Implant Extraction Set Implant Extraction Guide Module One & Two 1 Contents 1. Introduction Introduction Features and Benefits Contraindications 2. Product Description 3. Technical Details Screws Condyle Screws Cannulated Screws Damaged Screw Head Broken Screws Plates Broken Cannulated Screws Lag Screw IM Nails Broken IM Nails 4. Additional Information HydroSet References Ordering Information – Instruments This publication sets forth detailed recommended procedures for using Stryker Osteosynthesis devices and instruments. It offers guidance that you should heed, but, as with any such technical guide, each surgeon must consider the particular needs of each patient and make appropriate adjustments when and as required. A workshop training is required prior to first surgery. See package insert (L22000007) for a complete list of potential adverse effects, contraindications, warnings and precautions. The surgeon must discuss all relevant risks, including the finite lifetime of the device, with the patient, when necessary. Warning: All bone screws referenced in this document here are not approved for screw attachment or fixation to the posterior elements (pedicles) of the cervical, thoracic or lumbar spine. 2 Page 3 3 3 3 4 6 6 6 7 7 8 9 10 11 13 14 15 15 15 16 Although considered easy and straightforward by patients, hardware removal is almost always more challenging than the insertion of the implants ¹. Specialty instruments can significantly facilitate hardware removal while minimizing damage to the surrounding bone/soft-tissue. Stryker has developed a comprehensive set of instruments / techniques to assist the surgeon with these challenging issues, regardless of the indication or timing. Additionally, stripped screws and stripped IM Nails proximal threads (used for removal) may rise surgical difficulty and should be treated together. Stryker Extraction System is a set of instrumentation developed to meet the surgeons need for implant extraction. The System consist of two modules for the removal of almost any Stryker Trauma implant, as well as many nonStryker plates, nails, and screws*. Conical and Spreading Tip Screwdrivers are provided in varying sizes for the safe removal of torx, hex, and cannulated screws. Nail and Lag Screw removal is facilitated through the availability of different sized Adaptors and Conical Extraction Rods that are easily assembled. Module Two contains extraction instruments for the removal of stripped and / or broken screws and implants. Stryker Extraction System is a single instrument platform that can be used for various extraction methods according to each individual case, in a minimally invasive operating procedure, allowing for the removal of almost any Stryker Trauma implants. It may also be compatible with nonStryker implants*. Since broken hardware can often be identified on preoperative radiographs, but may also be encountered unexpectedly during an operation, Stryker recommends having both modules present in the operating room to facilitate surgical procedures and to reduce operative time. * Stryker can only recommend use of the extractor instruments with its own products. Application of the instruments to competitive products or to Stryker products that have been altered may be possible but has not been validated. Where competitive products are mentioned in this document this is solely to indicate where application of the extractor instruments appears possible due to similar design or dimensions, and Stryker does not guarantee that the extractor instruments demonstrated herein will work in any cases where competitive products are used, or in cases where Stryker products have been altered. As a precaution, make sure to have other standard instruments available in case the tolerances of the implants do not match the tolerances of the extractor tool. 1. J Am Acad Orthop Surg 2006;14:113-120 Hardware Removal: Indications and Expectations Matthew L. Busam, MD, Robert J. Esther, MD, MSc, William T. Obremskey, MD, 3 Universal Instruments • Compatible for use with other manufactures’ implants* Single Instrument Platform • Simplified surgical technique Contraindications Lag Screw In addition, there is frequently no bail out because the hardware must be removed in order to revise the fixation for a non-union or to address infection. Module One includes instrumentation for the removal of internal fixation systems and associated screws. Versatility: • Removal of standard, broken and / or stripped nails, plates and screws • Multiple extraction methods Cold welded screws require cutting tools for metal to remove the screws. The extraction set does not feature carbide drills or other cutting tools to remove cold welded screws. Nails The most challenging are typically points 3 and 4 as the hardware maybe broken and / or tissue planes distorted. It has evolved from our extensive clinical experience with trauma devices, as well as from the collaboration with experienced surgeons worldwide. HydroSet Hardware removal occurs for four reasons: 1. Elective removal. 2. Removal secondary to symptoms. 3. Removal for infection. 4. During revision procedures. Features and Benefits Instruments Introduction Screws Introduction Product Description Article Stryker Systems Teardrop handle, AO-medium For AO medium bits: - Screwdriver bits - Crowndrills (Trephines) - Conical extractors male/female Screwdriver Bit 2.5 (conical) For 2.5mm Hex Screws: T2 Hum Compression; Asnis III 4.0; Numelock 4.5; ISO 2.7; ISO 3.5; ISO 4.0 Screwdriver Bit 3.5 (conical) For 3.5mm Hex Screws: 4 and 5mm Locking Screws (T2, S2, Gamma3, IC etc.); T2/S2 End Caps; T2/S2 Fem/Tib Compr. Screws; TLN all Screws; T2 Recon Set Screws 3.7 and 4.6mm Locking Screws G&K; Asnis III 5.0; Numelock 6.5; ISO 4.5; ISO 6.5 Screwdriver Bit 4 (conical) Set Screws for Gamma, Gamma3, Gamma Ti, Dyax-A, AP, AP-J; Proximal Plugs for Gamma, Gamma Ti, Dyax, Dyax-A, AP, AP-J Screwdriver Bit 5 For 5mm Hex Screws: 6.28mm Locking Screws; Asnis III 6.5 and 8.0 and T2/S2 Recon Lag Screws Screwdriver Bit 6.3 For 6.3mm Hex Screws: T2/S2 Condyle Screws Screwdriver Bit 8 G&K SCN Condyle Screws; Gamma3 End Caps Screwdriver Bit T 8 (Torx) AxSOS 3.0 Screwdriver Bit T 15 (Torx) AxSOS 4.0 Screwdriver Bit T 20 (Torx) ALTA 3.7mm Locking Screws; AxSOS 5.0 Screwdriver Bit T 25 (Torx) ALTA 5mm Locking Screws, Lag Screws and Caps Conical Extractor, male, left hand, small (left hand driving) for diameter range 1–2.5mm Asnis III 4.0 Conical Extractor, male, left hand, 2.5 (left hand driving, for damaged hex 2.5mm and diameter range 2.3–4mm) Screws: T2 Hum Compression; Asnis III 4.0; ISO 2.7; ISO 3.5; ISO 4.0 Conical Extractor, male, left hand, 3.5 (left hand driving, for damaged hex 3.5mm and diameter range 3.3–4mm) Screws: 4 and 5mm Locking Screws (T2, S2, Gamma3, IC etc.); T2/S2 End Caps; T2/S2 Fem/Tib Compr. Screws; TLN all Screws; T2 Recon Set Screw 3.7 and 4.6mm Locking Screws G&K; Asnis III 5.0; ISO 4.5; ISO 6.5 Conical Extractor, male, left hand, 4 (left hand driving, for damaged hex 4mm and diameter range 3.8–4.4mm) Set Screws for Gamma, Gamma3, Gamma Ti, Dyax-A, AP, AP-J; Proximal Plugs for Gamma, Gamma Ti, Dyax, Dyax-A, AP, AP-J Conical Extractor, male, left hand, 5 (left hand driving, for damaged hex 5mm and diameter range 4.8–5.4mm) 6.28mm Locking Screws; Asnis III 6.5 and 8.0 and T2/S2 Recon Lag Screws Crowndrill 3 (bonedrill for broken Screws with diameter range =< 3mm) n/a Crowndrill 4 (bonedrill for broken Screws with diameter range =< 4mm) n/a Crowndrill 5 (bonedrill for broken Screws with diameter range =< 5mm) n/a Crowndrill 6.5 (bonedrill for broken Screws with diameter range =< 6.5mm) n/a Crowndrill 8 (bonedrill for broken Screws with diameter range =< 8mm) n/a Crowndrill 10 (bonedrill for broken Screws with diameter range =< 10mm) n/a Crowndrill 12 (bonedrill for broken Screws with diameter range =< 12mm) n/a Conical Extractor, female, left hand, 3 (left hand driving, for broken Screws with diameter range =<3mm) ISO 2.7 Screws, Ulna Locking Screws Conical Extractor, female, left hand, 4 (left hand driving, for broken Screws with diameter range =<4mm) T2/S2 4mm Locking Screws, G&K 3.7mm Locking Screws, ISO Screws 3.5 and 4.0, ALTA 3.7mm Locking Screws Conical Extractor, female, left hand, 5 (left hand driving, for broken Screws with diameter range =<5mm) 5mm Locking Screws (T2, S2, Gamma3, IC, ALTA etc.); ISO Srews 4.5 Conical Extractor, female, left hand, 6.3 (left hand driving, for broken Screws with diameter range =<6.3mm) 6.28mm Locking Screws 4 Product Description Article Stryker Systems Teardrop handle, AO-medium, cannulated (including Rotation Rod) for AO medium bits: Spreading Screwdriver Spreading Screwdriver Bit 5 6.28mm Locking Screws; Asnis III 6.5 and 8.0 and T2/S2 Recon Lag Screws Spreading Screwdriver Bit 6.3 T2/S2 Condyle Screws Spreading Screwdriver Bit 8 G&K SCN Condyle Screws; Gamma3 End Caps Punches 2.7 for broken Screws with diameter range =<3mm Punches 3.7 for broken Screws with diameter range from 3–4mm Punches 5 for broken Screws with diameter range >4mm Forceps, small for damaged Screws, broken Screws with diameter <9mm Forceps, large for damaged Screws, broken Screws with diameter >9mm Conical Extraction Rod 6 Extraction of nails using proximal Nail End: T2 Humeral Conical Extraction Rod 8 Extraction of nails using proximal Nail End: Humerus Seidel, T2 Proximal Humeral, T2 Humeral, Alta Humeral, TLN (M7),SCN (M8), Alta Femoral & Tibial, Zickel, IC Femoral & Tibial, T2/S2 Tibial & Femoral Antegrade/Retrograde Conical Extraction Rod 10 Extraction of nails for the proxmal Nail End: Gamma3, Dyax-A, all G&K Nails (Fem, Tib, SFN, STN, SCN) Conical Extraction Rod 13 Extraction of nails using proximal Nail End: Gamma, Gamma Ti, Dyax, AP, AP-J Extraction Hook, small Extraction of cannulated nails with inner diameter 4.6–5.5mm: G&K, Gamma3 (Ti), Seidel, IC, SCN, TLN, T2/S2 Extraction Hook, large Extraction of cannulated nails with inner diameter =>5.6mm: Gamma, Gamma3 (StSt), Dyax, Dyax-A, AP, AP-J, G&K, IC, SCN, Kuentscher Nails Extraction Instrument Lag Screw Consisting of Handle and Extraction Rod. To be used with the threaded rod and nut for the Lag screw extraction Nut Fastens the Extraction Rod to the threaded rods and Connectors Threaded Rod M7 Threaded into Lag screw (Gamma/Dyax-A), fastens connection between Extraction Rod and Connectors Threaded Rod M5 Threaded into Lag screw (Omega), fastens connection between Extraction Rod and Connectors Threaded Rod M4 Threaded into Lag screw (OHS/OCS), fastens connection between Extraction Rod and Connectors Spanner SW17 Serves for larger torque transmission of the Extraction Instrument Lag Screw Connector, Gamma Connector, Gamma U-Blade Connector, Gamma3 U-Blade Connector, Dyax-A Connector, Gamma3 Fits onto the specific Lag Screws, over the threaded Rod, and connects with the Extraction Instrument Lag Screw Connector, Omega and Omega plus Connector, OHS/OCS Sharp Hook (Optional) Removes from bone material Osteotome (Optional) Removes from bone material Outer Introducer (Optional) Hansson Pin Inner Introducer (Optional) Hansson Pin Extractor (Optional) Hansson Pin Emergency Inner Extractor (Optional) Hansson Pin Extractor Handle (Optional) Hansson Twin Hook Outer Extractor (Optional) Hansson Twin Hook Inner Extractor (Optional) Hansson Twin Hook T-Handle, AO-medium (Optional) for AO medium bits: Screwdriver–Screw removal, conical - Crowndrill Screw extraction, conical Screwdriver 2.5 Seidel Humerus Spreading Screw (Standard Seidel instrument) Caution: Implants can be subject to change. This can impact the compatibility of extraction instruments. It is therefore required to start the implant extraction with a complete Extraction Set in order to have access to alternative instruments. 5 Technical Details Screws Screws After identifying screw type and diameter, extract the screws with the appropriate screwdriver bit by turning the screwdriver counterclockwise. Screwdriver Bits (hex) To avoid damaging the screw, make sure the screwdriver is in line with the screw axis and fully inserted. Screwdriver Bits (torx) Solid Teardrop Handle Partially threaded screw removal (e.g. Asnis III screws, T2 Recon Lag Screws) is facilitated by using the spreading screwdriver bits and cannulated handle. For spreading screwdriver instructions see Condyle Screw removal below. Stryker offers a wide variety of hex (standard, conical, spreading) and torx screwdrivers. Check the available type and size on the Ordering Information page. Condyle Screws For T2/S2 Condyle Screw removal, assemble the necessary screwdrivers: The 6.3hex Screwdriver Bit with the Solid Teardrop Handle (for the nut) and the 6.3hex Spreading Screwdriver bit with the Cannulated Teardrop Handle (in combination with the Rotation Rod) as shown in the illustration. Screwdriver Bit Make sure to tighten the Rotation Rod until the tip of the screwdriver spreads firmly and fully into the screw head. Solid Teardrop Handle Spreading Screwdriver Bit Teardrop Handle (cannulated) Rotation Rod A screwdriver needs to be inserted from each side of the Condyle Screw using one to stabilize the Nut and the Spreading Screwdriver to loosen and extract the Condyle Screw. If necessary, use the Spreading Screwdriver to remove the Nut in a second step. The Condyle Screw is extracted by turning the Screwdriver in a counterclockwise direction. 6 Cannulated Screws Never use a worn or damaged screwdriver to remove Asnis screws. Reverse cutting flutes are present for this reason. It is recommended that the Solid Screwdriver be used for Screw removal. The Solid Screwdriver applies greater torque and will reduce the potential for damaging the hexagonal tip on the Screwdriver. Strong bone formation around the implant has been seen in the pediatric cases using partially threaded screws. This may lead to difficult implant removal with an increased risk of screw head breakage or stripping of screw hexagonal head. Solid Teardrop Handle Spreading Screwdriver Bit Screwdriver Bits (hex) Teardrop Handle (cannulated) Rotation Rod If the oblique direction of the screw (approximately 135° to the shaft) is not changed, then the reverse flutes are not in an opportune position to cut the cortex. If the screw head is placed under traction and the angle of the screw is brought to a perpendicular position relative to the bone, cutting the cortex will progress and facilitate screw removal. Caution: Be sure to use the Solid Screwdriver in combination with the appropriate sized screwdriver bits or the cannulated screwdriver with the Spreading Screwdriver Bits. Proceed as described above. Damaged Screw Head Screw stripping is commonly caused by slippage of a screwdriver that is not correctly aligned with the screw axis and/or fully seated. This can occur either during insertion or, more commonly, during attempted screw removal. The appropriate sized Conical Extractor (based on the size of the screw head hex / torx) is inserted firmly into the screw head. Conical Extractor (male) Lightly tapping the Conical Extractor with a Slotted Hammer may be tried if purchase is not initially obtained with manual pressure. It is at the surgeons’ discretion if and how hard to use the hammer. Solid Teardrop Handle Forceps for Screw Removal Assemble the selected Conical Extractor (male) with the Teardop- Handle and turn it counter-clockwise while applying pressure in line with the screw axis, extracting the screw at the same time. If the screw does not come completely out, the Foreceps can be used to complete the extraction. Slotted Hammer 7 Screws Technical Details Technical Details Screws Broken Screws In case of a Broken Screw Shaft: In case of a Torn off Screw Head: Step 1: Remove the screw head portion in order to gain access to the remaining part of the screw shaft. The screw head can be removed with the appropriate screwdriver as described on page 6. Step 1: Overdrill the remaining part of the screw with a Crowndrill. Use another Crowndrill, one size larger, in order to create space for the female Conical Extractor/Drift Punch. It may be necessary to start with light pressure on the crowndrill in order to avoid the drill walking on the cortex surface before applying additional pressure to penetrate the bone. Light tapping with the Slotted Hammer may be required. It remains at the surgeons` own discretion if and how hard to use the Slotted Hammer. Step 2: Use the Drift Punch to extract the remaining part of the screw. If difficulties are encountered with the above process, overdrill the remaining part of the screw with a Crowndrill before proceeding with the Drift Punch. Alternatively, the optional Countersink (6 or 8mm) can be used to create a path for the Crowndrill. Step 2: Remove the remaining part of the screw with the Conical Extractor, (female) if the screw is broken close to the first cortex or with the help of a Drift Punch if the screw is broken close to the second cortex. This procedures can also be applied to broken IM locking screws. Screwdriver Bit Drift Punches Slotted Hammer Crowndrill (Trephine) Forceps for Screw Removal Conical Extractor (female) Broken screw shaft - Step 1 Broke screw shaft - Step 2 Torn-off screw head - Step 1 Torn-off screw head - Step 2 8 Solid Teardrop Handle Technical Details Plates Screws To remove any plate, first extract all screws by using the appropriate size Screwdriver Bits. Remove the plate by using a regular forceps. The development of locking plate technology has lead to “cold welding” of screws to the plates. In this case, cutting tools for metal have to be used for the removal of the screws. In order to protect the soft tissue from excessive heat and metal debris accumulation, irrigation and suction should be used in combination with cutting tools. Warning: If screws are cold welded to the plate, carbide drills may be required. The extraction set does not feature carbide drills or any other instruments to remove cold welded screws. Solid Teardrop Handle Crowndrill (Trephine) Screwdriver Bit Solid Teardrop Handle Forceps 9 Technical Details Screws Broken Cannulated Screws To remove the torn-off head: If Steps 1 and 2 are unsuccessfully for screw removal: Step 1: Select the appropriate Spreading Screwdriver Bit. Attach Cannulated Teardrop Handle. Insert Rotation Rod through the top of the Teardrop Handle. Insert tip into the screw head and turn Rotation Rod to engage and remove screw head. To remove remaining screw body (parts): Step 2: Insert the Conical Extractor (male) and extract the remaining screw body turning the Conical Extractor in a counter-clockwise fashion. Step 3: Overdrill the shaft using the Crowndrill. Spreading Screwdriver Bit Crowndrill (Trephine) Conical Extractor Conical Extractor (female) (male) Teardrop Handle (cannulated) Step 4: Use a Conical Extractor (female) for screw removal. If the attempt for screw removal is not successful, follow the standard procedure for broken screw removal describes on page 8. Rotation Rod Cannulated Screw Removal - Method A - Step 1 Cannulated Screw Removal - Method A - Step 2 Cannulated Screw Removal - Method B - Step 1 Cannulated Screw Removal - Method B - Step 2 10 Technical Details Lag Screw Make a small incision through the old scar distal to the greater trochanter to expose the end of the Lag Screw. Screwdriver Bit 4.0mm Threaded Rod The Threaded Rod is then threaded and tightened into the end of the Lag Screw 2 . Solid Teardrop Handle For Gamma Implants: At first, position the K-Wire through the Lag Screw. Then, the Threaded Rod is inserted over the K-Wire (when used for Gamma) and tightened into the end of the Lag Screw. Remove the K-Wire, if used. 1 2 11 Lag Screw An incision is made over the proximal end of the nail. The End Cap, if used, is removed using the appropriate Screwdriver Bit followed by removal of the Set Screw using the 4.0mm Screwdriver as shown in the image below 1 . Technical Details Lag Screw (continued) Connector Threaded Rod Extraction Rod and Nut Lag Screw Wrench 8/10mm, standard 4 3 Check that ingrowth does not obstruct secure engagement of the Extraction Device, otherwise the implant or the instrument may be damaged and extraction will be more difficult. Slide the appropriate Connector over the Threaded Rod before adding the Extraction Rod & Nut as shown in the picture 3 . Note: In this Technical Guide the Gamma3 Lag Screw is selected as an example to demonstrate Lag Screw removal. However, different Connectors are available for other implants including a Lag Screw. See details on the ordering information page. Finish assembly of the Lag Screw Extraction Device by tightening the Nut 4 and attaching the T-Handle 5 in a final step as shown in the picture. Handle Spanner 17mm standard 5 6 12 The Lag Screw is extracted by turning counterclockwise direction 6 . Use the 17mm Spanner if higher forces are required for the removal of the Lag Screw. Technical Details IM Nails Caution: Special care must be taken to check if the nail moves offcenter from the entry point when screws are removed. Any attempt to remove a nail that is off-center may result in fractures of the distal condylar region. Conical Extraction Rod Universal Rod Strike Plate Sliding Hammer The End Cap, if used, is removed using a Screwdriver. If bone ingrowth obstructs access to the nail, use of either a Crowndrill, pick (not supplied), or currette (not supplied) may provide access. Slotted Hammer Remove the distal/proximal screw with the appropriate Screwdriver Bit. Do not take out the screws of the driving end until the Conical Extraction Rod is attached to the top of the nail in order to avoid rotation. Universal Rod Sliding Hammer Insert the Conical Extraction Rod into the driving end of the nail. or use the Slotted Hammer Lightly hammer the Conical Extractor in order to fully engage the cutting flutes. Connect the Strike Plate and the Universal Rod either adding the Sliding or Slotted Hammer as shown in the picture. Strike Plate Remove now the remaining locking screws before using either Hammer to remove the nail. Conical Extraction Rod Step 1 Step 2 13 Nails When removing an IM nail, it is helpful to identify the nail brand and its diameter in order to choose the correct instrumentation. Technical Details Broken IM Nails Removal of broken IM nails is particularly challenging. Stryker developed a system that can be used for the removal of many cannulated IM nails. An incision is made over the proximal end of the nail. The End Cap, if used, is removed using a Screwdriver. If bone ingrowth obstructs the access to the nail, the use of either a Chisel / Pick (not provided) or a Crowndrill will facilitate removal. Conical Extraction Rod Universal Rod Remove the distal screw with the appropriate Screwdriver Bit. Do not take out the proximal screws until you have attached the Conical Extraction Rod to the top of the nail in order to avoid rotation. Sliding Hammer Connect the Universal Rod and the Strike Plate to the Extraction Rod (center of page) either adding the Sliding or the Slotted Hammer. Strike Plate Extraction Hook Universal Rod Step 1: Insert the nail Extraction Device into the proximal end of the nail, tightening it as firm as possible. Remove the proximal screws before using either Hammer to remove the nail end. Nails Sliding Hammer Strike Plate Extraction Hook Broken IM Nails Step 1 Broken IM Nails Step 2 14 Step 2: After removal of the proximal nail end, exchange the Conical Extraction Rod for the Extraction Hook (as shown to the left). Insert Extraction Hook into the cannulation of the nail fragment. Step 3: Under fluoroscopy, verify that the Hook has passed through the nail end. Make sure that the Hook takes a hold at the end of the nail before pulling to remove it. Step 4: Use the Sliding or the Slotted Hammer to pull out the remaining part of the nail. Broken IM Nails Step 3 Broken IM Nails Step 4 Additional Information HydroSet HydroSet is an injectible self-setting calcium phosphate cement indicated to fill bony voids or gaps of the skeletal system (i.e. extremities, craniofacial, spine, and pelvis). These defects may be surgically created or osseous defects created from traumatic injury to the bone. HydroSet is indicated only for bony voids or gaps that are not intrinsic to the stability of the bony structure. HydroSet cured in situ provides an open void/gap filler that can augment provisional hardware (e.g. K-Wires, Plates, Screws) to help support bone fragments during the surgical procedure. The cured cement acts only as a temporary support media and is not intended to provide structural support during the healing process. Carefully read the IFU, the specific indications and the contraindications. REF 397003 397005 397010 397015 Description HydroSet 3cc HydroSet 5cc HydroSet 10cc HydroSet 15cc HydroSet References J Am Acad Orthop Surg 2006; 14:113- 120 Hardware Removal: Indications and Expectations Matthew L. Busam, MD, Robert J. Esther, MD, MSc, William T. Obremskey, MD 15 Ordering Information - Instruments REF 1806-6150 1806-6152 Description Tray Module 1 (Generic Sterilization and Storage Tray) Module 1 Fully loaded Universal Screw Extraction Devices 1806-6106 Screwdriver Bits conical, hex. 2.5mm 1806-6108 Screwdriver Bits conical, hex. 3.5mm 1806-6110 Screwdriver Bits conical, hex. 4.0mm 1806-6112 1806-6114 1806-6116 1806-6118 1806-6119 1806-6120 1806-6121 Screwdriver Bits, hex. 5.0mm Screwdriver Bits, hex. 6.3mm Screwdriver Bits, hex. 8.0mm Screwdriver Bits, Torx T 8.0 Screwdriver Bits, Torx T 15.0 Screwdriver Bits, Torx T 20.0 Screwdriver Bits, Torx T 25.0 1806-6113 1806-6115 1806-6117 Spreading Screwdriver Bit, hex. 5.0mm Spreading Screwdriver Bit, hex. 6.3mm Spreading Screwdriver Bit, hex. 8.0mm 1806-6102 Teardrop Handle, solid 1806-6104 Cannulated Teardrop Handle Rotation Rod used with Cannulated Teardrop Handle Universal Nail Extraction Device 1806-0353 Conical Extraction Rod, standard 6mm 1806-0350 Conical Extraction Rod, standard 7/8mm 1806-6125 Conical Extraction Rod, 10mm 1806-6130 Conical Extraction Rod, male, 13mm 1806-0130 Wrench 8 /10mm, standard 1806-0150 Strike Plate, standard 1806-6100 Sliding Hammer 1806-0110 Universal Rod 1806-0170 Slotted Hammer, standard Instruments Universal Lag Screw Extraction Device 1806-6140 Connector Gamma 1806-6141 Connector Gamma U-Blade 1806-6142 Connector Gamma3 U-Blade 1806-6144 Connector Gamma3 1806-6143 Connector Dyax-Asiatic 1806-6146 Connector Omega 1806-6148 Connector OHS /OCS 1806-6136 1806-6137 1806-6138 Threaded Rod Gamma etc. Threaded Rod Omega Threaded Rod OHS /OCS 1114-5002 Spanner 17mm standard 1806-6135 Extraction Instrument Lag Screw 1806-6139 Nut 16 Ordering Information - Instruments REF Description Universal Emergency Screw Extraction Devices 1806-6151 Tray Module 2 (Generic Sterilization and Storage Tray) 1806-6153 Module 2 Fully Loaded 1806-6169 1806-6170 1806-6171 1806-6172 1806-6173 Conical Extractor, male, small Conical Extractor, male, 2.5mm Conical Extractor, male, 3.5mm Conical Extractor, male, 4.0mm Conical Extractor, male, 5.0mm 1806-6165 1806-6166 1806-6167 1806-6168 1806-6180 1806-6181 1806-6182 Crowndrill (Trephine), 3.0mm Crowndrill (Trephine), 4.0mm Crowndrill (Trephine), 5.0mm Crowndrill (Trephine), 6.5mm Crowndrill (Trephine), 8.0mm Crowndrill (Trephine), 10.0mm Crowndrill (Trephine), 12.0mm 1806-6183 1806-6184 1806-6185 1806-6186 Conical Extractor, female, 3.0mm Conical Extractor, female, 4.0mm Conical Extractor, female, 5.0mm Conical Extractor, female, 6.3mm 1806-6175 1806-6176 1806-6177 Drift Punch, 2.7mm Drift Punch, 3.7mm Drift Punch, 5.0mm 1806-6102 Teardrop Handle, solid 1806-6160 1806-6162 Extraction Hook (can also be stored in Module 1), small Extraction Hook (can also be stored in Module 1), large 1806-6178 1806-6179 Forceps for Screw Removal, small Forceps for Screw Removal, large Instruments Optional Instruments Module 1 & 2 700151 Sharp Hook, Removal from bone material 700225 Osteotome, Removal from bone material 702811 Countersink 6mm, Preparing the cortex 702812 Countersink 8mm, Preparing the cortex 704515 Outer Introducer, Hansson Pin 704516 Inner Introducer, Hansson Pin 704518 Extractor, Hansson Pin 704540 Emergency Inner Extractor, Hansson Pin 704607 Extractor Handle, Hansson Twin Hook 704608 Outer Extractor, Hansson Twin Hook 704609 Inner Extractor, Hansson Twin Hook 702628 T-Handle, AO-medium, for AO medium bits: screwdriver - screw removal, conical - crowndrill - screw extraction, conical 0106-3043 Screwdriver 2.5, Seidel Humerus Spreading Screw 1806-6206 Gamma3 U-Blade Extractor * Please ask your Stryker sales representative for further information. 17 Notes 18 Notes 19 Stryker Trauma GmbH Prof.-Küntscher-Strasse 1–5 D - 24232 Schönkirchen Germany www.osteosynthesis.stryker.com This document is intended solely for the use of healthcare professionals. A surgeon must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense medical advice and recommends that surgeons be trained in the use of any particular product before using it in surgery. The information presented in this brochure is intended to demonstrate a Stryker product. Always refer to the package insert, product label and/or user instructions including the instructions for Cleaning and Sterilization (if applicable) before using any Stryker products. Products may not be available in all markets. Product availability is subject to the regulatory or medical practices that govern individual markets. Please contact 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 following trademarks or service marks: Stryker, Alta, Asnis, AxSOS, G&K, Gamma, IC Nails, Küntscher Nails, Numelock, OHS&OCS, S2, SCN, Seidel, T2, TLN, Zickel. All other trademarks are trademarks of their respective owners or holders. The products listed above are CE marked. Swemac Orthopaedics AB owns the following trademark: Hansson. Wacker-Chemie GmbH owns the following trademark: Elastosil. Literature Number : B1000057 LOT D4809 Copyright © 2009 Stryker
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