Femoral Neck Checking Option Pre-Collapsed Insertion

Option: Pre-Collapsed Insertion 4. Ream for Insertion of Plate and Bolt 1 1 Instrument 03.168.004 Reamer, complete Consisting of: 03.168.005 Drill Bit B 10.2 mm, cannulated, length 251 mm 03.168.006 Reamer B 12.5 mm 03.168.007 Nut, for Reamer 2 3 Assemble the reamer by sliding the reamer-component over the drill bit until it clicks into place at the calculated construct size (70 mm in the example*). Lock the reamer by adding and fully tightening the nut. (1) Note: Set the reamer to the calculated construct size (therefore 5 mm shorter than the construct size to be used, see table below). Pre-Collapsed Insertion – Reference Table: Calculated Construct Size (refer to page 12) 70 Setting on Reamer (refer to above) 70* Construct Size to be Used (Bolt/ARScrew) (refer to page 24/31) 75 Setting on Drill for ARScrew (refer to page 23) 75 * If not etched, select the groove next to 75 mm towards the drill tip. Note: This technique can be performed with other construct sizes as well, for example using a 100 mm construct size when the calculated construct size is 95 mm (see table below). Calculated Construct Size (refer to page 12) 95 Setting on Reamer (refer to above) 95 Construct Size to be Used (Bolt/ARScrew) (refer to page 24/31) 100 Setting on Drill for ARScrew (refer to page 23) 100 29 Pre-Collapsed Insertion Ream down until the reamer stops on the bone. (2) 2 An tiro tati on Wi re Notes: • It is recommended that the femoral head is temporarily fixated with an antirotation wire prior to reaming. • An inappropriate position of the antirotation wire may interfere with the proper placement of the implant. • Control guide wire migration, check reaming depth during reaming and ensure complete reaming is achieved using the image intensifier. • When reaming in dense bone, use of continuous irrigation is recommended. • Avoid excessive reaming force during reaming. Remove the reamer. It is important to reinsert the guide wire if it is removed accidentally. To reinsert the wire push the reamer back into the reamed hole (without the use of a power tool) and use the cannulation to reinsert the guide wire into the original position. 31 2 5. Assemble Implant and Insertion Instruments 1 Instruments 03.168.008 Insertion Handle 03.168.009 Insert, for Insertion Handle A A Slide the insert into the insertion handle, without tightening the black screw. (1) Fully insert the bolt with a 5 mm longer construct size than calculated and reamed (therefore 75 mm in the example, refer to table on page 29) into the plate. (2) 2 Option: A longer side plate with two locking holes (2-hole plate) is available as option. B Mount the implant onto the insertion handle. (3) Note: Ensure that the implant is correctly fixed to the insertion instrument and that the bolt is in the completely extended position. C Manually tighten the black screw of the insert to attach the implant. (4) Precaution: Hand-tightening the black screw is sufficient. Using additional tools might cause overtightening. 4 3 C B 31 Pre-Collapsed Insertion 6. Pre-Collapse Insertion Instruments 5 Instrument 03.168.003 Direct Measuring Device, for Guide Wires B 3.2 mm 5m After tightening, untighten (counter-clockwise) the black screw by at least 5 mm (e.g. by 5 halfturns), allowing the implant construct to shorten for 5 mm. (5) Precaution: Confirm that the distance is at least 5 mm, by loosely fitting the direct measuring device between the black screw and the insertion handle. (6) 6 32 m 7. Insert Implant 1 Instrument on Wi re Cylinder, for Insertion Instruments (optional) An tiro tati 03.168.015 Insert the implant over the central guide wire into the pre-reamed hole. (1) Precaution: When not using the cylinder, the guide wire will become visible on the outer side of the insert. Ensure not to move the guide wire. (2) Option: The cylinder can be used to manually tap the plate onto the bone. (3) If additional tapping is required, use a standard surgical hammer to slightly tap onto the cylinder. 2 Precaution: Ensure that the black screw is not turning (e.g. by holding it), if tapping is required during insertion. (3) An tiro tati on Wi re Use image intensification to confirm the insertion depth and ensure that the plate is inserted down to the bone as well as aligned with the axis of the femoral shaft. (4) Notes: • It is recommended that the femoral head is temporarily fixated with an antirotation wire prior to implant insertion. • Avoid excessive insertion force. tiro tati on Wi re 4 An 4 3 33 Pre-Collapsed Insertion 8. Remove Guide Wire 1 Remove the central guide wire. (1) Keep the antirotation wire to prevent loss of reduction and rotation of the head. 34 e Central Guide Wir An tiro tati on Wi re Continue with Locking Screw and AntirotationScrew Insertion (see page 18 to 25).