numelock2_optech_982195b1309

Trauma Applications

Operative Technique

Numelock IIPolyaxial Locking System

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Contents

Page

1. Rationale 3

Plates 4

Material Composition 4

Locking Screws 4

Polyaxial Locking Mechanism 5

Compatibility 5

Instrumentation 5

2. Introduction 5

Cases and Trays 5

Locking Screw Instrumentation 5

Locking Screws 5

3. Indications 7

4. Contraindications 8

5. Features and Benefits 9

Features 9

Benefits 9

6. Operative Technique 10

General Principles 10

Step One – Plate Contouring and Shaft Screw Placement 10

Step Two – Pre-drilling for Locking Screw Placement 10

Step Three – Depth measurement 11

Step Four – Locking Screw Placement 11

Step Five – Final Adjustments / Transport 12

Step Six – Final Locking 12

Step Seven – Remaining Diaphyseal Screws 12

Indication Procedures 13

7. Clinical Examples 16

Ordering Information - Plates 17

Ordering Information - Locking Screws 21

Ordering Information - Instruments 20

Ordering Information - Cases and Trays 21

This publication sets forth detailedrecommended procedures for usingStryker Trauma devices and instruments.It offers guidance that you should heed,but, as with any such technical guide,each surgeon must consider theparticular needs of each patient andmake appropriate adjustments when andas required.

A workshop training is required prior tofirst surgery. See package insert (V15013/ V15034) for a complete list of potentialadverse effects, contraindications,warnings and precautions.

The surgeon must discuss all relevantrisks, including the finite lifetime of thedevice, with the patient, when necessary.

Warning:All bone screws referenced in thisdocument here are not approvedfor screw attachment or fixationto the posterior elements(pedicles) of the cervical, thoracicor lumbar spine.

Special Acknowledgement:

Special acknowledgement is made toDr. Gilbert Taglang of the Centre deTraumatologie et d’Orthopédie,Strasbourg, for sharing his technicaland surgical expertise in thecompilation of this OperativeTechnique. Dr. Taglang significantlycontributed to this manual andlikewise supplied all clinical X-Raysdepicted herein.

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Rationale

Plating for skeletal fractures in theperiarticular regions of the bone hasbecome a widely accepted treatmentmodality.In recent years, the effectiveness ofepiphyseal/metaphyseal fracturemanagement has been enhancedthrough the introduction ofanatomically shaped and axiallystable locking plates.

Locking plates have become an implantcategory of increasing importance totrauma surgeons because they tend toimpart a higher degree of stability andimproved protection against primaryand secondary losses of reductionwhen compared to conventional plates.Additionally, locking plates can bemounted with limited contact andpressure to periosteal tissue.This reduction in pressure canminimize incidence of periostealnecrosis and may help preservevascularization to the zone of injury byminimizing the impairment to overallblood supply. The locked plate andscrews constitute a stable system thatdependably maintains the angularintegrity and axial alignment of theextremity, while at the same timeproviding reliable fixation in normaland osteoporotic bone.

Plates with threaded locking screwholes that are machine drilleddirectly into the implant at anglespredetermind by the manufacturerhave become widely available in manyparts of the world. These monoaxiallocking plates have been met withincreasing popularity among traumasurgeons because of the improvedoutcomes they offer in certainclinical situations compared toconventional plates.

Numelock II ’s polyaxial lockingmechanism offers the option ofadjustablity in the range of screwtrajectories through a broadcontinuum of positions in themetaphyseal zone.The Numelock II mechanism can beoptimally adjusted to meet the needs ofthe clinical indication. This featureallows the Numelock II plates to becorrectly situated with respect tothe patient’s anatomy, while eachindividual locking screw is accuratelytargeted to address the configuration ofthe fracture.

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Plates

The Numelock II polyaxial lockingsystem is designed to treat periarticularfractures of the upper and lowerextremities, with eight plates, coveringfive anatomical regions (shoulder,elbow, distal radius, knee and distaltibia).

The shape, material properties andsurface quality of the implants takeinto account the stringent demandsof surgeons for high fatigue strength,optimized transfer of loading forcesand a straightforward, standardizedoperative technique with broadapplicability. For the purposes ofsafety, traceability and convenience, allplates are packaged sterile.

The Numelock II system features eightplates, including distal radius (volar);proximal humerus; medial distalhumerus, lateral distal humerus;medial proximal tibia; lateral proximaltibia; medial distal tibia and lateraldistal femur.

MaterialCompositionThe implants are produced from316LVM Stainless Steel. ASTM F138and F139/ISO 5832-1 materialstandards provide rigid specificationsthat define the chemical composition,microstructural characteristics andmechanical properties of implantquality Stainless Steel. These standardsensure that 316LVM Stainless Steel,even if provided by different suppliers,is consistent and compatible.The material used for all Numelock IIplates and screws meets thesestandards.

Locking Screws

The Numelock II locking screwsare available in two diameters formetaphyseal fixation. The 4.5mmscrews are for all upper extremity andmedial distal tibia Numelock II platesand the 6.5mm screws are used withthe remaining lower extremityNumelock II plates. All screws arepackaged sterile.

Rationale

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CompatibilityDepending on the anatomical region,the epiphyseal/metaphyseal section ofeach plate includes three or morepolyaxial locking holes, with integratedrings that accept Numelock II lockingscrews.

This mechanism permits screws tobe adjusted through a continuum of15º from orthogonal, tracing out acone of up to 30º in all directions.This capability allows the surgeon toaim the screw at an optimal trajectory,within the 30º cone.

The Numelock II screws have a uniqueconical core design and thread patternin the head and tip areas. As the screwis threaded into the mechanism, itsconical head part engages with thecorresponding threads in the ring,which in turn expands into the plate,securely locking the position of thescrew at the chosen angle anddirection.

Prior to final locking of theNumelock II screw within themechanism, the ring is designed torotate freely. This attribute can beused to pull a bone segment intoalignment (see Operative Technique –General Principles, Step Five, foradditional information on thisfeature).

The screw holes in the diaphysealportion of the plates are neutraland permit incremental adjustmentto the plate’s position on the bone.These diaphyseal holes are designedto accept Stryker’s SPS (ISO standard)screws. All upper extremityNumelock II plates accept 3.5mmstandard cortical screws and 4.0mmstandard cancellous screws in thediaphyseal holes. All lower extremityNumelock II plates accept 4.5mmstandard cortical screws in thediaphyseal holes. The number ofdiaphyseal holes depends on eachgiven plate’s length.

InstrumentationThe Numelock II instrumentationis designed for accuracy and ease ofuse and precisely engages with allNumelock II implant components.The storage trays conveniently housethe Numelock II instrument set andprovide storage for unpackedNumelock II screws, including acompartment for miscellaneousunpacked plates or other instrumentsof choice.

Polyaxial Locking Mechanism

Rationale

6

Introduction

Locking ScrewInstrumentationThe range of instruments includedin each complete Numelock II setconsists of Drill Guides and Drill Bitsfor placement of 4.5mm and 6.5mmNumelock II locking screws; ScrewDrivers; Ring Drivers and HoldingSpanners. Additionally, each storagebase houses a set of Plate BendingIrons and Depth Gauges.

Note:Both Numelock II screw sizes(4.5mm and 6.5mm) use the sameDepth Gauge (Ref. No. JA65) formeasuring length.

Locking ScrewsThe Numelock II screws are availablein 4.5mm and 6.5mm diameters.The 4.5mm screws, for upperextremity and distal medial tibiaindications, are supplied in lengthsfrom 14mm to 75mm (14mm – 26mmin 2mm increments; 29mm – 38mm in3mm increments; 42mm – 50mm in4mm increments; 55mm – 75mm in5mm increments). The 6.5mm screws,for distal femur and proximal tibiaindications are provided in lengthsfrom 27mm to 85mm (27mm – 45mmin 3mm increments; 50mm – 85mm in5mm increments).

Cases and TraysThe complete Numelock II set consistsof two individual cases containing the4.5mm and 6.5mm Numelock IIinstrumentation, respectively.The bases include a compartment foradditional and miscellaneousinstruments or unpacked plates.There are also two individual inserttrays that can house unpacked 4.5mmor 6.5mm screws respectively.All Numelock II plates and screws arepackaged sterile.

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Indications

The Numelock II System implants mayalso be used in revision surgeries ofpseudoarthroses, non-unions andmal-unions. Osteotomies andarthrodeses may also be performedusing these implants with theapplicable operative technique.

Lateral DistalHumerus Plate

Lateral ProximalHumerus Plate

Medial DistalHumerus Plate

Volar DistalRadius Plate

Medial ProximalTibia Plate

Lateral DistalFemur Plate

Lateral ProximalTibia Plate

Medial DistalTibia Plate

The physician’s education, trainingand professional judgment mustbe relied upon to choose the mostappropriate device and treatment.Conditions presenting an increasedrisk of failure include:

• Any active or suspected latentinfection or marked localinflammation in or about theaffected area.

Implants of the Numelock II Systemare indicated for fractures in thefollowing areas:

• Compromised vascularity that wouldinhibit adequate blood supply to thefracture or the operative site.

• Bone stock compromised by disease,infection or prior implantation thatcannot provide adequate supportand/or fixation of the devices.

• Material sensitivity documented orsuspected.

• Obesity. An overweight or obesepatient can produce loads on theimplant which can lead to failure ofthe fixation of the device or tofailure of the device itself.

• Patients having inadequate tissuecoverage over the operative site.

• Implant utilization that wouldinterfere with anatomical structuresor physiological performance.

• Any mental or neuromusculardisorder which would create anunacceptable risk of fixation failureor complications in postoperativecare.

• Other medical or surgical conditionswhich would preclude the potentialbenefit of surgery.

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Relative ContraindicationsSince external fixation devices are oftenused in emergency situations to treatpatients with acute injuries, there areno absolute contraindications for use.The surgeon’s education, training andprofessional judgement must be reliedupon to choose the most appropriatedevice and treatment for eachindividual patient. Whenever possible,the device chosen should be of a typeindicated for the fracture being treatedand/or for the procedure beingutilized.

Conditions presenting an increasedrisk of failure include:

• Insufficient quantity or quality ofbone which would inhibitappropriate fixation of the device.

• Compromised vascularity that wouldinhibit adequate blood supply to thefracture or operative site.

• Previous history of infections.

• Any neuromuscular deficit whichcould interfere with the patient’sability to limit weight bearing.

• Any neuromuscular deficit whichplaces an unusually heavy load onthe device during the healing period.

• Malignancy in the fracture area.

• Mental, physical or neurologicalconditions which may impair thepatient’s ability to cooperate with thepostoperative regimen.

• Patients with a compromisedimmune system.

• Pre-existing internal fixation thatprohibits proper pin placement.

Contraindications

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Features and Benefits

FeaturesAxially stable, locking fixation

in epiphysis/metaphysis

Polyaxial locking mechanism

30º range of screw insertion angles

Eight plates cover fiveanatomical regions

All plates and screws packaged sterile

Screws with unique thread and conicalcore design

Shaft holes accept SPS ISO screws

Ring Driver permits screwand bone segment adjustments

Anatomically shaped plates

Numelock screws acceptstandard hex drivers

4.5mm and 6.5mm implantsand instruments

Rounded plate ends

K-Wire/suture holes in ProximalHumerus Plate

Drill guide constrains screwinsertion angle

Numelock II Screw Depth Gaugegives direct value

Complete set provided in separatelyhoused 4.5/6.5 kits

BenefitsHigh stability; protection againstprimary and secondary losses ofreduction; limited plate contact withperiostium; reliable purchase innormal and osteoporotic bone.

Screws positioned according tofracture pattern or to avoid anotherimplant; plate positioned to meetneeds of patient anatomy.

Adjustability in range of screwtrajectories over a continuum ofpositions.

Broad indication coveragewith one system.

Safety, traceability, convenience.

Low insertion torque and securelocking; reduced possibility ofcross-threading and cold welding.

Can be used with existing hospitalinventory of SPS ISO standard screws.

Distance of bone to plate can beaccurately adjusted; bone segmentsmay be pulled towards plate.

Limited need for contouring.

Screws can be removed with standarddrivers at end of treatment, in case ofplate extraction.

Coverage of both upperand lower extremities.

Reduced potential for soft tissueirritation.

Well-suited for rotator cuffreattachment.

Limits screw head protrusion forreduced soft tissue irritation.

No compensation requiredfor Numelock II locking screws.

Space saving in operating theater.

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• Establish primary stabilization of thefracture site through the use ofreduction forceps and/or K-Wire inthe appropriate manner. Althoughthe plates are pre-shaped, thediaphyseal portion of the implantmay require contouring with thePlate Bending Irons (Ref. No.TRTPS).

• Once the required shape has beenfashioned, the plate should bepositioned on the bone for optimalstability and ultimate fixation.

• Note that bending in the epiphyseal/metaphyseal part of the plate shouldbe avoided as this may damage thelocking mechanisms. Moreover, it isnot necessary to contour in this partof the plate because it is alreadypre-shaped and the underside of theplate in this region need not be incontact with the periosteal surfaceonce the locking screws are engaged.

• The Numelock II Drill Guide(Ref. No. GM25 for 4.5mmNumelock II Plates or GM35 for6.5mm Numelock II Plates) can bethreaded into one of theepiphyseal/metaphyseal locking holesto assist with plate positioning andholding. However, the Numelock IIDrill Guide is not for use withdiaphyseal screw placement.

• Pre-drill and measure for placementof an SPS Cortical Screw into oneof the diaphyseal holes using theappropriate sized Drill Bit, DrillGuide and Measuring Gauge fromyour SPS set. 3.5mm SPS CorticalScrews (or 4.0mm CancellousScrews) are used for upper extremityNumelock II Plates and 4.5mm SPSCortical Screws are used for lowerextremity Numelock II Plates.

• The SPS Cortical Screws areself-tapping. Typically, the first screwposition corresponds to one of themiddle diaphyseal holes (or, if moreappropriate, the next hole towardsthe joint can also be used). It is notrecommended that the firstdiaphyseal screw be placed into thelast diaphyseal hole. Avoid usingscrew hole(s) immediately adjacent tofracture line(s). After insertion,this screw should not be tightenedcompletely to allow for pivotaladjustment of the plate’s positioning.

• Once the orientation of the plate hasbeen finalized, place a second screwinto a second diaphyseal hole at leastone hole space away from the firstscrew and securely tighten bothscrews.

Step Two – Pre-drilling forLocking Screw Placement

• Choosing a hole position that isclosest to being equidistant frommedial to lateral, thread the DrillGuide (Ref. No. GM25 for 4.5mmNumelock II Plates or GM35 for6.5mm Numelock II Plates) into thelocking mechanism of one of theepiphyseal/metaphyseal holes andposition it at the desired angle.

• The Drill Guide constrains thedrilling angle, ensuring optimal screwhead profile to minimize possible softtissue irritation.

• Using the appropriate diameterNumelock II Drill Bit (Ref. No.700351 for 4.5mm screws orMCA35195 for 6.5mm screws), createa pilot hole for screw insertion.

• It is important to preplan theangles of inclination for each of theNumelock II epiphyseal/metaphyseallocking screws to optimize thefixation of any fragments whileexercising extreme caution to avoidcollision of any screws inside thebone and to avoid penetration ofjoint surfaces. When feasible, toavoid such intersection of theNumelock II screws within the bone,it is desirable to place them atdivergent angles to each other.

Operative Technique

General PrinciplesThe surgeon must first determineclear identification and classificationof the fracture using the suitableimaging methods.

The appropriate anatomicalreduction must be established beforeany definitive fixation is undertaken.

Step One – Plate Contouring and Shaft Screw Placement

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Step Two continued – Pre-drillingfor Locking Screw Placement.

• If hard cortical bone is encountered,use the tip of the Cutting Screwdriver(Ref. No. TASH5 for 4.5mm screws orTASH7 for 6.5mm screws) to incisethe near cortex. Additionally, a3.2mm Drill Bit (Ref. No. 700356)for 4.5mm screws and a 4.5mm DrillBit (Ref. No. 700354) for 6.5mmscrews are supplied and may be usedto overdrill the near cortex in case ofhard bone.

Note:The Drill Guides cannot be usedfor overdrilling.

Step Three – Depthmeasurement (Fig.1)

• Using the Numelock II Depth Gauge(Ref. No. JA65), measure the depthof the metaphyseal pilot hole directlythrough the plate. The depth gaugeprovides the actual length of thescrew required.

Note:This Depth Gauge is not designedto measure the lengths of standardSPS screws. If transport of a bonesegment is anticipated (see Step 5)a shorter screw than the lengthmeasured for that fragment willusually be required.

Step Four – Locking ScrewPlacement (Fig.2)

• Using the Cutting Screwdriver(Ref. No. TASH5 for 4.5mm screwsor TASH7 for 6.5mm screws),insert the Numelock II locking screwas far as possible without lockingthe ring mechanism. Preventrotation of the ring mechanism byengaging the Holding Spanner’s(Ref. No. CESH5 for 4.5mm screwsor CESH7 for 6.5mm screws) teethwith the corresponding slots in thering. Repeat Steps Two throughFour for all screw positions in theepiphysis/metaphysis. If transportof a bone fragment is anticipated,see Step Five.

Operative Technique

General Principles

Fig.1 Fig.2

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Step Five – Final Adjustments /Transport (Fig.3)

• To adjust the position of the bonewith respect to the plate or to pulla bone segment closer to the plate,use the Ring Driver (Ref. No.TVESH5 for 4.5mm screws orTVESH7 for 6.5mm screws) withautomatic centering. By turning thering clockwise with the Ring Driver,the bone is moved closer to the plateas required.

Note:Further displacement of the boneto the plate is no longer possible ifmore than three Numelock IIlocking screws have been applied.

Note:If using this feature to realign twobone segments, the orientation ofscrew placement must be parallelto the plane of the line of thefracture associated with these twosegments.

Step Six – Final Locking(Fig.4)

• When all desired adjustments arecomplete, lock each Numelock IIscrew with the screwdriver whileholding the ring steady with theHolding Spanner. Firm tightening ofthe screws ensures stability.After locking, it is no longer possibleto rotate the ring without damagingthe locking mechanism.

Note:To guarantee maximum stability,fill all Numelock II holes with ascrew of appropriate length.

Step Seven – RemainingDiaphyseal Screws

• Pre-drill and measure for placementof remaining SPS Cortical Screws asnecessary. Insert screws and securelytighten.

Operative Technique

General Principles

Fig.3 Fig.4

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Operative Technique

Indication Procedures

Proximal Humerus

Principal Indications:

• Fractures of the proximal segmentof the humerus (2, 3 and 4 partfractures).

Surgical Approach:

• Deltoidpectoral.

Tips and Additional Information:

• The additional small holes in theplate allow for the placement ofKirschner Wires to facilitate fracturereduction and for maintaining thereduction in correct position.

• Posterior sutures can be sewnthrough these holes to facilitatereattachment of the tuberosities.

• The placement of proximal axiallystable (locking) screws enhances thestability of the construct.

Post-Operative Considerations:

• Usage of axially stable locking screwsin the plate may permit mobilizationof the shoulder joint in the earlypost-operative phase.

Distal Humerus


• Extra-articular supra-condylarfractures.

• Fractures above and withinthe condyles.

• Epicondylar and lateralcolumn fractures.

• Epitrochlear and medialcolumn fractures.

Surgical Approach:

• The standard approach is madethrough a posterior medial incision.

• According to the type and locationof the fracture, additional approachesmay be necessary.


• The diaphyseal screws must bepositioned before insertion of theepiphyseal/metaphyseal screws tominimize risk of secondarydisplacement in the frontal planeinto varus or valgus deformity.

• The Numelock II plating systempermits the use of a single lateralplate for many distal humerusfractures. This is due to the inherentstability of the construct which canmake the use of an additional medialplate unnecessary.

• If the fracture affects only the medialstructures, fixation with only amedial plate is often sufficient.


• Mobilization is possible in the earlypost-operative phase.

• The stability provided by the lockingscrews allows many of these fracturesto be stabilized using only a lateralplate, without the need for amedial plate.

• Depending on the fracture and at thesurgeon’s discretion, a single lateralplate or two plates fixed medially andlaterally may be used. The choiceand number of plates used needsto be taken into consideration fordetermining correct post-operativerehabilitation protocol.

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Operative Technique

Proximal Tibia


• Fractures of the tibial condyles• Lateral (most frequent).

• Medial.

• Bi-condylar.

• Extra-articular metaphysealfractures.

Surgical Approach:

• The optimal approach is through alateral or medial incision dependingon the zone of the fracture.


• Given that affected articulationsmust be accurately reduced to restoreanatomical integrity, the use ofadditional bone graft (in cases withmajor crushing) is strongly advised.

• Placement of the plate begins withpositioning of the diaphyseal screwsand ends with placement of themetaphyseal and epiphyseal screws.

• Adjustments of the metaphysealscrews to compress the plate to thebone (see Step Five of GeneralPrinciples) are indicated for fracturesin the region of the tibial tuberosity.

• A similar adjustment using theepiphyseal screws can beimplemented in bicondylar fractures(type V in Schatzker’s classification)or fractures involving the tibialeminence.

• In most cases, application of twoplates (lateral and medial) shouldbe avoided. The concept of thisaxially stable system is such thatfixation with a single lateral plateis usually sufficient.


• Early mobilization and partialweight-bearing are possible formetaphyseal fractures withoutcartilaginous complicationsin the joint.

• In cases with cartilaginousinvolvement, mobilization withoutweight-bearing may be possible.

• Usage of a brace may be considered.

Distal Tibia


• Extra-articular fractures of thedistal tibia.

• Articular tibial (pilon) fractures.

Surgical Approach:

• The optimal approach is through amedial or posterior medial incision.


• Contouring of the proximal part ofthe plate is particularly important tominimize possible irritation of thesoft tissues.

• The anterior and distal parts of theplate allow control of certain anterioror posterior bone fragments.

• It is usually not necessary to placemore than three axially stable(locking screws). Surgeon discretionis required.


• Early mobilization is encouragedfor supramalleolar, extra-articularfractures.



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Distal Radius


• Extra and intra-articular fractures ofthe distal fourth of the radius.

Surgical Approach:

• The optimal approach is the classicvolar entry, going through thepronator quadratus muscle.


• The distal epiphyseal locking screwsprovide stability to the construct andhelp to minimize occurrence ofsecondary displacements.

• Severely comminuted fractures maynecessitate a supplementary dorsalapproach.


• The grip of the screws in the volarplate ensures the stability of theconstruct and usually eliminates theneed for an additional posteriorapproach and reduction.

• Active range of motion withflexion/extension is encouragedin the immediate post-operativephase, without need for additionalimmobilization in the majorityof cases.

Distal Femur


• Supra-condylar extra-articularfractures.

• Fractures above the condyles.

• Intercondylar fractures.

Surgical Approach:

• The lateral approach is optimal, goingbeneath the vastus lateralis muscle.


• Articular structures must bereduced first.

• The plate must be well adaptedanatomically by bending if necessary,but only in the proximal part to avoiddamage to the distal locking system.

• Diaphyseal screws are inserted first,followed by fixation of themetaphyseal zone and then followedby fixation in the epiphyseal region.

• Frontal (Hoffa type) fractures arereduced using additional,independent anteriorposterior screwswhich are not in the plate.


• Early mobilization may be consideredif all five locking screws are placed inthe condylar region.

• Weight-bearing should be postponedin cases with joint involvement withcartilaginous lesions.


Operative Technique


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Clinical Examples

Distal Humerus

Distal Femur

Proximal Tibia

17* Recommended Item

Stainless Steel Length Side Locking ShaftREF mm Holes Holes

SHHP8TDS * 75 Right 4 4SHHP8TGS * 75 Left 4 4SHHP10TDS * 95 Right 4 6SHHP10TGS * 95 Left 4 6SHHP12TDS 115 Right 4 8SHHP12TGS 115 Left 4 8SHHP14TDS * 135 Right 4 10SHHP14TGS * 135 Left 4 10


SHBEP7TDS * 85 Right 5 2SHBEP7TGS * 85 Left 5 2SHBEP8TDS * 98 Right 5 3SHBEP8TGS * 98 Left 5 3SHBEP10TDS 124 Right 5 5SHBEP10TGS 124 Left 5 5


SHBIP5TS * 70 Symmetrical 4 1SHBIP7TS * 100 Symmetrical 4 3SHBIP9TS 130 Symmetrical 4 5


SRBIP7TDS * 57 Right 4 3SRBIP7TGS * 57 Left 4 3SRBIP8TDS * 67 Right 4 4SRBIP8TGS * 67 Left 4 4

Ordering information – Plates

PROXIMAL HUMERUSStandard Screws Diameter 3.5mmLocking Screws Diameter 4.5mm

LATERAL DISTAL HUMERUSStandard Screws Diameter 3.5mmLocking Screws Diameter 4.5mm

MEDIAL DISTAL HUMERUSStandard Screws Diameter 3.5mmLocking Screws Diameter 4.5mm

VOLAR DISTAL RADIUSStandard Screws Diameter 3.5mmLocking Screws Diameter 4.5mm

Stainless Steel, Packaged Sterile



SFBEP10TDS * 124 Right 5 5SFBEP10TGS * 124 Left 5 5SFBEP12TDS * 158 Right 5 7SFBEP12TGS * 158 Left 5 7SFBEP14TDS * 192 Right 5 9SFBEP14TGS * 192 Left 5 9SFBEP16TDS 226 Right 5 11SFBEP16TGS 226 Left 5 11


STHEP7TDS * 84 Right 3 4STHEP7TGS * 84 Left 3 4STHEP8TDS * 97 Right 3 5STHEP8TGS * 97 Left 3 5STHEP9TDS 110 Right 3 6STHEP9TGS 110 Left 3 6STHEP10TDS * 123 Right 3 7STHEP10TGS * 123 Left 3 7


STHIP8TDS * 91 Right 3 5STHIP8TGS * 91 Left 3 5STHIP10TDS * 117 Right 3 7STHIP10TGS * 117 Left 3 7STHIP12TDS * 143 Right 3 9STHIP12TGS * 143 Left 3 9STHIP14TDS 169 Right 3 11STHIP14TGS 169 Left 3 11

LATERAL PROXIMAL TIBIAStandard Screws Diameter 4.5mmLocking Screws Diameter 6.5mm

LATERAL DISTAL FEMURStandard Screws Diameter 4.5mmLocking Screws Diameter 6.5mm

MEDIAL PROXIMAL TIBIAStandard Screws Diameter 4.5mmLocking Screws Diameter 6.5mm


STBIP9TDS * 81 Right 6 3STBIP9TGS * 81 Left 6 3STBIP11TDS * 107 Right 6 5STBIP11TGS * 107 Left 6 5STBIP13TDS * 133 Right 6 7STBIP13TGS * 133 Left 6 7STBIP15TDS 159 Right 6 9STBIP15TGS 159 Left 6 9

MEDIAL DISTAL TIBIAStandard Screws Diameter 4.5mmLocking Screws Diameter 4.5mm

Ordering information – Plates

Stainless Steel, Packaged Sterile

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Ordering information – Locking Screws

* Recommended Item

StSt LengthREF mm

S5SH14S * 14S5SH16S * 16S5SH18S * 18S5SH20S * 20S5SH22S * 22S5SH24S * 24S5SH26S * 26S5SH29S * 29S5SH32S * 32S5SH35S * 35S5SH38S * 38S5SH42S * 42S5SH46S * 46S5SH50S * 50S5SH55S * 55S5SH60S * 60S5SH65S * 65S5SH70S * 70S5SH75S * 75

StSt LengthREF mm

S7SH27S * 27S7SH30S * 30S7SH33S * 33S7SH36S * 36S7SH39S * 39S7SH42S * 42S7SH45S * 45S7SH50S * 50S7SH55S * 55S7SH60S * 60S7SH65S * 65S7SH70S * 70S7SH75S * 75S7SH80S * 80S7SH85S * 85

4.5MM LOCKING SCREWS STAINLESS STEEL, PACKAGED STERILE

6.5MM LOCKING SCREWS STAINLESS STEEL, PACKAGED STERILE


Ordering information – Instruments

REF Description

4.5mm Instrumentation

TRTPS * Plate Bending Iron (two required)

GM25 * Drill Guide

700351 * 2.5mm Drill Bit


JA65 * Depth Gauge

TASH5 * Cutting Screwdriver

TVESH5 * Ring Driver

CESH5 * Holding Spanner

900106 * Screw Forceps

6.5mm Instrumentation

TRTPS * Plate Bending Iron (two required)

GM35 * Drill Guide

MCA35195 * 3.5mm Drill Bit


JA65 * Depth Gauge

TASH7 * Cutting Screwdriver

TVESH7 * Ring Driver

CESH7 * Holding Spanner

900106 * Screw Forceps

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Ordering information – Cases and Trays

REF Description

BALOCK5 4.5mm Instrument Storage Base

BALOCK7 6.5mm Instrument Storage Base

INLOCK5 4.5mm Locking Screw Storage Tray

INLOCK7 6.5mm Locking Screw Storage Tray

COLOCK Lid (Fits 4.5mm and 6.5mm Storage Bases)

TALOCK Silicon Mat (Fits inside miscellaneous compartments of4.5mm and 6.5mm Storage Bases)

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Notes

23

Notes

This document is intended solely for the use of healthcare professionals. A surgeon must always rely on his or herown professional clinical judgment when deciding whether to use a particular product when treating a particularpatient. Stryker does not dispense medical advice and recommends that surgeons be trained in the use of anyparticular product before using it in surgery. The information presented in this brochure is intended to demonstratea Stryker product. Always refer to the package insert, product label and/or user instructions including the instructionsfor Cleaning and Sterilization (if applicable) before using any Stryker products. Products may not be available in allmarkets. Product availability is subject to the regulatory or medical practices that govern individual markets. Pleasecontact 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 followingtrademarks or service marks: Stryker, Numelock II.

All other trademarks are trademarks of their respective owners or holders.The products listed above are CE marked.

Literature Number: 982195LOT B1309

Copyright ©2009 Stryker

Stryker Trauma AGBohnackerweg 1CH-2545 SelzachSwitzerland

www.osteosynthesis.stryker.com

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