DCP AND LC-DCP SYSTEMS

1 DCP AND LC-DCP SYSTEMSD ynamic Compression Plates (DCP) and Dynamic Com-pression Plates with Limited Bone Contact ( LC-DCP )Surgical TechniqueImage intensifier controlThis 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 , Reprocessing, Care and MaintenanceFor general guidelines, function control and dismantling of multi-part instruments, as well as processing guidelines for implants, please contact your local sales representative or refer to: general information about reprocessing, care and maintenance of DePuy Synthes reusable devices, instrument trays and cases, as well as processing of DePuy Synthes non-sterile implants, please consult the Important Information leaflet (SE_023827) or refer to.

2 Of Contents1 DCP and LC-DCP SYSTEMS Surgical Technique Notes Precautions WARNINGSI ntroduction DCP and LC-DCP SYSTEMS 2 The AO Principles of Fracture Management 4 Surgical Technique Preparation 5 Drill Guides for DCP and LC-DCP 7 Compression Plate: Simple Fracture 10 Compression Plate: Multifragmentary Fracture 13 Buttress Plate 16 Neutralization Plate (Protecting Plate) 17 Product Information Screws, Drills and Taps 18 Mini Fragment System , , 20 Compact Hand.

3 25 Compact Hand 25 Compact Hand 27 Compact Hand 29 Compact Hand 32 Small Fragment Plates 36 MRI Information 372 Surgical Technique DCP and LC-DCP SystemsDCP and LC-DCP SystemsDynamic Compression Plates (DCP) and Dynamic Compression Plates with Limited Bone Contact ( LC-DCP )mid sectionNon-symmetrical holesSome Dynamic Compression Plates have non-symmetri-cal holes.

4 These plates have a mid section which is placed at the position of fragments to be non-symmetrical DCP holes are shaped like a portion of an inclined and angled cylinder. They possess one compression point at the inclined side and one neutral point in the Compression Plates are available in dimensions ranging from to mm, Limited Contact Dynamic Compression Plates range from to Use, Indication and Contraindication can be found in the corresponding Instruction For hole geometriesSymmetrical holesMost to mm Dynamic Compression Plates have symmetrical holes similar to the LC-DCP hole. The sym-metrical shape of the plate holes enables compression to be achieved in both directions, thus plate positioning is not restricted by the presence of a shaped DCP holes possess one compres-sion and one neutral point on both sides.

5 With some small and mini plates, the neutral points meet in the and LC-DCP SYSTEMS Surgical TechniqueUndercuts of the LC-DCP limit contact between plate and holesThe DCP allows up to 25 longitudinal and 7 transverse screw holesThe DCP hole allows up to 50 longitudinal screwangulation. LC-DCP holes allow wider angulations upto 80 . Both plate types allow for 14 transverse screw angulationsThe stiffness of the LC-DCP allows contouring of the plate to the ( LC-DCP only)LC-DCPS tandardSymmetrical LC-DCP hole4 Surgical Technique DCP and LC-DCP Systems1 M ller ME, M Allg wer, R Schneider, H Willenegger. Manual of Internal Fixation. 3rd ed. Berlin, Heidelberg, New York: Springer. 1991 2 Buckley RE, Moran CG, Apivatthakakul T. AO Principles of Fracture Management: 3rd ed.

6 Vol. 1: Principles, Vol. 2: Specific fractures. Thieme; AO s mission is promoting excellence in patient care and outcomes in trauma and musculoskeletal Principles1, reduction andfixation to restoreanatomical fixation pro-viding absolute or relative stability, as required by the personality of the fracture, the patient, and the of the blood supply to soft- tissues and bone by gentle reduction techniques and careful and safe mobilization and rehabilitation of the injured part and the patient as a AO Principles of Fracture Management5 DCP and LC-DCP SYSTEMS Surgical TechniquePreparation1. Plate contouringThe plates should not be bent beyond the necessary bending pliers or bending irons for plate contouring. Precautions: Avoid repeated bending.

7 Sharp indentations on the plate surface, especially around the plate holes, may impair resistance to fatigue and should be avoided. Reverse bending or use of the incorrect instrumentation for bending may weaken the plate and lead to premature plate failure ( breakage). Do not bend the plate beyond what is required to match the anatomy. Instruments and screws may have sharp edges or moving joints that may pinch or tear user s glove or skin. Handle devices with care and dispose worn bone cutting instruments in an approved sharps Technique DCP and LC-DCP Systems2. Use of lag screws Construct without lag screwUsing a lag screwPreparationabNeutral and eccentric drillingExample7 DCP and LC-DCP SYSTEMS Surgical TechniqueDrill Guides for DCP and LC-DCP a Drilling in neutral position Position the tube in the middle of the DCP Drilling in eccentric position compression Position the tube in plate hole remote from the drill guide types are available to perform drilling for DCP and LC-DCP fixation in both neutral and compression Standard drill guides (DCP, sizes )Standard drill guides feature a simple tube to protect soft tissues while drilling.

8 Depending on the positioning of the tube within the hole, neutral or eccentric (compression) drilling can be Technique DCP and LC-DCP Systems2. Universal drill guides (DCP and LC-DCP , sizes )Universal drill guides feature one end with a spring-loaded mechanism which facilitates all types of applications: Neutral position, compression position, buttress position ( LC-DCP only) and especially the positioning of inclined lag screws through the Neutral position Depress the drill guide. The upper part of the inner sleeve projects. Position the drill guide in the plate hole which is remote from the fracture ( LC-DCP ). When used with DC plates the drill guide automatically slides into the correct middle position when depressed. b Compression position Do not depress the drill guide.

9 The upper part is flush. Position the drill guide in the plate hole remote from the fracture. c Inclined position This technique is used for inserting lag screws through the plate. Place the drill guide in the hole adjacent to the fracture, depress (upper part projects), and set the desired drill angle. d Buttress position ( LC-DCP only) Depress the drill guide as shown for neutral position (upper part projects). Position the drill guide in the plate hole adjacent to the Guides for DCP and LC-DCP neutral positioninclined positioncompressionpositionbuttress positionacbd9 DCP and LC-DCP SYSTEMS Surgical Technique3. LC-DCP drill guides ( and LC-DC plates)The LC-DCP drill guides can be used with LC-DC plates only. They feature dedicated ends for neutral application (green) and for application in compression mode (yellow).

10 LC-DCP drill guides carry an arrow enabling correct posi-tioning of the screw. a Neutral position Use the green drill guide to place a screw in neutral position. The arrow on the green drill guide must point towards the fracture. Compression cannot be achieved with the green drill guide. b Compression Use the yellow drill guide to achieve compression. The arrow on the yellow drill guide must point towards the fracture. c Buttress position Use the green drill guide. A buttress effect is achieved when the arrow points away from the fracture. Pre-drilling in inclined position with LC-DCP drill guides is not recommended because correct positioning of the screw cannot be ensured. LC-DCP drill guides are designed to only fit the hole in a more or less vertical position.