Pelvic & Acetabular Fracture Treatment Solutions - Stryker

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Matta <strong>Pelvic</strong> 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). • Twist it along its main axis, to give it a helicoidal shape (Figure 5a, 5b). 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 3a Figure 4a Figure 5a Figure 3b Figure 4b Figure 5b 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 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. Figure 6 Figure 7 22
Matta <strong>Pelvic</strong> 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. 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. Furthermore, the plate holes are designed to accept 3.5mm screws inserted at extreme angles, up to 35 o 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. 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
Page 1 and 2: Pelvis Pelvic & Acetabular Fracture
Page 3 and 4: Contents Page 1. Introduction 5 2.
Page 5 and 6: Introduction “The perfect restora
Page 7 and 8: Precautions & Contraindications for
Page 9 and 10: Indications, Features & Benefits fo
Page 11 and 12: The Pelvic Ring and Acetabulum - Fr
Page 13 and 14: Pelvic Ring Fracture Types & Fixati
Page 15 and 16: Pelvic Ring Fracture Types & Fixati
Page 17 and 18: Acetabular Fracture Types & Fixatio
Page 19 and 20: Acetabular Fracture Types & Fixatio
Page 21: Matta Pelvic System - Plate Bending
Page 25 and 26: Matta Pelvic System - Reduction Ins
Page 27 and 28: Matta Pelvic System - Reduction Ins
Page 29 and 30: Hoffmann II MRI - Pin Placement Tec
Page 31 and 32: Apex Pin Fixation Technical Details
Page 33 and 34: Acetabular Articular Fragments Augm
Page 35 and 36: Ordering Information - MPS Screws 3
Page 37 and 38: Ordering Information - MPS Instrume
Page 39 and 40: Ordering Information - MPS Cases an
Page 41 and 42: Ordering Information - Hoffmann II
Page 43 and 44: Ordering Information - Apex Pelvic
Page 45 and 46: Ordering Information - Apex Instrum
Page 47 and 48: Ordering Information - Asnis III Sc
Page 49 and 50: Ordering Information - HydroSet Inj
Page 51 and 52: Notes 51

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