AO-鹰嘴钢板

3.5 mm LCP Olecranon Plates.Part of the Small Fragment LockingCompression Plate (LCP) System. Technique GuideIntroduction Surgical Technique Product Information Table of Contents3.5 mm LCP Olecranon Plates 2AO Principles 3Indications 4Clinical Cases5Preparation 6Implantation 8Insert Distal Screws 12Implant Removal14Implants 15Instruments 16Set List20Sterilization Parameters20Synthes3.5 mm LCP Olecranon Platesfixed-angle construct.Unicortical fixation optionUnicortical locking screws providestability and load transfer only at thenear cortex due to the threaded con-nection between the plate and thescrew. Because the screw is locked tothe plate, fixation does not rely solelyon the pullout strength of the screwor on the frictional force between theplate and the bone.2Synthes 3.5 mm LCP Olecranon PlatesAO PrinciplesIn 1958, the AO formulated four basic principles which havebecome the guidelines for internal fixation.1Those principles,as applied to the 3.5 mm LCP Olecranon Plate, are:Anatomic ReductionPrecontoured plate assists reduction of metaphysis todiaphysis and facilitates restoration of the articular surface.Stable FixationLocking screws create a fixed-angle construct providingangular stability.Preservation of Blood SupplyTapered end for submuscular plate insertion preservestissue viability.Early MobilizationEarly mobilization per standard AO technique createsan environment for bone healing, expediting a returnto optimal function.1. M.E. Müller, M. Allgöwer, R. Schneider, and H. Willenegger. AO Manualof Internal Fixation, 3rd Edition. Berlin: Springer-Verlag, 1991.Synthes3IndicationsFixation of fractures, osteotomies and nonunions of the olecranon, particularly in osteopenic bone. 4Synthes 3.5 mm LCP Olecranon PlatesClinical CasesCase 2–Male patient, 41 years old–Olecranon fracture: 21-C2, right arm–Implant: LCP Olecranon Plate with 4 holesSynthes5Image intensifier during surgery, lateral viewPreoperative, lateral viewPostoperative (ten days after surgery), lateral view Postoperative (ten days after surgery), PA view6Synthes 3.5 mm LCP Olecranon PlatesPreparation1Position the patientPlace the patient either in the lateral or the prone position with the elbow flexed over a side rest. Depending on the fracture, use a posterior access up to approximately 5 cm distal from the supracondylar region.The supine position with the forearm placed across the chest is also an acceptable option, especially with extendedapproaches to the lateral pillar or column.Synthes 72Surgical approachThe incision runs posterior from the supracondylar area to a point 4 cm –5 cm distal to the fracture. It can be slightly curved to the radial side to protect the ulnar nerve.3Reduce the fracture and provide temporary fixation Reduce the fracture directly or indirectly depending on the type of fracture. Ensure that the coracoid is properly reduced before fixation.Examine the reduction of the coracoid process to determine if it is correct before fixation.Use Kirschner wires for temporary fixation.1Determine plate length and adapt the plate Required Set105.434Small Fragment LCP Instrument andImplant Set, with self-tapping screwsor145.434Small Fragment Titanium LCP Instrumentand Implant Set, with self-tapping screwsInstruments329.04,Bending Irons329.05329.151Locking Calcaneal Plate CutterSelect a plate length appropriate for the fracture.For an optimum fit, the plate can be bent a maximumof 4°at each notch in the plane of the shaft.The triceps tendon may have to be split in order to apply the plate from a posterior direction.Evaluate whether or not the hole in the proximal tab should be used. If necessary, use the locking calcaneal plate cutter to remove the tab.Note:If bending the tab, take care that the screw inthe tab does not collide with the other proximal screws. Implantation8Synthes3.5 mm LCP Olecranon Platesmax. 4ºSynthes9Implantation continuedmax. 30 mmInsert Distal ScrewsImplant Removal (optional)Optional Set105.971Screw Removal SetInstruments309.520Conical Extraction Screw311.43Handle, with quick couplingTo remove locking screws, unlock all screws from the plate, then remove the screws completely from the bone. This prevents simultaneous rotation of the plate when unlocking the last locking screw.If the screws cannot be removed with the screwdriver (e.g. if the hexagonal or StarDrive recess of the locking screws is damaged or if the screws are stuck in the plate), insert the conical extraction screw with left-handed thread into the screw head, using the handle with quick coupling, and loosen the locking screw by turning it counterclockwise.Screws Used with the 3.5 mm LCP Olecranon Plate3.5 mm Locking Screws–Creates a locked, fixed-angle screw-plate construct –Fully threaded shaft–Self-tapping tip–Used in the locking portion of the Combi holesor in round locking holes3.5 mm Cortex Screws–May be used in the DCU portion of the Combi holes in the plate shaft or in round locking holes–Compresses the plate to the bone or createsaxial compression–Fully threaded shaft2.7 mm Cortex Screws–May be used in the proximal locking holes–Compresses the plate to the bone–Fully threaded shaft212.101–212.124 204.810–204.860202.810–202.855Instruments312.910 Guiding Block for 3.5 mm LCP OlecranonPlate, right312.911 Guiding Block for 3.5 mm LCP OlecranonPlate, leftSelected Instruments from the Small Fragment LCP Instrument and Implant Set (105.434)292.71 1.6 mm Kirschner Wire with thread,150 mm, trocar point310.25 2.5 mm Drill Bit310.288 2.8 mm Drill Bit311.43Handle, with quick coupling312.648 2.8 mm Threaded Drill Guide314.02Small Hexagonal Screwdriver withHolding Sleeve314.03Small Hexagonal Screwdriver ShaftSelected Instruments from the Small Fragment LCP Instrument and Implant Set (105.434) continued323.0542.8 mm Drill Sleeve 323.0551.6 mm Wire Sleeve314.115StarDrive Screwdriver, T15314.116StarDrive Screwdriver Shaft, T15,quick coupling319.01Depth Gauge323.023 1.6 mm Wire Sleeve, 55 mm323.025Direct Measuring Device323.36 3.5 mm Universal Drill Guide329.04Bending Iron, for 2.7 mm and 3.5 mm plates,150 mm lengthUsed with 329.05329.05Bending Iron, for 2.7 mm and 3.5 mm plates,150 mm lengthUsed with 329.04511.770Torque Limiting Attachment, 1.5 Nmor511.773Torque Limiting Attachment, 1.5 Nm,quick coupling20Synthes 3.5 mm LCP Olecranon Plates3.5 mm LCP Olecranon Plate Instrument and Implant Set Stainless Steel (01.104.015) and Titanium (01.104.016)Graphic Case 690.415 3.5 mm LCP Elbow System Graphic Case 690.417 3.5 mm Titanium LCP Elbow SystemGraphic CaseImplants3.5 mm LCP Olecranon Plates, right Stainless Steel Titanium Holes Length (mm)236.502436.502286236.504436.5044112236.506436.5066138236.508436.5088164236.510436.51010189236.512436.512122153.5 mm LCP Olecranon Plates, left Stainless Steel Titanium Holes Length (mm)236.503436.503286236.505436.5054112236.507436.5076138236.509436.5098164236.511436.51110189236.513436.51312215Instruments 312.910 Guiding Block for 3.5 mm LCP Olecranon Plate, right312.911Guiding Block for 3.5 mm LCP Olecranon Plate, left* Set is shown with Locking Calcaneal Plate Cutter (329.151) which is also available.SynthesSynthes (USA)1302 Wrights Lane East West Chester, PA 19380 Telephone: (610) 719-5000 To order: (800) 523-0322 Fax: (610) 251-9056Synthes (Canada) Ltd.2566 Meadowpine Boulevard Mississauga, Ontario L5N 6P9 Telephone: (905) 567-0440 To order: (800) 668-1119 Fax: (905) 567-3185© 2007 Synthes, Inc. or its affiliates. All rights bi, LCP and Synthes are trademarks of Synthes, Inc. or its affiliates.Printed in U.S.A. 6/07 J6645-A。