Monotube Triax External Fixation System...ring-to-tube clamp. Such a Triax Hybrid Frame was designed...

$Page 1: Monotube Triax External Fixation System...ring-to-tube clamp. Such a Triax Hybrid Frame was designed to address C type fracture of the proximal and distal tibia using K-wires. It combines$
Monotube TriaxExternal Fixation System

Operative Technique

5075-2-501 A5107 Monotube Triax OP-Tech:PDF 29.1.2008 14:53 Uhr Seite 1

2

Introduction


3

Components andInstrumentsThe Monotube Triax ExternalFixation System offers simple andversatile frame options that meettodays clinical needs.

Key system components include:

• Dynamic Monotubes (Red, Blue, Yellow)

• Carbon Monotubes (Red, Blue, Yellow)

• Standard Pin Clamps

• Single Pin Clamps

• Tube-to-Tube Clamps

• T-adapter

• Apex Pins (Self-Tapping, Blunt, or Self Drilling).

Instruments include:

• T-Handle (for locking the system)

• Torque Wrench (colour-coded)

• Dynamisation Wrench (used toopen/shut the dynamisation collar)

• External Compression/DistractionDevice for use with Triax CarbonTubes

• Fracture Reduction Handles.

Professor David Seligson, M.D.Department of Orthopaedic SurgeryUniversity of LouisvilleHealth Science CentreLouisville, KY 40292

Professor José CañadellChairman, Department of Orthopaedic Surgery andTraumatologyClinica Universitaria De NavarraPamplona, Spain 31080

Professor Francisco ForriolChairman, Orthopaedic Research LaboratoryDepartment of Orthopaedic Surgery and TraumatologyClinica Universitaria De NavarraPamplona, Spain 31080

This publication sets forth detailed recommendedprocedures for using Stryker devices and instruments.It offers guidance that you should heed, but, as withany such technical guide, each surgeon must considerthe particular needs of each patient and makeappropriate adjustments when and as required.

Indications• Treatment of all fractures of the long

bones and pelvis

• Joint Arthrodesis

• Limb Lengthening

• Angular Corrections

• When other methods of fracturefixation are not appropriate

• Osteotomies

• Delays in Consolidation.

Contraindications• If uncertainty exists with regard to

the anatomic location of theneurovascular structure due to post-traumatic destruction, the deviceshould be used with extremecaution. Under these circumstances,the pins should be inserted underdirect vision

• Local sepsis is also a relativecontraindication to the applicationof this device

• The presence of some internalfracture fixation devices

• Psychiatric Patients

• Osteoporotic Bone

• Pre-emptive medical condition.

Introduction


4

Components

DYNAMIC MONOTUBE

CARBON MONOTUBE

TRIAX SINGLE PIN CLAMP

TRIAXSTANDARDPIN CLAMP

TRIAX TUBE-TO-TUBE CLAMPRING TO MONOTUBETRIAX TUBE CLAMP

FRACTURE REDUCTION TOOL

TRIAX T-ADAPTER

APEX PIN COMPRESSION/DISTRACTIONDEVICE

TORQUE WRENCH DYNAMISATION WRENCH

CHARIOT

11


5

ComponentSelectionThe recommended charts on page 6can be used to determine proper framecomponents for the fracture beingtreated but can of course vary fromone clinical situation to another. Thetype of tube selected is determined by:

• Location/type of fracture

• Patient’s weight (Dynamic Tubes only)

• Length of tube required

• Dynamisation requirements.

Dynamic Monotube Triax

Dynamic Tubes include an internalcompression/distraction mechanism,which is useful in lengtheningprocedures and to adjust fracturereductions. The long portion of thetube is referenced as the LengtheningSegment. The shorter portion is calledthe Dynamisation Segment andincludes two adjustable dynamisationfeatures: Biocompression andAdjustable Bio-Spring. These tubes areavailable in three colour-coded sizes:Yellow, Blue, and Red. Use Chart No1(page 6) to select the proper tube size,based on fracture type and patient'sweight.

Triax Carbon Tubes

Carbon Tubes should be used whendynamisation is not desired, or when aradiolucent tube is helpful as in thecase with distal radius and proximaltibial fractures. This economical optionalso comes in the same three diametersizes and a variety of lengths aspresented in Chart No 2 (page 6). Thehollow carbon tube comes completewith end caps, which prevent the pinclamps from sliding off the tubeduring frame application.

11

DYNAMIC MONOTUBE

CARBON MONOTUBE

COMPRESSION/DISTRACTIONADJUSTMENT SCREW

BIO-SPRINGADJUSTMENT SCREW DYNAMISATION COLLAR

“O”-RING DYNAMISATION

SEGMENTLENGTHENING SEGMENT

“O”-RING

COLOUR-CODED

ENDCAPS

Components


6

Y Y Y Y Y Y Y B B

Y Y Y Y Y Y Y Y Y

Y Y Y Y Y Y Y Y Y

Y Y Y B B B B B B

Y Y B B B B B B B

Y B B B R R R R R

Y B B R R R R R R

Y Y B B B B B B R

Y B B B B R R R R

Fore

arm

Hum

eru

sFem

ur

Tib

ia

Chart No 1Selecting Proper Dynamic Monotube Size (Yellow, Blue, or Red)

10 20 30 40 50 60 70 80 90 100

Ulna

Radius

Colles

Simple/stable

Oblique/comminuted/unstable

Simple/stable


Simple/stable


Y=Yellow tube and clamps B=Blue tube and clamps R=Red tube and clamps

Chart No 2 Monotube Lengths and Pin Options

Tube Colour (Dynamic)End Cap Colour (Carbon)

Yellow

Blue

Red

DynamicMonotube

15mm x 180mmFully Compressed15mm x 250mmFully Distracted



CarbonMonotube

15mm x 150mm200mm250mm300mm

20mm x 200mm250mm300mm350mm

25mm x 250mm 300mm350mm400mm

PinSize

3mm&

4mm

4mm&

5mm

5mm6mm

Components

Patient’s Weight in Kg (1kg=2.2lb)


7

The Monotube Triax Pin Clamp allowsindependent control of the fracturereduction in three planes. Clamps maybe placed anywhere along the length ofthe tube at virtually any angle,wherever the best bone purchase maybe available.

A unique compression sleeve allows forexcellent mobility in rotationpreventing deviation of the pin clampwhile guaranteeing maximum stability.

The two outer square head screws Awhen tightened hold the pins in theclamp. Each screw can independentlylock up to two pins in place. The redand blue Triax Clamps have four pinpositions, and the yellow Triax Clamphas two pin positions.

The centre square head screw B allowsfor +/- 20° degrees of angulation in thesagittal plane.

The side square head screw C allowsfor 360° of rotation in the coronalplane.

The square head screw D at the bottomof the clamp allows for translationalong the length of the tube and for360° rotation around the axis of thetube.

Note: All square head screws need tobe tightened to the appropriatetorque to maintain adequate stabilityusing the torque wrench.

Monotube Triax Pin Clamps

Also identified by three colour-codedsizes, the Monotube Triax Clamps eachaccept a minimum of two half pindiameters as also indicated in ChartNo 2. The clamps come in a variety ofstyles, including Hybrid Clamps, toaccommodate even the mostchallenging fracture pattern.

Note: Blue and Red components have7mm square head screws and Yellowcomponents have 5mm square headscrews.

Triax Standard Pin Clamp

BA

C

D

A

Operative Technique


8

Triax Single Pin Clamp

The Monotube Triax Single PinClamps are designed for independentpin placement. They allow for captureand stabilisation of fracture fragments.They are also intended for use inpathologies that require non parallelpin position for additional stability ofthe frame.

The Single Pin Clamp features a snap-fit fixation mechanism which ensuresan easy and firm grip to the fixationpins. A serrated interlockingmechanism between the jaws of thepin clamp provides superior rotationallocking. A 7mm square head screwallows easy access.

Pins can be placed parallel orconvergent to improve stability.

• The Monotube Triax Single PinClamps comes in three sizes andaccepts the following Apex pins

• Yellow 3/4mm

• Blue 4/5mm

• Red 5/6mm

• Top locking for adjustable control ofthe pin placement

• The Single Pin Clamp allows 360° ofmedio lateral rotation

• The square head screw positioned atthe bottom of the pin clamp allowsfor translation along the length ofthe tube and 360° around the axis ofthe tube.

Operative Technique


9

The Monotube Triax can be connectedto the TenXor carbon ring by using aring-to-tube clamp. Such a TriaxHybrid Frame was designed to addressC type fracture of the proximal anddistal tibia using K-wires. It combinesthe principles of the circular ring andunilateral frame fixation to betterneutralise the forces acting upon thefracture.

The TenXor carbon ring is available invarious sizes and the ring-to-tubeclamp is available in 2 sizes for blueand red Monotube Triax.

Its main features are:

• Possibility of sliding along the ringin order to determine the bestposition according to frameconfiguration

• Integrated snap-fit mechanism for"clicking" the clamp on the ring

• Positioning the clamp inside oroutside the ring

• 3 axes of rotation

• 7mm square head locking screwscompatible with Hoffmann II andblue/red Monotube Triax wrenches

• Easy access of locking screws

• Manufactured from stainless steeland aluminium

Additional information is available inthe TenXor brochure and operativetechnique.

Triax Hybrid Frame

Operative Technique


10

Triax Tube-to-Tube

Triax Tube-to-Tube Clamps

These clamps allow connection ofYellow, Blue and Red tubes together totreat complex trauma or pelvicfractures. The clamps are suitable forboth Dynamic and Carbon Tubes(Figure 27). Clamps are available inthe following configurations:

• RED TO RED

• RED TO BLUE

• BLUE TO BLUE

• BLUE TO YELLOW

• YELLOW TO YELLOW

The clamp consists of two aluminiumjaws that hold the tubes and allow360° of rotation. A single 7mm squarehead screw positioned at the top of theclamp enables the device to be locked.There are 100 radially serrated teethbetween the jaws which allow precisepositioning of the tube components.Each tooth movement represents 3.6°of rotation.

NOTE: This device cannot bedismantled.

Operative Technique


Assembly Instructions

1. Select the appropriate T-Adapterand matching Standard Pin Clampusing the chart above.

2. Remove body screw (C) andcompression sleeve (E) from T-Adapter with the appropriateMonotube Triax Torque wrench.

3. Remove body screw (C) andcompression sleeve (E) fromStandard Pin Clamp. Separate pinconnector from the tube coupling.

4. Insert T-Adapter into the tubecoupling and replace compressionsleeve (E). Body screw (C) should beintroduced through the recessedportion of the clamp until fullyseated and finger tight.

5. Insert pin connector onto T-Adapterand replace compression sleeve (E).Body screw (C) should beintroduced through the recessedportion of the clamp until fullyseated and finger tight.

T-Clamps

T-Clamps are beneficial when treatingproximal and distal fractures orfractures that pass acrossa joint. The T-clamp allows for

perpendicular placement of pins.

Monotube T-Adapter Assembly

Standard Monotube Triax Clamps canbe converted to T-Clamps using the T-Adapter. Be sure you select the appropriateadapter for the size of clamp to bemodified.

11

Triax T-Adapter

(C)

(C)

(C)(E)

(E)

T-Adapter

Yellow (15mm)Blue (20mm)Red (25mm)

Catalogue

5150-4-0655150-4-0705150-4-075

RequiredStandardPin Clamp

Yellow (15mm)Blue (20mm)Red (25mm)

Catalogue

5150-3-0655150-3-0705150-3-075

T. ADAPTER

Operative Technique

NOTE: Body screws and compressionsleeves are exactly alike and will fit ineither position. However, if bodyscrews are not started from therecessed side of the clamp, they willnot fully seat. In addition, the T-adapter should always be connectedto the tube coupling before the pinconnector.


12

Preparation

To prepare for application of theframe, remove “O”-Rings, and placeselected clamps on the tube. Once theclamps are in place, replace the “O”-Rings to prevent the clamps fromsliding off the frame during theprocedure (Figure 1).

Positioning of theDynamic Tube

The Dynamic Tube may be placedwith the dynamisation segmentpositioned either proximally or distallyto accommodate any fracture patternand provide a variety of pin placementoptions (Figure 2).

The tube should be distracted to 1cmbefore use. The dynamisation collarshould be locked before placement(See figure 12 and 13).

Pin Placement

Once a gross reduction is achieved, thefirst Apex self-tapping, self-drillingpin†, usually considered the mostcritical, is placed approximately threefingerbreadths proximal or distal tothe fracture, depending on surgeonpreference. Care should be taken to seethat the first pin is placed properly inthe best quality bone. Insert thePredrill Assembly through the clampand into hole No 4 (Figure 4). (Theholes in the clamp are referred to asholes No 1-No 4; the hole closest tothe fracture is always hole No 4). Aftermaking a small incision, split the softtissue with forceps. Insert the PredrillAssembly through the incision andpush down until sleeve isperpendicular to and touches thebone. Holding the sleeve in thisposition, insert the self-drilling, self-tapping Apex Pin (Figure 5).

†If non-self-drilling self-tappingApex Pins are preferred, see page 8 ofthis technique for the pre-drillingprotocol.

Frame Application with Dynamic Monotube Triax

Figure 1

Figure 2

Figure 4

Figure 3

Figure 5

1 2 3 4

Operative Technique


13

Turn the drill brace counterclockwisefour to five turns. The Apex pin tip willmark the cortex and prevent slipping ofthe pin. Turn the drill brace clockwise,driving the Apex Pin through the firstcortex†. Resistance will be felt as the tipof the pin begins to penetrate the secondcortex. The pin should be advanced untilboth cortices are fully engaged. Removethe drill brace from the pin.

Place second pin in hole No 1, utilisingthe same technique (Figure 6).

Figure 6

Figure 7

Figure 8

a a

c

d

b


Operative Technique

NOTE: It is important that alladjustment screws should bepositioned outward and within easyreach to facilitate adjustment,tightening and final locking of thefixator. It is also important that theTube should be distracted at least onecentimetre prior to applicationallowing for compression/distractionand fine-tuning of the reductionpostoperatively. Care should be takenthat the collar should always be closedprior to dynamisation application.

Using the same technique for theopposite side of the fracture, place thethird pin at least three fingerbreadthsfrom the fracture, again taking care to seethat the pin is placed properly in the bestquality bone.A third incision is made and anadditional Predrill Assembly is insertedthrough hole No 1 in the Pin Clamp.The procedure is repeated for the finalpin in hole No 4 (Figure 7).

Although pins are typically placed inholes No 1 and No 4, when usingmultiple pin clamps, holes No 2 and No3 can be used, if necessary.

†NOTE: Always use Apex Pins with theMonotube Triax system.

Pin Clamp Function

It is important to review the function ofthe Pin Clamps. The two outer screws(A) on the clamp face, when tightened,hold the clamp to the pins. The centrescrew (B) locks +/– 20° of angulation.The side screw (C) locks the 360°rotation of the clamp. The nut on thebottom of the clamp (D) locks theclamp-to-tube connection (Figure 8).

Final Reduction

All Predrill Assemblies are nowremoved and the proximal pin groupis locked into the clamp, which is leftloose on the tube.

The tube will now slide freely with theclamps, allowing for final reduction.


14

Locking the Fixator

Once an anatomical reduction isachieved, lock the fixator in all planes.The torque wrench should be usedafter initial tightening to assure allclamps are locked properly. For theRed system, this assures thecomponents are tightened to 11Nm;for the Blue system 9Nm; and for theYellow 5Nm.

Use of Monotube Torque Wrench

Proper use of the torque wrench isimportant. Make sure the torquewrench head is fully seated over theclamp screw.

Grip the end of the wrench handle,keeping the thumb in a “fist” position(Figure 9). Tighten the clamp screwonly until the silver torque wrench barcontacts the colour-coded handle.When the bar and the wrench handlecome in contact, the clamp screw hasbeen tightened to the recommendedmaximum torque (Figure 10).

Improper placement of the thumb canchange the torque level achieved bythe wrench. This may result inundertightening of the screws on theclamp (Figure 11).

NOTE: Do not overtighten as thismay damage the clamp or torquewrench.

Figure 9

Figure 10

Figure 11


Operative Technique


15

11

1

Locking theDynamisation Features

Finally, and most importantly, be surethat the dynamisation collar is fullyclosed and that the frame is staticbefore application (Figure 12).

Bio-Spring tension should also be fullyreleased. The Bio-Spring tensionadjustment screw is located on the endof the dynamisation segment of thetube. Upon frame application, thespring should be in released position,i.e., turned until silver disc is flushwith the end of the tube (Figure 13).

Compression/Distraction

If compression/distraction of thereduction is required after frameapplication, this can be accomplishedby using the internal compression/distraction mechanism. Thecompression/distraction adjustmentnut is located on the end of thelengthening segment of the tube, (+)=distraction and (–)= compression. One complete revolution of the screwprovides 1mm of compression ordistraction (Figure 14).

The end of the tube is marked with avisual reference each 1/4 turn

4 dots 3 dots

2 dots 1 dot

NOTE: When you reduce a fracture withthe internal compression/distractionmechanism, please keep thedynamisation collar closed.

Figure 12

Figure 13

Figure 14

Released

Full tension


Operative Technique


16

Dynamic Monotube Triax allows thesurgeon to control the dynamisationprocess with two adjustments:

• The Biocompression Collar allowsuser to set the amount ofmicromotion at the fracture site.Although the collar opens to 3mm,it is not recommended to open itmore than 1mm (Figure 15)

• The Adjustable Bio-Spring allowsthe surgeon to vary the amount ofweight or force required to make theframe move the distance set on theBiocompression Collar. Chart No 3highlights the weight required tomove each size Monotube based onspring tension (1kg=2.2lb).

Dynamising the Frame

Dynamisation Protocol

11

DYNAMISATION COLLARSPRING

ADJUSTMENTNUT

Figure 15

Turns 71/2 7 6 5 4 3 2 1 None

Amount of Force (Kilograms)

Yellow 20 17.33 14.66 11.99 9.32 6.65 3.98 1.31 0

Blue 30 26 22 18 14 10 6 2 0

Red 45 39 33 27 21 15 9 3 0

Chart No 3Reducing Spring Tension

(Approximate Force Required to Dynamise)

Operative Technique

Stable Fracture patterns

Biocompression is recommended forstable fracture patterns. The framemay be dynamised anytime afterapplication. The following stepsshould be followed:

1. Open the dynamisation collar to1mm (one complete revolution ofthe dynamisation collar equates to1mm). Use the dynamisationwrench if necessary.

Unstable Fracture patterns

Adjustable Bio-Spring isrecommended for unstable fracturepatterns and leg lengthening. Theframe may be dynamised once callus isevident on the X-ray, approximately 21to 28 days postoperatively. Todynamise the frame, the followingsequence should be followed:

1. Advance Adjustable Bio-Springtension screw clockwise until fullycompressed, about 71/2 full turns.The screw will recede into the tubeas it compresses the spring.

2. Open the dynamisation collar to onemillimetre. Use the dynamisationwrench if necessary.

3. Reduce Bio-Spring tension one fullturn anti-clockwise each week. Besure to check that biocompressioncollar is still set at 1mm after eachspring adjustment. The forcerequired to dynamise the frame willbe progressively reduced.

Note: X-ray visualisation is requiredto determine callus formation.

Carbon Tubes


17

Triax Carbon Tubes

If the fracture does not requiredynamisation or if a radiolucent frameis desired, carbon tubes can besubstituted for the dynamic tube.Surgical protocol does not vary exceptfor placement of clamps on the tube.To place clamps on the tube, removecoloured end cap. Simply slide clampsonto the tube and replace end caps(Figure 16).

Carbon tubes are available in 3diameters; Yellow 15, Blue 20, Red 25and in lengths from 150 – 400mm.

• Compression or distraction can nowbe achieved – maximumdistraction/compression is asfollows:Yellow 20mmBlue 30mmRed 30mm.

Compression Distraction Device

The Triax Carbon Tube requires anexternal compression/distractiondevice. To use the device, position the“chariot” over the back of the pinclamp and wrap the lockingmechanism around the tube. Tightenthe locking screw, utilising the wrench.Loosen pin clamp screw (D), utilisingtorque wrench. Compression ordistraction can be useful when fine-tuning the reduction. One revolutionof the Thumbwheel provides for 1mm of compression or distraction. Theexternal compression/distractiondevice can then be removed or left on.In either case, retighten the pin clampscrews to proper torque once finishedwith adjustment.

LOCKING NUT

CHARIOT INNEUTRAL POSITION

THUMBWHEEL

TORQUEWRENCH

TORQUEWRENCH

CLAMPSCREW (D)

Figure 16

Figure 17

Operative Technique


18

If the surgeon would like to use blunt,self-tapping pins, the pin placementcan be facilitated using a triple guidesleeve mechanism and the appropriatedrill for the pins being used.

To place the pins, insert the desiredtriple drill guide into the pin clamp.The first pin should be placed threefingerbreadths from the fracture. A1cm longitudinal incision is madewith a blunt dissection through thetissue to bone. Insert the PredrillAssembly mechanism through hole No1 of the proximal clamp (Figure 18).Insert the Predrill Assemblymechanism down to bone, holding itperpendicular to the bone. Lightly tapthe trocar, which will prevent skiddingof the drill bit. The trocar is removedleaving the drill guide in the tissueprotecting sleeve. Introduce the drillbit, and drill through both cortices ofthe bone (Figure 19). Remove the drillbit and the drill guide sleeve, and insert selected blunt Apex Pinthrough the tissue sleeve, utilising aDrill Brace or a T-inserter (Figure 20).

Advance pin until both cortices arefully engaged. After placing the firstpin, repeat the procedure for the second pin in hole No 4 of theclamp. Use same technique for second pinclamp and continue with frameapplication (Figure 21).

Blunt, Self-tapping Pin Protocol

ApexPin Size

3mm4mm5mm6mm

Gray Bone Drill Size2.2mm3.2mm4.0mm4.5mm

Catalogue No.

5085-1-2225085-2-0325085-2-0405085-2-045

Chart No4

Figure 19

Figure 18

Figure 21

Figure 20

Operative Technique


19

Humeral

Femur

Wrist Knee Joint

��

yyyyyyyyyyyyyyyy

��

yyyyyyyyyyyyyyyyyyyyyyyyyyyyyy

Proximal Humerus

HumeralLengthening

Proximal Femur Femoral Shaft Femoral Lengthening

Segmental Femur

Radial Shaft Bridging Floating Knee Knee Arthrodesis

Diaphyseal Humerus Distal Humerus

Operative Technique


20

See page 6 for colour classification.

Tibial

Ankle

Hybrid

Pelvis

Proximal Tibia

Ankle Fracture

Proximal Tibia

Pelvic Fracture

DiaphysealTibia*

* *

Distal Tibia

SegmentalTibia

Tibial Plateau

TibiaLengthening

Tibial BoneTransport

* May also be placed antero-medial

Operative Technique


21

REF Description

5150-0-065 Dynamic Tube Assembly Yellow (15mm)

5150-0-070 Dynamic Tube Assembly Blue (20mm)

5150-0-075 Dynamic Tube Assembly Red (25mm)

5150-0-465 Dynamic Tube Yellow (15mm)

5150-0-470 Dynamic Tube Blue (20mm)

5150-0-475 Dynamic Tube Red (25mm)

5150-3-065 Pin Clamp Yellow (15mm)

5150-3-070 Pin Clamp Blue (20mm)

5150-3-075 Pin Clamp Red (25mm)

5150-3-165 Single Pin Clamp Yellow (15mm)

5150-3-170 Single Pin Clamp Blue (20mm)

5150-3-175 Single Pin Clamp Red (25mm)

5150-4-065 T-Adapter Yellow (15mm)

5150-4-070 T Adapter Blue (20mm)

5150-4-075 T-Adapter Red (25mm)

5150-3-415 Tube-to-Tube Clamp Yellow (15mm)

5150-3-420 Tube-to-Tube Clamp Blue/Blue (20mm)

5150-3-425 Tube-to-Tube Clamp Red/Red (25mm)

5150-3-435 Tube-to-Tube Clamp Yellow (15mm)/Blue (20mm)

5150-3-445 Tube-to-Tube Clamp Blue (20mm)/Red (25mm)

Please refer to the Tenxor Brochure (Cat. Number 5075-3-000) for the components of the Triax Hybrid Frame

5150-1-115 Carbon Tube Assembly Yellow Ø15/150mm




5150-2-371 Carbon Tube Yellow Ø15/150mm




5150-2-431 Carbon Tube Blue Ø20/200mm




5150-2-451 Carbon Tube Red Ø25/250mm




Ordering Information - Components


22

REF Description

5150-9-265 Long Handle Wrench Yellow

5150-9-270 Long Handle Wrench Blue

5150-9-275 Long Handle Wrench Red

5150-9-585 Reduction Handles Blue/Red Clamps

5054-8-009 Spanner Wrench

5150-9-465 Compression Distraction Device Yellow (15mm)

5150-9-470 Compression Distraction Device Blue (20mm)

5150-9-475 Compression Distraction Device Red (25mm)

5150-9-115 Dynamisation Wrench Yellow

5150-9-120 Dynamisation Wrench Blue

5150-9-125 Dynamisation Wrench Red

5150-9-916 Monotube Triax Yellow Case

5150-9-946 Monotube Triax Red/Blue Case

HoffmannII Swiss Patent Application: 01-709/94-3. Other Patents Pending. * Patents: EU 385,929; 374,093;Canada 1,193,506; U.S. 5,160,335 and 5,207,676. ** Swiss Patent Application: 02-709/94-3. Other Patents Pending.*** Patents: EU 230,856; Swiss CH 671,150; U.S. 4,978,350.†Data on file at Stryker.

Ordering Information - Instruments


23

Notes


Stryker Trauma AGBohnackerweg 1CH-2545 SelzachSwitzerland

www.osteosynthesis.stryker.com

The information presented in this brochure is intended to demonstrate a Stryker product. Always refer to the packageinsert, product label and/or user instructions before using any Stryker product. Surgeons must always rely on their ownclinical judgment when deciding which products and techniques to use with their patients. Products may not be availablein all markets. Product availability is subject to the regulatory or medical practices that govern individual markets. Please contact your Stryker representative if you have questions about the availability of Stryker products in your area.

Stryker Corporation or its subsidiary owns the registered trademark: Stryker, Monotube, Hoffmann, ApexStryker Corporation or its subsidiary owns, uses or has applied for the following trademarks: Triax, Tenxor

Literature Number: 5075-2-501LOT A5107

Copyright © 2007 Stryker


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Monotube Triax External Fixation System...ring-to-tube clamp. Such a Triax Hybrid Frame was designed...

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