Small Fragment LCP Set Implants & Instruments

1. Small Fragment LCP Set Implants & Instruments

2. 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

3. 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

4. ImplantsStandard 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)

5. 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

6. Implants3.5mm Locking Screw • StarDrive™ recess • Threaded underside of head • Locks screw to locking plate • Small thread pitch • Large 2.8mm core diameter

7. ImplantsStraight Plates 3.5mm Locking Compression • One Third Tubular 3.5mm Straight Reconstruction 3.5mm Curved Reconstruction

8. ImplantsSpecialty Plates 3.5mm Oblique T-Plate, L & R • 3.5mm T-Plate 3.5mm Locking Proximal Humeral Plate

9. Locking Plate FeaturesCombination “Combi” Hole • Smooth side accepts cortex, shaft & cancellous screws • Threaded side accepts locking screws • Plate is contourable

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

11. Exposure Instruments • Periosteal Elevator • Hohmann Retractors

12. Reduction Instruments • Forceps • With points -- narrow & broad • Serrated forceps

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

14. 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

15. 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)

16. Screw Insertion Instruments • Countersink • Use with quick connect Tap Handle

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

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

19. 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

20. 3.5mm Cortex Lag TechniqueSteps • Drill 3.5mm • Drill 2.5mm • Countersink • Measure • Tap sometimes – 3.5mm • Insert 3.5mm Cortex Screw

21. 4.0mm Cancellous Lag TechniqueSteps • Drill 2.5mm • Measure • Tap – rarely • Insert 4.0mm Cancellous Screw

22. Plate Bending Instruments • Bending Pliers • Bending Irons • Bending Templates

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

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

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

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

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

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

29. 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

30. 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)

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

32. Care & Maintenance • Tighten screwdriver holding sleeve • Clean graphic cases

33. Care & Maintenance • Inspect threads on Threaded Drill Guides

35. 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.

36. 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

37. 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 ?

38. 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