Pelvic & Acetabular Fracture Treatment Solutions s

Pelvic & Acetabular Fractures
Pelvis
Pelvic & Acetabular
Fracture Treatment
Solutions
Operative Technique
Matta
Asnis III
Hoffmann
Matta
Hoffmann
Asnis III
Pelvic & Acetabular
Fracture Treatment Solutions
Acknowledgments
Stryker acknowledges Joel Matta, M.D.
and Henry Claude Sagi, M.D. for their
support in the preparation of this
brochure.
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 recommended
prior to first surgery.
All non-sterile devices must be
cleaned and sterilized before use.
Follow the instructions provided in
our reprocessing guide (L24002000).
Multi-component instruments must
be disassembled for cleaning. Please
refer to the corresponding assembly/
disassembly instructions.
See package insert (V15011, V15013
and V15034) 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:
Fixation Screws:
Stryker Osteosynthesis bone
screws are not approved or
intended for screw attachment
or fixation to the posterior elements (pedicles) of the cervical,
thoracic or lumbar spine.
2
Contents
Page
1.Introduction
5
2.
Rationale for Stryker Pelvis & Acetabulum Products
6
Matta Pelvic System (MPS)
6
External Fixation
6
Apex Pin Fixation
6
Asnis Screw Fixation
6
HydroSet
6
3.
Precautions & Contraindications for Stryker
Pelvis & Acetabulum Products7
Precautions
7
Contraindications7
4.
Indications, Features & Benefits for the Matta Pelvic System
8
Matta Pelvic System Indications
8
Features and Benefits
8
Plates
8
Screws8
Instruments
9
Trays
9
5.
Plate Types of the Matta Pelvic System10
Female Pelvis
10
Male Pelvis
10
6.
The Pelvic Ring and Acetabulum – Fracture Types
11
Pelvic Ring
11
Acetabulum
11
7.
Assessment of Pelvic Ring and Acetabulum Fractures
12
Inlet Projection
12
Outlet Projection
12
8.
Pelvic Ring Fracture Types & Fixation
13
Symphysis Pubis Disruption13
Iliac Fracture
13
Sacroiliac Dislocation
14
Sacroiliac Fracture – Dislocation
14
Sacrum Fracture
15
9.
Acetabular Fracture Types & Fixation
16
Posterior Wall
16
Posterior Column
16
Anterior Wall
17
Anterior Column
17
Transverse18
T-Shaped
18
Posterior Column & Posterior Wall
19
Transverse & Posterior Wall
19
Anterior Column Posterior-Hemitransverse
20
Both Column
20
3
Contents - Continued
10.
11.
12.
13.
14.
15.
16.
17.
19.
Page
Matta Pelvic System – Plate Bending
21
Matta Pelvic System – Screw Fixation
23
Matta Pelvic System –Reduction Instruments
25
External Fixation Pelvic Frame
28
Hoffmann II MRI
28
Apex Pins
28
Hoffmann II MRI-Pin Placement Techniques
29
Hoffmann Xpress Immediate Care
30
Features and Benefits
30
Apex Pin Fixation
31
Technical Details – Self-Drilling/Self-Tapping Apex Pin
31
Asnis III Screw Fixation
32
Features and Benefits
32
Acetabular Articular Fragments Augmentation with HydroSet33
Features and Benefits
33
Ordering Information – MPS Plates34
Ordering Information – MPS Screws35
Ordering Information – MPS Instruments37
Ordering Information – MPS Cases and Trays39
Ordering Information – Hoffmann II MRI Components40
Ordering Information – Hoffmann II MRI Instruments41
Ordering Information – Hoffmann Xpress42
Ordering Information – Apex Pelvic Pins43
Ordering Information – Apex Instruments
44
Ordering Information – Asnis III Screws46
Ordering Information – HydroSet Injectable HA Bone Substitute49
4
Introduction
“The perfect restoration of the articular surface and associated osseous
architecture” was the goal set forth by R. Judet and E. Letournel in their surgical
treatment of fractures of the pelvis and the acetabulum.
However, before surgical intervention in a fractured acetabulum can be accepted
as a means of treatment, accurate diagnosis based on radiology is essential. As in
other conditions, classification also aids in the accurate understanding of these
sometimes complex fractures.
No one surgical approach is applicable for all acetabulum fractures. After
examination of the plain films as well as the CT scan the surgeons should be
knowledgeable of the precise anatomy of the fracture they are dealing with. A
surgical approach is selected with the expectation that the entire reduction and
fixation can be performed through the surgical approach.
The Letournel classification was first published in 1961. Apart from some minor
early modifications, it has since remained unchanged and is now the most widely
used classification system for acetabular fractures. This classification proposes the
division of the various fracture types into two large groups:
Elementary Fractures comprise those in which a part or all of one or both
columns supporting the acetabulum has been detached by a single fracture line.
The five elementary fracture types are:
- Fracture of the posterior wall
- Fracture of the posterior column
- Fracture of the anterior wall
- Fracture of the anterior column
- Transverse fracture
Associated Fractures comprise those in which two or more elementary patterns
are combined. The five associated fracture types are:
- T-shaped fracture
- Posterior column and posterior wall fracture
- Transverse and posterior wall fractures
- A nterior column or anterior wall with posterior
hemi-transverse fracture
- Both-column fracture
Judet and Letournel concluded early on the most important factor in a successful
operation was a thorough pre-operative three-dimensional understanding of the
X-Rays and fracture pattern. The same is true today. The surgeon’s knowledge,
skill and dedication remain the primary determinants of the patient’s outcome,
and the Stryker Pelvic & Acetabular Fracture Treatment Solutions seek to facilitate
this.
5
Rationale for Stryker Pelvis & Acetabulum
Products
Matta Pelvic System (MPS)
The Matta Pelvic System (MPS) is designed to address all fractures of the
acetabulum and pelvis. The shape, material properties, plate malleability and hole
spacing of the plates take into account today’s physician’s need for sufficient fatigue
strength, excellent transfer of loading forces and a standardized operative technique
with broad applicability. The current set also includes a variety of clamps and
reduction aids that are most valuable in pelvic and acetabular reduction technique.
External Fixation
Hoffmann II External Fixation plays a definitive role in the treatment of unstable
pelvic fractures using the device as provisional fixation. In contrast to internal
fixation, this method has three potential advantages: ease-of-use, versatility and
potential to increase OR efficiency.
Apex Pin Fixation
Solid pin fixation is essential for effective external fixation frames. The Apex Pin
uses advanced thread geometry designed to yield outstanding cutting performance
and excellent pin fixation.
Asnis Screw Fixation
Asnis III 6.5mm or 8.0mm cannulated screws can be utilized in surgical stabilization
of sacroiliac joint disruption and/or sacral fractures using a minimally invasive
approach.
HydroSet
HydroSet injectable HA bone void substitute can be utilized in comminuted
posterior wall fractures as an effective osteoconductive and osteointegrative material, as
well as to help support pelvic bone fragments.
6
Precautions & Contraindications for
Stryker Pelvis & Acetabulum Products
Precautions*
Stryker Osteosynthesis systems have
not been evaluated for safety and
compatibility in MR environment
and have not been tested for heating
or migration in the MR environment,
unless specified otherwise in the product labeling or respective operative
technique.
Contraindications*
The physician’s education, training
and professional judgment must
be relied on to choose the most
appropriate device and treatment.
• Obesity. An overweight or obese
patient can produce loads on the
implant that can lead to failure
of the fixation of the device or to
failure of the device itself.
Conditions presenting an increased
risk of failure include:
• Any active or suspected latent
infection, or marked local
inflammation in or about the
affected area.
• Patients having inadequate tissue
coverage over the operative site.
• Compromised vascularity that
would inhibit adequate blood
supply to the fracture or the
operative site.
• Any mental or neuromuscular
disorder that would create an
unacceptable risk of fixation failure
or complications in postoperative
care.
• Bone stock compromised by
disease, infection or prior implantation that cannot provide adequate
support and/or fixation of the
devices.
• Implant utilization that would
interfere with anatomical structures
or physiological performance.
• Other medical or surgical
conditions that would preclude the
potential benefit of surgery.
• Material sensitivity, documented or
suspected.
* Please refer also to Precautions and Contraindications listed in the respective
Instructions for Use: V15011, V15013, V15034, 90-01616.
7
Indications, Features & Benefits for the
Matta Pelvic System
Matta Pelvic System Indications
•
•
•
•
•
•
•
Acetabulum fracture
Pelvic Ring fracture
Sacrum fracture
Ilium fracture
Sacroiliac joint dislocations
Symphysis Pubis disruption
Revision surgery of pseudoarthroses, non-unions and malunions
• Osteotomies
• Pelvic arthrodeses
Features and Benefits
Plates
Stainless steel cold-worked and Variety of rigid and flexible plates
annealed plates allows excellent fit to pelvis surface
characteristics.
Curved Plates for male and fe- Excellent precontoured fit to pelvic
male pelvis brim radii contribute to broader indi-
cations.
Dedicated pubic symphysis Plate thickness offers increased stabilplates ity and anatomical plate shape may
reduce bending needs.
Equal hole spacing on plates Great operative flexibility for screw &
plate placement.
Round and tapered plate edges Facilitation of plate sliding sub-mus-
cularly.
Increased screw angulation with Optimized for better screw placement
3.5mm screws options especially for posterior wall
fixations.
Screws
Compatibility of 3.5/4.5mm Flexibility in screw choice according to
screws with all plates bony structures.
Self-tapping cortical screws Quick, simple and more efficient screw
placement.
Low screw head profile in plate Helps to prevent screw head promihole nence.
8
Indications, Features & Benefits for the
Matta Pelvic System
Instruments
Range of reduction instruments Great variety of reduction forceps and
optimized clamp design offer many
options for repositioning.
Advanced plate bender Excellent three dimensional bending
and curving of MPS Plates.
Screwdriver Holding Sleeve Efficiency in screw pick-up and inser-
tion as well as removal via “no-touch”
technique.
Elastosil or Canevasit handles Surgeon can choose handle according
to his/her preference.
Four options of reduction pins Great flexibility to select pin option.
(ø5mm or ø6mm and 150mm or
180mm length)
Specific Nerve Retractors Availability of 2 sizes creates potential
for excellent soft tissue protection.
Spiked Disk Usability options with reduction for-
ceps and ball spike for increased bone
contact.
MPS Plate Templates Allow plate bending away from opera-
tive field.
Trays
Four MPS Cases with modular Flexibility for storage and sterilization.
case design
Dedicated Basic Instruments Options offer intra-operative freedom
Case with all instruments for of choice and comfort to surgeon.
three screw sizes
Pre-formed inserts for Basic Logical instrument arrangement and
instruments easy access to the instruments.
9
Plate Types of the Matta Pelvic System
Female Pelvis
Radius 88mm
Male Pelvis
Radius 108mm
Curved and Straight Plates
Hard (cold-worked) material, 2.5mm
thick, 16mm spacing between the
holes.
Flex Plates
Soft (annealed) material, 2.5mm thick,
12mm spacing between the holes,
higher malleability than in hard plates.
Symphysis Plates
Hard (cold-worked) material, 3.2mm
thick, 16mm spacing between the
holes, 75mm radius.
10
The Pelvic Ring and Acetabulum –
Fracture Types
Pelvic Ring
Fracture Types:
-
Pubis Symphysis, Pubis Disruption
Ilium Fracture
Sacroiliac Dislocation
Sacroiliac Fracture
Dislocation
- Sacrum Fracture
Acetabulum
Fracture Types:
Elementary Fractures
-
Posterior Wall
Posterior Column
Anterior Wall
Anterior Column
Transverse
Associated Fractures
-
T-Shaped
Posterior Column & Posterior Wall
Transverse & Posterior Wall
Anterior Column PosteriorHemitransverse
- Both Column
11
Assessment of Pelvic Ring and Acetabulum
Fractures
The evaluation of a pelvic injury has to be based on repeated checks of the patient’s
vital parameters, a detailed clinical examination and a structured radiographic
evaluation. Emergency decisions can usually be based on a pelvis AP X-Ray,
whereas the detailed classification is assigned after additional oblique projections.
Inlet Projection
Positioning for Inlet projection (Fig.1)
and drawing of the X-Ray appearance
obtained from the Inlet projection
(Fig 1a).
Fig 1a
Fig 1
Outlet Projection
Positioning for Outlet projection
(Fig 2) and drawing of the X-Ray
appearance obtained from the Outlet
projection (Fig 2a).
Fig 2a
Fig 2
12
Pelvic Ring Fracture Types & Fixation
Symphysis Pubis Disruption
Approach:
The Symphysis (Anterior)/Pfannenstiel
approach to the the anterior pelvic
ring represents a standard for ORIF of
a disrupted Symphysis Pubis.
Fixation:
• Isolated Symphysis Pubis Disruptions
can be fi xed using a dedicated MPS
Symphysis four-hole or six-hole Plate.
Reduction/Fixation through the Symphysis (Anterior) Surgical Approach
(Pfannenstiel Type Aapproach).
Iliac Fracture
Approach:
Fractures of the Ilium can be operated
through the first window using the
Ilioinguinal approach or a Posterior
Pelvic Ring surgical approach is used.
Fixation:
• One 6.5mm partially threaded
cancellous screw is inserted from the
anterior-inferior iliac spine, passing
1cm to 2cm above the acetabulum.
Reduction/Fixation through the Ilioinguinal or Posterior Pelvic Ring Surgical
Approach.
• Additionally a 3.5mm independent
lag screw in the iliac crest is placed
starting from the anterior branch.
• One MPS Straight four-hole Plate can
be used over the fracture line in the
area of the pelvic brim.
13
Pelvic Ring Fracture Types & Fixation
Sacroiliac Dislocation
Approach:
Sacroiliac Dislocations can be operated
through the Posterior or Anterior
Pelvic Ring approach.
Fixation:
• A sacroiliac dislocation is fi xed
by using a 6.5 or 8.0mm Asnis III
cannulated iliosaccral screw.
Reduction/Fixation through the Posterior or Anterior Pelvic Ring Surgical
Approach.
Sacroiliac Fracture – Dislocation
Approach:
A Posterior Pelvic Ring surgical
approach is used to reduce/fi x a
sacroiliac fracture dislocation.
Fixation:
• One 4.5 or 6.5mm independent
lag screw is placed starting from
the posterior-inferior iliac spine to
stabilize the reduction of the inferior
aspect of the iliac wing.
• One MPS Flex six-hole Plate stabilizes
the reduction of the iliac crest.
Reduction/Fixation through the Posterior Pelvic Ring Surgical Approach.
• One 6.5 or 8.0mm Asnis III
cannulated ilio-sacral lag screw fi xes
the sacroiliac joint.
14
Pelvic Ring Fracture Types & Fixation
Sacrum Fracture
Approach:
A Posterior Pelvic Ring surgical
approach allows an ORIF of Sacrum
Fractures.
Fixation:
• A sacrum fracture is fi xed by
placing two 6.5 or 8.0mm Asnis III
cannulated lag screws (preferably
16mm thread). Alternatively a 6.5mm
cancellous screw is placed into the S1
or S2 vertebral bodies through the
lateral iliac wing.
Reduction/Fixation through the Posterior Pelvic Ring Surgical Approach.
15
Acetabular Fracture Types & Fixation
Posterior Wall
Approach:
Posterior Wall Fractures are reduced/
fi xed through the Kocher-Langenbeck
approach.
Fixation:
• Two 3.5mm independent lag screws
initially fi x the fragments with the
desired anatomical reduction.
• One MPS Curved R108 six or
seven-hole Plate or alternatively
a MPS Flex eight-hole Plate spans
the fragments along its axis
(neutralization plate).
Reduction/Fixation through the Kocher-Langenbeck Surgical Approach.
Posterior Column
Approach:
A Kocher-Langenbeck approach
is used to reduce/fi x the Posterior
Column.
Fixation:
• Definitive fi xation can be started
with an independent lag screw from
the distal fragment into the posterior
buttress of the ilium.
Reduction/Fixation through the Kocher-Langenbeck Surgical Approach.
• One MPS Curved six-hole Plate,
alternatively, a Flex eight-hole
plate along the acetabular margin
maintains the reduction.
16
Acetabular Fracture Types & Fixation
Anterior Wall
Approach:
Anterior Wall Fractures can be
fi xed using the Ilioinguinal surgical
approach.
Fixation:
• One or two independent lag screws
fi x the reduced fragments.
• One MPS Curved Plate bridges the
fragment on the pelvic brim from
the iliac fossa to the intact part of the
pubic ramus.
Reduction/Fixation through the Ilioinguinal Surgical Approach.
Anterior Column
Approach:
The Ilioinguinal or the Modified
Stoppa surgical approach can be
used to reduce/fi x Anterior Column
Fractures.
Fixation:
• An independent lag screw maintains
the reduction.
• Then a MPS Curved 10-hole Plate is
shaped to adapt itself to the pelvic
brim going from the pubic tubercle
to the vicinity of the sacroiliac joint.
A minimum of two screws should be
placed beyond the fracture line.
Reduction/Fixation through the Ilioinguinal or Modified Stoppa Surgical Approach.
• All central screws should be parallel
to the quadrilateral surface.
17
Acetabular Fracture Types & Fixation
Transverse
Approach:
The Kocher-Langenbeck approach can
be used to access Transverse Fractures.
Fixation:
• The posterior column is stabilized
with an independent 3.5 or 4.5mm
lag screw and an MPS Flex six-hole
Plate (neutralization plate).
• The anterior column is stabilized
with an independent 4.5mm lag
screw.
Reduction/Fixation through the Kocher-Langenbeck Surgical Approach.
T-Shaped
Approach:
A Kocher-Langenbeck or alternatively
an Extended Iliofemoral approach
are options to perform an ORIF of
T-Shaped Fractures.
Fixation:
• The posterior column is stabilized
with an independent 3.5 or 4.5mm
lag screw and an MPS Curved or
MPS Flex Plate (neutralization plate).
Reduction/Fixation through the Kocher-Langenbeck or Extended Iliofemoral
Surgical Approaches.
• The anterior column is then fi xed
with an independent 4.5mm lag
screw.
18
Acetabular Fracture Types & Fixation
Posterior Column & Posterior Wall
Approach:
Combined Posterior Column &
Posterior Wall Fractures can be
reduced/fi xed using the KocherLangenbeck approach.
Fixation:
• Initial fi xation of the posterior
column is done with an independent
lag screw and/or a five or six-hole
plate.
Reduction/Fixation through the Kocher-Langenbeck Surgical Approach.
• If the posterior wall fragment is large
enough, it should be fi xed into its bed
with one or two lag screws.
• Definitive stabilization of the
posterior wall and column is
obtained by adding a seven or eighthole MPS Curved Plate buttressing
the posterior wall and anchored
securely to the ilium and ischium
using 3.5mm screws.
Transverse & Posterior Wall
Approach:
Reduction/Fixation of Transverse &
Posterior Wall Fractures can be done
through the Kocher-Langenbeck
approach.
Fixation:
• Two 3.5 or 4.5mm independent
lag screws stabilize the transverse
fracture component.
Reduction/Fixation through the Kocher-Langenbeck Surgical Approach.
• One or two independent 3.5mm lag
screws maintain the reduction of the
posterior wall fragment.
• An MPS Flex eight-hole Plate or
alternatively a six or seven-hole MPS
Curved Plate is applied to buttress the
posterior wall.
19
Acetabular Fracture Types & Fixation
Anterior Column Posterior-Hemitransverse
Approach:
Anterior Column PosteriorHemitransverse Fractures can be fi xed
using the Ilioiguinal approach.
Fixation:
• Initial fi xation of the posterior
column is provided by a 3.5 or
4.5mm lag screw through the
pelvic brim.
• Stabilization of the anterior column
with one or two individual 3.5 or
4.5mm lag screws from the ASIS
(Anterior Superior Iliac Spine) and/
or the AIIS (Anterior Inferior Iliac
Spine).
Reduction/Fixation through the Ilioinguinal Surgical Approach.
• An MPS Curved Plate can then be
placed along the pelvic brim starting
in the sciatic buttress, just anterior to
the SI joint.
Both Column
Approach:
Both Column Fractures are operated
through the Ilioinguinal or Extended
Iliofemoral approach.
Fixation:
• Two 3.5mm independent lag screws
in the iliac crest fi x the reduction of
the wing fracture lines.
• One or two 3.5mm independent lag
screws should run from the upper
aspect of the true pelvis to fi x the
reduction of the posterior column.
• One independent lag screw fixes the
reduction of a separated posterior
fragment of the pelvic brim, just in
front of the sacroiliac joint.
Reduction/Fixation through the Ilioinguinal or Extended Iliofemoral Surgical
Approaches.
• One eight-hole MPS Flex Plate should
be placed along the iliac crest to
stabilize the iliac wing fracture.
• One long MPS Curved 10 or 12-hole
Plate along the pelvic brim stabilizes
the anterior column.
20
Matta Pelvic System – Plate Bending
The plate must be shaped correctly to fit with precision to the reduced contour of the pelvis or the acetabulum.
The fitting of the plate on the bony
surface should be as precise as possible
so the insertion of screws will not
cause the fragments to change position
(Figure 1).
During plating and screw insertion,
it is always the bone that is drawn
toward the plate, not the plate
toward the bone (Figure 2).
In certain instances it may be
advantageous to contour the plate
to a slight mis-match with the bone.
Subsequent insertion and tightening
of the screws causes the plate to
manipulate the bone, therefore aiding
in obtaining or maintaining the
reduction.
Figure 1 – Correct
If the plate fits precisely.
Figure 2 – Incorrect
When tightening the screws, the fragment will be drawn towards the plate.
21
Matta Pelvic System – Plate Bending
For a plate to apply perfectly on a bone, it must be possible to shape it in all directions:
• Curve it to adapt to the shapes of the
iliac crest or the upper aspect of the
pelvic brim, or to make it possible
to span a fragment of the posterior
wall or posterosuperior wall, along its
main axis (Figure 3a, 3b).
• Bend it along its main axis
(Figure 4a, 4b).
Figure 3a
Figure 4a
Figure 3b
It is an important fact that the plate
must be bent, as far as possible, in the
spaces between the holes, so as to alter
them as little as possible (Figure 6).
It is a well-known fact that rectangular
plates do not bend in a regular fashion
• Twist it along its main axis, to give it a
helicoidal shape (Figure 5a, 5b).
Figure 4b
but rather at their holes (Figure 7).
Sherman type plates with equal hole
spacing and narrowing between the
holes, are best adapted to such shaping
and allow for a more precise adaptation
to the pelvic contours.
Curving should always be performed
first, since it is very difficult to curve
the plate after a main axis bend or twist
has been made.
Figure 5a
Figure 5b
Figure 6
Figure 7
22
Matta Pelvic System – Screw Fixation
3.5/4.5mm MPS Screws used with MPS Plates
The 3.5mm self-tapping cortical screws
are the recommended screws for plate
fixation and are best adapted to the
pelvic bone. The 4.5mm cortical screw
is often too large and its voluminous
head creates a slight prominence above
the plates, which may lead to soft tissue
irritation in certain applications.
Furthermore, the plate holes are
designed to accept 3.5mm screws
inserted at extreme angles, up to 35o
in all directions.
This capability is essential, as it must
be possible to avoid penetrating the
hip joint or to be able to drive a screw
obliquely in the area of the iliac bone,
avoiding a previously inserted, isolated
screw.
Therefore, these screws should only
be used to fix a plate in exceptional
cases (symphysis pubis fixation), as
when a smaller screw does not
get sufficient purchase.
35º
4.5mm cortical or 6.5mm cancellous
screws used as Lag Screws:
•
•
Screw 1:
From the crest of the anterior
border into the iliac wing.
Screw 2:
From the anteroinferior iliac
spine, passing 1 or 2cm above the
acetabulum (length 100 –120mm).
•
Screw 3:
Along the axis of the anterior
column, starting from the
posterior aspect of the iliac wing
pillar approx. 3-4cm above the
acetabulum.
This screw is very useful to
secure a transverse fracture or
an anterior column, through an
extended ilio–femoral approach.
•
•
•
Screw 4:
From posterior to anterior part of
the iliac wing.
Screw 5:
From posterior superior iliac spine
to anterior part of the iliac wing to
reduce a sacroiliac joint fracture
dislocation.
Screw 6:
Along the axis of the posterior
column.
For each of these lag screw insertions,
it is essential to drill intermittently,
step-by-step, and change the direction
of the drill if you feel penetration of a
cortex.
Remain in the correct axis and
advance the drill as far as possible.
23
Matta Pelvic System – Screw Fixation
Independent Interfragmentary
Compression
Often, independent (isolated)
interfragmentary lag screws are used in
conjunction with pelvic and acetabular
fracture fixation. The screw thread
takes no purchase in the near fragment
because the screw has a shaft with
no thread and/or the drill hole in the
near fragment is equal to the outside
diameter of the screw.
Therefore, the cortex in the near
fragment has to be overdrilled to create
a “gliding” hole. Overdrilling the cortex
in this manner allows the screw thread
to take purchase in the bone of the
opposite fragment.
Drill Guides
Use the Double Drill Guide REF
702417 and the 4.5mm Drill or Double
Drill Guide REF 702418 and Drill
3.5mm for screws 3.5mm to overdrill
the near cortex. Insert the opposite side
of the relevant Drill Guide into the
pre-drilled hole for precise axial
alignment and use the corresponding
drill for the corehole of the screw.
This procedure should prevent the loss
of reduction and fixation during screw
insertion.
24
Matta Pelvic System – Reduction Instruments
The Matta Pelvic Systems forceps
and other reduction instruments are
designed for use with the irregular,
large and flat bony surfaces of the
pelvic region.
The angles and length of the jaws
are designed to accommodate the
innominate bone from the crest to
the pelvic brim and to provide
flexibility for various surgical
approaches.
Reduction of acetabular fractures
are best performed on the othopaedic
extension table allowing distal and
lateral traction.
Reduction Forceps with Points
Faraboef Forceps
702926 – L130mm
702927 – L200mm
702928 – L190mm
702929 – L250mm
These forceps can be applied directly
to the bone´s surface or be used with
shallow drill holes.
The versatile Faraboef clamps can be used to grasp and manipulate the iliac wing,
or as reduction forceps with provisional screws of either 3.5mm or 4.5mm diameter.
25
Matta Pelvic System – Reduction Instruments
Matta Reduction Forceps
Reduction Forceps for Screws,
Jungbluth
verbrugge Forceps
702921 – Small
702922 – Large
702924 – ø4.5mm
702925 – ø3.5mm Right
702947 – ø3.5mm Left
700641
These two oblique forceps are designed
so that the handles angle away from
both the surgeon`s sight line and
critical soft tissue structures. The sharp
points provide a secure hold on the
pelvic surfaces, while the balls prevent
penetration of bone with a thin cortex.
These two forceps have been designed
to be used with either 3.5mm or 4.5mm
screws (3.5mm version available in left
or right option). Screws inserted on
the opposite side of the fracture allow
considerable reduction forces and
manipulation in all three planes.
For easier reduction, there are times
when only one screw is inserted,
requiring the application of one jaw of
the Verbrugge forceps. The other jaw
takes direct hold on another part of the
bony surface.
26
Example: The angle of the greater
sciatic notch.
Matta Pelvic System – Reduction Instruments
Reduction Forceps, King Tong
Sciatic Nerve Retractor
Straight Ball Spike
702930 – 2x1 Jaws
702948 – 1x1 Jaws
702915 – Small
702916 – Large
702911
This long forceps with threepointed ball tips allow reduction of
perpendicular fractures. The long
handles provide increased leverage for
difficult reductions. These forceps are
also available in a 1x1 jaws version.
Two sizes are available to enable better
soft-tissue retraction.
This reduction instrument is used as a
pusher with pointed ball tip to reduce
bone fragments.
To distribute the reduction forces over
an increased area, the Spiked Disc can
be clipped onto the ball tip.
27
External Fixation Pelvic Frame
Hoffmann II MRI External Fixation System offers rapid application in times of hemodynamic compromise with the ability to
access the abdomen and pelvic viscera for secondary procedures.
External Fixation is most appropriate for open-book pelvic fractures in which the posterior structures are at least partially
intact, or lateral compression injuries with internal rotation of the hemipelvis.
Hoffmann II MRI
Features
‘Snap-Fit’ connections
Benefits
Rapid frame construction.
Single point of tightening
Fast and easy frame construction.
Small, lightweight clamps
Visualization and access to the fracture site.
Color–coded components
Quick and easy identification.
Non-ferromagnetic materials
No frame displacement using MRI.
Apex Pins
Features
Independent, multiplanar pin
Benefits
Stable frame construction.
placement
Self-drilling tip
316L Stainless Steel
No pre-drilling necessary.
MRI Conditional.
Double helical flute
Excellent pin/bone interface.
Cylindrical thread design
Great purchase and pull-out
resistance1, 2, 3.
Pubis symphysis dislocation.
ExFix stabilization.
1 Stryker Test Report BML 10-183; Pull-out test for several Apex pins, Labor job number V10219; 2010.
2 Stryker Test Report RA 05-168; Clinical Assessment - Hoffmann II; Hoffmann II Compact and Apex Pins; 2010.
3 Fachhochschule Hamburg; Vergleichende biomechanische Untersuchung von “Fixateur Externe-Pins”; 1997.
28
Definitive treatment.
Hoffmann II MRI - Pin Placement Techniques
The insertion of two K-wires,
one on the medial side and one on
the lateral side of the iliac wing,
provides an accurate targeting method.
They identify both borders of the crest
and plane of the ilium toward the
acetabular roof, helping to ensure safe
and correct placement of the Apex pins
between the two tables of the ilium.
Avoid penetration of the medial cortex
in order to limit pelvic viscera risk.
Illiac Crest Pin Placement.
Illiac Crest and Inferior Illiac spine combined Pin Placement.
Due to the supraacetabular bone mass
being significantly thicker, a frame
construct mounted on a single Apex
pin offers improved rigidity. Care has
to be taken not to injure the lateral
femoral cutaneous nerve during pin
insertion. The orientation of the Apex
pin can be perpendicular to the body
axis or directed somewhat cephalad,
depending on the location of the
starting point in relation to the greater
sciatic notch.
Illiac Spine Pin Placement.
29
Hoffmann Xpress Immediate Care
Features Benefits
Light weight Clamps
Pin clamp with integrated post
Removable/reversible Pin Insert
Coupling with ‘Snap-Fit’ mechanism
360º independent rotation on either side of the
Universal Coupling
MRI conditional
Sterile packed
30
Visualization and access to the fracture site.
Complete versatility of the frame.
Fast conversion from pin-to-tube, into tube-to-tube coupling.
Allows for a non-slip connection to the rod or pin.
Unlimited frame configuration options.
No additional risk of MRI injury for the patient in a MRI
environment up to 3.0 Tesla.
Safe and fast for acute trauma situations.
Apex Pin Fixation
Technical Details –
Self-Drilling/Self-Tapping Apex Pin
Pin Design
The self-drilling tip of the Apex Pin
acts like a new, sharp drill bit every
time, and therefore, pre-drilling is
not necessary. Combined with unique
cutting geometry, this one-step
procedure allows the pin to maintain a
reduced insertion temperature due to
decreased friction.
A double helical flute creates a
homogeneous thread profile that
transports bone chips out of the drill
hole for improved pin/bone interface.
The highly advanced cutting geometry
allows for more precise pin insertion
with reduced insertion time and
temperature for optimal performance.
The U-shaped thread maximizes contact
with the bone and controls stress
distribution on the pin/bone interface
by optimizing radial tension.
The cylindrical thread is designed for
good bone purchase, and pull-out
resistance1, 2, 3 , and offers the possibility
to backing out the pin without
compromising fixation.
1 Stryker Test Report BML 10-183; Pull-out test for
several Apex pins, Labor job number V10219; 2010.
2 Stryker Test Report RA 05-168; Clinical
Assessment - Hoffmann II; Hoffmann II Compact
and Apex Pins; 2010.
3 Fachhochschule Hamburg; Vergleichende biomechanische Untersuchung von “Fixateur Externe-Pins”;
1997.
U-shaped thread
Self-tapping action
Self-drilling tip
31
Asnis III Screw Fixation
The Asnis III Cannulated Screw Systems have been designed to optimize surgical outcomes while simplifying procedures.
The systems incorporate several features intended to enhance screw placement, insertion and removal.
Features Benefits
Low Profile Screw Head
Stainless Steel (316LvM)
Shaft and Core Diameter Equal
Self-drilling/self-tapping design
Large diameter Guide wires
Percutaneous screw placement
Reduced potential for soft-tissue irritation.
Excellent strength.
Added strength.
Improves operating efficiency.
More precise screw placement.
Potential for minimal invasive surgery.
Partially threaded
Interfragmentary compression.
8mm Long screws
Excellent stability4 .
Asnis III Pelvic Screws
Especially 8.0mm partially threaded
screws with length of 125mm up to
180mm are used as well as 6.5mm
screws with 20mm thread up to
120mm length.
4 Stryker Test Report BML 01/033; Biomechanical
Tests on Cannulated Screws; Asnis III diam. 8mm,
Labor job number S01012; 2001.
32
Acetabular Articular Fragments Augmentation
with HydroSet
Fractures of the posterior wall of the acetabulum comprise one-fourth to one-third
of all acetabular fractures, representing the most common pattern of fracture of the
acetabulum.*
In fractures with intra-articular comminution and intercalary osteochondral
fragments, one can use HydroSet calcium phosphate cement, an injectable,
sculptable bone substitute to help support bone fragments during the surgical
procedure**.
It is recommended that the femoral head is used as a template to orientate and to
reduce the different articular fragments.
Features Benefits
Excellent wet-Field Characteristics
Fast Setting
Isothermic
Injectable or Manual Implantation
Osteoconductive
Radiopaque
Decreases potential for waiting time.
Limited waiting time.
No damaging heat is released to the
surrounding tissue.
Greater number of options for the
surgeon and the opportunity to sculpt
HydroSet.
The composition of hydroxyapitite
closely matches that of bone mineral
thus.
Impenetrable by X-Ray. Visible under
fluoroscopy.
* Baumgaertner MR. Fractures of the posterior wall
of the acetabulum. J Am Acad Orthop Surg. 1999;
7:54–65. Aho AJ, Isberg UK, Katevuo VK. Acetabular
posterior wall fractures: 38 cases followed for 5
years. Acta Orthop Scand. 1986; 57:101–5.
Letournel E, Judet R. Fractures of the Acetabulum.
2nd ed. Berlin, Germany: Springer Verlag; 1993.
** The current cement acts only as a temporary
support media and is not intended to provide
structural support.
33
Ordering Information – MPS Plates
MPS Curved R108 Plate
Stainless Steel
REF
425604
425605
425606
425607
425608
425609
425610
425611
425612
425613
425614
425615
425616
425618
425620
MPS Straight Plate
Plate
Holes
Length
mm
Titanium
REF
58.54 PN/A
74.55 PN/A
90.56 PN/A
106.57
N/A
122.58 PN/A
138.59
N/A
154.510 PN/A
170.511
N/A
186.512 PN/A
202.513
N/A
218.514 PN/A
234.515
N/A
250.516 PN/A
282.518
N/A
314.520
N/A
MPS Curved R88 Plate
Stainless Steel
REF
425654
425655
425656
425657
425658
425659
425660
425661
425662
425663
425664
425665
425666
425668
425670
Stainless Steel
REF
425702
425703
425704
425705
425706
425707
425708
425709
425710
425711
425712
425713
425714
425715
425716
425718
425720
Plate
Holes
Length
mm
Titanium
REF
26.52
N/A
42.53 PN/A
58.54 PN/A
74.55
N/A
90.56 PN/A
106.57
N/A
122.58 PN/A
138.59
N/A
154.510 PN/A
170.511
N/A
186.512 PN/A
202.513
N/A
218.514 PN/A
234.515
N/A
250.516 PN/A
282.518
N/A
314.520
N/A
MPS Flex Plate (annealed)
Plate
Holes
Length
mm
Titanium
REF
58.54 PN/A
74.55 PN/A
90.56 PN/A
106.57
N/A
122.58 PN/A
138.59
N/A
154.510 PN/A
170.511
N/A
186.512 PN/A
202.513
N/A
218.514 PN/A
234.515
N/A
250.516 PN/A
282.518
N/A
314.520
N/A
Stainless Steel
REF
425754
425755
425756
425757
425758
425759
425760
425761
425762
425763
425764
425765
425766
425767
425768
425770
425772
Plate
Holes
Length
mm
Titanium
REF
46.54 PN/A
58.55
N/A
70.56 PN/A
82.57
N/A
94.58 PN/A
106.59
N/A
118.510 PN/A
130.511
N/A
142.512 PN/A
154.513
N/A
166.514 PN/A
178.515
N/A
190.516 PN/A
202.517
N/A
214.518 PN/A
238.520
N/A
262.522
N/A
MPS Symphysis Plate, R75
Stainless Steel
REF
425794
425796
Plate
Holes
Length
mm
Titanium
REF
58.54 PN/A
90.56 PN/A
P Recommended set item
34
Ordering Information – MPS Screws
3.5mm Cortical Screw, Self–Tapping
Stainless
Steel
REF
Screw
Length
mm
4.5mm Cortical Screw, Self-Tapping
Titanium
REF
338610
338612
338614
338616
338618
338620
338622
338624
338626
338628
338630
338632
338634
338636
338638
338640
338642
338644
338645
338646
338648
338650
338655
338660
338665
338670
338675
338680
338685
338690
338695
338700
338705
338710
10
N/A
12 PN/A
14 PN/A
16 PN/A
18 PN/A
20 PN/A
22 PN/A
24 PN/A
26 PN/A
28 PN/A
30 PN/A
32 PN/A
34 PN/A
36 PN/A
38 PN/A
40 PN/A
42
N/A
44
N/A
45 PN/A
46
N/A
48
N/A
50 PN/A
55 PN/A
60 PN/A
65 PN/A
70 PN/A
75 PN/A
80 PN/A
85 PN/A
90 PN/A
95 PN/A
100 PN/A
105 PN/A
110 PN/A
338715
338720
115
120
Stainless
Steel
REF
340614
340616
340618
340620
340622
340624
340626
340628
340630
340632
340634
340636
340638
340640
340642
340644
340646
340648
340650
340652
340654
340655
340656
340658
340660
340662
340664
340665
340666
340668
340670
340672
340675
340676
340680
340685
340690
340695
340700
340705
340710
340715
340720
340725
340730
340735
340740
340745
340750
N/A
N/A
Screw
Length
mm
Titanium
REF
14 PN/A
16 PN/A
18 PN/A
20 PN/A
22 PN/A
24 PN/A
26 PN/A
28 PN/A
30 PN/A
32 PN/A
34 PN/A
36 PN/A
38 PN/A
40 PN/A
42 PN/A
44 PN/A
46 PN/A
48 PN/A
50 PN/A
52 PN/A
54 PN/A
55 N/A
56 PN/A
58 PN/A
60 PN/A
62
N/A
64
N/A
65 PN/A
66
N/A
68
N/A
70 PN/A
72
N/A
75 PN/A
76
N/A
80 PN/A
85 PN/A
90 PN/A
95 PN/A
100 PN/A
105 PN/A
110 PN/A
115 PN/A
120 PN/A
125
130
135
140
145
150
N/A
N/A
N/A
N/A
N/A
N/A
Special Order
P Recommended set item
35
Ordering Information – MPS Screws
6.5mm CANCELLOUS Screw, 16mm Thread
Stainless
Steel
REF
Screw
Length
mm
341030
341035
341040
341045
341050
341055
341060
341065
341070
341075
341080
341085
341090
341095
341100
341105
341110
341115
341120
341125
341130
341135
341140
341145
341150
Titanium
REF
30
N/A
35
N/A
40
N/A
45
N/A
50 PN/A
55 PN/A
60 PN/A
65 PN/A
70 PN/A
75 PN/A
80 PN/A
85 PN/A
90 PN/A
95 PN/A
100 PN/A
105 PN/A
110 PN/A
115 PN/A
120 PN/A
125 PN/A
130PN/A
135
N/A
140
N/A
145
N/A
150
N/A
6.5mm CANCELLOUS Screw, 32mm Thread
Stainless
Steel
REF
342045
342050
342055
342060
342065
342070
342075
342080
342085
342090
342095
342100
342105
342110
342115
342120
342125
342130
342135
342140
342145
342150
Screw
Length
mm
Titanium
REF
45
N/A
50 PN/A
55 PN/A
60 PN/A
65 PN/A
70 PN/A
75 PN/A
80 PN/A
85 PN/A
90 PN/A
95 PN/A
100 PN/A
105 PN/A
110 PN/A
115 PN/A
120 PN/A
125 PN/A
130 PN/A
135
N/A
140
N/A
145
N/A
150
N/A
Washer
Stainless Steel
REF
390016
390019
Diameter
mm
Thickness
mm
Titanium
REF
13.0 P1.5 N/A
9.0 P1.0 N/A
For the full range of standard non-self-tapping screws,
please refer to the Stryker Osteosynthesis Product Catalog
36
Special Order
P Recommended set item
Ordering Information – MPS Instruments
REFDescription
700351 PCalibrated Drill Bit ø2.5mm × 180mm, AO Fitting
700355 PCalibrated Drill Bit ø2.5mm × 230mm, AO Fitting
700353 PDrill Bit ø3.5mm × 180mm, AO Fitting
700356 PCalibrated Drill Bit ø3.2mm × 180mm, AO Fitting
700357 PCalibrated Drill Bit ø3.2mm × 230mm, AO Fitting
700354 PDrill Bit ø4.5mm × 180mm, AO Fitting
702804 P
Tap ø3.5mm × 180mm, AO Fitting
702806 P
Tap ø4.5mm × 180mm, AO Fitting
702807 P
Tap ø6.5mm × 180mm, AO Fitting
702811 PCountersink ø6.0mm × 100mm, AO Fitting
702812 PCountersink ø8.0mm × 100mm, AO Fitting
702842 P
702843 P
Screwdriver Hex 2.5mm, L280mm
Screwdriver Hex 3.5mm, L300mm
702851 PScrewdriver Hex 2.5mm, L165mm, AO Fitting
702853 PScrewdriver Hex 3.5mm, L165mm, AO Fitting
702861 PScrewdriver Holding Sleeve for Screws ø3.5mm
702862 PScrewdriver Holding Sleeve for Screws ø4.5/6.5mm
702417 P
702418 P
Double Drill Guide ø3.2/4.5mm
Double Drill Guide ø2.5/3.5mm
702876 PDepth Gauge 0-110mm, for Screws ø2.7/3.5/4.0mm, Titanium
702877 PDepth Gauge 0-150mm, for Screws ø4.5/6.5mm, Titanium
702911 P
Straight Ball Spike
702912 P
Straight Ball Spike, AO Fitting
702923 P
Spiked Disk
702427 P
T-Handle small, AO Quick Coupling
702428 PSmall Teardrop-Handle, AO Quick Coupling
702429 PLarge Teardrop-Handle, AO Quick Coupling
702915 P
702916 P
Small Sciatic Nerve Retractor
Large Sciatic Nerve Retractor
390083 PReduction Pin ø5.0mm L150mm, AO Fitting
390084 PReduction Pin ø5.0mm L180mm, AO Fitting
900106 P
Screw Forceps
P Recommended set item
37
Ordering Information – MPS Instruments
REF
Description
710312 P
710313 P
710315 P
710316 P
710318 P
710319 P
710321 P
710322 P
Template MPS Flex plate, 8H
Template MPS Flex plate, 18H
Template MPS Straight plate, 8H
Template MPS Straight plate, 18H
Template MPS Curved R108 plate, 8H
Template MPS Curved R108 plate, 18H
Template MPS Curved R88 plate, 8H
Template MPS Curved R88 plate, 18H
702902 P
Bending Iron for Pelvic plates
702903 P
Bending Plier
702921 P
702922 P
Small Repositioning Forceps, type Matta
Large Repositioning Forceps, type Matta
702924 P
702925 P
702947 P
Repositioning Forceps for Screws ø4.5mm
Repositioning Forceps for Screws ø3.5mm, Right
Repositioning Forceps for Screws ø3.5mm, Left
702926 P
702927 P
Small Reduction Forceps with Points L130mm
Large Reduction Forceps with Points L200mm
702928 P
702929 P
Faraboef Forceps L190mm
Faraboef Forceps L250mm
702930 P
702948 P
Repositioning Forceps, 2×1 Jaws
Repositioning Forceps, 1×1 Jaws
702932 P
Repositioning Forceps with Serrated Jaws L140mm
700641 P
Modified Verbrugge Forceps
700647 P
Curved Chisel
Optional Instruments
390086
Reduction Pin ø6.0mm × 150mm, AO Fitting
390087
700367
702845
702846
702847
702848
702849
710311
710314
710317
710320
Reduction Pin ø6.0mm × 180mm, AO Fitting
Large T-Handle, AO Quick Coupling
Screwdriver Hex. 2.5mm, L280, with Canevasit Handle
Screwdriver Hex. 3.5mm, L300, with Canevasit Handle
Straight Ball Spike L300mm, with Canevasit Handle
Canevasit Handle Small, AO Coupling
Canevasit Handle Large, AO Coupling
Template MPS Flex plate, 5H
Template MPS Straight plate, 5H
Template MPS Curved R108 plate, 5H
Template MPS Curved R88 plate, 5H
P Recommended set item
38
Ordering Information – MPS Cases and Trays
REFDescription
REFDescription
901557 PPlastic Base
(Implant Case Plates)
901557 PPlastic Base
(Implant Case Screws)
901686 PScrew Rack with Lids
(Implant Case Screws)
901591Metal Base Optional
(Implant Case Plates)
901591Metal Base Optional
(Implant Case Screws)
901618 PPlastic Base
(Basic Instruments)
901681 PPlastic Lid
(Implant Case Plates)
901682 PTray Insert
(Implant Case Plates)
901619Metal Base Optional
(Basic Instruments)
901687 PPlastic Lid
(Basic Instruments)
901683 PRack with Lid # 1
(Implant Case Plates)
901688 PUpper Tray Insert
(Basic Instruments)
901684 PRack with Lid # 2
(Implant Case Plates)
901689 PLower Tray Insert
(Basic Instruments)
901690 PPlastic Base
(Reduction Instruments)
901685 PPlastic Lid
(Implant Case Screws)
901691 P
Plastic Lid
P Recommended set item
39
Ordering Information –
Hoffmann II MRI Components
REF
Description
Hoff mann II MRI Components
4921-2-020
Five-Hole Pin Clamp for ø4, ø5, and ø6mm pins
4921-2-060
10-Hole Pin Clamp for ø4, ø5, and ø6mm pins
4921-2-080
Pelvic Clamp for ø4, ø5, and ø6mm pins
4921-1-010
Rod-to-Rod Coupling for ø8mm rods or posts
4921-1-020
Pin-to-Rod Coupling for ø4-5mm pins/ø8mm rods or posts
4921-1-030
Inverted Pin-to-Rod Coupling for ø8mm rods or posts/ø4-5mm pins
4921-2-140
30° Angled Post, ø8mm
4921-2-120
Straight Post, ø8mm
ø8mm Rods
174mm (L)
40
5028-8-065
5028-8-100
5028-8-150
5028-8-200
5028-8-250
5028-8-300
5028-8-350
5028-8-400
5028-8-450
Carbon Connecting Rod
Carbon Connecting Rod
Carbon Connecting Rod
Carbon Connecting Rod
Carbon Connecting Rod
Carbon Connecting Rod
Carbon Connecting Rod
Carbon Connecting Rod
Carbon Connecting Rod
65mm
100mm
150mm
200mm
250mm
300mm
350mm
400mm
450mm
5028-7-030
Semi-Circular Carbon Rod
174mm (L)
Ordering Information –
Hoffmann II MRI Instruments
REF
Description
Hoff mann II Instruments for MRI System (not for use in the MRI suite)
4920-9-010
Stabilization/Reduction Wrench
4920-9-020
Thumbwheel
4920-9-030
7mm T-Wrench/ø5-6mm Pin Inserter
4920-9-036
7mm Spanner Wrench
4921-9-984
Storage Case Lid
4921-9-983
Storage Case Upper Insert
4921-9-982
Storage Case Lower Insert
4921-9-981
Storage Case Base
41
Ordering Information – Hoffmann Xpress
REFDescription
Hoffmann Xpress Components
4980-1-010S Universal Coupling Ø15/15mm 4-5/15mm
For Tubes and Curved Rod 15mm Ø, Pins 4mm, 5mm and 6mm cancellous
(shaft Ø5mm)
4980-2-020S 5-Pin Clamp, 2 Posts For Pins Ø4mm, 5mm and 6mm and to connect with Universal Coupling
For Ø4, Ø5 and Ø6mm pins
4980-2-010S 5-Pin Clamp, 1 Post REF
Description
Length mm
Hoffmann Xpress Components
4980-3-150S Aluminum Tube 150mm
4980-3-210S Aluminum Tube
210mm
4980-3-260S Aluminum Tube 260mm
4980-3-330S Aluminum Tube 330mm
4980-3-440S Aluminum Tube 440mm
4980-3-500S Aluminum Tube 500mm
4980-3-020S Semi Circular Curved Tube Ø15mm 42
160 x 235
Ordering Information – Apex Pelvic Pins
Self Drilling/Self Tapping
Stainless Steel
REF
Diameter
mm
Thread/Shaft 5018-6-150
5018-3-180
5018-6-180
5018-8-180
5018-5-200
5018-6-200
5018-5-250
5018-7-250
5021-7-150
5021-6-180
5021-8-200
5021-8-250
5.0
5.0
5.0
5.0
5.0
5.0
5.0
5.0
6.0
6.0
6.0
6.0
Stainless Steel
REF
Diameter
mm
Thread/Shaft 5015-3-120
5015-4-150
5015-5-150
5015-6-180
5015-7-250
6.0/5.0
6.0/5.0
6.0/5.0
6.0/5.0
6.0/5.0
Total
Length
mm
150
180
180
180
200
200
250
250
150
180
200
250
Thread
Length
mm
50
35
50
60
50
60
50
70
50
60
70
80
Cancellous
Total
Length
mm
120
150
150
180
250
43
Thread
Length
mm
35
40
50
60
70
Ordering Information – Apex Instruments
REF
Description
Apex Instruments
44
5057-0-300
Drill Brace Assembly
5057-0-310
Handle for Drill Brace
4920-9-030
T-Wrench/Pin Inserter, 7mm
5057-1-003
Quick Release Apex Chuck with AO fitting, 3mm
5057-1-004
Quick Release Apex Chuck with AO fitting, 4mm
5057-1-005
Quick Release Apex Chuck with AO fitting, 5mm
5057-1-006
Quick Release Apex Chuck with AO fitting, 6mm
5057-1-110
Drill Guide Handle
5057-1-115
Drill Guide Block, 5 holes, Hoffmann II
5057-1-116
Drill Guide Block, 10 holes, Hoffmann II
5057-1-117
Drill Guide Block, 4 holes, Hoffmann II Compact
5057-1-118
Drill Guide Block, 4 holes, Hoffmann II Compact, Peri Articular Clamp
5057-1-119
Drill Guide Block, 4 holes, Monotube Triax, blue, red
5057-1-120
Drill Guide Block, 2 holes, Monotube Triax, yellow
Ordering Information – Apex Instruments
REF
Description
Apex Instruments
5057-4-000
Predrilling Assembly, Ø 4.0mm, extra short
35mm protection length
5057-5-000
Predrilling Assembly, Ø 5.0mm, extra short
50mm protection length
5057-6-000
Predrilling Assembly, Ø 6.0mm, extra short
60mm protection length
5057-3-100
Predrilling Assembly, Ø 3.0mm, short
33mm protection length
5057-4-100
Predrilling Assembly, Ø 4.0mm, short
70mm protection length
5057-5-100
Predrilling Assembly, Ø 5.0mm, short
73mm protection length
5057-6-100
Predrilling Assembly, Ø 6.0mm, short
90mm protection length
5057-3-200
Predrilling Assembly, Ø 3.0mm, long
43mm protection length
5057-4-200
Predrilling Assembly, Ø 4.0mm, long
100mm protection length
5057-5-200
Predrilling Assembly, Ø 5.0mm, long
113mm protection length
5057-6-200
Predrilling Assembly, Ø 6.0mm, long
120mm protection length
5057-6-300
Pin Cutter, 4mm, 5mm & 6mm, Extension Handles
5057-9-913
Apex Storage Tray, Metal Lid
A
5057-9-912
Apex Storage Tray, Upper Insert
5057-9-911
Apex Storage Tray, Lower Insert
5057-9-910
Apex Storage Tray, Metal Base
45
Ordering Information - Asnis III Screws
6.5mm Implants - 20mm Thread Screws*
Stainless Steel
Description
REF
326040S
326045S 326050S 326055S 326060S 326065S 326070S 326075S 326080S 326085S 326090S 326095S 326100S 326105S 326110S 326115S 326120S Asnis III Cannulated Screw 6.5 × 40mm Asnis III Cannulated Screw 6.5 × 45mm Asnis III Cannulated Screw 6.5 × 50mm Asnis III Cannulated Screw 6.5 × 55mm Asnis III Cannulated Screw 6.5 × 60mm Asnis III Cannulated Screw 6.5 × 65mm Asnis III Cannulated Screw 6.5 × 70mm Asnis III Cannulated Screw 6.5 × 75mm Asnis III Cannulated Screw 6.5 × 80mm Asnis III Cannulated Screw 6.5 × 85mm Asnis III Cannulated Screw 6.5 × 90mm Asnis III Cannulated Screw 6.5 × 95mm Asnis III Cannulated Screw 6.5 × 100mm Asnis III Cannulated Screw 6.5 × 105mm Asnis III Cannulated Screw 6.5 × 110mm Asnis III Cannulated Screw 6.5 × 115mm Asnis III Cannulated Screw 6.5 × 120mm Titanium
REF
602640S
602645S
602650S
602655S
602660S
602665S
602670S
602675S
602680S
602685S
602690S
602695S
602700S
602705S
602710S
602715S
602720S
6.5mm Implants - 40mm Thread Screws*
Stainless Steel
REF
Diameter
mm
Titanium
REF
Asnis III Cannulated Screw 6.5 × 55mm Asnis III Cannulated Screw 6.5 × 60mm Asnis III Cannulated Screw 6.5 × 65mm Asnis III Cannulated Screw 6.5 × 70mm Asnis III Cannulated Screw 6.5 × 75mm Asnis III Cannulated Screw 6.5 × 80mm Asnis III Cannulated Screw 6.5 × 85mm Asnis III Cannulated Screw 6.5 × 90mm Asnis III Cannulated Screw 6.5 × 95mm Asnis III Cannulated Screw 6.5 × 100mm Asnis III Cannulated Screw 6.5 × 105mm Asnis III Cannulated Screw 6.5 × 110mm Asnis III Cannulated Screw 6.5 × 115mm Asnis III Cannulated Screw 6.5 × 120mm Asnis III Cannulated Screw 6.5 × 125mm Asnis III Cannulated Screw 6.5 × 130mm 602855S
602860S
602865S
602870S
602875S
602880S
602885S
602890S
602895S
602900S
602905S
602910S
602915S
602920S
602925S**
602930S**
326255S 326260S 326265S 326270S 326275S 326280S 326285S 326290S 326295S 326300S 326305S 326310S 326315S 326320S 326325S** 326330S** * N
ote: For Non-Sterile Implants remove the “S” from
REF.
** Special Order
46
Ordering Information - Asnis III Screws
6.5mm Implants - Full Thread screws
Stainless Steel
REF
Diameter
mm
Titanium
REF
Asnis III Cannulated Screw 6.5 × 30mm Asnis III Cannulated Screw 6.5 × 35mm Asnis III Cannulated Screw 6.5 × 40mm Asnis III Cannulated Screw 6.5 × 45mm Asnis III Cannulated Screw 6.5 × 50mm Asnis III Cannulated Screw 6.5 × 55mm Asnis III Cannulated Screw 6.5 × 60mm Asnis III Cannulated Screw 6.5 × 65mm Asnis III Cannulated Screw 6.5 × 70mm Asnis III Cannulated Screw 6.5 × 75mm Asnis III Cannulated Screw 6.5 × 80mm Asnis III Cannulated Screw 6.5 × 85mm Asnis III Cannulated Screw 6.5 × 90mm Asnis III Cannulated Screw 6.5 × 95mm Asnis III Cannulated Screw 6.5 × 100mm Asnis III Cannulated Screw 6.5 × 105mm Asnis III Cannulated Screw 6.5 × 110mm Asnis III Cannulated Screw 6.5 × 115mm Asnis III Cannulated Screw 6.5 × 120mm Asnis III Cannulated Screw 6.5 × 125mm Asnis III Cannulated Screw 6.5 × 130mm Asnis III Cannulated Screw 6.5 × 135mm Asnis III Cannulated Screw 6.5 × 140mm Asnis III Cannulated Screw 6.5 × 145mm Asnis III Cannulated Screw 6.5 × 150mm 606030S
606035S
606040S
606045S
606050S
606055S
606060S
606065S
606070S
606075S
606080S
606085S
606090S
606095S
606100S
606105S
606110S
606115S
606120S
606125S**
606130S**
606135**
606140**
606145**
606150**
326430S 326435S 326440S 326445S 326450S 326455S 326460S 326465S 326470S 326475S
326480S 326485S 326490S 326495S 326500S 326505S 326510S 326515S 326520S 326525S** 326530S** -
-
-
-
* N
ote: For Non-Sterile Implants remove the “S” from
REF.
** Special Order
47
Ordering Information - Asnis III Screws
8.0MM IMPLANTS - PARTIAL THREAD SCREwS*
Stainless Steel
REF
326640S
326645S
326650S
326655S
326660S
326665S
326670S
326675S
326680S
326685S
326690S
326695S
326700S
326705S
326710S
326715S
326720S
326725S**
326730S**
Description
Titanium
REF
Asnis III Cannulated Screw 8.0 × 40mm
611040S
Asnis III Cannulated Screw 8.0 × 45mm
611045S
Asnis III Cannulated Screw 8.0 × 50mm
611050S
Asnis III Cannulated Screw 8.0 × 55mm
611055S
Asnis III Cannulated Screw 8.0 × 60mm
611060S
Asnis III Cannulated Screw 8.0 × 65mm
611065S
Asnis III Cannulated Screw 8.0 × 70mm
611070S
Asnis III Cannulated Screw 8.0 × 75mm
611075S
Asnis III Cannulated Screw 8.0 × 80mm
611080S
Asnis III Cannulated Screw 8.0 × 85mm
611085S
Asnis III Cannulated Screw 8.0 × 90mm
611090S
Asnis III Cannulated Screw 8.0 × 95mm
611095S
Asnis III Cannulated Screw 8.0 × 100mm 611100S
Asnis III Cannulated Screw 8.0 × 105mm 611105S
Asnis III Cannulated Screw 8.0 × 110mm 611110S
Asnis III Cannulated Screw 8.0 × 115mm 611115S
Asnis III Cannulated Screw 8.0 × 120mm 611120S
Asnis III Cannulated Screw 8.0 × 125mm 611125S**
Asnis III Cannulated Screw 8.0 × 130mm 611130S**
8.0MM IMPLANTS - 20MM THREAD SCREwS*
Stainless Steel
REF
326840S
326845S
326850S
326855S
326860S
326865S
326870S
326875S
326880S
326885S
326890S
326895S
326900S
326905S
326910S
326915S
326920S
326925S**
326930S**
326935**
326940**
326945**
326950**
Description
Titanium
REF
Asnis III Cannulated Screw 8.0 × 40mm
611240S
Asnis III Cannulated Screw 8.0 × 45mm
611245S
Asnis III Cannulated Screw 8.0 × 50mm
611250S
Asnis III Cannulated Screw 8.0 × 55mm
611255S
Asnis III Cannulated Screw 8.0 × 60mm
611260S
Asnis III Cannulated Screw 8.0 × 65mm
611265S
Asnis III Cannulated Screw 8.0 × 70mm
611270S
Asnis III Cannulated Screw 8.0 × 75mm
611275S
Asnis III Cannulated Screw 8.0 × 80mm
611280S
Asnis III Cannulated Screw 8.0 × 85mm
611285S
Asnis III Cannulated Screw 8.0 × 90mm
611290S
Asnis III Cannulated Screw 8.0 × 95mm
611295S
Asnis III Cannulated Screw 8.0 × 100mm 611300S
Asnis III Cannulated Screw 8.0 × 105mm 611305S
Asnis III Cannulated Screw 8.0 × 110mm 611310S
Asnis III Cannulated Screw 8.0 × 115mm 611315S
Asnis III Cannulated Screw 8.0 × 120mm 611320S
Asnis III Cannulated Screw 8.0 × 125mm 611325S**
Asnis III Cannulated Screw 8.0 × 130mm 611330S**
Asnis III Cannulated Screw 8.0 × 135mm 611335**
Asnis III Cannulated Screw 8.0 × 140mm 611340**
Asnis III Cannulated Screw 8.0 × 145mm 611345**
Asnis III Cannulated Screw 8.0 × 150mm 611350**
Instruments and Case
702462S*
702463S*, **
702627S
702626*
702495
702629
901596
* Note: For Non-Sterile Implants remove the “S”
from REF.
** Special Order
48
Asnis III Threaded Guide Wire ø3.2 × 300mm
Asnis III Guide Wire without Thread ø3.2 × 300mm
Asnis III Guide Wire with Calibrations and Quick Release Fitting ø3.2 × 300mm
Asnis III 6.5/8.0mm, Drill Bit ø3.2 × 300mm
Asnis III 8.0mm Direct Measuring Gauge for ø3.2mm Guide Wires
Asnis III 6.5/8.0mm, Cannulated Screwdriver with Elastosil Handle – Hex 5.0mm
Asnis III 8.0mm Plastic Base with Lid
Ordering Information – HydroSet Injectable HA
Bone Substitute
REF
397003
397005
397010
397015
Description
3cc HydroSet Bone Substitute
5cc HydroSet Bone Substitute
10cc HydroSet Bone Substitute
15cc HydroSet Bone Substitute
49
Notes
50
Notes
51
Manufactured by:
Stryker Trauma AG
Bohnackerweg 1
CH-2545 Selzach
Switzerland
Manufactured for:
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 is intended to demonstrate a Stryker product. A surgeon must always refer to the
package insert, product label and/or instructions for use, including the instructions for Cleaning and Sterilization
(if applicable), before using any Stryker product. Products may not be available in all markets because product
availability is subject to the regulatory and/or medical practices in 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: Apex, Asnis, Hoffmann, HydroSet, Monotube, Stryker, Triax. All other trademarks
are trademarks of their respective owners or holders.
The products listed above are CE marked.
Literature Number: 982350 Rev. 1
10/11
Copyright © 2011 Stryker
Stryker Leibinger GmbH & Co. KG
Bötzinger Strasse 41
D-79111 Freiburg
Germany
www.osteosynthesis.stryker.com