2.7 mm/3.5 mm Variable Angle LCP Elbow System. Part

88 Pages·2013·2.29 MB·English

2.7 mm/3.5 mm Variable Angle LCP
Elbow System. Part of the Synthes
variable angle locking compression plate
(VA-LCP) system.
Technique Guide
Table of Contents
Introduction 2.7 mm/3.5 mm Variable Angle LCP Elbow System 3
AO Principles 8
Indications 9
Surgical Technique Parallel Distal Humerus Plating
– Preparation 11
– Lateral Plate Insertion 16
– Insert Distal Screws in Lateral Plate 20
– Medial Plate Insertion 25
– Insert Distal Screws in Medial Plate 27
– Insert Screws in Plate Shaft 28
Perpendicular Distal Humerus Plating
– Preparation 31
– Posterolateral Plate Insertion 36
– Insert Distal Screws in Posterolateral Plate 41
– Medial Plate Insertion 47
– Insert Distal Screws in Medial Plate 49
– Insert Screws in Plate Shaft 50
Olecranon Plating
– Preparation 53
– Olecranon Plate Insertion 58
– Insert Proximal Screws 60
– Insert Distal Screws 65
Postoperative Treatment 67
Implant Removal 67
Product Information Implants 69
Instruments 73
Set List 75
Modular Graphic Cases 81
Image intensifier control
2.7 mm/3.5 mm Variable Angle LCP Elbow System Technique Guide Synthes
In
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Introduction io
n
The Synthes VA-LCP Elbow
System is a result of a
techno logical milestone in
locked plating technology.
The system utilizes the
variable angle locking
technology platform that
is based on a common
approach to implant design
and instrumentation,
reducing complexity and
ensuring a familiar technique.
2.7 mm/3.5 mm Variable Angle LCP Elbow System
Built on Success
Synthes 2.7 mm/3.5 mm VA-LCP Elbow
Plates accept 2.7 mm variable angle locking
screws in the metaphyseal region. The
2.7 mm/3.5 mm
2.7 mm variable angle locking screws allow
VA-LCP Lateral
a fixed angle construct, 15° off normal axis, Distal Humerus Plate
or variable angulation within a 30° cone.
The variable angle screw holes feature four
points of threaded locking between the
plate and the variable angle locking screw to
create a fixed-angle construct at the desired
screw angle.
Designed for the Patient
Synthes is a company dedicated to
improving patient care. Our products are a
combination of innovation and surgeon
partnerships. A dedicated, global surgeon
team was integral on the design of this
system through extensive consultation and
participation in multiple design labs.
Surgeon interviews, design and develop-
2.7 mm/3.5 mm
ment meetings, and collaboration with key VA-LCP Extended
opinion leaders determined the clinical Medial Distal
Humerus Plate
components necessary for the Synthes
VA-LCP Elbow system. 2.7 mm/3.5 mm
VA-LCP
Posterolateral
The anatomic shape for each plate is based Plate
on a detailed analysis of over 100 skeletal
2.7 mm/3.5 mm
specimens. Plates are designed with a
VA-LCP Medial Distal
rounded profile to help reduce the risk for Humerus Plate
soft tissue irritation.
System Snapshot
– Short, medium, long and extra long
plates with additional longer lengths
available, sterile only
– Available in 316L stainless steel and
titanium alloy (Ti-6Al-7Nb) 2.7 mm/3.5 mm
– Left and right plate designs VA-LCP Olecranon Plate
– New depth gauge allows for
measurement of longer screws
– Two forceps to aid in reduction
– Available sterile-packed
– Used with the Synthes Locking Small
Fragment System
2.7 mm/3.5 mm Variable Angle LCP Elbow System Technique Guide Synthes 3
2.7 mm/3.5 mm Variable Angle LCP Elbow System
2.7 mm/3.5 mm VA-LCP Elbow Plates
Metaphyseal Screw Options
Features variable angle locking holes that
accept 2.7 mm variable angle locking,
2.7 mm metaphyseal, 2.7 mm locking,
2.7 mm cortex and 2.4 mm cortex screws
Reconstruction plate segments
Allow additional contouring of
plates to fit patient anatomy
Suture holes and undercuts
Allow passage of suture needles
through the undercut after plate
application
2.7 mm/3.5 mm
VA-LCP Olecranon Plate Tapered plate tip
Tapered end for submuscular plate insertion
which may help to preserve tissue viability
Combi Holes
Accept 3.5 mm locking, 3.5 mm cortex
and 4.0 mm cancellous bone screws
Rounded plate profile
Minimizes the risk for soft
tissue irritation
2.7 mm/3.5 mm
VA-LCP Lateral Distal
Limited-contact shaft profile
Humerus Plate
Limits plate-to-bone contact to reduce
impairment of blood supply
Variable Angle Screw Holes
Recess for screwhead minimizes screw
prominence to create a low-profile construct
when used at the nominal angle. Screws can
also be angled within a 30° cone around the
central axis of the plate hole.
4 Synthes 2.7 mm/3.5 mm Variable Angle LCP Elbow System Technique Guide
Recommended Use for Olecranon Plates
Proximal Olecranon Plate
For very proximal, short, comminuted
avulsion type fractures (fractures that
are above the coronoid)
Olecranon Plate
For complex fractures involving the
trochlear notch of ulna and coronoid
Extra Articular Proximal Ulna Plate
For proximal ulna metaphyseal-
diaphyseal fractures (fractures that
are distal to the coronoid)
2.7 mm/3.5 mm Variable Angle LCP Elbow System Technique Guide Synthes 5
2.7 mm/3.5 mm Variable Angle LCP Elbow System
Screws for the 2.7 mm/3.5 mm Variable Angle
LCP Elbow System
2.7 mm Metaphyseal Screws
– Low profile screw that can be used in the metaphyseal
portion of the plate (2.7 mm VA holes) to pull the plate
to the bone
2.7 mm 2.7 mm
– Shaft profile is identical to a 2.7 mm variable angle Cortex Metaphyseal
locking screw
– 2.7 mm metaphyseal screws allow 15° off normal-axis,
or variable angulation within a 30° cone
– 2.7 mm metaphyseal screws can also be replaced with
locking screws after plate to bone compression is achieved.
– The 2.7 mm locking screw shaft profile had a higher average
pull-out resistance than a 2.7 mm cortex screw shaft
profile. In-house testing on file at Synthes, MT10-636.
Test conducted using 20 PCF Foam.*
2.7 mm Variable Angle Locking Screws
– Threaded, rounded heads lock securely into the variable
angle locking holes
– Color coded for easier identification
– T8 StarDrive recess
– Self-tapping tip
2.7 mm Locking Screws
– Only for axial insertion in the variable angle locking holes
– Threaded, rounded conical head locks securely into the
variable angle locking holes
– T8 StarDrive recess
– Self-tapping tip
2.4 mm Cortex Screws
– Can be used in variable angle holes to compress the
plate to the bone
– Self-tapping tip
2.7 mm Cortex Screws
– Can be used in variable angle holes
– Used to provide compression or neutral fixation
– Self-tapping tip
*Bench tests do not necessarily reflect clinical performance.
6 Synthes 2.7 mm/3.5 mm Variable Angle LCP Elbow System Technique Guide
Two Forceps to Aid in
Reduction/Compression
Straight/Curved Reduction Forceps
– 2.5 mm drill bit is used to create a small hole in the shaft
to accommodate the straight tip of the forceps
– Curved tip will engage tip of olecranon to allow placement
of the plate while holding reduction
Periarticular Reduction Forceps, 6.5 mm ball and
pointed tip, small
– Appropriately sized for distal humerus reduction, among
other fractures
– Curved tips allow access to and visualization of distal
humerus while holding reduction
2.7 mm/3.5 mm Variable Angle LCP Elbow System Technique Guide Synthes 7
AO Principles
In 1958, the AO formulated four basic principles, which
have become the guidelines for internal fixation.1They are:
Anatomic reduction
Fracture reduction and fixation to restore anatomical
relationships.
Stable fixation
Stability by fixation or splintage, as the personality of
the fracture and the injury requires.
Preservation of blood supply
Preservation of the blood supply to soft tissue and bone
by careful handling.
Early, active mobilization
Early, active mobilization of the part and patient.
1. Müller ME, M Allgöwer, R Schneider, H Willenegger. Manual of Internal Fixation.
3rd Edition. Berlin: Springer-Verlag. 1991.
8 Synthes 2.7 mm/3.5 mm Variable Angle LCP Elbow System Technique Guide
Indications
The Synthes Variable Angle LCP Elbow System is intended for
fixation of fractures of the distal humerus, olecranon and
ulna in adults and adolescents (12-21) in which the growth
plates have fused.
Specifically,
– Distal humerus plates are indicated for intra-articular
fractures, comminuted supracondylar fractures, osteotomies,
malunions and nonunions of the distal humerus
– Olecranon and proximal ulna plates are indicated for
fractures, osteotomies, malunions and nonunions of the
olecranon and proximal ulna
2.7 mm/3.5 mm Variable Angle LCP Elbow System Technique Guide Synthes 9