VariAx FibulaLocking Plate System

• Distal Fibula Fracture Repair

• Polyaxial Locking Technology

• Low Profile Design

Operative Technique

Foot and Ankle

Fibu

la F

ract

ures

Contributing SurgeonBradley R. Merk, MD Associate Professor of Orthopaedic Surgery Director of Orthopaedic Trauma Feinberg School of Medicine Northwestern University Chicago, USA

John Early, MD Clinical Professor of Orthopaedic Surgery,University of Texas South Western Medical Centre,Dallas, USA

VariAx Fibula Locking Plate System

This publication sets forth detailed recommended procedures for using Stryker Osteosynthesis devices and instruments.It offers guidance that you should heed, but, as with any such technical guide, each surgeon must consider the particular needs of each patient and make appropriate adjustments when and as required.

A workshop training is recommended prior to first surgery.

All non-sterile devices must be cleaned and sterilized before use. Follow the appropriate Instructions for use (IFU). For additional information please refer to the instructions in our reprocessing guide (L24002000). Multi-component instruments must be disassembled for cleaning. Please refer to the corresponding assembly/disassembly instructions.

See package insert for a complete list of potential adverse effects, contraindications, warnings and precautions. The surgeon must discuss all relevant risks, including the finite lifetime of the device, with the patient, when necessary.

Warning: Fixation Screws:Stryker Osteosynthesis bone screws are not approved or intended for screw attachment or fixation to the posterior elements (pedicles) of the cervical, thoracic or lumbar spine.

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Page

1. Introduction 4

2. Features & Benefits 5

3. Overview 6

Plate Options 6

Screw Options 6

4. Indications, Precautions & Contraindications 7

Indications 7

Warnings & Precautions 7

Contraindications 7

5. Operative Technique 8

Planning and Preparation 8

Lateral Plate Positioning 9

Posterior Lateral Plate Placement 9

Preparation for Screw Insertion 10

Screw Insertion 13

Final Steps 13

Optional: Independent Lag Screw Technique 14

Optional: Syndesmotic Screw Fixation Technique 16

Ordering Information - Implants 17

Ordering Information - Instruments 20

Ordering Information - Cases & Trays 23

Table of Contents

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• The VariAx Fibula Locking Plate System represents a new generation of implant technology The reconstruction and fixation of distal fibular fractures can now be enhanced by means of the SmartLock polyaxial locking mechanism. This powerful feature allows a surgeon to insert polyaxial locking or non-locking screws at variable angles with respect to the plate, so that they can be targeted to address the location and geometry of any given fracture, without the constraint of existing monoaxial plate designs or screw trajectories.

• Polyaxial Locking Technology Each screw is made of a harder

titanium alloy than the plates. When a locking screw is used, the thread in the head of the screw re-shapes the titanium used in the plate, thus allowing for a secure form-fitting geometry. This process is designed to result in a solid, locked connection between the head of the screw and the plate.

• One-Step Locking Achieved by simply inserting a

locking screw within the polyaxial locking range of ±15°, without the need for further steps.

• Modular System Design The modular instrumentation system

is designed for seamless integration of other products from the Stryker Foot portfolio.

• Color-Coding of Instruments The instruments are color-coded to

facilitate ease-of-use during surgery.

The SmartLock Locking Technology is patented (US 6,322,562; DE 43 43 117; EP 1 143 867) by Professor Dietmar Wolter, Hamburg, Germany.

Introduction

-15° +15°

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• Pre-contoured Periarticular Plate Design The pre-contoured shape of the VariAx Lateral Fibula Plates was carefully designed using a comprehensive CT scan database of human fibulas. The end result is a pre-contoured plate that closely matches the average anatomical shape of the distal fibula, and thus requires minimal intra-operative plate contouring*.

• Low Profile Plate Design and Reduced Screw Head Prominence Each plate is designed to have a low profile design. The lateral plates are only 1.3mm distally, while the shaft and straight plates are 2.0mm in profile. Furthermore, the screws are designed to have minimal head prominence when fully inserted in a plate.

• K-Wire Holes in the Plate To allow for temporary fixation in order to ease plate application.

• A Clustering of Distal Screws on the Lateral PlateAllows for multiple points of fixation to treat comminuted fractures or fractures with limited distal bone stock.

• Full-Range of 3.5mm Locking and Non-Locking Screws

Offers intra-operative solutions to cover a broad range of clinical situations.

• Polyaxial Drill Guide Allows placement of locking screws at a variable angle (up to ± 15°).

• T10 Screw Head Design All 3.5mm VariAx Fibula Locking Plate screws are designed with a T10 head.

• Optional Independent Lag Screw Fixation A full range of non-locking VariAx screws are available for placement of independent lag screws.

Features & Benefits

* MEM Research Center ISTB Fibula Bone Implant Fitting Project.

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Plate Options

The fibula plate only accepts 3.5mm screws

Overview

3.5mmLocking

3.5mmNon-

Locking

Lateral Plate

Range 3 Holes - 12 HolesLength 77mm - 185mm

Straight Plate Range 2 Holes - 16 HolesLength 28.5 - 204 mm

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Screw Options

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Indications, Precautions & Contraindications

Fig. 1 Lateral fibula plate

Fig. 2 Straight plate positioned posterior lateral

The VariAx Fibula Locking Plate System is intended for use in internal fixation of the distal fibula.

IndicationsSee package insert for warnings, precautions, adverse effects and other essential product information.

The VariAx system has not been evaluated for safety and use in MR environment and has not been tested for heating or migration in the MR environment, unless specified otherwise in the product labeling.

Warnings & Precautions

ContraindicationsThe following contraindications may be of a relative or absolute nature, and must be taken into account by the attending surgeon:

• Inadequate bone quantity and quality.

• Patients with active infections.• Patients with metal allergies and foreign body sensitivity.• Severely non-compliant patients with mental or neurological conditions who are unwilling or incapable of following post-operative care instructions.• Patients with limited blood supply or insufficient quality or quantity of bone.• Patients with unstable physical and/ or mental health conditions.• Obesity. An overweight or obese patient can produce loads on the implant that can lead to failure of the fixation of the device or to failure of the device itself.• Patients having inadequate tissue coverage over the operative site.• Bone stock compromised by disease, infection or prior implantation that can not provide adequate support and/or fixation of the devices.• Other medical or surgical conditions which would preclude the potential benefit of surgery.

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Planning and Preparation

The Operative Technique listed below is designed to provide a general overview on the instruments and procedure required to implant a VariAx Fibula Plate.

Clear identification and classification of the fracture site should first be established pre-operatively using the appropriate methods and visualization.A lateral incision is typically used to perform an extra-periosteal exposure of the distal fibula. A direct reduction and provisional fixation of the fracture can frequently be achieved. If the fracture morphology is amenable, an independent lag screw can be inserted first (see page 14). Alternatively, indirect reduction techniques may be employed such as a distal fibula plate.

Although the lateral plates are pre-contoured, additional contouring of both the lateral and straight plates is possible using the Plate Bending Pliers (45-80010) when required based on local patient factors or anatomy. In order to reduce the likelihood of a stress riser effect and avoid reducing the fatigue properties of the implant, care should be taken to bend the plate in between holes. Always attach the bending pliers to two adjacent holes to prevent deformation of the screw holes.

Note: • Excessive plate bending may

lead to failure of the locking mechanism and should be avoided. Do not re-bend plates.

• If the oblong hole in the VariAx Straight Plate is deformed, there is potential for a screw to pass through the hole upon insertion.

Operative Technique

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Having achieved reduction, the plate is selected and applied to the direct lateral surface of the distal fibula. The position should be adjusted to optimize fit and to allow for optimal screw fixation as per the fracture pattern and the pre-operative plan.Fluoroscopy can be utilized as needed to confirm position. The plate can then be stabilized by the insertion of K-Wires to ensure anatomical alignment (proximally and distally).

The VariAx straight plate may be applied laterally (as described) or posterior laterally, as an antiglide plate to resist proximal migration and rotation of the distal fragment.

To place the plate in a posterior lateral position, an incision more posterior to the fibula may be made. Individual patient anatomy should be assessed, as some bending of the straight plate may be required. Bending of the plate can be achieved using the Bending Pliers (45-80010) as illustrated on page 8.

The elongated oblong hole is designed to assist in allowing flexibility with plate placement. A non-locking screw can be initially placed through the hole, allowing for some stability until the ideal plate placement is determined. This hole will not accept a locking screw. As such, the locking Drill Guide (45-80001) will not engage into the plate (it will sit on top of the hole).

Operative Technique

Lateral Plate Positioning

Posterior Lateral Plate Placement

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A drill guide must first be placed into a corresponding plate screw hole (in a plate), prior to pre-drilling a pilot hole. The Drill Guide for Circular Locking Holes (45-80001) must be used in all VariAx Fibula Plate holes. Use the end of the drill guide indicated with yellow color-coded lines to pre-drill for VariAx Fibula plating procedures. Yellow color-coding is associated with 3.5mm VariAx Foot and Ankle screws.

Note: The other end of the drill guide is indicated with black color- coded lines, and is designed for use with VariAx Foot and Ankle Plates that accept 2.7mm screws. This end of the drill guide must not be used for VariAx Fibula procedures.

The drill guide is designed to limit drilling to a ±15° angle with respect to the plate. Drilling at an angle greater than ±15° may prevent locking from taking place, and should be avoided.Always use the drill guide when pre-drilling a pilot hole, either for a locking or non-locking 3.5mm screw.

VariAx Fibula Plates include K-Wireholes that are designed to accommodate 1.4mm Trocar Tipped K-Wires (45-80200), for use in temporarily stabilizing the plate to bone.

The K-Wire Cutting Pliers (45-80020) can be used to cut the K-Wires to the desired length. This instrument includes a silicon inlay which prevents the cut end of a K-Wire from being ejected from the instrument.

Preparation for Screw Insertion

Operative Technique

Note:Drill guides should always fit securely within a screw hole – a mis-match between the drill guide and the plate hole indicates that the wrong dimension drill guide has been chosen.

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Use the drill to create a pilot hole through the drill guide. The 2.6mm Twist Drill (45-35010) is color-coded yellow to match the color associated with the 3.5mm drill guide (double yellow).Although the locking and non-locking screws found in the VariAx Foot and Ankle system are self-tapping, when encountering hard bone a tap may be required. For 3.5mm screws the appropriate tap is similarly color-coded yellow (45-35005).

Measure the depth of the pre-drilled hole using the Depth Gauge for 3.5mm screws (45-35002). Always measure the depth of the pre-drilled hole by inserting the depth gauge first through the plate, and then into the pre-drilled hole.

Use depth gauge to attain appropriate screw length. The sleeve of the depth gauge must be fully inserted into therespective plate hole prior to measuring. Measuring without a plate will result in a false reading.

Operative Technique

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Assemble the appropriate Screwdriver Blade (with AO fitting) with the Screwdriver Handle, Revolving/Rigid, AO (45-85000).

Note: The yellow color-coded Screwdriver Blade, AO, T10(45-35015) or Self Retaining Screwdriver Blade, AO, T10(703667) can be used to insert 3.5mm screws.

Begin by pushing the AO quick-connect sleeve towards the body of the Screwdriver Handle, insert the screwdriver blade into the AO quick-connect coupling, and then release the sleeve.

Operative Technique

Push the holding sleeve back so that the tip of the screwdriver becomes visible. Engage the screwdriver tip with the head of the chosen screw, then push the holding sleeve forward, as shown. The holding sleeve will engage with the head of the screw, firmly holding it in place. The screw can then be removed securely from the screw rack, and the screw can be inserted into the plate.

Holding sleeves for screws can be used to securely attach a screw to the yellow color-coded Screwdriver Blade (45-35015) during screw insertion. The yellow color-coded Holding Sleeve for 3.5mm screws (45-35030), must be used. Assemble the appropriate holding sleeve and slide it over the screwdriver until it engages, as shown.

Note: The Self Retaining Screwdriver

Blade (703667) does not require a screw holding sleeve.

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Screw InsertionInsert the screw into the pre-drilled hole using the screwdriver assembly.

As the screw head approaches the plate, draw the holding sleeve back from the screw head, and continue with final tightening then remove the screwdriver from the screw.

Repeat drilling, measuring, and placement of locking or non-locking screws in the remaining holes, as required. Always remember to use the appropriate sized drill guide.

Operative Technique

Final StepsIntra-operative fluoroscopy is performed to confirm appropriate reduction and implant placement.

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Optional: Independent Lag Screw Technique

Operative Technique

A 3.5mm VariAx Foot and Ankle Non-Locking Screw can be used as an independent lag screw to reduce fibula fractures, prior to fixation using a VariAx Fibula plate. The VariAx Foot and Ankle instrumentation system includes a Drill Guide for a 3.5mm Independent Lag Screw (45-80003), which is designed to only be used when drilling and overdrilling a hole for independent lag screw fixation using a 3.5mm screw. This technique must not be performed through a plate due to the locking mechanism.

The procedure for preparing a hole for independent lag screw insertion is as follows:

1. Anatomic reduction is achieved and maintained with a pointed reduction clamp.

2. Identify the appropriate drill guide. For 3.5mm screws, use the Drill Guide for 3.5mm Independent Lag Screws (45-80003). This drill guide has two sides/sleeves. Identify the side labeled “Near Fragment”, which is color-coded red and yellow.

3. The correct overdrill is directly placed against bone for drilling the near fragment. For 3.5mm screws, use the overdrill that is color-coded with a red and yellow line. (45-35020).

4. The red and yellow color-coded drill bit is then inserted through the identical red and yellow drill guide, and drilling is performed completely through the near fragment to create a gliding hole. This drilling must completely pass through the near fragment, and into the interfragmentary space, otherwise lagging of the far fragment will not be possible.

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5. The other side of the drill guide, which is yellow color-coded, is then fully inserted into the newly created gliding hole. This drill guide must be inserted as deep as possible into the overdrilled hole. Drilling is performed using the yellow color-coded 2.6mm drill (45-35010), into the far fragment. The end result of the drilling process will be a co-linear hole through the near fragment, and into the far fragment, where the diameter of the hole in the near fragment will be bigger than the diameter of the hole in the far fragment (thus allowing for lagging).

6. When appropriate, use the countersink (45-80040) to minimize screw head prominence and reduce stress riser effects to the bone during final screw tightening.

7. Screw length is then measured using the Depth Gauge for 3.5mm screws (45-35002).

8. The screw can then be inserted. A washer (40-35900) could also be used if necessary due to bone quality. If a washer is intended to be used the countersink should not be applied before.

Operative Technique

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Operative Technique

Optional: Syndesmotic Screw Fixation Technique• After completion of all fixation,

an intra-operative Cotton test or external rotation stress test is performed under fluoroscopy to assess syndesmotic stability. Fixation is perfomed as needed.

- A stab incision is made medially near the metaphysis.

- A large peri-articular clamp is used to obtain and maintain an anatomic syndesmotic reduction which should be confirmed fluoroscopically on the A/P, mortise, lateral view by inspection or palpation via the surgical exposure. Using the drill guide the 2.6mm yellow color-coded drill bit is used to make a pilot hole parallel to the tibio-talar articulation and the trans-malleolar axis. Care must be taken to avoid excessive angulation through the plate beyond 15°.

- An angulation beyond 15° may cause the screw head to pass through the plate hole.

• One or two tri-cortical or tetra-cortical 3.5mm non-locking screws can be used to achieve syndesmotic fixation based on patient factors, injury factors, and surgeon preference.

For Bi Malleolar Fractures

Asnis III

4mm 5mm

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Ordering Information – Implants

PLATES

* Please add “S” to the article number (REF) for sterile packed product.

Length REF Description mm

VariAx Fibula Lateral Plates

40-20903 VariAx Fibula Plate, 3 holes 77

40-20904 VariAx Fibula Plate, 4 holes 89

40-20905 VariAx Fibula Plate, 5 holes 101

40-20906 VariAx Fibula Plate, 6 holes 113

40-20907 VariAx Fibula Plate, 7 holes 125

40-20908 VariAx Fibula Plate, 8 holes 137

40-20909 VariAx Fibula Plate, 9 holes 149

40-20910S VariAx Fibula Plate, 10 holes 161

40-20912S VariAx Fibula Plate, 12 holes 185

VariAx Fibula Straight Plates*

40-20802 VariAx Fibula Straight Plates, 2 holes 28.5

40-20803 VariAx Fibula Straight Plates, 3 holes 40.5

40-20804 VariAx Fibula Straight Plates, 4 holes 60

40-20805 VariAx Fibula Straight Plates, 5 holes 72

40-20806 VariAx Fibula Straight Plates, 6 holes 84

40-20807 VariAx Fibula Straight Plates, 7 holes 96

40-20808 VariAx Fibula Straight Plates, 8 holes 108

40-20810 VariAx Fibula Straight Plates, 10 holes 132

40-20812 VariAx Fibula Straight Plates, 12 holes 156

40-20814 VariAx Fibula Straight Plates, 14 holes 180

40-20816 VariAx Fibula Straight Plates, 16 holes 204

Plate specification for Lateral Fibula Plate

Thickness Shaft 2.0 mmDistal End 1.3 mmWidth Shaft 10 mmWidth Distal End 16 mm

Plate specification for Straight Plate

Thickness Shaft 2.0 mm

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Ordering Information – Implants

3.5MM LOCKING SCREWS REF Description Description

40-35610 Locking Screw, T10, 3.5 × 10mm 40-35612 Locking Screw, T10, 3.5 × 12mm 40-35614 Locking Screw, T10, 3.5 × 14mm 40-35616 Locking Screw, T10, 3.5 × 16mm 40-35618 Locking Screw, T10, 3.5 × 18mm 40-35620 Locking Screw, T10, 3.5 × 20mm 40-35622 Locking Screw, T10, 3.5 × 22mm 40-35624 Locking Screw, T10, 3.5 × 24mm 40-35626 Locking Screw, T10, 3.5 × 26mm 40-35628 Locking Screw, T10, 3.5 × 28mm 40-35630 Locking Screw, T10, 3.5 × 30mm 40-35632 Locking Screw, T10, 3.5 × 32mm 40-35634 Locking Screw, T10, 3.5 × 34mm 40-35636 Locking Screw, T10, 3.5 × 36mm 40-35638 Locking Screw, T10, 3.5 × 38mm 40-35640 Locking Screw, T10, 3.5 × 40mm 40-35642 Locking Screw, T10, 3.5 × 42mm 40-35644 Locking Screw, T10, 3.5 × 44mm 40-35646 Locking Screw, T10, 3.5 × 46mm 40-35648 Locking Screw, T10, 3.5 × 48mm 40-35650 Locking Screw, T10, 3.5 × 50mm 40-35655 Locking Screw, T10, 3.5 × 55mm 40-35660 Locking Screw, T10, 3.5 × 60mm 40-35665 Locking Screw, T10, 3.5 × 65mm 40-35670 Locking Screw, T10, 3.5 × 70mm

3.5MM NON-LOCKING SCREWS REF Description 40-35010 Bone Screw, T10, 3.5 × 10mm 40-35012 Bone Screw, T10, 3.5 × 12mm 40-35014 Bone Screw, T10, 3.5 × 14mm 40-35016 Bone Screw, T10, 3.5 × 16mm 40-35018 Bone Screw, T10, 3.5 × 18mm 40-35020 Bone Screw, T10, 3.5 × 20mm 40-35022 Bone Screw, T10, 3.5 × 22mm 40-35024 Bone Screw, T10, 3.5 × 24mm 40-35026 Bone Screw, T10, 3.5 × 26mm 40-35028 Bone Screw, T10, 3.5 × 28mm 40-35030 Bone Screw, T10, 3.5 × 30mm 40-35032 Bone Screw, T10, 3.5 × 32mm 40-35034 Bone Screw, T10, 3.5 × 34mm 40-35036 Bone Screw, T10, 3.5 × 36mm 40-35038 Bone Screw, T10, 3.5 × 38mm 40-35040 Bone Screw, T10, 3.5 × 40mm 40-35042 Bone Screw, T10, 3.5 × 42mm 40-35044 Bone Screw, T10, 3.5 × 44mm 40-35046 Bone Screw, T10, 3.5 × 46mm 40-35048 Bone Screw, T10, 3.5 × 48mm 40-35050 Bone Screw, T10, 3.5 × 50mm 40-35055 Bone Screw, T10, 3.5 × 55mm 40-35060 Bone Screw, T10, 3.5 × 60mm 40-35065 Bone Screw, T10, 3.5 × 65mm 40-35070 Bone Screw, T10, 3.5 × 70mm

Sterile Screws only available outside the US

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Ordering Information – Implants

REF Description

40-35900 Washer for 3.5mm Screw

REF Description 45-80100 K-Wire, Fully Threaded, 1.6mm × 200mm

45-80200 K-Wire, Smooth, 1.4mm × 100mm

45-80300 Steinmann Pin, Smooth, 2.5mm x 100mm

WASHERS

K-WIRES & STEINMANN PINS

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Ordering Information – Instruments

REF Description

Instruments 45-35010 Drill, 2.6mm x 122mm, WL70mm, AO-Shaft

45-35020 Overdrill for 3.5mm Screws, AO Fitting

45-35005 Tap for 3.5mm Screws, AO, 70mm

45-80040 Countersink for Screws ø2.7/3.5mm, AO Fitting

45-35015 Screwdriver Blade, AO, T7

703667 Self Retaining Screwdriver Blade, AO, T10

45-35002 VariAx Depth Gauge for 2.7/3.5mm Screws, Black

45-85000 Screwdriver Handle, Revolving/Rigid, AO

45-35030 Holding Sleeve for 3.5mm Screws

45-80010 Plate Bending Pliers

45-80020 K-Wire Cutting Pliers (max 1.6mm)

64-20129 Forceps with Grasping Lips

45-80001 Drill Guide for Circular Locking Holes

45-80003 Drill Guide for 3.5mm Independent Lag Screw

45-80030 Joint Distraction Forceps

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Ordering Information – Ankle Tray Reduction Instruments

REF Description Qty

700666 Periosteal and Freer Elevator (Length 190mm) 1

07-10021 Periosteal Elevator Double Sided 1

702927 Repositioning Forceps Ratchet 2

01-02620 Zygoma Hook 1

07-10006 Elevator Wide Hohmanns 2

702926 Repositioning Forceps with Points 1

702932 Repositioning Forceps with Serrated Jaws 2

700151 Hook 1

700665 Hohmann Retractor 8mm 2

700667 Hohmann Retractor 15mm 2

Optional

702944 Repositioning Forceps with Ballspike

702936 Mantis Tongs Forceps - King

700664 Hohmann Retractor 6mm

Templates 45-90001 Distal Lateral Fibula X-Ray Template

710405 Straight Plate Bending Template 5 Hole/L72

710410 Straight Plate Bending Template 10 Hole/L132mm

710416 Straight Plate Bending Template 16 Hole/L204mm

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Ordering Information – Cases & Trays

REF Description

VariAx Low Energy Ankle Tray

940041 Metal Tray and Tray Lid, Without Inlays & Screw Rack

940042 Plate Insert

940043 Instrument Insert, Brackets

940045 Screw Rack

1806-9700 Lid Metal Tray (Replacement)

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Ordering Information – Cases & Trays

REF Description

Modules And Trays

29-35000 Sterilization Container, 3 levels

29-13009 Sterilization Container, 4 levels

29-35200 Stryker Foot Container Lid - Half Size

29-32401 Sterilization Lid

29-31400 VariAx Foot Instrument Tray

29-31460 Instrument/Accessory Tray

29-31001 VariAx Distal Fibula Plate Module incl. Lid

29-31024 Straight Plate Inlay

29-31014 Lid for VariAx Distal Fibula Plate Module (spare part)

29-31007 Drawer for Screw Racks

29-13462 Accessory Tray

29-31008 Customizable Screw Rack without Markers

29-31009 Screw Rack with Markers**

29-31004 Screw Rack for 3.5 Locking Screws

29-31005 Screw Rack for 3.5 Bone Screws

Note:** Pre-configured screw rack (29-31009) for VariAx Fibula Locking Plate System for 3.5mm

Locking and Non-Locking screw lengths 10mm - 28mm.

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Ordering Information – Instruments

REF Description

Screw markers (For use with Screw Rack 29-31008)

52-00010 Screw Length Marker for 10mm 52-00012 Screw Length Marker for 12mm 52-00014 Screw Length Marker for 14mm 52-00016 Screw Length Marker for 16mm 52-00018 Screw Length Marker for 18mm 52-00020 Screw Length Marker for 20mm 52-00022 Screw Length Marker for 22mm 52-00024 Screw Length Marker for 24mm 52-00026 Screw Length Marker for 26mm 52-00028 Screw Length Marker for 28mm 52-00030 Screw Length Marker for 30mm

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Notes

25

Notes

26

Notes

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Manufactured by:

Stryker GmbH & Co. KGBötzingerstraße 41D-79111 Freiburg/Germany

Stryker Trauma AGBohnackerweg 1CH-2545 SelzachSwitzerland

www.osteosynthesis.stryker.comThis document is intended solely for the use of healthcare professionals. A surgeon must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense medical advice and recommends that surgeons be trained in the use of any particular product before using it in surgery. The information presented is intended to demonstrate a Stryker product. A surgeon must always refer to the package insert, product label and/or instructions for use, including the instructions for Cleaning and Sterilization (if applicable), before using any Stryker product. Products may not be available in all markets because product availability is subject to the regulatory and/or medical practices in individual markets. Please contact your Stryker representative if you have questions about the availability of Stryker products in your area.

Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: SmartLock, Stryker, VariAx. All other trademarks are trademarks of their respective owners or holders.

The products listed above are CE marked.

Literature Number : 90-07815 Rev 2

Copyright © 2012 Stryker