2.7 mm/3.5 mm Variable Angle LCP® Ankle Trauma System

105 Pages·2017·4.44 MB·English

Part of the DePuy Synthes Variable Angle
Locking Compression Plate (VA LCP®) System
2.7 mm/3.5 mm Variable Angle
LCP® Ankle Trauma System
Surgical Technique
Table of Contents
Introduction 2.7 mm/3.5 mm Variable Angle LCP Ankle 5
Trauma System
AO Principles 6
Indications 7
System Features 2.7 mm/3.5 mm Variable Angle LCP Technology 9
Plates
– Distal Tibia Plates 10
– Anteromedial Distal Tibia Plates 11
– Anterolateral Distal Tibia Plates 12
– Distal Tibia T- and L- Plates 13
– Lateral Distal Fibula Plates 14
Compression and Distraction System 15
Guide Blocks 17
Reduction Forceps 18
Surgical Technique Compression and Distraction System Technique: 19
Compressing or Distracting a Fracture or Osteotomy
2.7 mm/3.5 mm Variable Angle Locking Technique 23
2.7 mm/3.5 mm VA LCP Medial and Anteromedial
Distal Tibia Plate Technique
– Preparation 31
– Reduce Articular Surface 33
– Insert Plate 34
– Position Plate and Fix Provisionally 35
– Insert Distal Screws 36
– Anteromedial Plate—Insert Screws in Arm 38
– Insert Shaft Screws 38
– Lock Variable Angle Screws 39
MR Information – Confirm Reduction and Fixation 39
The 2.7 mm/3.5 mm Variable Angle LCP Ankle Trauma System has not been
evaluated for safety and compatibility in the MR environment. It has not been
tested for heating, migration or image artifact in the MR environment. The safety
of the 2.7 mm/3.5 mm Variable Angle LCP Ankle Trauma System in the MR
environment is unknown. Scanning a patient who has this device may result in
patient injury.
Image intensifier control
2.7 mm/3.5 mm Variable Angle LCP® Ankle Trauma System Surgical Technique DePuy Synthes 1
Table of Contents
Surgical Technique 2.7 mm/3.5 mm VA LCP Anterolateral Distal Tibia Plate
Technique
– Preparation 41
– Reduce Articular Surface 43
– Insert Plate 44
– Position Plate and Fix Provisionally 45
– Insert Distal Screws 46
– Insert Shaft Screws 47
– Lock Variable Angle Screws 47
– Confirm Reduction and Fixation 48
– Repair Joint Capsule 48
2.7 mm VA LCP Lateral Distal Fibula Plate Technique
– Preparation 49
– Reduce Fracture 51
– Insert Plate 52
– Position Plate and Fix Provisionally 53
– Insert Distal Screws 54
– Insert Shaft Screws 55
– Insert Screw(s) in Syndesmotic slots 56
– Lock Variable Angle Screws 57
– Confirm Reduction and Fixation 57
2.7 mm VA LCP Distal Tibia T- and L-Plate Technique
– Preparation 59
– Reduce Articular Surface 61
– Insert Plate 62
– Position Plate and Fix Provisionally 63
– Insert Shaft Screw 64
– Insert Distal Screws 65
– Lock Variable Angle Screws 66
– Confirm Reduction and Fixation 66
Implant Removal 67
2 DePuy Synthes 2.7 mm/3.5 mm Variable Angle LCP® Ankle Trauma System Surgical Technique
Table of Contents
Product Information Implants 69
Instruments 75

Set Configurations 84
2.7 mm/3.5 mm Variable Angle LCP® Ankle Trauma System Surgical Technique DePuy Synthes 3
Introduction and Indications
2.7 mm/3.5 mm Variable Angle LCP Ankle Trauma System
The 2.7 mm/3.5 mm Variable Angle LCP® Ankle Trauma System consists of:
– Medial Distal Tibia Plates of articular fragments and to confirm
– Anteromedial Distal Tibia Plates the location of the plate relative to the
– Anterolateral Distal Tibia Plates distal tibia and fibula. These are
– Distal Tibia T- and L-Plates periarticular plates that are less thick
– Lateral Distal Fibula Plates in the metaphyseal region and not
ideal for the treatment of primarily
The plates are part of the metaphyseal or tibial shaft fractures.
DePuy Synthes Variable Angle These are primarily for the treatment
Locking Compression (VA LCP) of articular injuries.
System that merges variable angle
locking screw technology with Fixation with the system has many
conventional plating techniques. similarities to traditional plate fixation
methods with several important
The plates are available in stainless improvements. Variable angle locking
steel and feature an anatomic shape screws provide the ability to create a
and profile, both distally and along the fixed-angle construct at the desired
limited-contact shaft. The Combi holes screw angle while using standard
in the shaft portion of the Variable AO plating techniques. Variable angle
Angle LCP Plate combine a dynamic locking provides the capability for
compression unit (DCU) hole with a fixed-angle constructs in osteopenic
variable angle locking screw hole. bone in multifragmentary fractures
Combi holes provide the flexibility of where screw purchase is compromised
axial compression and variable angle and in fracture patterns where the
locking capability throughout the screw direction must be altered to allow
length of the plate shaft. The Combi maximum fragment engagement.
holes allow fixation with locking screws Similar to other locking screws, the
in the threaded section for angular variable angle screws do not rely on
stability, and cortex screws in the dynamic plate-to-bone compression to resist
compression unit (DCU) section for patient load, but function similarly to
compression. Distally, the fixed-angle multiple, small, angled blade plates.
construct is designed to facilitate fixation
of small metaphyseal and epiphyseal The sets are modular which allows
segments where traditional screw customized selection of implants. This
fixation may be limited. The K-wire holes may reduce inventory and overall costs
accept wires up to 1.6 mm in diameter by eliminating seldom-used implants.
to provisionally maintain the reduction
2.7 mm/3.5 mm Variable Angle LCP® Ankle Trauma System Surgical Technique DePuy Synthes 5
AO Principles
AO PRINCIPLES
In 1958, the AO formulated four basic principles, which
have become the guidelines for internal fixation.1,2
In 1958, the AO formulated four basic principles, which
have become the guidelines for internal fixation1, 2.
4_Priciples_03.pdf 1 05.07.12 12:08
Anatomic reduction Stable fixation
Anatomic reduction Stable fixation
Fracture reduction and fixation to Fracture fixation providing absolute
Fracture reduction and fixation to Fracture fixation providing abso-
restore anatomical relationships. or relative stability, as required by
restore anatomical relationships. lute or relative stability, as
the patient, the injury, and the
required by the patient, the injury,
1 2 personality of the fracture.
and the personality of the
fracture.
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1. Müller ME, Allgöwer M, Schneider R, Willenegger H. Manual of Internal Fixation.
3rd ed. Berlin, Heidelberg, New York: Springer-Verlag; 1991.
2. Rüedi TP, RE Buckley, CG Moran. AO Principles of Fracture Management.
1 Müller ME, M Allgöwer, R Schneider, H Willenegger. Manual of Internal
2nd ed. Stuttgart New York: Thieme; 2007.
Fixation. 3rd ed. Berlin Heidelberg New York: Springer. 1991.
2 Rüedi TP, RE Buckley, CG Moran. AO Principles of Fracture Management.
2nd ed. Stuttgart, New York: Thieme. 2007.
6 DePuy Synthes 2.7 mm/3.5 mm Variable Angle LCP® Ankle Trauma System Surgical Technique
4 DePuy Synthes Expert Lateral Femoral Nail Surgical Technique
Indications
The Synthes 2.7 mm/3.5 mm Variable Angle LCP Ankle
Trauma System is intended for fixation of the ankle in adults
and adolescents (12–21) in which the growth plates have
fused, and particularly in osteopenic bone.

Medial and Anteromedial Distal Tibia Plates
Intended for fixation of osteotomies, fractures, nonunions,
malunions, and replantations of bones and bone fragments
of the diaphyseal and metaphyseal regions of the distal tibia.
Anterolateral Distal Tibia Plates
Intended for fixation of osteotomies, fractures, nonunions,
malunions, and replantations of bones and bone fragments
of the diaphyseal and metaphyseal regions of the distal tibia.
Distal Tibia T-Plates and Distal Tibia L-Plates
Intended to buttress partial articular fractures and bone
fragments of the distal tibia.
Lateral Distal Fibula Plates
Intended for fixation of osteotomies, fractures, nonunions,
malunions, and replantations of bones and bone fragments
of the diaphyseal and metaphyseal regions of the distal fibula.
2.7 mm/3.5 mm Variable Angle LCP® Ankle Trauma System Surgical Technique DePuy Synthes 7
System Features
2.7 mm/3.5 mm Variable Angle LCP Technology Plates
The plates feature variable angle locking
holes, with or without the dynamic
compression portion. Four columns
of threads in the variable angle locking
hole provide 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.
– Plate holes accept 2.7 mm and 3.5 mm
variable angle locking screws
– 2.7 mm or 3.5 mm variable angle
locking screws create a fixed-angle
construct, with up to 15° off-nominal
axis screw angulation (variable
angulation within a 30° cone
of angulation)
– Standard 2.7 mm and 3.5 mm
locking screws can be used in the
variable angle holes. However,
these screws can only be placed
coaxially (along the nominal axis
of the variable angle holes)
– 2.7 mm or 3.5 mm cortex screws
can be used in the plate positioning
slots for traditional compression and
fixation. The 2.7 mm cortex screws
can be used in the locking holes in
the head of plates
– 2.7 mm metaphyseal screws can be
used in the plate head to compress
the plate to the bone
– 4.0 mm or 3.5 mm cortex screws
can be used in the slotted holes in
the fibula plates for placement of
syndesmotic screws
Note: Refer to plate features for details
on screw locations and sizes for each
plate (see pages 10–14).
2.7 mm/3.5 mm Variable Angle LCP® Ankle Trauma System Surgical Technique DePuy Synthes 9