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For Angular Stable Locking of Intramedullary Nails

Angular Stable Locking System (ASLS)Surgical Technique

Introduction

Surgical Technique

Product Information

Angular Stable Locking System (ASLS) Surgical Technique DePuy Synthes 1

Table of Contents

Angular Stable Locking System (ASLS) 2

AO Principles 4

Indications 5

Preparation 6

Targeted Locking 8

Freehand Locking 14

Screw Insertion 21

Implant Removal 27

Implants 28

ASLS Compatibility With Existing Nails 29

Instruments 30

Set Lists 33

MR Information The Angular Stable Locking System has not been evaluated for safety and compatibility in the MR environment. It has not been tested for heating, migration or image artifact in the MR environment. The safety of the Angular Stable Locking System in the MR environment is unknown. Scanning a patient who has this device may result in patient injury.

Image intensifier control

Angular Stable Locking System (ASLS)

Diameter 2: Expands sleeve, providing angular stability

Diameter 1: Provides purchase in reamed near cortex

Angular and axial stability– Improved fixation in poor quality bone

– Decreased risk of secondary loss of reduction

Compatibility with existing nails– Compatible with all DePuy Synthes

cannulated titanium nails (see page 29 for nail compatibility)

– A combination of standard and ASLS screws may be used in the same nail

– Intraoperative choice for ASLS

Titanium Angular Stable Locking Screws– Titanium alloy*

– Available lengths – 4.0 mm ASLS screw: 26 mm–80 mm

– 5.0 mm ASLS screw: 30 mm–100 mm

– 6.0 mm ASLS screw: 32 mm–125 mm

– Instruments are color coded to screws

4.0 mm ASLS (brown)

5.0 mm ASLS (light blue)

6.0 mm ASLS (dark purple)

*Titanium-6% aluminum-7% niobium alloy

2 DePuy Synthes Angular Stable Locking System (ASLS) Surgical Technique

Angular Stable Locking System (ASLS)

Diameter 3: Holds unexpanded sleeve for screw insertion, provides purchase in far cortex

Technique overview

1. Drill both cortices

2. Ream near cortex

3. Insert unexpanded sleeve into nail

4. Expanded sleeve provides angular stability

Resorbable Sleeve– 70:30 poly (L /DL-lactide)– 4.0 mm, 5.0 mm and 6.0 mm sleeves

are used with corresponding ASLS screws



AO Principles

1

4

2

3

4_Priciples_03.pdf 1 05.07.12 12:08

4 DePuy Synthes Expert Lateral Femoral Nail Surgical Technique

AO PRINCIPLES

In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation1, 2.

1 Müller ME, M Allgöwer, R Schneider, H Willenegger. Manual of Internal Fixation. 3rd ed. Berlin Heidelberg New York: Springer. 1991.

2 Rüedi TP, RE Buckley, CG Moran. AO Principles of Fracture Management. 2nd ed. Stuttgart, New York: Thieme. 2007.

Anatomic reductionFracture reduction and fixation to restore anatomical relationships.

Early, active mobilizationEarly and safe mobilization and rehabilitation of the injured part and the patient as a whole.

Stable fixationFracture fixation providing abso-lute or relative stability, as required by the patient, the injury, and the personality of the fracture.

Preservation of blood supplyPreservation of the blood supply to soft tissues and bone by gentle reduction techniques and careful handling.

In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation.1,2

Anatomic reductionFracture reduction and fixation to restore anatomical relationships.

Early, active mobilizationEarly and safe mobilization and rehabilitation of the injured part and the patient as a whole.

Stable fixationFracture fixation providing absolute or relative stability, as required by the patient, the injury, and the personality of the fracture.

Preservation of blood supplyPreservation of the blood supply to soft tissues and bone by gentle reduction techniques and careful handling.

1. Müller ME, Allgöwer M, Schneider R, Willenegger H. Manual of Internal Fixation. 3rd ed. Berlin, Heidelberg, New York: Springer-Verlag; 1991.

2. Rüedi TP, RE Buckley, CG Moran. AO Principles of Fracture Management. 2nd ed. Stuttgart New York: Thieme; 2007.


Indications

The Synthes Angular Stable Locking System (ASLS), when used with Synthes cannulated titanium intramedullary nails, is intended to aid in the alignment and stabilization of tibial, humeral, femoral and ankle fractures.


Preparation

The following pages describe techniques for locking with ASLS. All illustrations use the Tibial Nail-EX, as an example.

1Preoperative planning

Use the appropriate AO preoperative planner template to estimate nail diameter and length.

2Reduce fracture and insert nail

Reduce the fracture and insert the nail. Use a compatible DePuy Synthes titanium cannulated intramedullary nailing system according to the relevant technique guide.

Note: The ASLS is only compatible with cannulated nails. It is necessary for the sleeve to expand within the cannulation of the intramedullary nail to provide sufficient stability.


3Choose appropriate locking screws

For each locking hole, preselect the optimal locking implant to stabilize the fracture. If using an ASLS screw, the diameter of the ASLS screw and instruments will match the diameter of the standard screw/bolt for the particular nail.

Note: A combination of standard locking screws/bolts and ASLS screws can be used in the same nail.

Caution: Do not exchange a standard locking screw/bolt for an ASLS screw or vice versa as this may reduce screw-to-bone interface stability.

Preparation


Targeted Locking

1Attach aiming arm and insert trocar combination

Instruments

03.010.063† 12.0 mm/8.0 mm Protection Sleeve, 188 mm (for Expert nails)

03.025.040* 11.0 mm/8.0 mm Protection Sleeve, 188 mm, for ASLS

4.0 mm

03.010.064† 8.0 mm/3.2 mm Drill Sleeve

03.010.069† 3.2 mm Trocar

5.0 mm


03.010.070† 4.2 mm Trocar

6.0 mm


03.010.071† 5.0 mm Trocar

Once the nail is inserted, attach the aiming arm to the insertion handle. Confirm that the nail is tightly connected to the insertion handle.

Insert the appropriate three-part trocar combination (protection sleeve, drill sleeve and trocar) through the desired hole in the aiming arm. Make a skin incision and ensure that the dissection of the fascia is in line with the path of the protection sleeve. Advance the three-part trocar combination to the bone. Remove the trocar.

Note: Ensure that the drill sleeve is pressed firmly to the near cortex.

†Found in the EXPERT NAIL® Instrument Sets.*Also available.


2Drill through both cortices

Instruments

4.0 mm

03.025.104 2.9 mm/3.2 mm Three-Fluted Drill Bit, quick coupling, 331 mm

5.0 mm


6.0 mm


Using the appropriate drill bit, drill through both cortices until the tip of the drill bit penetrates the far cortex.

If necessary, use image intensification to control the position of the drill bit.

Note: Follow all recommended techniques for screw/bolt insertion for the relevant nail system. When inserting a screw monocortically, stop drilling immediately after penetrating the near cortex.

Targeted Locking


3Determine ASLS screw length

Read the measurement from the calibrated drill bit at the back of the drill sleeve. Select the ASLS screw length accordingly. Remove the drill bit and drill sleeve.

Note: Follow all recommended techniques for screw/bolt measurement for the relevant nail system.

Precaution: Do not exchange a standard locking screw/bolt for an ASLS screw or vice versa as this may reduce screw-to-bone interface stability.

Targeted Locking


Alternative technique

Instrument

03.025.052 Depth Gauge, for ASLS screws

Remove the drill bit and the drill sleeve. Disassemble the depth gauge, separating the outer sleeve from the measuring device with hook. Insert the measuring device with hook into the protection sleeve.

Read the measurement from the back of the protectionsleeve and select the ASLS screw length accordingly.

Note: Ensure that the hook grasps the far cortex and that the protection sleeve is pressed firmly to the bone.

Targeted Locking


Targeted Locking

4Ream near cortex

Instruments

4.0 mm

03.025.030 2.9 mm/5.0 mm Hand Reamer

5.0 mm

03.025.031 3.9 mm/6.0 mm Hand Reamer

6.0 mm

03.025.032 4.9 mm/7.0 mm Hand Reamer

Align the hand reamer with the locking hole axis. Ream the near cortex and clear the passage down to the nail. Remove the hand reamer.

If necessary, use image intensification to control the position of the hand reamer.

Note: To correctly insert the ASLS sleeve, ensure: – the near cortex is completely reamed; – the passage from the near cortex to the nail’s locking hole is cleared; – the drilled/reamed hole aligns with the nail’s locking hole.



Instruments

4.0 mm

03.025.134 2.9 mm/5.0 mm Drill-Reamer, quick coupling, 268 mm

5.0 mm


6.0 mm


Use a power-driven drill-reamer to open the near cortex. Align the drill-reamer with the locking hole axis and ream the near cortex. Once the large diameter of the drill-reamer passes through the near cortex, stop reaming immediately. Remove the drill-reamer.

If necessary, clear the passage down to the nail with the hand reamer.

If necessary, use image intensification to control the positionof the drill-reamer.

Precaution: Ensure that the drill-reamer does not damage the nail.

Insert screws in targeted locking holes (see Screw Insertion, page 21), before continuing with freehand locking.

Targeted Locking


Freehand Locking

2Make incision

Using image intensification, place a long K-wire or alternative long instrument on the skin over the center of the hole to mark the incision point.

Make a skin incision with a scalpel blade at this location.

Note: Check the reduction, correct alignment of the fragments, and limb length before locking.

1Align image

The techniques for distal locking apply. Align the image intensifier with the desired locking hole until a perfect circle is visible in the center of the screen.

Note: Ensure that the image displayed on the image intensifier mirrors the actual image in all axes.


3Drill through both cortices

Instruments

511.30* Radiolucent Drive

4.0 mm

03.025.124* 2.9 mm/3.2 mm Three-Fluted Drill Bit, quick coupling, 145 mm, for Radiolucent Drive

5.0 mm


6.0 mm


Attach the appropriate drill bit to the radiolucent drive. Using image intensification, insert the tip of the drill bit through the incision and to the bone.

Incline the drive to center the tip of the drill bit over the locking hole. The drill bit should nearly fill the circle of the locking hole. Hold the drill bit in this position and drill through both cortices. Stop drilling immediately after the tip of the drill penetrates the far cortex. Remove the drill bit.

Precaution: Follow all recommended techniques for screw/bolt insertion for the relevant nail system. When inserting locking screws monocortically, stop drilling immediately after penetrating the near cortex.

Freehand Locking

*Also available.


3Drill through both cortices continued


Instruments

4.0 mm


5.0 mm


6.0 mm


Standard freehand locking technique can be performed without the radiolucent drive, using the appropriate drill bit.

Freehand Locking


4Determine ASLS screw length

Instrument


Insert the depth gauge into the drilled hole. Read the measurement from the outer sleeve of the depth gauge and select the ASLS screw length accordingly.

Note: Follow all recommended techniques for screw/bolt measurement for the relevant nail system. Ensure that the hook grasps the far cortex and that the protection sleeve is pressed firmly to the bone.

Freehand Locking


4Determine ASLS screw length continued

Alternative technique for radiolucent drill bits

Instrument

03.010.106† Direct Measuring Device, for Locking Screws to 100 mm

Stop drilling immediately after the tip of the drill penetrates the far cortex.

Disassemble the drill bit from the radiolucent drive.

Place the direct measuring device onto the drill bit. Read the graduation of the measuring device at the end of the drill bit. This corresponds to the appropriate screw length.

Freehand Locking

†Found in the EXPERT NAIL Instrument Sets.


5Ream near cortex

Instruments

4.0 mm

03.025.030 2.9 mm/5.0 mm Hand Reamer

5.0 mm

03.025.031 3.9 mm/6.0 mm Hand Reamer

6.0 mm

03.025.032 4.9 mm/7.0 mm Hand Reamer

Align the hand reamer with the locking hole axis. Ream the near cortex and clear the passage down to the nail. Remove the hand reamer.

If necessary, use image intensification to control the position of the hand reamer.

Note: To correctly insert the ASLS sleeve, ensure: – the near cortex is completely reamed; – the passage from the near cortex to the nail’s locking hole is cleared; – the drilled/reamed hole aligns with the nail’s locking hole.

Freehand Locking


5Ream near cortex continued


Instruments

4.0 mm


5.0 mm


6.0 mm


Use the appropriate drill-reamer to open the near cortex. Align the drill-reamer with the locking hole axis and ream the near cortex. Once the large diameter of the drill-reamer passes through the near cortex, stop reaming immediately. Remove the drill-reamer.

If necessary, clear the passage down to the nail with the hand reamer.

If necessary, use image intensification to control the position of the drill-reamer.

Precaution: Ensure that the drill-reamer does not damage the nail.

Freehand Locking


Screw Insertion

1Position sleeve

Select the appropriate resorbable sleeve.

Position the sleeve so that the sleeve lip is facing the screwhead. Thread the ASLS sleeve onto the ASLS screw.

Note: The sleeve is positioned correctly when gold is visible on either side of the sleeve and the screw tip protrudes 1 mm–2 mm beyond the sleeve.

Precautions: Do not use ASLS screws without sleeves. When attaching the sleeve, stop threading the sleeve once resistance increases. Resistance occurs when the sleeve expands as it moves onto the larger diameter of the screw. An expanded sleeve will prevent screw/sleeve insertion into a locking hole.

1–2 mm

Sleeve lip


1Position sleeve continued


Instruments

4.0 mm/5.0 mm

03.025.067 Sleeve Positioner

6.0 mm

03.025.066 Sleeve Positioner

Place the sleeve into the appropriate side of the sleeve positioner. Rotate the screw into the sleeve until the sleeve is pushed out of the sleeve positioner.

Screw Insertion


2Insert screw/sleeve assembly into locking hole

Instruments

03.010.063† 12.0 mm/8.0 mm, Protection Sleeve, 188 mm (for Expert nails)

03.010.107† StarDrive Screwdriver, T25, self-retaining

03.025.040* 11.0 mm/8.0 mm, Protection Sleeve, 188 mm, for ASLS

4.0 mm


03.010.069† 3.2 mm Trocar

5.0 mm


03.010.070† 4.2 mm Trocar

6.0 mm


03.010.071† 5.0 mm Trocar

Assemble the appropriate protection sleeve, drill sleeve and trocar and advance the assembly to the bone. Remove the drill sleeve and trocar. Attach the ASLS screw/sleeve assembly to the screwdriver.

Screw Insertion

†Found in the EXPERT NAIL Instrument Sets.*Also available.


2Insert screw/sleeve assembly into locking hole continued

Push the ASLS screw/sleeve assembly through the protection sleeve and near cortex, and into the nail’s locking hole. If necessary, lightly tap the screwdriver to advance the screw/sleeve into the locking hole.

Precaution: Do not rotate the screwdriver until the sleeve is seated in the locking hole.

Note: If the screw/sleeve assembly cannot be pushed to the nail stop, use the appropriate reamer to completely open the near cortex (see earlier step “Ream near cortex”).

Optional technique

Instrument

399.505 Synthetic Hammer

If necessary, lightly hammer to advance the screw/sleeve assembly into the nail’s locking hole.

Screw Insertion


3Screw into far cortex

Push the screwdriver to get the screw started. Rotate the screwdriver to advance the screw until the screw threads engage the far cortex.

Notes: The larger diameter core expands the sleeve in the nail, providing angular stability. In the final screw position, the largest diameter screw threads will engage the near cortex and the screw tip will protrude beyond the far cortex.

Screw Insertion


3Screw into far cortex continued

Note: To prevent overinsertion of the ASLS screw, use a protection sleeve during screw insertion. Ensure that the protection sleeve is pressed to the bone. Advance the screw until the engraved line on the screwdriver shaft meets the edge of the protection sleeve.

After insertion of all screws, use image intensification to ensure that reduction is maintained, that the screwheads contact the bone, and that the screws are not overinserted.

Screw Insertion


4Intraoperative screw exchange

Instruments


03.010.112† Holding Sleeve, with Locking Device

Using standard technique, remove the ASLS screw with the screwdriver and, if necessary, by pulling with the holding sleeve.

Note: Since the sleeve remains in the nail, it does not need to be removed and exchanged.

Insert a new ASLS screw.


Implant Removal

1Remove screws

Instruments



Using standard technique, remove ASLS screws with the screwdriver and, if necessary, the holding sleeve.

2Remove nail

Remove the nail using standard technique for the relevant nail system.

Note: The sleeves remain in the nail if not fully resorbed and can be removed with the nail during nail removal.



Resorbable Sleeves for Angular Stable Locking Screws, sterile*

– 70:30 poly (L /DL-lactide)

– Inner thread for secure fit to ASLS screw

– Expands in nail’s locking hole to provide angular stability

– 4.0 mm, 5.0 mm, and 6.0 mm sleeves used with corresponding ASLS screws

– Sterile packaged (2 per package)

Implants

Titanium Angular Stable Locking Screws, with T25 StarDriveTM Recess, for intramedullary nails, sterile*

– Titanium alloy**

– Available lengths – 4.0 mm ASLS screw: 26 mm–80 mm – 5.0 mm ASLS screw: 30 mm–100 mm – 6.0 mm ASLS screw: 32 mm–125 mm

– Fully threaded shaft with 3 diameters – D1: Provides purchase in reamed near cortex – D2: Expands sleeve, providing angular stability – D3: Holds unexpanded sleeve for screw insertion,

provides purchase in far cortex

– T25 StarDrive Recess

– Sterile packaged

D1

D2

D3

*Also available. **Titanium-6% aluminum-7% niobium alloy


ASLS Compatibility With Existing Nails

The Angular Stable Locking System is compatible with all DePuy Synthes titanium cannulated nailing systems.

Angular Stable Locking Systems

Nail 4.0 mm 5.0 mm 6.0 mm Nailing System Diameters (mm) (brown) (light blue) (dark purple)

Humerus Titanium Cannulated Humeral Nail and Proximal Humeral Nail-EX

7, 9, 11

•

Femur Titanium Trochanteric Fixation Nail 10, 11, 12, 14 •

Titanium Cannulated Lateral Entry 9–13 • Femoral Nail-EX and Lateral Entry Femoral Recon Nail-EX 14–16 •

Titanium Cannulated Retrograde/ 9–13 • Antegrade Femoral Nail-EX 14, 15 •

Titanium Femoral Nail (cannulated) 10–15 •

Titanium Distal Femoral Nail (cannulated)

10–13

• •

Titanium Cannulated Adolescent Lateral Entry Femoral Nail-EX

8.2, 9, 10

•

Tibia Titanium Cannulated Tibial Nail-EX 8, 9 • and Tibial Nail-EX with Proximal Bend 10–13 •

Titanium Tibial Nail (cannulated) 10–13 •

Ankle Titanium Cannulated Hindfoot • •

Arthrodesis Nail-EX

10, 12, 13


Instruments

03.025.040* 11.0 mm/8.0 mm, Protection Sleeve, 188 mm, for ASLS – to be used with non-Expert nails

03.010.107† StarDrive Screwdriver, T25



03.025.067 Sleeve Positioner, for 4.0 mm and 5.0 mm ASLS sleeves

03.025.066 Sleeve Positioner, for 6.0 mm ASLS sleeves

399.505 Synthetic Hammer (100 g)

General instruments

03.010.063† 12.0 mm/8.0 mm, Protection Sleeve, 188 mm – to be used with Expert nails

†Found in the EXPERT NAIL Instrument Sets.*Also available.


Instruments

Instruments for targeted locking

03.010.064† 8.0 mm/3.2 mm Drill Sleeve03.010.065† 8.0 mm/4.2 mm Drill Sleeve03.010.066† 8.0 mm/5.0 mm Drill Sleeve

03.010.069† 3.2 mm Trocar03.010.070† 4.2 mm Trocar03.010.071† 5.0 mm Trocar

03.025.104 2.9 mm/3.2 mm Three-Fluted Drill Bit, quick coupling, 331 mm, for 4.0 mm ASLS screws03.025.105 3.9 mm/4.2 mm Three-Fluted Drill Bit, quick coupling, 331 mm, for 5.0 mm ASLS screws 03.025.106 4.9 mm/5.0 mm Three-Fluted Drill Bit, quick coupling, 331 mm, for 6.0 mm ASLS screws

03.025.134 2.9 mm/5.0 mm Drill-Reamer, quick coupling, 268 mm, for 4.0 mm ASLS screws03.025.135 3.9 mm/6.0 mm Drill-Reamer, quick coupling, 288 mm, for 5.0 mm ASLS screws 03.025.136 4.9 mm/7.0 mm Drill-Reamer, quick coupling, 288 mm, for 6.0 mm ASLS screws

03.025.030 2.9 mm/5.0 mm Hand Reamer, for 4.0 mm ASLS screws03.025.031 3.9 mm/6.0 mm Hand Reamer, for 5.0 mm ASLS screws03.025.032 4.9 mm/7.0 mm Hand Reamer, for 6.0 mm ASLS screws



03.025.030 2.9 mm/5.0 mm Hand Reamer, for 4.0 mm ASLS screws03.025.031 3.9 mm/6.0 mm Hand Reamer, for 5.0 mm ASLS screws03.025.032 4.9 mm/7.0 mm Hand Reamer, for 6.0 mm ASLS screws

Instruments

03.025.082 2.9 mm/3.2 mm Three-Fluted Drill Bit, quick coupling, 150 mm, for 4.0 mm ASLS screws03.025.083 3.9 mm/4.2 mm Three-Fluted Drill Bit, quick coupling, 150 mm, for 5.0 mm ASLS screws03.025.084 4.9 mm/5.0 mm Three-Fluted Drill Bit, quick coupling, 150 mm, for 6.0 mm ASLS screws

Instruments for freehand locking

03.025.027 2.9 mm/5.0 mm Drill-Reamer, quick coupling, 145 mm, for 4.0 mm ASLS screws03.025.028 3.9 mm/6.0 mm Drill-Reamer, quick coupling, 145 mm, for 5.0 mm ASLS screws03.025.029 4.9 mm/7.0 mm Drill-Reamer, quick coupling, 145 mm, for 6.0 mm ASLS screws

03.025.124* 2.9 mm/3.2 mm Three-Fluted Drill Bit, quick coupling, 145 mm, for 4.0 mm ASLS screws, for Radiolucent Drive03.025.125* 3.9 mm/4.2 mm Three-Fluted Drill Bit, quick coupling, 145 mm, for 5.0 mm ASLS screws, for Radiolucent Drive03.025.126* 4.9 mm/5.0 mm Three-Fluted Drill Bit, quick coupling, 145 mm, for 6.0 mm ASLS screws, for Radiolucent Drive

*Also available.


Drill-Reamers, quick coupling, 2 ea. 03.025.134 2.9 mm/5.0 mm, 268 mm, for 4.0 mm Angular Stable Locking Screws

03.025.135 3.9 mm/6.0 mm, 288 mm, for 5.0 mm Angular Stable Locking Screws

03.025.136 4.9 mm/7.0 mm, 288 mm, for 6.0 mm Angular Stable Locking Screws

Angular Stable Locking System Instrument Set (01.025.002)

60.025.002 Graphic Case for Angular Stable Locking System, for Cannulated Titanium Intramedullary Nails

Instruments399.505 Synthetic Hammer

Drill-Reamers, quick coupling, 145 mm, 2 ea. 03.025.027 2.9 mm/5.0 mm, for 4.0 mm Angular Stable Locking Screws

03.025.028 3.9 mm/6.0 mm, for 5.0 mm Angular Stable Locking Screws


Hand Reamers 03.025.030 2.9 mm/5.0 mm, for 4.0 mm Angular Stable Locking Screws



03.025.052 Depth Gauge, for Angular Stable Locking System

03.025.066 Sleeve Positioner, for 6.0 mm Angular Stable Locking System Sleeves

03.025.067 Sleeve Positioner, for 4.0 mm and 5.0 mm Angular Stable Locking System Sleeves

Three-Fluted Drill Bits, quick coupling, needle point, 150 mm, 2 ea.




Three-Fluted Drill Bits, quick coupling, needle point, 331 mm, 100 mm calibration, 2 ea.




Note: For additional information, precautions and warnings, please see the package insert.

For detailed cleaning and sterilizationinstructions, please refer towww.synthes.com/hcp/cleaning-sterilization or sterilization instructions, if provided.


Implant Sets

01.025.008 4.0 mm Angular Stable Locking System Screw Set

4.0 mm Titanium Angular Stable Locking Screws, with T25 StarDrive Recess, for intramedullary nails, sterile, 2 ea.

Length Length (mm) (mm)04.025.416S 26 04.025.444S 5404.025.418S 28 04.025.446S 5604.025.420S 30 04.025.448S 5804.025.422S 32 04.025.450S 6004.025.424S 34 04.025.452S 6204.025.426S 36 04.025.454S 6404.025.428S 38 04.025.456S 6604.025.430S 40 04.025.458S 6804.025.432S 42 04.025.460S 7004.025.434S 44 04.025.462S 7204.025.436S 46 04.025.464S 7404.025.438S 48 04.025.466S 7604.025.440S 50 04.025.468S 7804.025.442S 52 04.025.470S 80



Length Length (mm) (mm)04.025.520S 30 04.025.550S 6004.025.522S 32 04.025.552S 6204.025.524S 34 04.025.554S 6404.025.526S 36 04.025.556S 6604.025.528S 38 04.025.558S 6804.025.530S 40 04.025.560S 7004.025.532S 42 04.025.562S 7204.025.534S 44 04.025.564S 7404.025.536S 46 04.025.566S 7604.025.538S 48 04.025.568S 7804.025.540S 50 04.025.570S 8004.025.542S 52 04.025.575S 8504.025.544S 54 04.025.580S 9004.025.546S 56 04.025.585S 9504.025.548S 58 04.025.590S 100

ASLS Screws


Implant Sets



Length Length (mm) (mm)04.025.622S 32 04.025.656S 6604.025.624S 34 04.025.658S 6804.025.626S 36 04.025.660S 7004.025.628S 38 04.025.662S 7204.025.630S 40 04.025.664S 7404.025.632S 42 04.025.666S 7604.025.634S 44 04.025.668S 7804.025.636S 46 04.025.670S 8004.025.638S 48 04.025.675S 8504.025.640S 50 04.025.680S 9004.025.642S 52 04.025.685S 9504.025.644S 54 04.025.690S 10004.025.646S 56 04.025.695S 10504.025.648S 58 04.025.700S 11004.025.650S 60 04.025.705S 11504.025.652S 62 04.025.710S 12004.025.654S 64 04.025.715S 125

Alternative Set Configurations

01.025.001 Angular Stable Locking System Screw Set Consists of: 4.0 mm ASLS Screw Set (01.025.008) and 5.0 mm ASLS Screw Set (01.025.009)

ASLS Sleeves*

Resorbable Sleeve for Angular Stable Locking Screws, sterile, 2/pkg.

08.025.032S for 4.0 mm ASLS Screws08.025.044S for 5.0 mm ASLS Screws08.025.057S for 6.0 mm ASLS Screws

*Must be ordered separately.


Instruments Drill-Reamers, quick coupling, 145 mm, for Radiolucent Drive 03.025.037 2.9 mm/5.0 mm, for 4.0 mm Angular Stable Locking Screws



03.025.040 11.0 mm/8.0 mm Protection Sleeve, 188 mm, for Angular Stable Locking System

Three-Fluted Drill Bits, quick coupling, needle point, 145 mm, for Radiolucent Drive 03.025.124 2.9 mm / 3.2 mm, for 4.0 mm Angular Stable Locking Screws



Expert Nail Instruments†

03.010.063 12.0 mm/8.0 mm Protection Sleeve, 188 mm

Drill Sleeves 03.010.064 8.0 mm/3.2 mm, 200 mm

03.010.065 8.0 mm/4.2 mm, 200 mm

03.010.066 8.0 mm/5.0 mm, 200 mm

Trocars 03.010.069 3.2 mm, 210 mm

03.010.070 4.2 mm, 210 mm

03.010.071 5.0 mm, 210 mm

03.010.106 Direct Measuring Device, for Locking Screws to 100 mm, for IM Nails03.010.107 StarDrive Screwdriver, T25, self-retaining

03.010.112 Holding Sleeve, with Locking Device

03.010.150 Star/HexDrive Screwdriver, T25, 3.5 mm hex, self-retaining

Power Equipment105.955 Small Battery Drive Set

150.119 Battery Power Line Set

511.30 Radiolucent Drive

530.605 Battery Reamer/Drill

530.620 Battery, for Battery Power Line

530.680 Battery Casing, for Battery Power Line

530.741 Adaptor for Radiolucent Drive, for Battery Power Line

530.750 Quick Coupling for Drill Bits, for Battery Power Line

532.010 Small Battery Drive

532.013 Quick Coupling for Drill Bits

532.031 Adaptor for Radiolucent Drive

532.032 Small Battery Drive Battery Casing, for 14.4 V Battery

532.033 Small Battery Drive 14.4 V Battery

Also Available


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Please also refer to the package insert(s) or other labeling associated with the devices identified in this surgical technique for additional information.

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Some devices listed in this surgical technique may not have been licensed in accordance with Canadian law and may not be for sale in Canada. Please contact your sales consultant for items approved for sale in Canada.

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