Implants & Instruments Small Fragment LCP Set Implants & Instruments

Objectives Describe the implants found in the Small Fragment Locking Compression Plate (LCP) Set Identify the standard and new instruments that are used with locking screws & plates

Small Fragment LCP Set Used on small bone fractures -- ankle, forearm, humerus, pelvis Instruments same as standard Small Fragment plus more Available in graphic cases with stainless steel or titanium implants

Implants Standard Screws 3.5mm Cortex 3.5mm Shaft (Cortex) 4.0mm Cancellous Fully threaded Partially threaded All with standard small fragment hex head 2.7mm Cortex Screw also in set (not shown)

Screw Characteristics Head Shaft Thread Core Dimensions determine drill bit sizes Core of all screws = 2.5mm drill bit Thread diameter of cortex screws = 3.5mm drill bit

Implants 3.5mm Locking Screw StarDrive™ recess Threaded underside of head Locks screw to locking plate Small thread pitch Large 2.8mm core diameter

Implants Straight Plates 3.5mm Locking Compression One Third Tubular 3.5mm Straight Reconstruction 3.5mm Curved Reconstruction

Implants Specialty Plates 3.5mm Oblique T-Plate, L & R 3.5mm T-Plate 3.5mm Locking Proximal Humeral Plate

Locking Plate Features Combination “Combi” Hole Smooth side accepts cortex, shaft & cancellous screws Threaded side accepts locking screws Plate is contourable

Standard Instruments Same as other Small Fragment Sets: Exposure Reduction Screw insertion Plate bending Plate application

Exposure Instruments Periosteal Elevator Hohmann Retractors

Reduction Instruments Forceps With points -- narrow & broad Serrated forceps

Screw Insertion Instruments Drill Bits 3.5mm 2.5mm 2.0mm (not shown)

Screw Insertion Instruments Universal Drill Guide Spring loaded side accepts 2.5mm drill bit Opposite side accepts 3.5mm drill bit & taps Must be used with locking plates 2.5mm 3.5mm

Screw Insertion Instruments 3.5mm Universal Drill Guide Spring loaded end allows precise placement of screw in non-threaded end of plate hole Spring activated = “neutral” position Spring not activated = “load” or “compression” position (away from fracture line)

Screw Insertion Instruments Countersink Use with quick connect Tap Handle

Screw Insertion Instruments Depth Gauge Calibrations in 2mm increments Measures to 50mm length screws Hook on same side as calibrations

Screw Insertion Instruments Taps 3.5mm cortex 4.0mm cancellous Used w/QC Tap Handle Always pass with Tap Sleeve

Screw Insertion Instruments Small Fragment Hex Screwdriver Hints: Screw driver shaft + tap handle = back-up screwdriver Use holding sleeve to remove screws from screw rack

3.5mm Cortex Lag Technique Steps Drill 3.5mm Drill 2.5mm Countersink Measure Tap sometimes – 3.5mm Insert 3.5mm Cortex Screw

4.0mm Cancellous Lag Technique Steps Drill 2.5mm Measure Tap – rarely Insert 4.0mm Cancellous Screw

Plate Bending Instruments Bending Pliers Bending Irons Bending Templates

Instruments for Locking Plates 2.8mm Drill Bit Used to drill for 3.5mm Locking Screws

LCP Instruments 2.8mm Threaded Drill Guide Correct Incorrect Ensures proper drilling angle Not for use as a plate bender Correct Incorrect

LCP Instruments 1.6mm Wire Sleeve Inserts into Threaded Drill Guide to accept 1.6mm Guide Wire Screw placement can be checked under image

LCP Instruments Direct Measuring Device Used over 1.6mm K-wires to measure for locking screw length

LCP Instruments StarDrive Screwdrivers Self-retaining StarDrive Shaft used with Torque Limiting Attachment

LCP Instruments Torque Limiting Attachment Allows power insertion of locking screws No further tightening of screws necessary

LCP Instruments Threaded Plate Holder Non-cannulated Used as handle to position plate and insert plate in percutaneous technique Can be used to bend T-plates and One-third Tubular Plates when used in pairs

LCP Instruments Push-Pull Reduction Device (Whirly-Bird) Secures plate to bone Guards against “helicopter effect” of the plate Hole can be used for cortex screw insertion (same 2.5mm diameter as drill bit)

Care & Maintenance Keep drill bits & taps sharp Clean cannulations Disassemble instruments Lubricate

Care & Maintenance Tighten screwdriver holding sleeve Clean graphic cases

Care & Maintenance Inspect threads on Threaded Drill Guides

Quiz Question True or false? You must remember to pull the Small Fragment locking screw rack in addition to the instrument and plate set. False. Small fragment instruments, plates & screws are in the same graphic case.

What is the drill bit size used to drill for the core of the 3 What is the drill bit size used to drill for the core of the 3.5mm cortex screw? 2.5mm What is the drill bit size used to drill for the core of the 3.5mm locking screw? 2.8mm

For what types of procedures might you have the LCP Small Fragment Set in the room? Older patients (osteoporosis) Re-operation on a non-union Replacing broken hardware Other ?

Now you should be able to: Describe the implants (screws & plates) in the LCP Small Fragment Set Identify the instruments that are used with standard and locking screws & plates