Variable Angle LCP Opening Wedge Plates 2.4/2.7. Part of the Variable Angle LCP Forefoot ...

32 Pages·2015·1.33 MB·English

Variable Angle LCP Opening Wedge
Plates 2.4/2.7. Part of the Variable
Angle LCP Forefoot/Midfoot System
2.4/2.7.
Surgical Technique
This publication is not intended for
distribution in the USA.
Instruments and implants
approved by the AO Foundation.

Table of Contents
Introduction Variable Angle LCP Opening Wedge Plates 2.4 / 2.7 2
Indications 4
Screw Insertion Techniques 5
Surgical Technique Approach 6
Implantation 7
Implant Removal 20
Product Information Screws 21
Plates 23
Instruments 24
MRI Information 28
Image intensifier control
Warning
This description alone does not provide sufficient background for direct use
of DePuy Synthes products. Instruction by a surgeon experienced in handling
these products is highly recommended.
Processing, Reprocessing, Care and Maintenance
For general guidelines, function control and dismantling of m ulti-part
instruments, as well as processing guidelines for i mplants, please contact your
local sales representative or refer to:
http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance
For general information about reprocessing, care and maintenance of Synthes
reusable devices, instrument trays and cases, as well as processing of Synthes
non-sterile implants, please consult the Important Information leaflet
(SE_023827) or refer to:
http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance
Variable Angle LCP Opening Wedge Plates 2.4/2.7 Surgical Technique DePuy Synthes 1
Variable Angle LCP Opening Wedge
Plates 2.4/2.7. Part of the Variable Angle
LCP Forefoot/Midfoot System 2.4/2.7.
Features and Benefits
Compression wire holes for prelimi- Variable angle
nary fixation of the plate to the bone Screw holes allow up to 15° off-axis
screw angulation in all directions
Minimized soft tissue irritation
Low profile plates with rounded edges
and highly polished surface minimize
soft tissue irritation
Spacer includes a tapered tip for easier
insertion into the osteotomy site
6 plates with varying spacer lengths:
– 3 mm, 4 mm, 5 mm, 6 mm and
7 mm
– One plate without spacer
Anatomic, low profile designed
specifically for opening wedge osteo­
tomies for hallux valgus correction and
other foot deformities
2 DePuy Synthes Variable Angle LCP Opening Wedge Plates 2.4/2.7 Surgical Technique
Opening Wedge Measuring Instrument
Ratchet mechanism
holds osteo tomy open
Thin tip slides into osteotomy site
and opens the wedge for the desired
correction
Measurement scale indicates the
appropriate size wedge for the desired
opening
Variable Angle LCP Opening Wedge Plates 2.4/2.7 Surgical Technique DePuy Synthes 3
Indications
The Opening Wedge Plate of the Variable Angle LCP Fore-
foot/Midfoot System 2.4/2.7 is indicated for deformations
(e.g. hallux valgus), nonunions, and replantations of the first
metatarsal bone, particularly in osteopenic bone.
4 DePuy Synthes Variable Angle LCP Opening Wedge Plates 2.4/2.7 Surgical Technique
Screw Insertion Techniques
The plate holes of the Variable Angle LCP Technology
2.4 / 2.7 accept 2.4 mm and 2.7 mm Variable Angle (VA)
Locking Screws.
Screws can be inserted using two different techniques:
– Variable angle technique
– Pre­defined nominal angle technique
Variable angle technique
To drill variable angle holes at a ±15° deviation from the
nominal trajectory of the locking hole, insert the tip of the VA-LCP drill sleeve, conical, for Drill Bits (03.211.003/03.110.023)
conical VA-LCP drill sleeve (03.211.003 / 03.110.023) and key
into the cloverleaf design of the VA-LCP hole.
Precaution: It is important not to angulate more than 15°
from the central axis of the screw hole. Overangulation may
result in difficulty while locking the screw and inadequate
screw locking.
Pre-defined nominal angle technique
The fixed­angle VA­LCP drill sleeve (03.211.004 / 03.110.024) Use of funnel-shaped VA-LCP Drill Sleeve
only allows the drill bit to follow the nominal trajectory of
the locking hole.
VA-LCP Drill Sleeve, coaxial, for Drill Bits (03.211.004/03.110.024)
Variable Angle LCP Opening Wedge Plates 2.4/2.7 Surgical Technique DePuy Synthes 5
Approach
Make a 3 to 4 cm dorsomedial incision from the first tarsal
metatarsal (TMT) joint, distally along the midline of the first
metatarsal.
Dissect down to the bone and isolate the medial branch of
the superficial fibular nerve.
6 DePuy Synthes Variable Angle LCP Opening Wedge Plates 2.4/2.7 Surgical Technique
Implantation
1
Create osteotomy
Identify a point medial on the metatarsal, approximately
1.5 cm distal to the TMT joint. Create an osteotomy starting
from the medial side of the metatarsal but do not cut
through the bone. Leave the lateral cortex intact to act as a
hinge point for opening the wedge.
Variable Angle LCP Opening Wedge Plates 2.4/2.7 Surgical Technique DePuy Synthes 7
Implantation
2
Open osteotomy and measure
Instrument
03.211.009 Opening Wedge Measuring Device
Open the osteotomy using osteotomes or the opening
wedge measuring device. Slide the tip of the opening wedge
device into the osteotomy. Open the osteotomy by squeez-
ing the handle until the desired correction is achieved.
The measuring instrument should be placed in the final im-
plant position to ensure correct alignment and measurement.
Use image intensifier control to confirm that the desired
correction has been achieved.
Read the measurement on the back of the instrument to
determine the appropriate spacer size.

Remove the measuring instrument.
8 DePuy Synthes Variable Angle LCP Opening Wedge Plates 2.4/2.7 Surgical Technique