shaft).The arrow on the cylinder will indicate at which angle theguide pin has been inserted (3), and therefore the angle of the barrel plate to be selected.

FRONTAL VIEW

LATERAL VIEW

(1) (2) (3)

12

GUIDE PIN MEASUREMENT

The direct-reading Lag Screw Depth Gauge is used to determine the proper depth ofpenetration of the guide pin. This reading determines the settings for the CombinationReamer and Tap, and indicates the length of the Lag Screw to be used.

EXAMPLE:

• Direct reading depth gauge measurement: 110mm

• Reamer depth Setting: 100mm

• Tapping depth (if required): 100mm

• Lag Screw Length selected: 100mm

To set the reaming depth, and the Lag Screw length,

substract 10mm from the reading.

13

ANTI-ROTATION GUIDE PIN INSERTION

This step is especially useful in providing temporarystability for femoral neck fractures and basal neckfractures, where the head could rotate during reaming or screw insertion.

Correct positioning of the anti-rotational wire can bedone by rotating the instrument anteriorly or posteriorly (see illustration).

This instrument also accommodates a 3.2mm guide wire,should the surgeon wish to insert a 6.5mm ASNIS IIICannulated Screw for definitive rotational stability, like in Basal Neck fractures or Femoral Neck Fractures.

The Guide Pin Replacement Instrument can be used toinsert a second guide pin parallel to the primary guide pin.

Diam. 2.8mm hole

Diam. 3.2mm hole

Select and assemble the correct Barrel Reamer (according to the standard or short barrel plate selected).For assembling instructions see page 23.

The Combination Reamer is set and locked at thepredetermined reading (10mm less than the guide pinmeasurement).

Ream over the guide pin with the Combination Reameruntil the stop reaches the lateral cortex.

Remove the Combination Reamer.

14

FEMORAL HEAD / NECK REAMING

Should the guide pin be inadvertently withdrawn, reverse the Guide Pin Replacement Instrument, insert it into the femur, and reinsert the guide pin.

NOTE FOR SHORT BARREL PLATES:

For more lateral intertrochanteric fractures or medialdisplacement osteotomies, the short barrel plates providefixation without the barrel crossing the fracture.

Reaming is accomplished using the Short Barrel Reamer,following the same procedure for standard barrel reaming.

15

FEMORAL HEAD / NECK TAPPING

The Lag Screw Tap should be used when good quality, dense bone is encountered; the Calibrated Tap Sleeve indicatesthe proper depth of the Tap.

The Tap is advanced until the indicator ring on the Tap reachesthe correct depth marking on the Centering Sleeve. (For assembling instructions see page 24).

EXAMPLE:

•Direct reading depth gauge measurement: 110mm

•Reamer depth setting: 100mm

•Tapping depth: 100mm

•Lag Screw length selected: 100mm

16

LAG SCREW INSERTION

Depth indicator rings measure desired compression.

DEPTH INDICATOR RINGS

NO COMPRESSION 5mm COMPRESSION

The T-Handle of the insertion/extractionwrench is aligned with the long axis ofthe femur in preparation for placement of the Hip Plate.

Position the “flats” of the Lag Screw toensure proper alignment with the barrel of the Hip plate for the keyed system.

10mm COMPRESSION

For typical anatomy (135° head/neck angle), advance the Lag Screw InserterAssembly until the ring marked “135°” reaches the mark on the Inserter. Center the sleeve corresponding to the amount of compression desired (see picture above).

For Valgus anatomy (150° head/neck angle), advance the Lag Screw InserterAssembly until the ring marked “150°” reaches the mark on the inserter. Center the sleeve corresponding to the amount of compression desired.

Select a Lag Screw of the appropriatelength and assemble it to the Lag Screw Adapter. Place into the Lag Screw Inserter Assembly theLag Screw Adapter Assembly, and direct it toward the bone over the guide pin. (For assemblinginstructions see page 24).

The Centering Sleeve on the InserterAssembly is advanced into the pre-reamed hole, and the Lag Screw is driven into the prepared channel.

Depth of insertion of the Lag Screwis determined by observing the twodepth indicator rings on the inserter. (See picture below).

17

PLATE INSERTION

Upon completion of Lag Screwinsertion, the Lag Screw Inserterassembly is removed from the Lag Screw, leaving the Lag ScrewAdapter in place.

The selected Hip Plate is nowplaced over the Lag ScrewAdapter and advanced toengage the Lag Screw.

The Plate Impactor should be used to fully seatthe plate. Unscrew the Lag Screw Adapter andremove it. Then, remove the 2.8mm guide pin.

NOTE: All guide pins are “Single-use” productsand therefore must be discarded at theend of the surgical procedure.

18

ONE-STEP INSERTION

Assemble the appropriate Hip Plate and the Lag Screwonto the One-Step Insertion Wrench (for assemblinginstructions see page 24).

Place the entire assembly over the guide pin andintroduce it into the reamed hole.

Advance the Lag Screw into the proximal femur to thepredetermined depth and verify using image intensification.Depth of the insertion of the Lag Screw is determined byobserving the two depth indicator rings on the One-StepInserter Wrench.

For typical anatomy (135° head/neck angle), advance theOne-Step Insertion Wrench until the ring marked ”135°“reaches the One-Step Insertion Sleeve (see picture above).

For Valgus anatomy (150° head/neck angle), advance theOne-Step Insertion Wrench until the ring marked ”150°“reaches the One-Step Insertion Sleeve. Other angled plates should be inserted proportionallybetween the marks.

At the conclusion of screw insertion, the handle of theOne-Step Insertion Instrument must be perpendicular to the axis of the femoral shaft to allow proper keying of the Lag Screw to the plate barrel.

Remove the One-Step Insertion Sleeve and advance theHip Plate onto the Lag Screw shaft.

The Plate Impactor should be used to fully seat the plate.

Unscrew the Connecting Bolt and remove the One-StepInsertion Wrench from the back of the Lag Screw; then remove the 2.8mm Guide Pin.

As an option to the standard technique, the One-Step Insertion Instrument may be used to insertthe plate and the Lag Screw in a one-step procedure.

Stop inserting the Lag Screw when the 135° ring reaches the One-Step InsertionSleeve (when a 135° Hip plate is selected)

19

PLATE ATTACHMENT

Use the 3.2mm drill bit through the 3.2 drill sleeve with the green ring(Neutral) assembled to the Drill GuideHandle, to drill the bone screw holes.

NOTE: If necessary it is possible to obtaincompression of a shaft fracture or osteotomy site when using the 3.2mm drill sleeve with theyellow ring (1mm compression).

Determine appropriate Cortical Screwlength using the Depth Gauge.

Insert the screw using the 3.5mm HexScrewdriver with Elastosil® handle and the holding sleeve, or the 3.5mm HexScrewdriver with AO fitting attacheddirectly to a power source.However, final tightening should alwaysbe done by hand.

A 4.5mm Tap is available, to pre-tap inextremely hard cortical bone.

Using standard screw insertion technique, fix the Omega™ 2 Hip Plateto the femoral shaft beginning at the proximal end of the plate.

Option

20

FRACTURE COMPRESSION

When all screws are inserted and tightened, and all traction is released, fracture compression can be accomplished by means of the Compression Screw, or with the Compression Instrument connected to the Large Elastosil® T-Handle.

21

CLOSING THE WOUND

Closure of the wound is done in layers, closing separately the fascia of the vastus lateralis muscle and the facia lata. Carefully reapproximate the subcutaneous tissue and the skin to facilitate prompt healing of the wound.

22

REMOVAL

Should the need arise for hardware removal, the Lag Screw is extractedafter removal of the Hip Plate through use of the Large Elastosil® T-Handleconnected to the Lag Screw Inserter and the Connecting Bolt. (See assembling instructions page 25).

23

INSTRUMENT ASSEMBLY INSTRUCTIONS

Combination Reamer Drill

Flat sides

Step 1 Select the Barrel Reamer Assembly that correspondsto the selected plate (Standard or Short Barrel).

Step 2 Align the flat side of the Barrel Reamer tothe flat side of the Combination ReamerDrill, and engage the Barrel Reamer overthe coupling end of the CombinationReamer Drill.

Barrel Reamer Assembly, ShortBarrel Reamer Assembly, Standard

Step 3 Slide the Barrel reamer until the stop has been adjusted to the rightmeasurement. Lock the Barrel Reamer by turning the Stop Sleeve firmly.

Barrel Reamer Assembly, Standard

COMBINATION REAMER ASSEMBLY:


Large Elastosil® T-Handle


Calibrated Tap Sleeve

Lag Screw Inserter Sleeve Lag Screw Inserter

Lag Screw Adapter (Inner Part) (1)

Lag Screw Adapter(Outer part) (2)

Lag Screw (3)

24

LAG SCREW TAP ASSEMBLY:

LAG SCREW ADAPTER ASSEMBLY:

Push the quick coupling sleeve on the Large Elastosil® T-Handle andinsert the Lag Screw Tap fitting into the coupling.

Assemble the Lag Screw Tap Sleeve to the Lag Screw Tap by aligningthe flat sides of the Tap to the flat sides in the Tap Sleeve.

The appropriate Lag Screw is prepared by placing the inner part of the Lag Screw Adapter (1)through the outer part (2), and threading it into the Lag Screw (3).

ONE-STEP INSERTION ASSEMBLY:

STEP ONE:Assemble the Large Elastosil® T-Handle to the One-Step Insertion Wrench as described in instruction below. Slide the One-Step Insertion Wrench through the barrel of the Hip Plate. The Connecting Bolt is inserted through the Large Elastosil® T-Handle and threaded into the Lag Screw.

LAG SCREW INSERTER ASSEMBLY:Push the quick coupling sleeve on the Large Elastosil® T-Handle and insert the Lag Screw Inserter into the coupling. Slide the Lag Screw Inserter Sleeve over the Lag Screw Inserter.

Lag Screw Tap

Lag Screw Adapter Assembly

Lag Screw One-Step Insertion Wrench

Omega 2 Hip Plate

Connecting Bolt


One-Step Insertion Sleeve

25


Assemble the Large Elastosil® T-handle to the Lag Screw Inserter as described in instruction above. The Connecting Bolt is inserted through the Large Elastosil® T-handle and threaded in to the Lag Screw.

LAG SCREW REMOVAL ASSEMBLY:


Lag Screw InserterLag Screw Connecting Bolt

ONE-STEP INSERTION ASSEMBLY:

STEP TWO:Prior to assemble the One-Step Insertion Sleeve to the One-Step Insertion Wrench/Hip plate assembly, ensure that theOne-Step Insertion Sleeve is opened (mark on the inner sleeve lining up with the ”open“ mark on the outer sleeve).Assemble the One-Step Insertion Sleeve to the One-Step Insertion Wrench between the Hip plate and the Lag Screw,and lock the One-Step Insertion Sleeve.

To lock the One-Step Insertion Sleeve,the inner and outer sleeve are twisted in opposite directions until the mark on the inner sleevelines up with the ”close“ mark on the outer sleeve.

To unlock the sleeve, align the markwith the "open" mark on the outersleeve.

26

ORDERING INFORMATION — INSTRUMENTS

Reference Description

CASES

901724 Omega 2 Lag Screw Instruments Sterilisation Tray901725 Omega 2 Standard Lower Sterilisation Tray901728 Omega 2 Lag Screw Instruments Sterilisation

Tray Lid

UPPER TRAY CONFIGURATION

704013 Fixed Angle Guide 135°

704014 Variable Angle Guide

704020 Large Elastosil® T-Handle

704010 Lag Screw Depth Gauge

704004 Connecting Bolt

704005 Combination Reamer Assembly, Std

704009 Lag Screw Adapter Assembly

704021 Lag Screw Inserter

704022 Inserter Sleeve

704026 Cleaning Stylet

704001 Impactor Assembly

LOWER TRAY CONFIGURATION

702823 Compression Drill sleeve

702824 Neutral Drill Sleeve

702822 Drill Guide Handle

702402 Tissue Protection Sleeve

700358 Drill Bit ø3.2mm

700359 Drill Bit ø4.5mm

702808 Tap ø4.5mm

702809 Tap ø6.5mm

702878 Depth Gauge Assembly

702430 Medium Elastosil® T-Handle

702844 Screwdriver Hex 3.5mm

704006-20 Barrel Reamer Assembly, Short

702863 Screw Holder Assembly

704007 Lag Screw Tap

704008 Lag Screw Tap Sleeve

704019 Guide Pin Replacement Instrument

901713 Screw Rack

Reference Description

CASES

901727 Optional Instruments Sterilization Tray901729 Optional Instruments Sterilization Tray Lid

TRAY CONFIGURATION

704020 Large Elastosil® T-Handle

704030 Trial Side Plates 130°





704023 Screwdriver Hex 3.5mm

704002 One-Step Insertion Wrench

704003 One-Step Insertion Sleeve

704024 Compression Instrument

702634 AO/Hall Coupling

704027 Quick Coupling for Guide Pin ø2.8mm

702939 Self-Centering Bone Forceps, Ball Spike, size 3

702946 Self-Centering Bone Forceps, Swivel Head, size 3

981010 X-Ray Template

REPLACEMENT PARTS

704001-1 Impactor Head

Lag Screw set configuration Optional instruments

27

ORDERING INFORMATION — IMPLANTS

LAG SCREW

Stainless Steel LengthREF mm

3362-5-050 503362-5-055 553362-5-060 603362-5-065 653362-5-070 703362-5-075 753362-5-080 803362-5-085 853362-5-090 903362-5-095 953362-5-100 1003362-5-105 1053362-5-110 1103362-5-115 1153362-5-120 1203362-5-125 1253362-5-130 130

SUPER LAG SCREW


3362-8-050 503362-8-055 553362-8-060 603362-8-065 653362-8-070 703362-8-075 753362-8-080 803362-8-085 853362-8-090 903362-8-095 953362-8-100 1003362-8-105 1053362-8-110 1103362-8-115 1153362-8-120 1203362-8-125 1253362-8-130 130

OMEGA™ 2 COMPRESSION SCREW


596001S 32.3

GUIDE PIN CoCR THREADED TIP

REF Length Diameter Fittingmm mm

704011S 230 2.8 Jacobs chuck704012S 230 2.8 Quick coupling

chuck

✓ Recommended set item

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✓

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✓

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NOTE: All the implants are sterile packed

KEYED HIP-PLATE STANDARD BARREL

Stainless Steel Holes Angle LengthREF mm

596302S 2 130˚ 46596303S 3 130˚ 62596304S 4 130˚ 78596305S 5 130˚ 94596306S 6 130˚ 110596308S 8 130˚ 142596310S 10 130˚ 174596312S 12 130˚ 206596322S 2 135˚ 46596323S 3 135˚ 62596324S 4 135˚ 78596325S 5 135˚ 94596326S 6 135˚ 110596328S 8 135˚ 142596330S 10 135˚ 174596332S 12 135˚ 206596342S 2 140˚ 46596343S 3 140˚ 62596344S 4 140˚ 78596345S 5 140˚ 94596346S 6 140˚ 110596348S 8 140˚ 142596350S 10 140˚ 174596352S 12 140˚ 206596362S 2 145˚ 46596363S 3 145˚ 62596364S 4 145˚ 78596365S 5 145˚ 94596366S 6 145˚ 110596368S 8 145˚ 142596370S 10 145˚ 174596372S 12 145˚ 206596382S 2 150˚ 46596383S 3 150˚ 62596384S 4 150˚ 78596385S 5 150˚ 94596386S 6 150˚ 110596388S 8 150˚ 142596390S 10 150˚ 174596392S 12 150˚ 206

✓

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✓

KEYED HIP-PLATE SHORT BARREL

Stainless Steel Holes Angle LengthREF mm

596504S 4 130˚ 78596505S 5 130˚ 94596514S 4 135˚ 78596515S 5 135˚ 94596524S 4 140˚ 78596525S 5 140˚ 94596534S 4 145˚ 78596535S 5 145˚ 94596544S 4 150˚ 78596545S 5 150˚ 94

✓

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✓

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28

ORDERING INFORMATION — IMPLANTS

CORTICAL SCREWS ø4.5mm

Stainless Steel Diameter LengthREF mm mm

340614 4.5 14340616 4.5 16340618 4.5 18340620 4.5 20340622 4.5 22340624 4.5 24340626 4.5 26340628 4.5 28340630 4.5 30340632 4.5 32340634 4.5 34340636 4.5 36340638 4.5 38340640 4.5 40340642 4.5 42340644 4.5 44340646 4.5 46340648 4.5 48340650 4.5 50340652 4.5 52340654 4.5 54340655 4.5 55340656 4.5 56340658 4.5 58340660 4.5 60340662 4.5 62340664 4.5 64340665 4.5 65340666 4.5 66340668 4.5 68340670 4.5 70340672 4.5 72340674 4.5 74340675 4.5 75340676 4.5 76340678 4.5 78340680 4.5 80340685 4.5 85340690 4.5 90340695 4.5 95340700 4.5 100340705 4.5 105340710 4.5 110

CANCELLOUS SCREWS ø6.5mm – 16mm thread


341030 6.5 30341035 6.5 35341040 6.5 40341045 6.5 45341050 6.5 50341055 6.5 55341060 6.5 60341065 6.5 65341070 6.5 70341075 6.5 75341080 6.5 80341085 6.5 85341090 6.5 90341095 6.5 95341100 6.5 100341105 6.5 105341110 6.5 110341115 6.5 115341120 6.5 120341125 6.5 125341130 6.5 130

CANCELLOUS SCREWS ø6.5mm – 32mm thread


342045 6.5 45342050 6.5 50342055 6.5 55342060 6.5 60342065 6.5 65342070 6.5 70342075 6.5 75342080 6.5 80342085 6.5 85342090 6.5 90342095 6.5 95342100 6.5 100342105 6.5 105342110 6.5 110342115 6.5 115342120 6.5 120342125 6.5 125342130 6.5 130

CANCELLOUS SCREWS ø6.5mm – Fully threaded


343020 6.5 20343025 6.5 25343030 6.5 30343035 6.5 35343040 6.5 40343045 6.5 45343050 6.5 50343055 6.5 55343060 6.5 60343065 6.5 65343070 6.5 70343075 6.5 75343080 6.5 80343085 6.5 85343090 6.5 90343095 6.5 95343100 6.5 100343105 6.5 105343110 6.5 110343115 6.5 115343120 6.5 120343125 6.5 125343130 6.5 130

ASNIS III CANNULATED SCREWS ø6.5mm

Stainless Steel Total ThreadREF Length mm Length mm

326255S 55 40326260S 60 40326265S 65 40326270S 70 40326275S 75 40326280S 80 40326285S 85 40326290S 90 40326295S 95 40326300S 100 40326305S 105 40326310S 110 40326315S 115 40326320S 120 40

BONE SCREWS

✓

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✓ Recommended set item

Stryker Trauma AGBohnackerweg 12545 SelzachSwitzerland

REF NO: 982271

© 2003 Stryker Corporation. All rights reserved.

MANFACTURER:

The TGN is the latest development in the continuing evolution of the Gamma Locking Nail family designed for rapid and secure fixation of intertrochantericand pertrochanteric fractures. Combining strength and biomechanical advantages of the existing Gamma family it is the Golden standard for proximal femoral fractures.

The Long Gamma Nail is a specialised development of the original GammaLocking Nail allowing surgeons to extend the benefits of the highly successfulstandard implant for trochanteric fractures. It has been designed to treatsubtrochanteric, ipsilateral neck and shaft fractures as well as for prophylactic use.

This new generation of Cannulated Screws has been designed to optimise surgicaloutcomes while simplifying procedures. The ASNIS III System offers the surgeon a complete choice of implants, material and packaging combined with a newuser-friendly instrumentation.

This innovative device has been developed for Femoral Neck Fracture and SlippedCapital Femoral Epiphysis treatments. The Hansson Pin System is a simple andprecise instrumentation combined with a unique implant. This unthreaded pinwith a spreading hook allows a strong and stable fixation through a simple andshort procedure, thus preserving the blood supply and the bone integrity.

www.strykertrauma.com

Based on the long Hansson Pin experience, the Hansson™ Twin Hook is a uniquealternative to the traditional lag screw, and is used together with the Omega 2 or the Omega Plus Hip plate. The operative procedure includes a minimallyinvasive surgical approach. If necessary, cephalic implant revision can beaccomplished without removing the sideplate.

c2433 lag screw op-tec broch - stryker 2 - lag screw technical guide... · guide pin insertion 10...

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