3.0/3.5/4.0/4.5/6.5/7.0/7.3 Cannulated Screws

1 Cannulated Screws Surgical Technique Image intensi er control 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: 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: Table of Contents Indications 2.

2 Implants 4. Surgical technique Surgical technique for all Cannulated Screws 7. Surgical technique for Cannulated screw with support screw 13. Open insertion for Cannulated screw 17. Implant removal 18. Instrument cleaning 19. MRI Information 20. Surgical Technique Cannulated Screws DePuy Synthes 1. Indications CSS Fixation of fractures of the forearm, hand and foot, : fractures and arthrodeses of the carpals and metacar- pals fractures of the distal radius and radial head metatarsal fractures CSS Fixation of fractures with small fragments, : wrist fractures metacarpal and metatarsal fractures and fixation in metacarpal and metatarsal osteotomies tarsal fractures transcondylar humeral fractures in children CSS Fixation of fractures with medium fragments.

3 Tarsal and metatarsal fractures and fixation in metatar- sal and phalangeal osteotomies tarsometatarsal and metatarsophalangeal arthrodeses ligament fixations hallux valgus corrections CSS Fixation of fractures with medium fragments, : malleolar fractures pilon tibial fractures fractures of the calcaneus and talus tibial plateau fractures carpal and tarsal arthrodeses CSS , und Fixation of fractures with large fragments, : femoral neck fractures intercondylar femoral fractures epiphyseolysis of the femoral head ankle arthrodeses iliosacral dislocations Warning: These devices are not approved for screw attachment or fixation to the posterior elements (pedicles) of the cervical, thoracic or lumbar spine.

4 2 DePuy Synthes Cannulated Screws Surgical Technique Fields of application Adults Use correspondingly smaller Screws for children, adolescents and adults of small stature. / / / / / / / / / / / / / / / / / / Surgical Technique Cannulated Screws DePuy Synthes 3. Implants Cannulated Screws Short thread Long thread Full thread Cannulated Recess** Art. no. External Shaft Length Screws short long full dia- dia- thread thread thread meter meter mm 650 * 749 * mm mm 8 50 mm self-drilling cruciform 1). mm 150, 350, mm mm 10 50 mm Hex self-drilling self-drilling *. 050, 250. , , , mm 672* 772* mm mm 10 72 mm self-drilling Hex 2). mm 580 777 mm mm 20 80 mm Hex self-drilling*. 472, 672.

5 , mm 425* 452* 482* mm mm 20 150 mm self-drilling Hex 3). mm 171, 191, 223, mm mm 20 130 mm Hex self-drilling self-drilling self-drilling 130 130 530. 4). mm 950* 950* 730* mm mm 20 150 mm self-drilling Hex 5). All Cannulated Screws have reverse-cutting flutes, allowing efficient removal of even firmly embedded Screws . 1) Additionally available , TAV, sterile 2) Additionally available , TAV, sterile 3) Additionally available , TAV, sterile 4) Additionally available , TAV, sterile, self-drilling 5) Additionally available , TAV. For additional foot notes see next page. 4 DePuy Synthes Cannulated Screws Surgical Technique Additional lengths for and Cannulated Screws Cannulated Recess** Art.

6 No. External Shaft Length Screws short long full dia- dia- thread thread thread meter meter mm 428S 455S 487S mm mm 140 180 mm self-drilling Hex mm 980S 980S 780S mm mm 135 180 mm self-drilling Hex Note: These additional lengths are available sterile only (the Cannulated Screws are only available in stainless steel). ** cruciform X = 2: Stainless Steel X = 4: TAN/TAV. Hex * Available nonsterile or sterile-packed. Add s . to catalogue number to order sterile product Surgical Technique Cannulated Screws DePuy Synthes 5. Implants Guide Wires Cannulated Screw Guide Wire Diameter Length Tip Art. no. / mm 150 mm Threaded tip with / or triangular trocar mm 150 mm Threaded tip with rectangular trocar mm 150 mm Threaded tip with rectangular trocar mm 150 mm Threaded tip with rectangular trocar mm 230 mm Threaded tip with rectangular trocar mm 300 mm Threaded tip with triangular trocar mm 300 mm Drill bit Washers All Cannulated Screws can be used with or without a washer (or support screw for the Cannulated screw ).

7 Cannulated Screw Washer Outside diameter Internal diameter Art. no. mm mm mm mm mm mm mm mm mm mm mm mm Washer, spherical Prevents projection of the screw head, when the screw must be inserted at an acute angle. a a b b Cannulated Screw Washer Height (a) Width (b) Depth Art. no. 22 mm 16 mm mm 22 mm 22 mm mm Support Screw for Cannulated Screw Outside diameter mm, core diameter mm, length 3 mm, with cannulation and hexagonal socket mm ( *. *). 6 DePuy Synthes Cannulated Screws Surgical Technique Surgical technique for all Cannulated Screws The following surgical technique is explained using the example of a malleolar fracture . 1. R. educe fracture and insert guide wire After a stab incision, advance the drill sleeve or drill sleeve assembly through the soft tissues to the bone.

8 In- sert the guide wire through the drill sleeve to the desired depth and position. Remove the drill sleeve and check the position of the guide wire under the image intensifier. Required instruments Cannulated Screw Guide Wire Drill Sleeve B mm ( ) Double Drill Sleeve ( ). B mm ( ) Double Drill Sleeve ( ). B mm ( ) Double Drill Sleeve ( ). B mm ( ) Percutaneous Drill Sleeve Assembly: Protection Sleeve ( ). Drill Sleeve ( ). Drill Sleeve ( ). Trocar B mm ( ). B mm ( ) Percutaneous Drill Sleeve Assembly: Protection Sleeve ( ). Drill Sleeve ( ). Drill Sleeve ( ). Trocar B mm ( ). B mm ( , Drill Sleeve Assembly: ) Protection Sleeve ( ). Drill Sleeve ( ). Trocar B mm ( ). Surgical Technique Cannulated Screws DePuy Synthes 7.

9 Surgical technique for all Cannulated Screws 2. O. ption: Insert guide wires in parallel (only for Cannulated Screws ). Slide the non-adjustable guide sleeve (1) of the parallel guide over the already inserted guide wire. Move the (adjustable) guide sleeve (2) to the desired position and 1. 2. tighten the nut. Insert the second guide wire. Insert the desired number of parallel guide wires as described and remove the parallel guide. Note: The placement of three guide wires is recom- mended to achieve adequate rotational stability. Required instruments Cannulated Screw Parallel Guide for Guide Wires adjustable ( ). non-adjustable ( ). for percutaneous insertion ( ). adjustable ( ).

10 For open insertion ( ); see the section on Open insertion for Cannulated screw . for percutaneous insertion ( ). 5. 8 DePuy Synthes Cannulated Screws Surgical Technique 3. Drilling For self-tapping Screws (see page 4), the desired length must be predrilled with the Cannulated drill bit. Predrill- ing the near cortex is also recommended for hard bones when using the self-drilling Screws . For the following Screws , drilling and tapping is required: , , , , Required instruments Cannulated Screw Drill Bit, Cannulated B mm ( ). B mm ( ). B mm ( ). B mm ( ). B mm ( ). B mm ( ). 4. Tapping Where necessary, tap the near cortex with the cannu- lated tap. Required instruments Cannulated Screw Tap Surgical Technique Cannulated Screws DePuy Synthes 9.