Zimmer A.L.P.S. Distal Tibia Plating Systems Owner's Manual
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A.L.P.S.
®
Distal Tibia
Plating System
Surgical Technique
A.L.P.S. Distal Tibia Plating System
Contents
The Distal Tibia Locking Plate System ................................................................................................................................. 5
F.A.S.T. Guide and F.A.S.T. Tabs Technologies ....................................................................................................................... 7
Locking, Non-Locking, and Multi-Directional Screw Options ............................................................................................... 9
Introduction ...................................................................................................................................................................... 11
Anterolateral Distal Tibia Locking Plate .............................................................................................................................. 12
Anterolateral Plate Specifications ...................................................................................................................................... 13
Medial Distal Tibia Locking Plate ........................................................................................................................................ 14
Medial Plate Specifications ................................................................................................................................................ 15
Staged Protocol ................................................................................................................................................................. 16
Surgical Approaches .......................................................................................................................................................... 17
Internal Fixation of Fibula and Malleolus ............................................................................................................................ 19
Reconstruction of the Tibia ................................................................................................................................................ 20
Plate Selection ................................................................................................................................................................... 21
Plates ................................................................................................................................................................................ 22
Application of the Plates .................................................................................................................................................... 24
Screw Insertion .................................................................................................................................................................. 26
Ordering Information ........................................................................................................................................................ 33
4
A.L.P.S. Distal Tibia Plating System
Low Profile Anatomically Contoured
The Distal Tibia Locking Plate System
•
A low-profile designed to help minimize potential discomfort and soft tissue irritation
•
Contoured plates mimic the anatomy of the distal tibia
•
Anterolateral plate is available in wide and narrow widths to suit patient size
•
Bullet tip designed to minimize soft tissue disruption during insertion
•
Plate insertion handle simplifies submuscular application
For distal tibia procedures that often involve complex fractures and minimal tissue coverage, the Distal Tibia Plating System provides both strength and low-profile advantages. Having a slim profile with the capability to contour in-situ, these plates may be used successfully to treat even the most challenging cases.
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6
A.L.P.S. Distal Tibia Plating System
Fast, Accurate Surgeries
F.A.S.T. Guide
®
and F.A.S.T. Tabs
®
Technologies
F.A.S.T. Guide
• Facilitates accurate drilling
• Pre-loaded and disposable
• Saves time in the OR since no intraoperative assembly is required
• Color-coded guides make identification easy: Red guide=Right, Lime guide=Left
F.A.S.T. Tabs
• Distal tabs of the Anterolateral Plate easily contour to conform to the bone
• Threaded holes in the tabs of the Anterolateral Plate allow screws to lock to the plate, providing stability and support
• Interlocking alignment of distal screws can create a subchondral scaffold for rigid fixation
To facilitate surgical procedures even more, our Distal Tibia Plates come pre-loaded with Fixed Angle Screw Targeting
Guides - F.A.S.T. Guide inserts - that direct the trajectory of the drill right into the plate. Additionally, our F.A.S.T. Tabs technology provides a robust interlocking construct for bone fragments.
Note: The F.A.S.T. Guide inserts are NOT to be removed prior to sterilization.
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8
A.L.P.S. Distal Tibia Plating System
Versatility in construct
Locking, non-locking, and multi-directional screw options
• Choose Locking, Non-Locking, or Multi-Directional Screws according to need
• All options available in each construct
• Tapered, threaded screws lock into position when tightened to establish a fixed angle construct for strong fixation or when optimal screw purchase is required
• Locking Multi-Directional Screws (MDS) allow for up to 15 degrees of angulation from center
• Non-Locking Screws can be positioned and used in compression, neutral, and buttress modes
Particularly helpful in challenging fracture cases, the interlocking screw construct of the Distal Tibia Plates provides both versatility and strength.
9
Introduction
The Zimmer Biomet A.L.P.S. Distal Tibia Plating System represents the next generation in anatomic plate design. It combines the benefits of low-profile titanium plate metallurgy with the advantages of multiplanar locked screw technology.
These features allow the formation of a three dimensional matrix of fixed and variable angle screws to create a true subchondral scaffold that can provide strong fixation in comminuted fractures or osteopenic bone.
The Medial Locking Plate is indicated for:
• Pilon Fractures: distal tibial intra-articular fractures
• High medial malleolar fractures
• Low boot type rotational distal extra-articular shaft fractures
The Zimmer Biomet A.L.P.S. Distal Tibia Plating System features Type 2 Anodized Titanium Alloy low-profile, anatomically contoured implants. In distal tibial surgery where soft tissue coverage is at risk, these low-profile plates are designed to minimize discomfort and soft tissue irritation matching the anatomy of the distal tibia, while still having the required strength.
The Anterolateral Locking Plate is indicated for:
• Distal intra-articular tibia fractures
• Proximal tibia fractures
• Proximal and distal humerus fractures
The System features F.A.S.T. Guide and F.A.S.T. Tabs technology to facilitate surgical procedures and save time in the operating room. F.A.S.T. Guide inserts allow for accurate drilling and placement of screws. F.A.S.T. Guide come preloaded and do not require intraoperative assembly, which can result in significant time savings. F.A.S.T. Tabs are distal versatile tabs with threaded screw holes to lock small distal articular fragments to the plate. Screws placed in these locking holes create an intersecting three-dimensional scaffold to support the distal articular surface.
Additionally, the Zimmer Biomet A.L.P.S. Distal Tibia Plating
System allows the use of locking, variable angle, and standard screws. This hybrid fixation concept allows the surgeon to stabilize the fracture either by the use of lag screw techniques through the plate, or by compression plating techniques.
Locking screws serve to provide stability to comminuted, unstable metaphyseal fractures or in osteopenic bone.
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A.L.P.S. Distal Tibia Plating System
Anterolateral Distal Tibia Locking Plate
Proximal bullet tip facilitates submuscular plate insertion
Type 2 Anodized Titanium Alloy for strength and biocompatibility
Threaded holes for Locking 3.5 mm, 4.0 mm, and 3.5 mm Multi-Directional Screws
Low-profile, anatomically contoured plate design to minimize soft tissue irritation
Compression holes in the shaft of the plate for 3.5 mm and 4.0 mm Non-Locking Screws
F.A.S.T. Guide inserts for easy drilling
3.5 mm Multi-Directional Locking
Screws allow for up to 15 degrees of angulation from center
Versatile anatomic locking F.A.S.T. Tabs form an intersecting scaffold to capture and support distal fragments
Non-Locking Screws
3.5 mm Cortical Screws
4.0 mm Cancellous Screws, Full Thread
4.0 mm Cancellous Lag Screws
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4.0 mm Cannulated Cancellous Lag Screws
Locking Screws
3.5 mm Cortical Screws
4.0 mm Cancellous Screws
3.5 mm Multi-Directional Screws
Anterolateral Plate Specifications
Distance between center holes of shaft
Orientations
Lengths
14 mm
Left / Right
6H, 9H, 12H, 15H
14 mm
Left / Right
6H, 9H, 12H, 15H
3.5 mm Locking Cortical Screw:
• Large core diameter and shallow thread pitch for bending and shear strength
• Self-tapping tip minimizes the need for pre-tapping and eases screw insertion
• Tapered screw head helps ensure alignment of the screw head into the plate hole
• Tapered threaded head minimizes screw back-out and construct pullout
• T-15 drive
• Available in lengths of 10 – 70 mm
3.5 mm Locking Multi-Directional Screw:
• Cobalt-Chrome screw with large core diameter
• Multi-directional capability offers 15 degrees of angulation from center
• Creates own thread in plate to help provide strong and stable construct
• Screw head designed to prevent it from going through the threaded screw hole
• Self-tapping tip minimizes the need for pre-tapping and eases screw insertion
• 2.2 mm square drive
• Available in lengths of 20 – 60 mm
4.0 mm Locking Cancellous Screw:
• Self-tapping tip minimizes the need for pre-tapping and eases screw insertion
• Tapered screw head helps ensure alignment of the screw head into the plate hole
• Tapered threaded head minimizes screw back-out and construct pullout
• T-15 drive
• Available in lengths of 10 – 70 mm
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A.L.P.S. Distal Tibia Plating System
Medial Distal Tibia Locking Plate
Proximal bullet tip facilitates submuscular plate insertion
Type 2 Anodized Titanium Alloy for strength and biocompatibility
Threaded holes for locking 3.5 mm, 4.0 mm, and 3.5 mm Multi-Directional Screws
Low-profile, anatomically contoured plate design to minimize soft tissue irritation
Compression holes in the shaft of the plate for
3.5 mm and 4.0 mm Non-Locking Screws
F.A.S.T. Guide inserts for easy drilling
Distal tab for 3.5 mm and 4.0 mm Non-Locking Screw conforms to shape of medial malleolus
3.5 mm Multi-Directional Locking
Screws allow for up to 15 degrees of angulation from center
Non-Locking Screws
3.5 mm cortical screws
4.0 mm cancellous screws, full thread
4.0 mm cancellous lag screws
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4.0 mm cannulated cancellous lag screws
Locking Screws
3.5 mm cortical screws
4.0 mm cancellous screws
3.5 mm multi-directional screws
Medial Plate Specifications
Medial Plate
Head Width
Average Head Thickness
Tab Thickness
Shaft Width
Shaft Thickness
Distance between center holes of shaft
Orientations
Lengths
23 mm
3 mm
2 mm
12 mm
3 mm
14 mm
Left / Right
6H, 9H, 12H, 15H
3.5 mm Locking Cortical Screw:
• Large core diameter and shallow thread pitch for bending and shear strength
• Self-tapping tip minimizes the need for pre-tapping and eases screw insertion
• Tapered screw head helps ensure alignment of the screw head into the plate hole
• Tapered threaded head minimizes screw back-out and construct pullout
• T-15 drive
• Available in lengths of 10 – 70 mm
3.5 mm Locking Multi-Directional Screw:
• Cobalt-Chrome screw with large core diameter
• Multi-directional capability offers 15 degrees of angulation from center
• Creates own thread in plate to help provide strong and stable construct
• Screw head designed to prevent it from going through the threaded screw hole
• Self-tapping tip minimizes the need for pre-tapping and eases screw insertion
• 2.2 mm square drive
• Available in lengths of 20 – 60 mm
4.0 mm Locking Cancellous Screw:
• Self-tapping tip minimizes the need for pre-tapping and eases screw insertion
• Tapered screw head helps ensure alignment of the screw head into the plate hole
• Tapered threaded head minimizes screw back-out and construct pullout
• T-15 drive
• Available in lengths of 10 – 70 mm
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A.L.P.S. Distal Tibia Plating System
Figure 1
When planning to treat a distal tibia fracture surgically using plates, application of a spanning external fixator should be performed as soon as possible.
Portable Traction
When planning to treat a distal tibia fracture surgically using plates, application of a spanning external fixator should be performed as soon as possible (Figure 1).
Pin placement distally is dependent on the type of frame employed. Proximally placed tibial pins should be away from planned incisions to avoid pin tracts possibly infecting the surgical site. When placing frames, the surgeon should verify that the tibial shaft is in acceptable alignment, as posterior subluxation of the talus and hindfoot can lead to pressure necrosis of the anterior skin. Once the multi-planar frame has been applied, the patient should undergo a CT scan, with sagittal and transverse reconstructions.
After review of the CT scans and plane films, a determination can be made regarding the correct surgical approach and plate application. The fibula should undergo internal fixation after the CT scan has been performed, in order to determine the location of the incisions.
Zimmer Biomet’s temporary spanning fixation device is
TempFix ® . It is offered with a U-ring (Cat. No. 8081-09-000 -
Left, 8081-10-000 - Right) or without (Cat. No. 8081-11-000).
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Figure 2
One of three surgical approaches can be used.
An example of an Antero-Medial approach.
Surgical Approaches
Approaches include an antero-medial incision, a standard anterior incision, or the lateral Böhler approach. When plating the fibula through a standard lateral approach, the surgeon should identify the tibial incision first to avoid narrow skin bridges between the two incisions.
1. The Antero-Medial Approach
Begin at the level of the distal shaft of the tibia, just lateral to the anterior crest, and continue distally as far as needed, staying medial to the anterior tibial tendon. Take the skin together with the subcutaneous tissue and the periosteum in a full thickness flap to prevent separation of the medial skin from its periosteal blood supply. Expose the joint through major tears in the soft tissue envelope. If needed, the joint capsule can be incised in line with the skin incision, to visualize the articular surface. This approach offers the surgeon an excellent view of the medial and anterior distal tibia, but visualization of the lateral tibial articular surface will be limited (Figure 2).
17
A.L.P.S. Distal Tibia Plating System
Figure 3
Standard Anterior approach.
Figure 4
Lateral approach.
2. The Standard Anterior Approach
Make an 8 - 10 cm skin incision centered over the ankle, with most of the incision proximal to the joint. Distally, the incision stops at the level of the talo-navicular joint. Find and protect the superficial peroneal nerve, which crosses the wound from the lateral side. Incise the extensor retinaculum in line with the skin incision, and expose the anterior tibial
(AT) and extensor hallucis longus (EHL) tendons. Locate and protect the anterior tibial artery and deep peroneal nerve just medial to the EHL tendon at the level of the joint. Move the neurovascular bundle laterally along with the EHL; the AT should be moved medially. This exposes the ankle capsule.
The exposure of the joint should be through the major tears in the soft tissue envelope. Excellent visualization of the medial, and anterior tibial plafond are possible with this approach, but visualization of the lateral tibial plafond again is somewhat limited (Figure 3).
3. The Lateral Approach
Start 5 cm proximal to the ankle joint and slightly medial to
Chaput’s tubercle. Continue distally in a straight line toward the base of the third and fourth metatarsals. Identify and protect the superficial peroneal nerve and proceed through the subcutaneous tissue to expose the superior and inferior extensor retinaculum, and the tendons of the extensor digitorum longus, peroneus tertius, hallucis brevis, and the extensor hallucis longus. After dividing the extensor retinaculum, the tendons of the extensor digitorum longus and peroneus tertius, the deep peroneal nerve, and the dorsalis pedis artery are moved medially. In the distal aspect of the incision, the muscle belly of the extensor digitorum brevis can be seen, and, if greater distal exposure is needed, this can be mobilized. At completion, the exposure should allow visualization of the entire anterior face of the distal tibia, with excellent visualization of the lateral articular surface of the tibia. It will be impossible to apply a medial plate from this incision (Figure 4).
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Figure 5
The fibular shaft should be reconstructed initially using standard techniques.
Internal Fixation of Fibula and Malleolus
Fibula and Posterior Malleolar Reconstruction
The fibular shaft and lateral malleolus should be reconstructed initially, depending on the tibial incision planned. If a midline or antero-medial incision is planned, a straight lateral or postero-lateral incision can be used. Standard techniques of fibular plating
(Cat. No. 8141-23-0XX) are used (Figure 5). If an anterolateral approach to the tibia is employed, a postero-lateral incision can be used to fix the fibula.
Alternately, both tibial and fibular fixation may be performed through the same anterolateral incision.
Furthermore, if plain films and CT scan indicate that the posterior malleolus is “free floating”, then this fragment must be fixed at the time of fibula fixation so that a stable fragment exists to reconstruct the articular surface. If this is not performed, the joint will be malreduced at the end of the surgery.
Note: A.L.P.S. Distal Tibia Anterolateral and Medial
Plates are not indicated to treat fibular fractures.
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A.L.P.S. Distal Tibia Plating System
Figure 6
Reconstruct the articular surface by using 1.6 mm K-wires, either with direct reduction of one fragment to another, or by wedging small fragments between larger fragments.
Figure 7
The reconstructed articular block can then be attached to the meta-diaphyseal shaft.
Tibial Reconstruction
When reducing a long bone fracture, axial alignment is the predominant functional requirement. When reducing an articular fracture, both anatomic reconstruction of the joint surface, as well as axial alignment of the shaft is required.
While a millimeter step in the joint will result in mild angular mal-alignment in the metaphysis, a millimeter offset in the metaphysis will translate to several millimeters of joint incongruity. For this reason, the articular surface should be approached first.
Once satisfied with the articular reduction, the metaphysis is evaluated. Impaction fractures associated with metaphyseal crush require a cancellous bone graft. Once completed, each critical K-wire is replaced with an isolated 3.5 mm cortical, or
4.0 mm cancellous lag screw. The reconstructed articular block can then be attached to the meta-diaphyseal shaft using either isolated lag screws and a neutralization plate, or a plate alone in compression mode, with or without lag screws through the plate (Figure 7).
First externally rotate the medial malleolar fragment. Next, apply ligamentotaxis through distraction using either an external fixator or a femoral distractor. In this way, the comminuted central articular surface can be visualized. Reduce the comminuted fragments by using the constant postero-lateral fragment as the key to the articular reduction. Rebuild the articular surface by using 1.6 mm K-wires (Cat. No. 14425-6), either with direct reduction of one fragment to another, or by wedging small fragments between larger fragments. When the surface has been reconstructed, the medial malleolus is reduced and provisionally pinned (Figure 6).
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Figure 9
Figure 8 Figure 10
Plate Selection
Medial plates cannot be applied using a lateral incision.
Similarly lateral plates cannot be applied through a medial incision. While a midline incision allows application of a lateral plate, a medial plate can be applied only with difficulty.
Therefore:
• If the fracture is more comminuted medially, and lateral joint involvement is minimal, a medial incision is used and a medial plate is applied (Figure 9).
• If comminution is both anterior, medial and lateral, then a midline incision may be best, coupled with an anterolateral plate (Figure 10).
• If the fracture is unstable, with lateral comminution, and anterior metaphyseal crush is evident, a lateral approach is chosen, and an anterolateral plate is recommended
(Figure 8).
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A.L.P.S. Distal Tibia Plating System
Figure 11
Anterolateral Plates are available in 4 lengths and in wide and narrow widths.
Wide plates have three F.A.S.T. Tabs, while narrow plates have two F.A.S.T. Tabs.
Plates
Anterolateral Distal Tibial Plate
(Cat. No. 8162-0X-0XX).
The Anterolateral Distal Tibial Plate is a low-profile, anatomically contoured plate, designed to fit on the anterolateral aspect of the distal tibia. These thin plates are designed to minimize discomfort and soft tissue irritation around the ankle, while still having the strength needed to achieve rigid fixation of the distal tibial fracture. All plates come with F.A.S.T. Guide inserts for accurate drilling and placement of screws, with locking, lagging, or variable angle screw options available in the same construct (Figure 11).
Contourable F.A.S.T. Tabs with threaded screw holes are present distally to lock small distal articular fragments to the plate. These tabs are adjustable with Plate Tab Benders that fit over the F.A.S.T. Guide inserts for easy and secure control.
Contouring can be performed before application, or in situ.
Should these tabs not be desired, they are cleanly removed with a few bending cycles, without leaving sharp edges.
Alternatively, they may be clipped off with a wire cutter.
Screws placed in these rows will create an intersecting scaffold to support the distal articular surface.
These plates are pre-contoured and need little, if any, secondary adjustments to their shape. In addition, wide and narrow widths are available to accommodate patient size. Wide plates contain three F.A.S.T. Tabs, while narrow plates contain two F.A.S.T. Tabs.
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Figure 12
Medial Plates are available in 4 lengths.
Medial Tibial Plate
(Cat. No. 8162-1X-0XX).
Similar to the Anterolateral Plate, the Medial Plate is a low-profile, anatomically contoured plate, designed to fit the medial aspect of the distal tibia. These thin plates are designed to minimize discomfort and soft tissue irritation around the ankle, while still having the strength needed to achieve rigid fixation of the distal tibial fracture. All plates come with F.A.S.T. Guide inserts for accurate drilling and placement of screws, with locking, lagging, or variable angle screw options available in the same construct (Figure 12).
In addition, these plates are precontoured and need little, if any, secondary adjustments to their shape.
A plate handle can be attached to the distal end of the plate to facilitate insertion and positioning of the plate. The distal tab with a non-locking hole is present to connect distal fragments to the plate. If this tab is not desired, it can remain unfilled.
Alternatively, it can be easily removed with a wire cutter.
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A.L.P.S. Distal Tibia Plating System
Figure 13
The optimal position of the
Anterolateral Plate F.A.S.T. Tabs in relation to the joint is approximately
2 mm from the anterior articular surface.
Figure 14
A Plate Handle can be used to facilitate plate insertion and positioning.
Figure 15
Medium Bone/Plate
Forceps can be used to provisionally hold the plate to the bone.
Figure 16
Plate can be shaped using the benders over the F.A.S.T. Guide inserts.
Application of the Plates
The proper plate length is selected by ensuring at least 3-4 screw holes are present proximal to the most proximal extent of the shaft component of the fracture.
Application of the Anterolateral Plate
Slide the shaft of the Anterolateral Plate submuscularly along the lateral border of the tibia, beneath the anterior compartment muscles and neurovascular bundle.
The optimal position of the distal plate F.A.S.T. Tabs in relation to the joint is approximately 2 mm from the anterior articular surface (Figure 13). There should be enough clearance to permit full dorsiflexion of the ankle.
Use fluoroscopic imaging during plate placement in both the AP and lateral planes to ensure a safe implant position proximally along the lateral tibia.
connects to the distal compression hole on the shaft of the plate. The Plate Handle is secured to the plate by tightening the set screw with the T-15 driver until secured tightly with two fingers. The plate is provisionally clamped to the bone using the Medium Bone/Plate Forceps
(Cat. No. 8163-01-006) proximally (Figure 15).
In most cases the pre-contoured plate will fit without the need for further bending. The distal tabs may be contoured as needed using F.A.S.T. Guide inserts and Plate Tab Benders
(Cat. No. 8163-01-001).
To contour the F.A.S.T Tabs, place the benders over a F.A.S.T.
Guide insert in each row and exert pressure on the distal bender until the desired contour is achieved (Figure 16).
The Plate Handle can be attached to the plate to facilitate insertion and position the plate in either an open or percutaneous manner (Figure 14). The Plate
Handle comes in right (Cat. No. 8163-01-003) and left
(Cat. No. 8163-01-004) orientations. The Plate Handle
CAUTION: Bending the distal tabs beyond 25 degrees may result in breakage. Continuous bending will also fatigue the tab and cause it to break.
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Figure 18
Secure plate to the articular block using
1.6 mm K-wires.
Figure 17
Slide the Medial Plate under the soft tissue using Plate Handle.
Figure 19
A provisional Fixation Pin may also be used to secure the plate temporarily.
Application of the Medial Plate
Slide the Medial Plate proximally under the soft tissue. The plate conforms to the shape of the distal tibia and the distal end of the plate should conform to the shape of the medial malleolus (Figure 17).
The Plate Handle can be attached to the plate to facilitate insertion and position the plate in either an open or percutaneous manner. The Plate Handle connects to the distal compression hole on the shaft of the plate. The plate handle is secured to the plate by tightening the set screw with the T-15 driver until secured tightly with 2 fingers.
A Provisional Fixation Pin (Cat. No. 8242-99-000/1) may also be used to secure the plate temporarily. The pin has a selfdrilling tip and an AO quick connection for power insertion.
Advance the pin slowly until the shoulder of the pin contacts the plate and pulls the plate down to the bone. Advancing the pin beyond that point could result in the threads stripping in the bone (Figure 19).
When placing screws in the plate, the plate should be secured from the distal end to the proximal end to prevent the plate from “walking” distally.
Provisional Fixation
Once the fit of either the Anterolateral Plate or the
Medial Plate has been confirmed both visually and fluoroscopically, 1.6 mm K-wires can be placed into the distal K-wire holes to secure the plate to the articular block
(Figure 18).
If the surgeon desires for the distal end of the plate to sit flush against the bone, then a 4.0 mm non-locked lag screw should be used. Instructions on how to insert a 4.0 mm lag screw can be found in the section titled, “Insertion of a 4.0 mm Non-Locking Screw”.
Note: If a lag screw is used in the metaphyseal part of the plate or distal tabs, then that F.A.S.T. Guide insert needs to be removed prior to drilling.
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A.L.P.S. Distal Tibia Plating System
Figure 20
Slide the Measuring Drill Sleeve onto the 2.7 mm Calibrated Drill Bit.
Figure 21
Drill through the F.A.S.T. Guide insert with the 2.7 mm Drill Bit.
Slide the Measuring Drill Sleeve to the top end of the F.A.S.T. Guide insert and read the measurement of the Locking Screw length from the proximal end.
Figure 22
Insert the pre-determined Locking Screw using the T-15 Driver attached to Torque Limiting Driver Handle.
Screw Insertion
Insertion of a 3.5 mm Cortical Locking Screw (Cat. No. 8161-35-0XX) or 4.0 mm Cancellous Locking
Screw (Cat. No. 8161-40-0XX) into a Distal Threaded Hole.
Slide the Measuring Drill Sleeve (Cat. No. 8163-01-005) onto the 2.7 mm Calibrated Drill Bit (Cat. No. 2142-27-070) (Figure
20). Drill through the F.A.S.T. Guide insert until the far cortex is reached. Slide the Measuring Drill Sleeve onto the top end of the F.A.S.T. Guide insert and read the measurement of the locking screw length from the proximal end of the Drill Measuring
Sleeve (Figure 21). Next, remove the F.A.S.T. Guide insert with the T-15 Driver that is attached to the Ratchet Handle (8261-
66-000) and insert the pre-determined locking screw using the
T-15 Driver that is attached to the 2.0 Nm Torque-Limiting
Screwdriver Handle (Cat. No. 2141-18-001) (Figure 22).
Note: Using a power screwdriver is not recommended for insertion of any locking screws.
If using power, it should be at a slow speed. Perform all final screw tightening by hand with the torque-limiting screwdriver.
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3.5 mm Multi-Directional Screws
15°
15°
Figure 23
MDS Screw allows up to 15 degrees of angulation from center.
Figure 24
Drill with the 2.7 mm Drill Bit through the 2.0/2.7 mm Drill Guide.
Figure 25
Take a direct reading from the LOCK Line on the Depth Gauge.
Figure 26
Insert the MDS screw using the
2.2 mm Square Driver coupled to the Rachet Handle.
Insertion of a 3.5 mm Multi-Directional Locking Screw in a Threaded Locking Hole
(Cat. No. 8163-35-0XX).
Note: If a 3.5 mm Multi-Directional Screw is used in the metaphyseal part of the plate or distal tabs, then that
F.A.S.T. Guide insert needs to be removed prior to drilling.
Additionally, note that the Torque Limiting Handle should not be used.
Measure the drilled hole with the Small Fragment
Depth Gauge (Cat. No. 2142-35-100) by taking a direct reading from the LOCK line (Figure 25) and insert the appropriate length 3.5 mm Multi-Directional Screw with the
2.2 mm Square Driver (Cat. No. 8163-01-000) coupled to the
Ratchet Handle (Cat. No. 8261-66-000) (Figure 26).
Insert the 2.7 mm end of the 2.0/2.7 mm Drill Guide (Cat.
No. 9399-99-435) into the plate hole and angle the drill as needed within an arc of 15 degrees (Figure 23). Drill through both cortices with the 2.7 mm Drill Bit (Figure 24).
27
A.L.P.S. Distal Tibia Plating System
Figure 28
Take reading directly from the LOCK Line on the Small Fragment
Depth Gauge.
Figure 27
Drill with the 2.7 mm Calibrated Drill Bit reading the depth from the top of the Drill Guide.
Figure 29
Insert the Locking Screw using the T-15 Driver coupled to the Torque-Limiting
Screwdriver Handle.
The proximal end of the plate can now be secured to the bone. This can be achieved through the following options:
Insertion of a Locking Screw (3.5 mm Cortical Cat. No. 8161-35-0XX or 4.0 mm Cancellous
Cat. No. 8161-40-0XX) in a Threaded Hole.
Screw the 2.7 mm Locking Drill Guide (Cat. No. 2142-
07-027) into a threaded plate hole until fully seated.
Drill both cortices with the 2.7 mm Calibrated Drill Bit to the desired depth and read the depth measurement from the calibrated drill bit at the top of the Drill Guide
(Figure 27). Remove the 2.7 mm Locking Drill Guide.
Note: If a second method of measurement is desired, measure the drilled hole by taking a direct reading from the
LOCK line on the Small Fragment Depth Gauge (Figure 28).
Insert the selected locking screw with the T-15 Driver coupled to the 2.0 Nm Torque-Limiting Screwdriver Handle
(Figure 29).
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Figure 31
Take a depth reading from the NON-L Line.
Figure 32
Insert the 3.5 mm Non-Locking Cortical Screw using the 2.5 mm Hex Driver.
Figure 30
Drill with the 2.5 mm Drill Bit in the neutral position.
Neutral insertion of a 3.5mm Non-Locking
Cortical Screw (Cat. No. 8150-37-0XX) in a Compression Slot.
Apply the neutral (green) end of the 2.5 mm ACP Drill
Guide (Cat. No. 8241-68-000) onto a compression slot in the plate, with the arrow pointed toward the fracture line (Figure 30). Drill through both cortices with the
2.5 mm Drill Bit (Cat. No. 8290-29-070).
Measure the drilled hole with the Small Fragment Depth
Gauge (Figure 31) by taking a direct reading from the NON-L line.
Insert the 3.5 mm Non-Locking Cortical Screw with the Screw
Holder Sleeve (Cat. No. 8241-66-000) over the 2.5 mm Hex
Driver (Cat. No. 8241-57-071) in the Ratchet Handle (Cat.
No. 8261-66-000) (Figure 32).
Caution: The arrow on the neutral (green) end of the 2.5 mm ACP Drill Guide must point toward the fracture site to ensure neutral screw placement.
29
A.L.P.S. Distal Tibia Plating System
Figure 34
Take the depth reading from the
NON-L line.
Figure 33
Drill with the 2.5 mm Drill Bit in the eccentric position.
Figure 35
Insert the 3.5 mm Non-Locking Cortical Screw using the 2.5 mm Hex Driver.
Dynamic compression using a 3.5 mm Non-Locking Cortical Screw in a Compression Slot.
Apply the compression (gold) end of the 2.5 mm ACP Drill
Guide onto the compression slot with the arrow pointed toward the fracture line (Figure 33). Drill through both cortices with the 2.5 mm Drill Bit.
Measure the drilled hole with the Small Fragment Depth
Gauge (Figure 33) by taking a direct reading from the
NON-Line (Figure 34).
Insert the appropriate length 3.5 mm Non-Locking Cortical
Screw with the Screw Holder Sleeve over the 2.5 mm Hex
Driver coupled to the Ratchet Handle (Figure 35).
30
Figure 37
Take a depth reading from the NON-L Line.
Figure 36
Drill with the 2.5 mm Drill Bit through the 2.5/3.5 mm Drill Guide.
Figure 38
Insert the 3.5 mm Non-Locking Cortical Screw using the 2.5 mm Hex Driver.
Insertion of a 3.5 mm Non-Locking Cortical Screw in a Threaded Hole.
Insert the 2.5 mm end of the 2.5/3.5 mm Drill Guide (Cat.
No. 8241-96-000) into the threaded hole and drill through both cortices with the 2.5 mm Drill Bit (Figure 36).
Measure the drilled hole with the Small Fragment Depth
Gauge (Figure 37) by taking a direct reading from the
NON-L line.
Insert the appropriate length 3.5 mm Non-Locking Cortical
Screw with the Screw Holder Sleeve over the 2.5 mm Hex
Driver coupled to the Ratchet Handle (Figure 38).
31
A.L.P.S. Distal Tibia Plating System
Figure 40
Take a depth reading from the NON-L Line.
Figure 39
Drill using 2.9 mm Drill Bit through 2.9/4.0 mm Drill Guide.
Figure 41
Insert the 4.0 mm Non-Locking Screw using the 2.5 mm Hex Driver.
4.0 mm Non-Locking Screw (Cancellous Full Thread Cat. No. 8153-41-0XX or Cancellous Lag Cat. No. 8155-40-0XX) into any Plate Hole.
Insert the 2.9 mm end of the 2.9/4.0 mm Drill Guide (Cat.
No. 2141-29-400) into a plate hole and drill through both cortices with the 2.9 mm Drill Bit (Cat. No.
8290-31-070) (Figure 39).
Measure the drilled hole with the Small Fragment Depth
Gauge by taking a direct reading from the NON-L line
(Figure 40).
Insert the appropriate length 4.0 mm cancellous screw with the screw holder sleeve over the 2.5 mm Hex Driver coupled to the Ratchet Handle (Figure 41).
32
Instruments and Implants
Ordering Information
Instruments
8162-99-001
8162-99-006
8241-66-000
8163-01-000
2142-15-070
2141-18-001
8163-05-006
8163-05-009
8163-05-015
8163-05-106
8163-05-109
8163-05-115
8163-05-206
8163-05-209
Order Code
8241-68-000
8241-76-000
8261-66-000
2142-35-100
8163-01-007
8163-01-003
8163-01-004
9399-99-435
8241-96-000
2141-29-400
2312-18-015
8241-57-071
2142-07-027
8163-01-006
8163-01-001
8163-05-215
8163-05-306
8163-05-309
8163-05-315
8163-06-006
8163-06-009
8163-06-015
8163-06-106
8163-06-109
8163-06-115
8163-07-315
8163-07-305
8163-07-403
8163-07-407
Description
2.5 mm ACP Drill Guide
Bending Sticks
Cannulated Ratchet Handle
Depth Gauge
Distal Tibia Handle Set Screw
Distal Tibia Plate Handle, Right
Distal Tibia Plate Handle, Left
2.0 / 2.7 mm Drill Guide
2.5 / 3.5 mm Drill Guide
2.9 / 4.0 mm Drill Guide
1.6 mm F.A.S.T. Guide Adapter
2.5 mm Hex Driver
2.7 mm Locking Drill Guide
Medium Plate / Bone Forceps
Plate Tab Benders
20.0 mm Provisional Fixation Pin
40.0 mm Provisional Fixation Pin
Screw Holder Sleeve
2.2 mm Square Driver
T-15 Driver
20Nm Torque-Limiting Screwdriver
Left Distal Tibial Anterolateral Wide Plate Template, 6 Hole
Left Distal Tibial Anterolateral Wide Plate Template, 9 Hole
Left Distal Tibial Anterolateral Wide Plate Template, 12/15 Hole
Right Distal Tibial Anterolateral Wide Plate Template, 6 Hole
Right Distal Tibial Anterolateral Wide Plate Template, 9 Hole
Right Distal Tibial Anterolateral Wide Plate Template, 12/15 Hole
Left Distal Tibial Anterolateral Narrow Plate Template, 6 Hole
Left Distal Tibial Anterolateral Narrow Plate Template, 9 Hole
Left Distal Tibial Anterolateral Narrow Plate Template, 12/15 Hole
Right Distal Tibial Anterolateral Narrow Plate Template, 6 Hole
Right Distal Tibial Anterolateral Narrow Plate Template, 9 Hole
Right Distal Tibial Anterolateral Narrow Plate Template, 12/15 Hole
Left Distal Tibia Medial Plate Template, 6 Hole
Left Distal Tibia Medial Plate Template, 9 Hole
Left Distal Tibia Medial Plate Template, 12/15 Hole
Right Distal Tibia Medial Plate Template, 6 Hole
Right Distal Tibia Medial Plate Template, 9 Hole
Right Distal Tibia Medial Plate Template, 12/15 Hole
Small Metal Plate Template, 3/5 Hole
Large Metal Plate Template, 3/5 Hole
Medial Pilon Plate Template, 3 Hole
Medial Pilon Plate Template, 5 Hole
33
Instruments and Implants
Ordering Information
Instrument Cases
Order Code
8299-53-500
8299-53-000
Description
A.L.P.S. Tibia and Fibula Sterile Case
A.L.P.S. Tibia Non-Sterile Case
Disposables
Order Code
8563-01-005
2142-27-160
8295-16-150
8290-29-170
8290-31-170
Implants
Non-Sterile
8162-00-006
8162-00-009
8162-00-012
8162-00-015
8162-01-006
8162-01-009
8162-01-012
8162-01-015
8162-02-006
8162-02-009
8162-02-012
8162-02-015
8162-03-006
8162-03-009
8162-03-012
8162-03-015
8162-10-006
8162-10-009
8162-10-012
8162-10-015
8162-11-006
8162-11-009
8162-11-012
8162-11-015
Description
Drill Sleeve
2.7 Calibrated Drill Bit
1.6 mm K-wire
2.5 mm Drill Bit
2.9 mm Drill Bit
Sterile
8562-00-006
8562-00-009
8562-00-012
8562-00-015
8562-01-006
8562-01-009
8562-01-012
8562-01-015
8562-02-006
8562-02-009
8562-02-012
8562-02-015
8562-03-006
8562-03-009
8562-03-012
8562-03-015
8562-10-006
8562-10-009
8562-10-012
8562-10-015
8562-11-006
8562-11-009
8562-11-012
8562-11-015
Description
Right Distal Tibial Anterolateral Locking Wide Plate, 6 Hole
Right Distal Tibial Anterolateral Locking Wide Plate, 9 Hole
Right Distal Tibial Anterolateral Locking Wide Plate, 12 Hole
Right Distal Tibial Anterolateral Locking Wide Plate, 15 Hole
Left Distal Tibial Anterolateral Locking Wide Plate, 6 Hole
Left Distal Tibial Anterolateral Locking Wide Plate, 9 Hole
Left Distal Tibial Anterolateral Locking Wide Plate, 12 Hole
Left Distal Tibial Anterolateral Locking Wide Plate, 15 Hole
Right Distal Tibial Anterolateral Locking Narrow Plate, 6 Hole
Right Distal Tibial Anterolateral Locking Narrow Plate, 9 Hole
Right Distal Tibial Anterolateral Locking Narrow Plate, 12 Hole
Right Distal Tibial Anterolateral Locking Narrow Plate, 15 Hole
Left Distal Tibial Anterolateral Locking Narrow Plate, 6 Hole
Left Distal Tibial Anterolateral Locking Narrow Plate, 9 Hole
Left Distal Tibial Anterolateral Locking Narrow Plate, 12 Hole
Left Distal Tibial Anterolateral Locking Narrow Plate, 15 Hole
Right Distal Tibia Medial Locking Plate, 6 Hole
Right Distal Tibia Medial Locking Plate, 9 Hole
Right Distal Tibia Medial Locking Plate, 12 Hole
Right Distal Tibia Medial Locking Plate, 15 Hole
Left Distal Tibia Medial Locking Plate, 6 Hole
Left Distal Tibia Medial Locking Plate, 9 Hole
Left Distal Tibia Medial Locking Plate, 12 Hole
Left Distal Tibia Medial Locking Plate, 15 Hole
34
Screws
Ordering Information
Non-Locking Cortical Screw
Non-Sterile Sterile
8150-37-010
8150-37-012
8150-37-014
8150-37-016
8150-37-018
8150-37-020
8150-37-022
8150-37-024
8150-37-026
8150-37-028
8150-37-030
8150-37-032
8150-37-034
8150-37-036
8150-37-038
8150-37-040
8150-37-042
8150-37-044
8150-37-046
8150-37-048
8150-37-050
8150-37-055
8150-37-060
8150-37-065
8150-37-070
8550-37-010
8550-37-012
8550-37-014
8550-37-016
8550-37-018
8550-37-020
8550-37-022
8550-37-024
8550-37-026
8550-37-028
8550-37-030
8550-37-032
8550-37-034
8550-37-036
8550-37-038
8550-37-040
8550-37-042
8550-37-044
8550-37-046
8550-37-048
8550-37-050
8550-37-055
8550-37-060
8550-37-065
8550-37-070
Description
3.5 x 10.0 mm Non-Locking Cortical Screw
3.5 x 12.0 mm Non-Locking Cortical Screw
3.5 x 14.0 mm Non-Locking Cortical Screw
3.5 x 16.0 mm Non-Locking Cortical Screw
3.5 x 18.0 mm Non-Locking Cortical Screw
3.5 x 20.0 mm Non-Locking Cortical Screw
3.5 x 22.0 mm Non-Locking Cortical Screw
3.5 x 24.0 mm Non-Locking Cortical Screw
3.5 x 26.0 mm Non-Locking Cortical Screw
3.5 x 28.0 mm Non-Locking Cortical Screw
3.5 x 30.0 mm Non-Locking Cortical Screw
3.5 x 32.0 mm Non-Locking Cortical Screw
3.5 x 34.0 mm Non-Locking Cortical Screw
3.5 x 36.0 mm Non-Locking Cortical Screw
3.5 x 38.0 mm Non-Locking Cortical Screw
3.5 x 40.0 mm Non-Locking Cortical Screw
3.5 x 42.0 mm Non-Locking Cortical Screw
3.5 x 44.0 mm Non-Locking Cortical Screw
3.5 x 46.0 mm Non-Locking Cortical Screw
3.5 x 48.0 mm Non-Locking Cortical Screw
3.5 x 50.0 mm Non-Locking Cortical Screw
3.5 x 55.0 mm Non-Locking Cortical Screw
3.5 x 60.0 mm Non-Locking Cortical Screw
3.5 x 65.0 mm Non-Locking Cortical Screw
3.5 x 70.0 mm Non-Locking Cortical Screw
35
Screws
Ordering Information
Low-Profile Cortical Screw
Non-Sterile Sterile
1312-18-010
1312-18-012
1312-18-014
1312-18-016
1312-18-018
1312-18-020
1312-18-022
1312-18-024
1312-18-026
1312-18-028
1312-18-030
1312-18-032
1312-18-034
1312-18-036
1312-18-038
1312-18-040
1312-18-042
1312-18-044
1312-18-046
1312-18-048
1312-18-050
8512-35-010
8512-35-012
8512-35-014
8512-35-016
8512-35-018
8512-35-020
8512-35-022
8512-35-024
8512-35-026
8512-35-028
8512-35-030
8512-35-032
8512-35-034
8512-35-036
8512-35-038
8512-35-040
8512-35-042
8512-35-044
8512-35-046
8512-35-048
8512-35-050
Description
3.5 x 10.0 mm Low-Profile Cortical Screw
3.5 x 12.0 mm Low-Profile Cortical Screw
3.5 x 14.0 mm Low-Profile Cortical Screw
3.5 x 16.0 mm Low-Profile Cortical Screw
3.5 x 18.0 mm Low-Profile Cortical Screw
3.5 x 20.0 mm Low-Profile Cortical Screw
3.5 x 22.0 mm Low-Profile Cortical Screw
3.5 x 24.0 mm Low-Profile Cortical Screw
3.5 x 26.0 mm Low-Profile Cortical Screw
3.5 x 28.0 mm Low-Profile Cortical Screw
3.5 x 30.0 mm Low-Profile Cortical Screw
3.5 x 32.0 mm Low-Profile Cortical Screw
3.5 x 34.0 mm Low-Profile Cortical Screw
3.5 x 36.0 mm Low-Profile Cortical Screw
3.5 x 38.0 mm Low-Profile Cortical Screw
3.5 x 40.0 mm Low-Profile Cortical Screw
3.5 x 42.0 mm Low-Profile Cortical Screw
3.5 x 44.0 mm Low-Profile Cortical Screw
3.5 x 46.0 mm Low-Profile Cortical Screw
3.5 x 48.0 mm Low-Profile Cortical Screw
3.5 x 50.0 mm Low-Profile Cortical Screw
36
Screws
Ordering Information
Locking Cortical Screw
Non-Sterile Sterile
8161-35-010
8161-35-012
8161-35-014
8161-35-016
8161-35-018
8161-35-020
8161-35-022
8161-35-024
8161-35-026
8161-35-028
8161-35-030
8161-35-032
8161-35-034
8161-35-036
8161-35-038
8161-35-040
8161-35-042
8161-35-044
8161-35-046
8161-35-048
8161-35-050
8161-35-052
8161-35-054
8161-35-056
8161-35-058
8161-35-060
8161-35-065
8161-35-070
8561-35-010
8561-35-012
8561-35-014
8561-35-016
8561-35-018
8561-35-020
8561-35-022
8561-35-024
8561-35-026
8561-35-028
8561-35-030
8561-35-032
8561-35-034
8561-35-036
8561-35-038
8561-35-040
8561-35-042
8561-35-044
8561-35-046
8561-35-048
8561-35-050
8561-35-052
8561-35-054
8561-35-056
8561-35-058
8561-35-060
8561-35-065
8561-35-070
Description
3.5 x 10.0 mm Locking Cortical Screw
3.5 x 12.0 mm Locking Cortical Screw
3.5 x 14.0 mm Locking Cortical Screw
3.5 x 16.0 mm Locking Cortical Screw
3.5 x 18.0 mm Locking Cortical Screw
3.5 x 20.0 mm Locking Cortical Screw
3.5 x 22.0 mm Locking Cortical Screw
3.5 x 24.0 mm Locking Cortical Screw
3.5 x 26.0 mm Locking Cortical Screw
3.5 x 28.0 mm Locking Cortical Screw
3.5 x 30.0 mm Locking Cortical Screw
3.5 x 32.0 mm Locking Cortical Screw
3.5 x 34.0 mm Locking Cortical Screw
3.5 x 36.0 mm Locking Cortical Screw
3.5 x 38.0 mm Locking Cortical Screw
3.5 x 40.0 mm Locking Cortical Screw
3.5 x 42.0 mm Locking Cortical Screw
3.5 x 44.0 mm Locking Cortical Screw
3.5 x 46.0 mm Locking Cortical Screw
3.5 x 48.0 mm Locking Cortical Screw
3.5 x 50.0 mm Locking Cortical Screw
3.5 x 52.0 mm Locking Cortical Screw
3.5 x 54.0 mm Locking Cortical Screw
3.5 x 56.0 mm Locking Cortical Screw
3.5 x 58.0 mm Locking Cortical Screw
3.5 x 60.0 mm Locking Cortical Screw
3.5 x 65.0 mm Locking Cortical Screw
3.5 x 70.0 mm Locking Cortical Screw
37
Screws
Ordering Information
Non-Locking Cancellous Screw
Non-Sterile Sterile
8153-41-010
8153-41-012
8153-41-014
8153-41-016
8153-41-018
8153-41-020
8153-41-022
8153-41-024
8153-41-026
8153-41-028
8153-41-030
8153-41-032
8153-41-034
8153-41-036
8153-41-038
8153-41-040
8153-41-042
8153-41-044
8153-41-046
8153-41-048
8153-41-050
8153-41-055
8153-41-060
8153-41-065
8153-41-070
8553-40-010
8553-40-012
8553-40-014
8553-40-016
8553-40-018
8553-40-020
8553-40-022
8553-40-024
8553-40-026
8553-40-028
8553-40-030
8553-40-032
8553-40-034
8553-40-036
8553-40-038
8553-40-040
8553-40-042
8553-40-044
8553-40-046
8553-40-048
8553-40-050
8553-40-055
8553-40-060
8553-40-065
8553-40-070
Description
4.0 x 10.0 Non-Locking Cancellous Screw
4.0 x 12.0 Non-Locking Cancellous Screw
4.0 x 14.0 Non-Locking Cancellous Screw
4.0 x 16.0 Non-Locking Cancellous Screw
4.0 x 18.0 Non-Locking Cancellous Screw
4.0 x 20.0 Non-Locking Cancellous Screw
4.0 x 22.0 Non-Locking Cancellous Screw
4.0 x 24.0 Non-Locking Cancellous Screw
4.0 x 26.0 Non-Locking Cancellous Screw
4.0 x 28.0 Non-Locking Cancellous Screw
4.0 x 30.0 Non-Locking Cancellous Screw
4.0 x 32.0 Non-Locking Cancellous Screw
4.0 x 34.0 Non-Locking Cancellous Screw
4.0 x 36.0 Non-Locking Cancellous Screw
4.0 x 38.0 Non-Locking Cancellous Screw
4.0 x 40.0 Non-Locking Cancellous Screw
4.0 x 42.0 Non-Locking Cancellous Screw
4.0 x 44.0 Non-Locking Cancellous Screw
4.0 x 46.0 Non-Locking Cancellous Screw
4.0 x 48.0 Non-Locking Cancellous Screw
4.0 x 50.0 Non-Locking Cancellous Screw
4.0 x 55.0 Non-Locking Cancellous Screw
4.0 x 60.0 Non-Locking Cancellous Screw
4.0 x 65.0 Non-Locking Cancellous Screw
4.0 x 70.0 Non-Locking Cancellous Screw
38
Screws
Ordering Information
Locking Cancellous Screw
Non-Sterile Sterile
8161-40-010
8161-40-012
8161-40-014
8161-40-016
8161-40-018
8161-40-020
8161-40-022
8161-40-024
8161-40-026
8161-40-028
8161-40-030
8161-40-032
8161-40-034
8161-40-036
8161-40-038
8161-40-040
8161-40-042
8161-40-044
8161-40-046
8161-40-048
8161-40-050
8161-40-055
8161-40-060
8161-40-065
8161-40-070
8561-40-010
8561-40-012
8561-40-014
8561-40-016
8561-40-018
8561-40-020
8561-40-022
8561-40-024
8561-40-026
8561-40-028
8561-40-030
8561-40-032
8561-40-034
8561-40-036
8561-40-038
8561-40-040
8561-40-042
8561-40-044
8561-40-046
8561-40-048
8561-40-050
8561-40-055
8561-40-060
8561-40-065
8561-40-070
Description
4.0 x 10.0 mm Locking Cancellous Screw
4.0 x 12.0 mm Locking Cancellous Screw
4.0 x 14.0 mm Locking Cancellous Screw
4.0 x 16.0 mm Locking Cancellous Screw
4.0 x 18.0 mm Locking Cancellous Screw
4.0 x 20.0 mm Locking Cancellous Screw
4.0 x 22.0 mm Locking Cancellous Screw
4.0 x 24.0 mm Locking Cancellous Screw
4.0 x 26.0 mm Locking Cancellous Screw
4.0 x 28.0 mm Locking Cancellous Screw
4.0 x 30.0 mm Locking Cancellous Screw
4.0 x 32.0 mm Locking Cancellous Screw
4.0 x 34.0 mm Locking Cancellous Screw
4.0 x 36.0 mm Locking Cancellous Screw
4.0 x 38.0 mm Locking Cancellous Screw
4.0 x 40.0 mm Locking Cancellous Screw
4.0 x 42.0 mm Locking Cancellous Screw
4.0 x 44.0 mm Locking Cancellous Screw
4.0 x 46.0 mm Locking Cancellous Screw
4.0 x 48.0 mm Locking Cancellous Screw
4.0 x 50.0 mm Locking Cancellous Screw
4.0 x 55.0 mm Locking Cancellous Screw
4.0 x 60.0 mm Locking Cancellous Screw
4.0 x 65.0 mm Locking Cancellous Screw
4.0 x 70.0 mm Locking Cancellous Screw
39
Screws
Ordering Information
8155-40-020
8155-40-022
8155-40-024
8155-40-026
8155-40-028
8155-40-030
8155-40-035
8155-40-040
8155-40-045
8155-40-050
8155-40-055
8155-40-060
8155-40-065
8155-40-070
8155-40-075
8155-40-080
8155-40-085
8155-40-090
8155-40-095
8155-40-100
Cancellous Lag Screw
Non-Sterile
8155-40-014
8155-40-016
8155-40-018
Sterile
8555-40-014
8555-40-016
8555-40-018
8555-40-020
8555-40-022
8555-40-024
8555-40-026
8555-40-028
8555-40-030
8555-40-035
8555-40-040
8555-40-045
8555-40-050
8555-40-055
8555-40-060
8555-40-065
8555-40-070
8555-40-075
8555-40-080
8555-40-085
8555-40-090
8555-40-095
8555-40-100
Description
4.0 x 14.0 mm Cancellous Lag Screw
4.0 x 16.0 mm Cancellous Lag Screw
4.0 x 18.0 mm Cancellous Lag Screw
4.0 x 20.0 mm Cancellous Lag Screw
4.0 x 22.0 mm Cancellous Lag Screw
4.0 x 24.0 mm Cancellous Lag Screw
4.0 x 26.0 mm Cancellous Lag Screw
4.0 x 28.0 mm Cancellous Lag Screw
4.0 x 30.0 mm Cancellous Lag Screw
4.0 x 35.0 mm Cancellous Lag Screw
4.0 x 40.0 mm Cancellous Lag Screw
4.0 x 45.0 mm Cancellous Lag Screw
4.0 x 50.0 mm Cancellous Lag Screw
4.0 x 55.0 mm Cancellous Lag Screw
4.0 x 60.0 mm Cancellous Lag Screw
4.0 x 65.0 mm Cancellous Lag Screw
4.0 x 70.0 mm Cancellous Lag Screw
4.0 x 75.0 mm Cancellous Lag Screw
4.0 x 80.0 mm Cancellous Lag Screw
4.0 x 85.0 mm Cancellous Lag Screw
4.0 x 90.0 mm Cancellous Lag Screw
4.0 x 95.0 mm Cancellous Lag Screw
4.0 x 100.0 mm Cancellous Lag Screw
40
Screws
Ordering Information
Cannulated Cancellous Lag Screw
Non-Sterile Sterile
1437610 8514-40-010
1437612
1437614
8514-40-012
8514-40-014
1437616
1437618
1437620
1437622
1437624
1437626
1437628
1437630
1437632
1437634
1437636
1437638
1437640
1437642
1437644
1437646
1437648
1437650
1437655
1437660
1437665
1437670
8514-40-016
8514-40-018
8514-40-020
8514-40-022
8514-40-024
8514-40-026
8514-40-028
8514-40-030
8514-40-032
8514-40-034
8514-40-036
8514-40-038
8514-40-040
8514-40-042
8514-40-044
8514-40-046
8514-40-048
8514-40-050
8514-40-055
8514-40-060
8514-40-065
8514-40-070
Description
4.0 x 10.0 mm Cannulated Cancellous Lag Screw
4.0 x 12.0 mm Cannulated Cancellous Lag Screw
4.0 x 14.0 mm Cannulated Cancellous Lag Screw
4.0 x 16.0 mm Cannulated Cancellous Lag Screw
4.0 x 18.0 mm Cannulated Cancellous Lag Screw
4.0 x 20.0 mm Cannulated Cancellous Lag Screw
4.0 x 22.0 mm Cannulated Cancellous Lag Screw
4.0 x 24.0 mm Cannulated Cancellous Lag Screw
4.0 x 26.0 mm Cannulated Cancellous Lag Screw
4.0 x 28.0 mm Cannulated Cancellous Lag Screw
4.0 x 30.0 mm Cannulated Cancellous Lag Screw
4.0 x 32.0 mm Cannulated Cancellous Lag Screw
4.0 x 34.0 mm Cannulated Cancellous Lag Screw
4.0 x 36.0 mm Cannulated Cancellous Lag Screw
4.0 x 38.0 mm Cannulated Cancellous Lag Screw
4.0 x 40.0 mm Cannulated Cancellous Lag Screw
4.0 x 42.0 mm Cannulated Cancellous Lag Screw
4.0 x 44.0 mm Cannulated Cancellous Lag Screw
4.0 x 46.0 mm Cannulated Cancellous Lag Screw
4.0 x 48.0 mm Cannulated Cancellous Lag Screw
4.0 x 50.0 mm Cannulated Cancellous Lag Screw
4.0 x 55.0 mm Cannulated Cancellous Lag Screw
4.0 x 60.0 mm Cannulated Cancellous Lag Screw
4.0 x 65.0 mm Cannulated Cancellous Lag Screw
4.0 x 70.0 mm Cannulated Cancellous Lag Screw
41
Screws
Ordering Information
Multi-Directional Locking Screw
Non-Sterile
8163-35-010
Sterile
8563-35-010
8163-35-012
8163-35-014
8163-35-016
8163-35-018
8163-35-020
8163-35-022
8163-35-024
8163-35-026
8163-35-028
8163-35-030
8163-35-032
8163-35-034
8163-35-036
8163-35-038
8163-35-040
8163-35-042
8163-35-044
8163-35-046
8163-35-048
8163-35-050
8163-35-052
8163-35-054
8163-35-056
8163-35-058
8163-35-060
8563-35-012
8563-35-014
8563-35-016
8563-35-018
8563-35-020
8563-35-022
8563-35-024
8563-35-026
8563-35-028
8563-35-030
8563-35-032
8563-35-034
8563-35-036
8563-35-038
8563-35-040
8563-35-042
8563-35-044
8563-35-046
8563-35-048
8563-35-050
8563-35-052
8563-35-054
8563-35-056
8563-35-058
8563-35-060
Description
3.5 x 10.0 mm Multi-Directional Locking Screw
3.5 x 12.0 mm Multi-Directional Locking Screw
3.5 x 14.0 mm Multi-Directional Locking Screw
3.5 x 16.0 mm Multi-Directional Locking Screw
3.5 x 18.0 mm Multi-Directional Locking Screw
3.5 x 20.0 mm Multi-Directional Locking Screw
3.5 x 22.0 mm Multi-Directional Locking Screw
3.5 x 24.0 mm Multi-Directional Locking Screw
3.5 x 26.0 mm Multi-Directional Locking Screw
3.5 x 28.0 mm Multi-Directional Locking Screw
3.5 x 30.0 mm Multi-Directional Locking Screw
3.5 x 32.0 mm Multi-Directional Locking Screw
3.5 x 34.0 mm Multi-Directional Locking Screw
3.5 x 36.0 mm Multi-Directional Locking Screw
3.5 x 38.0 mm Multi-Directional Locking Screw
3.5 x 40.0 mm Multi-Directional Locking Screw
3.5 x 42.0 mm Multi-Directional Locking Screw
3.5 x 44.0 mm Multi-Directional Locking Screw
3.5 x 46.0 mm Multi-Directional Locking Screw
3.5 x 48.0 mm Multi-Directional Locking Screw
3.5 x 50.0 mm Multi-Directional Locking Screw
3.5 x 52.0 mm Multi-Directional Locking Screw
3.5 x 54.0 mm Multi-Directional Locking Screw
3.5 x 56.0 mm Multi-Directional Locking Screw
3.5 x 58.0 mm Multi-Directional Locking Screw
3.5 x 60.0 mm Multi-Directional Locking Screw
42
Indications for Use:
The Medial Locking Plate is indicated for:
· Pilon Fractures: distal tibial intra-articular fractures.
· High medial malleolar fractures.
· Low boot type rotational distal extra-articular shaft fractures.
while the Anterolateral Locking Plate is indicated for:
· Distal intra-articular tibia fractures.
· Proximal tibia fractures.
· Proximal and distal humerus fractures.
Contraindications:
Contraindications (orthopaedic screws, intramedullary nails, plates, compression hip screws, pins and wires):
· Cases where there is an active infection.
· Conditions which tend to retard healing such as, blood supply limitations, previous infections, etc.
· Insufficient quantity or quality of bone to permit stabilization of the fracture.
· Conditions that restrict the patient’s ability or willingness to follow postoperative instructions during the healing process.
· Foreign body sensitivity – where material sensitivity is suspected, appropriate tests should be made and sensitivity ruled out prior to implantations.
· Cases where the implant(s) would cross open epiphyseal plates in skeletally immature patients.
Additional Contraindications – Orthopaedic Screws and Plates Only:
Cases with malignant primary or metastatic tumors which preclude adequate bone support or screw fixations, unless supplemental fixation or stabilization methods are utilized.
This material is intended for healthcare professionals and the Zimmer
Biomet sales force. Distribution to any other recipient is prohibited.
For indications, contraindications, warnings, precautions, potential adverse effects and patient counseling information, see the package insert or contact your local representative; visit www.zimmerbiomet.
com for additional product information. All content herein is protected by copyright, trademarks and other intellectual property rights, as applicable, owned by or licensed to Zimmer Biomet or its affiliates unless otherwise indicated, and must not be redistributed, duplicated or disclosed, in whole or in part, without the express written consent of
Zimmer Biomet.
Check for country product clearances and reference product specific instructions for use. Zimmer Biomet does not practice medicine. This technique was developed in conjunction with health care professional.
This document is intended for surgeons and is not intended for laypersons. Each surgeon should exercise his or her own independent judgment in the diagnosis and treatment of an individual patient, and this information does not purport to replace the comprehensive training surgeons have received. As with all surgical procedures, the technique used in each case will depend on the surgeon’s medical judgment as the best treatment for each patient. Results will vary based on health, weight, activity and other variables. Not all patients are candidates for this product and/or procedure. Caution: Federal (USA) law restricts this device to sale by or on the order of a surgeon. Rx only.
CE Mark on the surgical technique is not valid unless there is a CE Mark on the product (description) label.
©2019, 2021 Zimmer Biomet
BMET0030.2-GBL Issue Date 2021-12-27
Legal Manufacturer
Biomet Trauma
56 East Bell Drive
P.O. Box 587
Warsaw, Indiana 46581
USA www.zimmerbiomet.com
2797
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