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ZIMMER®
LOCKING
BLADE PLATE
SYSTEM
Surgical Technique for 95° Fracture,Adult & Small Blade Plates
1
SURGICAL TECHNIQUE FOR THE
ZIMMER LOCKINGBLADE PLATE SYSTEM
BY:
Paul J. Duwelius, M.D.Adjuvant Associate Professor Orthopaedics
Oregon Health Sciences UniversityClinical Attending
St. Vincent Hospital & Medical Ctr.
Portland, OR
James A. Goulet, M.D.Professor and Director
Section of Orthopaedic TraumaDepartment of Orthopaedic SurgeryThe University of Michigan Hospitals
David Templeman, M.D.Assistant Professor Orthopaedic Surgery
University of MinnesotaStaff,Hennepin County Medical Center
Robert winquist, M.D.Clinical Professor
University of Washington
Orthopaedic SurgeonSwedish Hospital and Medical Center
Seattle, WA
CONTENTS
INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
SURGICAL TECHNIQUE . . . . . . . . . . . . . . . . . . . . .4
Guide Wire Insertion . . . . . . . . . . . . . . . . . . . .4
Chisel Prep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Chisel Insertion . . . . . . . . . . . . . . . . . . . . . . . . .8
Chamfering Entry Point . . . . . . . . . . . . . . . . .10
Blade Insertion . . . . . . . . . . . . . . . . . . . . . . . . .11
Reduction and Fixation . . . . . . . . . . . . . . . . .13
#1 Screw Insertion . . . . . . . . . . . . . . . . . . . . .14
Shaft Screw Insertion . . . . . . . . . . . . . . . . . .15
Strut Screw Insertion . . . . . . . . . . . . . . . . . . .16
Final Fixation Options . . . . . . . . . . . . . . . . . .18
2
INTRODUCTIONThe Zimmer® Locking Blade Plate System
provides an instrument set developed to align
and insert a Locking Blade Plate. Instruments
in the system provide a reliable and reproducible
technique for the insertion of a blade plate,
providing surgeons with limited blade plate
experience the ability to easily implant the blade
plate. The Zimmer Locking Blade Plate System
also provides for various fixation options,
including the use of a strut screw and/or
divergent screw placement in the metaphysis.
The following technique details the use of the
instruments for the Zimmer Locking Blade Plate.
(Note: Use of an image intensifier is
recommended and described in the following tech-
nique. If an image intensifier is not
used, the anatomic descriptions provided
will help in alignment
using standard
fixation concepts/
technique.)
The blade plate
is manufactured
from Rex 734 Stainless
Steel. The implants are
available in a wide range of size plates as well
as blade lengths. The blade is designed with a
U-cross-section, which provides high strength
with minimum bone displacement. The blade
lengths range between 40-80mm. The plates can
accept a 4.5mm cortical strut screw for increase
structural stability. The #1 and #2 holes can
accept a 4.5mm cortical screw or a 6.5mm can-
cellous screw for all 60-80mm blade plates.
The compression holes will accept 4.5mm
cortical screws
INDICATIONS FOR USEThe Zimmer Locking Blade Plate 95 Degree
Fracture System is indicated for use in the
following femoral fractures:
* Proximal Femoral Fractures
* Distal Femoral Fractures
Preoperative Planning
Due to the design of the Locking Blade Plate,
the insertion of the blade plate requires a well
thought out preoperative plan. It is essential to
determine the exact placement of the chisel
guide for placement of the locking blade plate.
The blade must be correctly placed in both the
frontal and the sagittal planes, and the shaft
must line up with the axis of the femur. An A/P
and lateral pre-operative x-rays must be taken
to assess plate size. X-ray templates are available
to determine the correct implant size.
Distal Femur Patient Positioning After anesthesia is administered, place the
patient in the supine position on the radiolucent
operating table. If desired, place a sterile bump
under the ipsilateral thigh. Prep and drape the
affected leg using a sterile technique. Place
the calf and foot in a sterile stockinette. The
ipsilateral iliac crest should be included in the
operative field, should a bone graft be required.
It will be necessary to use image intensification
or other x-ray imaging. The image intensifier
should be sterile draped and is typically
positioned from the contralateral side of the
operating table.
3
Incision, and ExposureExpose the supracondylar fracture through an
anterolateral approach. Make a linear incision
starting approximately 10cm to 15 cm proximal
to the patella along a line that runs from the
anterior-superior iliac spine to the lateral border
of the patella. The exact length of the incision is
based on the location and extent of the fracture.
Continue the incision through the iliotibial band
and fascialata and expose the distal femur by
reflecting the vastus lateralis muscle anteriorly.
Reduction Intraarticular fractures should be reduced and
stabilized with interfragmentary screws. The
interfragmentary screws should be positioned to
avoid interference with blade plate instrumenta-
tion. Correct placement of the chisel and of the
blade plate will allow an “indirect” reduction of
the stabilized articular fragments to the femoral
shaft. The technique of chisel and blade plate
insertion can be found starting on page 8.
Proximal Femur Patient Positioning After anesthesia is administered, place the
patient in the supine or lateral decubitus position
on the radiolucent operating table. Some
surgeons may prefer to place patient on fracture
table to administer traction. The supine position
facilitates fracture reduction and rotational
alignment of the femur. The image intensifier
should be sterile-draped and positioned from
the contralateral side of the operating table.
Incision, and ExposureBegin the incision laterally 1cm distal to the tip
of the greater trochanter and extend it distally
to accommodate the length of the blade plate.
Expose the lateral surface of the femur.
Reduction Fractures are usually reduced with pointed
reduction forceps. Additional provisional
stabilization with Kirshchner wires may be
required for some fractures. Proper placement
of the chisel and the blade, as described below,
will allow an indirect reduction of the fracture
using standard techniques.
The Chisel Guide should lie parallel to the
femoral shaft if enough of the shaft is intact
to allow this determination to be made; often
a small anterior fragment of the anterior margin
of the lateral femoral condyle is present to allow
appropriate placement. If the amount of bone
present is insufficient to be used as a guide, the
lateral condylar axis can be used as a secondary
guide. Note: The axis of the lateral femoral
condyle is not perfectly perpendicular to the
femoral shaft; rather, this axis is relatively extended
(approximately 10 degrees). All Guide Pins placed
through the Chisel Guide should be oriented
perpendicular to the surface of the lateral
femoral condyle.
SURGICAL TECHNIQUEGuide Wire InsertionPlacement of the appropriate Chisel Guide (white
grooves for adult blade plates and black grooves
for small blade plates) and Guide Pins is the first
step. The Chisel Guide targets the placement of
the Guide Pins, which directs the insertion of the
Chisel and blade plate. The T-Handle attachment
assists in positioning the Chisel Guide.
Distal Femur: Place the Chisel Guide directly
on the lateral surface of the distal femur
approximately 1cm proximal from the articular
surface and 1cm posterior from the anterior
margin of the lateral femoral condyle (Fig. 1).
Fig. 1
4
Fig. 2
5
* Saleh KJ, Gross AF, Gafni A, et al. Radiographic classification for failed hip arthroplasty. 53rd Annual Meeting, Canadian Orthopaedic Association, June 1998, Ottawa, Ontario.
Insert a 3.2mm Guide Pin into the anterior
or posterior hole of the Chisel Guide continuing
into the far cortex (Fig. 2). A Guide Pin Extension
(Screw Inserter/Extractor) may be used to aid in
insertion of the second Guide Pin. Confirm the
Guide Pin position with an image intensifier.
The anterior Guide Pin should not penetrate the
articular surface of the patello-femoral joint. Note
that the distal femur increases in width from the
anterior to posterior. Penetration of the anterior
medial cortex is possible even when the Guide
Pin appears to be within the cortex as judged on
AP X-ray views.
Oblique views on the image intensifier may help
clarify this. Depth of the anterior Guide Pin may
be referenced to estimate the Chisel/blade length
in the distal femur. For most patients, 60mm
blade lengths are commonly used in the distal
femur; large patients may require a longer blade.
After reconfirming the plate orientation with the
shaft of the femur, insert a second Guide Pin into
the posterior or anterior hole of the Chisel Guide
(Fig. 3). The placement of two pins stabilizes the
Chisel Guide for blade preparation. One Guide
Pin can be inserted in the middle hole but Chisel
Guide orientation must be controlled during
bone preparation and chisel insertion.
Note: When longer plates are required, the bow
of the femur should be considered when using
the guide. X-ray templates are available to assist
with preoperative planning. Blade length can be
estimated from pre-op X-ray, X-ray templates, and
confirmed from the chisel depth. Plate length is
chosen to provide sufficient support to the fracture.
Proximal Femur: Place the appropriate Chisel
Guide (white grooves for adult blade plates and
black grooves for small blade plates) on the
femur approximately 1cm from proximal end of
the greater trochanter. The Guide Pins should not
penetrate the superior cortex of the femoral neck
in this position. Insert 3.2mm Guide Pins into the
anterior and posterior holes of the Chisel Guide
continuing into the far cortex. Confirm Guide
Pin and Chisel Guide position with the image
intensifier. When the Guide Pin/Chisel Guide
position is checked on the lateral view, both the
anterior and posterior cortices of the femoral
neck should be visible around the Guide Pins.
This confirms that the implant will lie within
the femoral neck and will not penetrate the
anterior or posterior cortex of the femoral neck.
The Chisel Guide should lie parallel to the
femoral shaft, if enough of the shaft is intact
to allow this determination to be made, to
reference the long axis of the femur.
Fig. 3
6
7
Chisel PrepInsert the attached Chisel Guide Sleeve into the
Chisel Guide slot. Drill each of the three sleeve
holes with the 4.5mm 95 Degree Adult Chisel
Drill (Fig. 4) or the 3.2mm 95 Degree Small
Chisel Drill. Epoxy lines on drills match the
corresponding Chisel and Chisel Guide. This
prepares the near cortex for the insertion of the
Chisel. Calibrations on the drill correspond to
blade lengths (Fig. 5). Remove the sleeve.
Note: The Chisel and Chisel Guide can be matched
by the colored stripes on each.
White grooves on the Chisel Guide and Chisel indi-
cate use for the Adult 95 Degree Fracture Blade
Plates. Black grooves indicate use for the Small 95
Degree Fracture Blade Plates. The Chisel can only
be inserted in one direction to match the orienta-
tion of the Blade Plate. If the Chisel can fit in both
ways, then the wrong Chisel has been inserted.
Fig. 4
Fig. 5
Double Lines For Every 50mm
Posterior Pin
Anterior Pin
Chisel Guide Sleeve
8
Chisel InsertionAttach the Slap Hammer onto the Chisel for
impacting the Chisel (Fig. 6). Insert the Chisel
into the Chisel Guide and impact to the appro-
priate blade plate depth (Fig. 7), for example
up to 60mm for a 60mm blade plate. (For soft
osteoporotic bone, it is recommended to stop
approximately 10mm from the desired blade
length.) The depth of the Chisel is determined
from the inscribed calibrations (Fig. 8). Ensure
Chisel Guide is seated flush on the bone when
reading the calibration.
Fig. 6
Fig. 8
Fig. 7
9
Note: When inserting the Chisel into dense
cancellous bone, it is recommended to partially
insert the Chisel then partially back-out the Chisel.
Repeat this motion until the Chisel
is inserted to the desired depth. This helps
prevent the Chisel from becoming
incarcerated (stuck).
Two sets of calibrations exist on the Chisel
for determining blade depths with and without
use of the Chisel Guide (Fig. 9). The second
set of calibrations should be used with the
Chisel Guide referencing the edge of the Chisel
opening in the guide. If the Chisel Guide is not
used, then the first set of calibrations, noted
as “w/o guide”, should be used referencing
the bone surface directly.
Fig. 9
Double Lines for 50mm
10
Fig. 10
Chamfering Entry PointRemove the Chisel from the Chisel Guide. Insert
the Chamfer Router into the angled chamfer slot
of the Chisel Guide (Fig. 10). Chamfering will
allow the plate to sit flush against the bone at
the blade entry point. Use the router to chamfer
the slot from end to end. The router should be
inserted from both sides of the guide (Fig. 11)
and moved back and forth to make sure that the
chamfer extends along the whole width of the
blade. Remove the Chisel Guide from the bone.
Fig. 11
11
Blade InsertionAttach the Insertion Guide to the Blade Plate by
placing the alignment peg into the top through
hole of the plate and the Thumb Screw into the
#2 Screw Hole of the plate (Fig. 12). The Thumb
Screw should be finger tightened to avoid
cross-threading (Fig. 13). After finger tightening,
the Thumb Screw can be gently tightened with
a 3.5mm hex screwdriver, but care should be
taken not to strip the thread in the plate.
Fig. 12
Fig. 13
12
Fig. 14
Place the Insertion Guide over the Guide Pins
while inserting the blade into the hole made
by the Chisel (Fig. 14). Use the Impactor and a
surgical mallet to insert the blade into the bone
(Fig. 15). The Impactor fits around the Insertion
Guide in one direction only to contact the plate
surface (Fig. 16). The Impactor can be used to
direct the alignment of the Blade Plate during
insertion. Slowly impact the blade into the
bone. If the Blade Plate does not advance,
confirm alignment with fluoroscopy.
Fig. 15
Fig. 16
13
Reduction and FixationBlade Plate fixation is a versatile technique.
In certain instances the Blade Plate can be used
as a reduction tool, alternatively Blade Plates
can be inserted after reduction of the fracture.
Once the Blade Plate is inserted, screws are
inserted into the #1 screw hole of the plate to
secure the plate to the metaphysis. Before the
Strut Screw is inserted, a 4.5mm cortical screw
should be inserted into the compression slot
closest to the Strut Screw hole to secure the
plate to the diaphysis (Fig. 17). When a Strut
Screw is used, the two screw holes closest to the
blade (#1 & #2 screw holes) must be targeted
with the Insertion Guide and Second Screw
Guide, respectively.
Screws inserted in this area without the proper
orientation may block the subsequent insertion
of the Strut Screw (Fig. 17). Either 4.5mm corti-
cal or 6.5mm cancellous screws can be inserted
into the #1 and #2 holes of 60-80mm blade
plates. In 40-50mm Blade Plates, 4.5mm cortical
screws are recommended in the #1 and #2 holes
to avoid interference with the Strut Screw.
Without a Strut Screw, the Insertion Guide and
Second Screw Guide can still be used to orient
the #1 and #2 screws in anterior or posterior
directions, if desired (surgeon preference could
be either). Otherwise, a free hand approach may
be used without the Insertion Guide using stan-
dard screw insertion techniques and equipment.
Fig. 17
#3
Compression Slots
#1
#2
Dual Hole
Insertion Guide Hole
Screw insertion is based
on strut angle, therefore it
is based on the blade length.
• 60-80mm blades (blue)
can use either 4.5mm or
6.5mm screws in #1 & #2 holes
• 40 to 50mm blades (green)
can only use 4.5mm screws in
in #1 & #2 holes
Fig. 19
14
#1 Screw InsertionThread the metal Drill and Tap Bushings into
the Insertion Guide and drill the #1 hole with
the 3.2mm Guide Calibrated Drill Bit (Fig. 18).
Drilling is recommended from anterior to
posterior (surgeon preference could be either).
The length of screw is determined from
the drill calibrations when used in the Drill
Bushing (Fig. 19). Note the measurement on
the Calibrated Drill to determine the appropriate
screw length. The inner sleeve is removed to
allow passage of the 4.5mm Guide Calibrated
Tap, if a non-self tapping screw is used.
Otherwise remove both sleeves and insert a
4.5mm self-tapping cortical screw (Fig. 20).
If a 6.5mm screw is desired, drill with the 3.2mm
Guide Calibrated Drill using the metal Drill and
Tap Bushing. To tap, remove the Drill Tap Sleeve
and use a free hand technique to tap using the
3.2mm drill hole path and Insertion Guide
as reference.
Fig. 20
Fig. 18
15
Fig. 21
Fig. 22
Shaft Screw Insertion4.5mm Cortical Screws are inserted into the
compression screw holes (#5 through 18 holes)
lying over the intact shaft of the femur (Fig. 21).
Securing the Blade Plate to the shaft of the
bone will help reduce the fracture and is recom-
mended before Strut Screw insertion (Fig. 22).
A 4.5mm compression Drill Guide is used to
drill for the 4.5mm Cortical Screws in neutral
or compression, as needed. A Large Fragment
Depth Gauge can be used to determine screw
length.
Note: An articulated compression device can be
inserted into the slot in the end of the Locking
Blade Plate if further fracture compression is
desired. Care should be taken to not change the
angle of the blade with too much tension.
Fig. 23
16
Strut Screw InsertionRemove all Guide Pins. Confirm the Insertion
Guide is firmly against the Blade Plate. Retighten
the Thumb Screw if needed. Attach the Strut
Screw Guide (Fig. 23) by threading the Thumb
Screw into the Insertion Guide, which
is already in place. The Strut Screw Guide is
matched to blade length and color-coded
accordingly. Insert the matching color of the
metal Drill Sleeve into the colored Strut Screw
Guide. Note: The Guide is to be tightened prior to
sleeve insertion.
Push the metal Drill Sleeve down to the bone.
This will prevent the drill from skiving.
For 60-80mm blades, the Blue Guide and Drill
Sleeve is used to prepare for a 4.5mm x 95mm
cortical Strut Screw. For 40- 50mm blades, the
Green Guide and Drill Sleeve is used to prepare
for a 4.5mm x 85mm cortical Strut Screw.
17
Drill with the 3.2mm Guide Calibrated Drill Bit
(Fig. 24). Drilling slightly past the required screw
length is recommended. To assist in targeting
the drill with an image intensifier, each blade
has locator ‘notches’ on the top edge of the blade
(Fig. 25). The notches are located over the middle
of the blade screw hole and a landing area
adjacent to the hole in the blade, respectively.
The drill will pass through or deflect into the
blade screw hole when it passes through the
area between these notches. A drill that is
diverging past both notches may miss the hole.
Correct insertion may be confirmed with AP
and lateral image intensifier views. Remove
the Drill Sleeve. Insert the gray Tap Sleeve to
tap with a 4.5mm tap, if necessary (Fig. 26).
Fig. 25
Fig. 24
Fig. 26
Tap Sleeve
Blade Notches
Blade StrutScrew Hole
18
The #4 hole in the plate provides the option of
“Blocking” the Strut Screw in place if the near
cortex is compromised or the Strut Screw strips
in the blade. To BLOCK the Strut Screw, use a
Compression Drill Guide placed against the
hole edge nearest to the Strut Screw, with the
arrow pointing away from the Strut Screw.
This positions the #4 screw head in contact
with the head of the Strut Screw and prevent
the Strut Screw from backing out. If the
BLOCKED position is NOT required, a
Neutral Drill Guide is placed at the hole edge
farthest from the Strut Screw, placing the #4
screw away from the Strut Screw, and avoiding
contact between the screw heads.
Fixation is now complete. Radiographs
should be obtained intraoperatively to
confirm implant position.
Remove all sleeves from the guide. Insert the
Strut Screw through the guide with a standard
hex screwdriver (Fig. 27). The image intensifier
can help target the screw into the hole. DO NOT
overtighten the Strut Screw, as the screw hole in
the blade can strip out. Remove the Strut Screw
guide by loosening the Thumb Screw.
Final Fixation OptionsAfter the Strut Screw is inserted the #2 and #4
screws are then inserted. The Second Screw Drill
Guide is used to insert the #2 screw (Fig. 28),
orienting the screw to pass by the Strut Screw.
Note: This guide does not secure to the plate. The
Second Screw Guide is matched to blade length
and color-coded accordingly. Drill with the
3.2mm Guide Calibrated Drill Bit, using the
Drill Guide and Drill and Tap Bushings. Note
the measurement on the calibrated drill to
determine the appropriate screw length. The
Drill Bushing is then removed to allow passage
of a 4.5mm tap through the tap bushing.
Tapping is optional if self-tapping screws are
used. After the Tap Bushing is removed, a
4.5mm Cortical Screw is inserted through
the guide.
Fig. 28
Fig. 29: Both views are recommended forconfirmation of screw placement.
Fig. 27
19
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Please refer to package insert for complete product information, including contraindications, warnings, precautions, and adverse effects.
Contact your Zimmer representative, or visit us at www.zimmer.com.
LOCKING BLADE PLATE 95° ADULT STANDARDAssembly
Part Product Name Qty4745 95° Fracture Adult Standard Implant Set w/o case
(Includes each of the items listed below)4745-60 95° Adult Standard Case 14745-06-50 95° Fracture Blade-Plate, Adult 6 Hole 50mm Blade 14745-06-60 95° Fracture Blade-Plate, Adult 6 Hole 60mm Blade 14745-06-70 95° Fracture Blade-Plate, Adult 6 Hole 70mm Blade 14745-06-80 95° Fracture Blade-Plate, Adult 6 Hole 80mm Blade 14745-07-50 95° Fracture Blade-Plate, Adult 7 Hole 50mm Blade 14745-07-60 95° Fracture Blade-Plate, Adult 7 Hole 60mm Blade 14745-07-70 95° Fracture Blade-Plate, Adult 7 Hole 70mm Blade 14745-07-80 95° Fracture Blade-Plate, Adult 7 Hole 80mm Blade 14745-09-50 95° Fracture Blade-Plate, Adult 9 Hole 50mm Blade 14745-09-60 95° Fracture Blade-Plate, Adult 9 Hole 60mm Blade 14745-09-70 95° Fracture Blade-Plate, Adult 9 Hole 70mm Blade 14745-09-80 95° Fracture Blade-Plate, Adult 9 Hole 80mm Blade 14745-11-50 95° Fracture Blade-Plate, Adult 11 Hole 50mm Blade 14745-11-60 95° Fracture Blade-Plate, Adult 11 Hole 60mm Blade 14745-11-70 95° Fracture Blade-Plate, Adult 11 Hole 70mm Blade 14745-11-80 95° Fracture Blade-Plate, Adult 11 Hole 80mm Blade 14845-85 4.5mm Cortical Screw, Non Self-Tapping, Large Hex,
85mm Length 34845-95 4.5mm Cortical Screw, Non Self-Tapping, Large Hex,
95mm Length 3
LOCKING BLADE PLATE 95° ADULT EXTENDEDAssembly
Part Product Name Qty4745-00-01 95° Fracture Adult Extended Implant Set w/o Case
(Includes each of the items listed below)4745-65 95° Adult Extended Case 14745-13-50 95° Fracture Blade-Plate, Adult 13 Hole 50mm Blade 14745-13-60 95° Fracture Blade-Plate, Adult 13 Hole 60mm Blade 14745-13-70 95° Fracture Blade-Plate, Adult 13 Hole 70mm Blade 14745-13-80 95° Fracture Blade-Plate, Adult 13 Hole 80mm Blade 14745-15-50 95° Fracture Blade-Plate, Adult 15 Hole 50mm Blade 14745-15-60 95° Fracture Blade-Plate, Adult 15 Hole 60mm Blade 14745-15-70 95° Fracture Blade-Plate, Adult 15 Hole 70mm Blade 14745-15-80 95° Fracture Blade-Plate, Adult 15 Hole 80mm Blade 14745-18-50 95° Fracture Blade-Plate, Adult 18 Hole 50mm Blade 14745-18-60 95° Fracture Blade-Plate, Adult 18 Hole 60mm Blade 14745-18-70 95° Fracture Blade-Plate, Adult 18 Hole 70mm Blade 14745-18-80 95° Fracture Blade-Plate, Adult 18 Hole 80mm Blade 14845-85 4.5mm Cortical Screw, Non Self-Tapping, Large Hex,
85mm Length 34845-95 4.5mm Cortical Screw, Non Self-Tapping, Large Hex,
95mm Length 3
LOCKING BLADE PLATE 95° SMALLAssembly
Part Product Name Qty4745-00-02 95° Fracture Small Implant Set w/o Case
(Includes each of the items listed below)4745--70 95° Small Case 14745-107-40 95° Fracture Blade-Plate, Small 7 Hole 40mm Blade 14745-107-50 95° Fracture Blade-Plate, Small 7 Hole 50mm Blade 14745-107-60 95° Fracture Blade-Plate, Small 7 Hole 60mm Blade 14745-109-40 95° Fracture Blade-Plate, Small 9 Hole 40mm Blade 14745-109-50 95° Fracture Blade-Plate, Small 9 Hole 50mm Blade 14745-109-60 95° Fracture Blade-Plate, Small 9 Hole 60mm Blade 14745-111-40 95° Fracture Blade-Plate, Small 11 Hole 40mm Blade 14745-111-50 95° Fracture Blade-Plate, Small 11 Hole 50mm Blade 14745-111-60 95° Fracture Blade-Plate, Small 11 Hole 60mm Blade 14845-85 4.5mm Cortical Screw, Non Self-Tapping, Large Hex,
85mm Length 34845-95 4.5mm Cortical Screw, Non Self-Tapping, Large Hex,
95mm Length 3
LOCKING BLADE PLATE 95° INSTRUMENT SETAssembly
Part Product Name Qty4745-00-10 95° Fracture Instrument Set w/Case and Lid
(Includes each of the items listed below)4745-75 95° Instrument Case with Lid 14745-61 Locking Blade Plate Lid1193-08 T-Handle 14705-01 Chamfer Router 24705-04 Insertion Guide, 95° 14705-04-02 Guide Thumb Screw 14705-05 Impactor Handle 14705-06 Slap Hammer 14705-07 Strut Guide, 60-80mm Blade 14705-07-02 Strut Guide Screw, 95° 14705-07-10 Strut Guide, 95° 40-50mm Blade 14705-08 3.2 Drill Sleeve-Strut, 95° 60-80mm Blade 14705-08-10 3.2 Drill Sleeve-Strut, 95° 40-50mm Blade 14705-09 4.5 Tap Sleeve-Strut, 95° 14705-10 Drill Guide, Second Screw, 95° 60-80mm Blade 14705-10-10 Drill Guide, Second Screw, 95° 40-50mm Blade 14705-11 3.2mm Drill Bushing, Insertion Guide, 95° 14705-12 4.5mm Tap Bushing, Insertion Guide, 95° 14705-13 Wedge Extractor 14705-20-32 Drill Bit, Q-C 3.2mm x 215mm, Guide Calibrated 34705-21-45 Tap, Q-C 4.5mm x 215mm Guide Calibrated 24901-32-16 K-Wires, Trocar Point, 3.2mm x 165mm 15791-49 Guide Pin Extension (Screw Inserter/Extractor) 1
LOCKING BLADE PLATE 95° ADULT SPECIAL INSTRUMENT SETAssembly
Part Product Name Qty4745-00-11 95° Fracture Adult Special Instrument Set w/o Case
(Includes each of the items listed below)4705-02 Chisel Guide, 95°, Adult 14705-03 Chisel, 95°, Adult 14705-20-45 Drill Bit, Q-C 4.5mm x 215mm, Adult Chisel Guide Calibrated 3
LOCKING BLADE PLATE 95° SMALL SPECIAL INSTRUMENT SETAssembly
Part Product Name Qty4745-00-12 95° Fracture Small Special Instrument Set w/o Case
(Includes each of the items listed below)4705-02-10 Chisel Guide, 95°, Small 14705-03-10 Chisel, 95°, Small 14705-22-32 Drill Bit, Q-C 3.2mm x 195mm, Small Chisel Guide Calibrated 3