Wrist arthrodesis product info.pdf - Stratmed.co.za

PRODUCT INFORMATIONArthrodesisSystem2.0/2.3, 2.5APTUS ®Wrist

2 | Arthrodesis System 2.0/2.3, 2.5Arthrodesis System 2.0/2.3, 2.5Multidirectional and angular stable partial or totalwrist arthrodesisPainfree mobility and stability are the prerequisites for unhindered hand function. If "normal hand function" isno longer possible, there is a significant limitation to the quality of life of the afflicted person.Partial or total arthrodesis is very frequently performed as a last resort to give this patient a painfree life with asmuch freedom of motion as possible.Clinical benefits and plate featuresArthrodesis Plates 2.0/2.3• Specially developed plates for four cornerfusions (4CF) and scaphotrapeziotrapezoidal(STT) fusions• The plates have two different rows ofscrew holes:o Inner plate holes for compression ofthe carpal bones, using gold corticalscrews (optional for small 4CF and STT)o Outer plate holes for the angular stablefixation, using blue TriLock screwso In every carpal bone at least two screwscan be inserted• Concave shape of the reamers and theplates for minimal bone removal• Easy handling without intra-operativetilting4 fixation holes8 locking holes8 locking holes6 locking holesnon-lockedlockedCortical screws can be used for locking holesas an alternativewww.medartis.com/products/aptus/wrist

Arthrodesis System 2.0/2.3, 2.5 | 3Plate designs2.0/2.3 Four Corner Fusion Plate (4CF)• The 4CF plate is intended for patients withmedium to large wrists• It has 12 screw holes, including 4 for corticalscrews and 8 for TriLock screws2.0/2.3 Four Corner Fusion Plate small(4CF small)• The small 4CF plate is intended for patientswith small wrists• It has 8 TriLock screw holes2.0/2.3 STT Fusion Plate• For scaphoid, trapezium and trapezoideumfusion• The STT Fusion Plate has 6 TriLock screw holeswww.medartis.com/products/aptus/wrist

4 | Arthrodesis System 2.0/2.3, 2.5Clinical benefits and plate featuresArthrodesis plates 2.5• Specially developed anatomical platesfor radiocarpal fusion and total wristarthrodesis• Anatomical plate geometries for simpleintraoperative application• Offset screw alignment in the shaft areao For increased rotational stabilityo For the prevention of screw collisionsAnatomical plate geometries• Low overall profile height to minimize softtissue irritationOffset screw holesLow overall profile heightTwo pre-angled screw holes to facilitatebone graft fixationwww.medartis.com/products/aptus/wrist

Arthrodesis System 2.0/2.3, 2.5 | 5Plate designs2.5 RSL Plates• Specially developed plates for Radial,Scaphoidal and Lunate fusion (RSL)2.5 Total Wrist Fusion Plates (TWF) long and short bend• The carpometacarpal joint is not fused, thereforemaintaining physiological motion in this joint• Anatomically contoured Total Wrist Fusion (TWF)plates with numerous plate holes to fixatevarious carpal bones• Two pre-angled screw holes to facilitate bonegraft fixation• The long bend plate is intended for patients withmedium to large wrists.• The short bend plate is intended for patientswith small wrists and for fusion followingproximal row carpectomy2.5 Total Wrist Fusion Plate (TWF)• Total Wrist Fusion (TWF) plates with two preangledscrew holes to fixate bone graft• Preferred for patients with severely deviantanatomical conditions, such as rheumaticpatientswww.medartis.com/products/aptus/wrist

6 | Arthrodesis System 2.0/2.3, 2.5Technology, Biomechanics andScrew FeaturesMultidirectional and angular stable TriLocklocking technologyTechnologyLockingLocked• TriLock locking technology – secure, angularstable locking of the screw in the plateo Spherical three-point wedge-lockingo Friction locking through radial bracingof the screw head in the plate – withoutadditional tensioning components• Screws can pivot freely by ± 15° in alldirections for optimal positioning• Intra-operative fine tuning capabilities• TriLock screws can be re-locked in the sameplate hole under individual angles up tothree times• Minimal screw head protrusion thanks tointernal locking contour• No cold welding between plate and screwsSecure locking of the TriLock screwTriLock screwscan be re-lockedup to three timesVariable angle of ±15°www.medartis.com/products/aptus/wrist

Arthrodesis System 2.0/2.3, 2.5 | 7Biomechanics• Internal fixator principleo Stable plate – screw construct allows thebridging of unstable zoneso Improved vascularization of the periosteumdue to low contact of the plateLoad-free zoneScrew Features• HexaDrive screw head designExcellentself-holding propertieso Secure connection between screw andscrewdrivero Increased torque transmissiono Optimal self-retaining mechanism• Atraumatic tip prevents soft tissue irritationwhen inserting screws bicortically• Tapered core diameter for increased torsionaland tensile strength• Precision cut thread profile for improvedsharpness and self-tapping properties• Double threaded for faster screw insertion• Titanium Alloy (TiAl6V4) for improved strengthContact surface forscrew retentionDouble threadContact surface fortorque transmissionMinimal screwhead designTaperedcore diameterwww.medartis.com/products/aptus/wrist

8 | Arthrodesis System 2.0/2.3, 2.5Storage in Perfection• Modular concept• Economic and compact system• Easy to handle• Intuitive storage for implantsand instruments• Improved cleaning andsterilization capabilitiesAlso available separately:APTUS Arthrodesis Set 2.0/2.3APTUS Arthrodesis Set 2.5www.medartis.com/products/aptus/wrist

Arthrodesis System 2.0/2.3, 2.5 | 9Equipped 1/5 Implant ModuleArt. No. A-6570Equipped 1/5 Screw ModuleArt. No. A-6573Equipped 2/5 Plate ModuleArt. No. A-6572Equipped 1/5 Instrument ModuleArt. No. A-6571Equipped 2/5 Instrument ModuleArt. No. A-6574www.medartis.com/products/aptus/wrist

10 | Arthrodesis System 2.0/2.3, 2.5Ordering Information2.0/2.3 TriLock Arthrodesis PlatesMaterial: Titanium (ASTM F67)Plate thickness: 1.4 mm14.5 mm12.5 mm12.4 mm14.5 mm12.5 mmA-4660.10 A-4660.11 A-4660.15Art. No. Description Holes Piece/PkgA-4660.10 TriLock Four Corner Fusion Plate, Fixation and TriLock 12 (4+8) 1A-4660.11 TriLock Four Corner Fusion Plate, small 8 (4+4) 1A-4660.15 STT Fusion Plate 6 (3+3) 12.5 TriLock Arthrodesis PlatesMaterial: Titanium (ASTM F67)Plate thickness : 2.4 mm23 mm22 mm66 mm59 mmA-4760.01A-4760.02Art. No. Description Holes Piece/PkgA-4760.01 Wrist Fusion Plate, long bend, dorsal 19 1A-4760.02 Wrist Fusion Plate, short bend, dorsal 18 1www.medartis.com/products/aptus/wristScale: 1:1

Arthrodesis System 2.0/2.3, 2.5 | 112.5 TriLock Arthrodesis Plates17 mmMaterial: Titanium (ASTM F67)Plate thickness: 1.8 – 2.6 mm115 mmArt. No. Description Holes Piece/PkgA-4760.03 Total Wrist Fusion Plate, straight, dorsal 15 12.5 TriLock Arthrodesis Plates28 mmMaterial: Titanium (ASTM F67)Plate thickness: 1.6 mm50 mmA-4760.11A-4760.12Art. No. Description Holes Plate thickness Piece/PkgA-4760.11 RSL Fusion plate, left, dorsal 11 1.6 mm 1A-4760.12 RSL Fusion plate, right, dorsal 11 1.6 mm 1Scale: 1:1www.medartis.com/products/aptus/wrist

12 | Arthrodesis System 2.0/2.3, 2.52.0 Cortical Screws, HexaDrive 6 Material: Titanium (ASTM F136)Length Art. No. Piece/Pkg Art. No. Piece/Pkg6 mm A-5400.06/1 1 A-5400.06 57 mm A-5400.07/1 1 A-5400.07 58 mm A-5400.08/1 1 A-5400.08 59 mm A-5400.09/1 1 A-5400.09 510 mm A-5400.10/1 1 A-5400.10 511 mm A-5400.11/1 1 A-5400.11 512 mm A-5400.12/1 1 A-5400.12 513 mm A-5400.13/1 1 A-5400.13 514 mm A-5400.14/1 1 A-5400.14 515 mm A-5400.15/1 1 A-5400.15 516 mm A-5400.16/1 1 A-5400.16 517 mm A-5400.17/1 1 A-5400.17 518 mm A-5400.18/1 1 A-5400.18 519 mm A-5400.19/1 1 A-5400.19 520 mm A-5400.20/1 1 A-5400.20 52.0 TriLock Screws, HexaDrive 6 Material: Titanium (ASTM F136)Length Art. No. Piece/Pkg Art. No. Piece/Pkg6 mm A-5450.06/1 1 A-5450.06 57 mm A-5450.07/1 1 A-5450.07 58 mm A-5450.08/1 1 A-5450.08 59 mm A-5450.09/1 1 A-5450.09 510 mm A-5450.10/1 1 A-5450.10 511 mm A-5450.11/1 1 A-5450.11 512 mm A-5450.12/1 1 A-5450.12 513 mm A-5450.13/1 1 A-5450.13 514 mm A-5450.14/1 1 A-5450.14 516 mm A-5450.16/1 1 A-5450.16 518 mm A-5450.18/1 1 A-5450.18 520 mm A-5450.20/1 1 A-5450.20 52.3 Cortical Screws, HexaDrive 6 Material: Titanium (ASTM F136)Length Art. No. Piece/Pkg Art. No. Piece/Pkg8 mm A-5500.08/1 1 A-5500.08 510 mm A-5500.10/1 1 A-5500.10 512 mm A-5500.12/1 1 A-5500.12 514 mm A-5500.14/1 1 A-5500.14 516 mm A-5500.16/1 1 A-5500.16 5 www.medartis.com/products/aptus/wrist Scale: 1:1

Arthrodesis System 2.0/2.3, 2.5 | 132.5 Cortical Screws, HexaDrive 7 Material: Titanium (ASTM F136)Length Art. No. Piece/Pkg Art. No. Piece/Pkg8 mm A-5700.08/1 1 A-5700.08 510 mm A-5700.10/1 1 A-5700.10 512 mm A-5700.12/1 1 A-5700.12 514 mm A-5700.14/1 1 A-5700.14 516 mm A-5700.16/1 1 A-5700.16 518 mm A-5700.18/1 1 A-5700.18 520 mm A-5700.20/1 1 A-5700.20 522 mm A-5700.22/1 1 A-5700.22 524 mm A-5700.24/1 1 A-5700.24 526 mm A-5700.26/1 1 A-5700.26 528 mm A-5700.28/1 1 A-5700.28 530 mm A-5700.30/1 1 A-5700.30 532 mm A-5700.32/1 1 A-5700.32 534 mm A-5700.34/1 1 A-5700.34 52.5 TriLock Screws, HexaDrive 7 Material: Titanium (ASTM F136)Length Art. No. Piece/Pkg Art. No. Piece/Pkg8 mm A-5750.08/1 1 A-5750.08 510 mm A-5750.10/1 1 A-5750.10 512 mm A-5750.12/1 1 A-5750.12 514 mm A-5750.14/1 1 A-5750.14 516 mm A-5750.16/1 1 A-5750.16 518 mm A-5750.18/1 1 A-5750.18 520 mm A-5750.20/1 1 A-5750.20 522 mm A-5750.22/1 1 A-5750.22 524 mm A-5750.24/1 1 A-5750.24 526 mm A-5750.26/1 1 A-5750.26 528 mm A-5750.28/1 1 A-5750.28 530 mm A-5750.30/1 1 A-5750.30 532 mm A-5750.32/1 1 A-5750.32 534 mm A-5750.34/1 1 A-5750.34 5www.medartis.com/products/aptus/wrist

14 | Arthrodesis System 2.0/2.3, 2.5Twist Drills for Screws Ø 2.0/2.3 mmA-3410A-3420A-3430Art. No. Ø Twist Drill Stop Length Drill Shaft End Piece/PkgA-3410 2.0 25 mm 87 mm Dental 1A-3420 2.0 25 mm 87 mm Stryker J-Latch 1A-3430 2.0 25 mm 81 mm AO Quick Coupling 1Twist Drills for Screws Ø 2.5 mmA-3713A-3723A-3733Art. No. Ø Twist Drill Stop Length Drill Shaft End Piece/PkgA-3713 2.5 40 mm 97 mm Dental 1A-3723 2.5 40 mm 97 mm Stryker J-Latch 1A-3733 2.5 40 mm 91 mm AO Quick Coupling 1 www.medartis.com/products/aptus/wrist Scale: 1:1

Arthrodesis System 2.0/2.3, 2.5 | 152.0/2.3 ReamersA-3630A-3631A-3635Art. No. Description Ø Length Shaft End Piece/PkgA-3630 for Four Corner Fusion Plate (A-4660.10) 17 mm 87 mm AO Quick Coupling 1A-3631 for Four Corner Fusion Plate, small (A-4660.11) 15 mm 80.5 mm AO Quick Coupling 1A-3635 for STT Fusion Plate (A-4660.15) 13 mm 80.5 mm AO Quick Coupling 1K-Wires, Stainless SteelTrocarLancetArt. No. Ø Description Length Piece/PkgA-5040.21 1.2 mm Trocar 150 mm 10A-5040.41 1.6 mm Trocar 150 mm 10A-5042.21 1.2 mm Lancet 150 mm 10A-5042.41 1.6 mm Lancet 150 mm 10www.medartis.com/products/aptus/wrist

16 | Arthrodesis System 2.0/2.3, 2.5Screwdrivers, Self-HoldingA-2610A-2710Art. No. System size Interface Length Piece/PkgA-2610 2.0/2.3 HD6 153 mm 1A-2710 2.5 HD7 166 mmHandle with Quick ConnectorArt. No. Length for shaft end Piece/PkgA-2070 119 mm AO Quick Coupling 1Screwdriver Blade, Self-Holding, HexaDrive 7Art. No. System size Length for shaft end Piece/PkgA-2013 2.5/2.8 75 mm AO Quick Coupling 1Depth GaugesA-2032A-2730Art. No. System size Description Length Piece/PkgA-2032 2.0/2.3 151 mm 1A-2032.1 2.0/2.3 Caliper 149 mm 1A-2730 2.5 151 mm 1A-2730.1 2.5 Caliper 149 mm 1www.medartis.com/products/aptus/wrist

Arthrodesis System 2.0/2.3, 2.5 | 17Plate Bending PliersArt. No. System size Description Length Piece/PkgA-2047 2.0 - 2.8 with pins 158 mm 1Drill GuidesA-2020A-2720Art. No. System size Description Length Piece/PkgA-2020 2.0/2.3 149 mm 1A-2722 2.5 scaled 114 mm 1Plate and Screw Holding ForcepsArt. No. Description Length Piece/PkgA-2060 angled 148 mm 1Scale: 1:1 / 1:2www.medartis.com/products/aptus/wrist

18 | Arthrodesis System 2.0/2.3, 2.5CasesA-6506 A-6508 A-6507Art. No. Description Size Piece/PkgA-6506 2/5 Case Effective height 96 mm 1A-6507 5/5 Case Effective height 48 mm 1A-6508 2/5 Case Effective height 48 mm 1Lids for CasesA-6500 A-6501Art. No. Description Piece/PkgA-6500 for 2/5 Case 1A-6501 for 5/5 Case 1www.medartis.com/products/aptus/wrist

Arthrodesis System 2.0/2.3, 2.5 | 19Modules for Arthrodesis Set 2.0/2.3A-6570 A-6571Art. No. Description Size Piece/PkgA-6570 Implant module 1/5 x 48 mm 1A-6571 Instrument module 1/5 x 48 mm 1Modules for Arthrodesis Set 2.5A-6572 A-6573 A-6574Art. No. Description Size Piece/PkgA-6572 Plate module 2/5 x 24 mm 1A-6573 Screw module 1/5 x 120 mm 1A-6574 Instrument module 2/5 x 24 mm 1www.medartis.com/products/aptus/wrist

20 | Arthrodesis System 2.0/2.3, 2.5Clinical ExamplesArthrodesis Set 2.0/2.3Case 1 – STT FusionIntraoperative X-raysResult after wrist fusion with STT PlatePostoperative X-raysCase 2 – SNAC WristPreoperative X-raysCreating a recessCompression of the carpal bones, using corticalscrewsResult after wrist fusion with 4CF plate. 3 screws(1 x cortical screw, 2 x TriLock screws) were insertedfor each carpal capitate, hamate, triquetrum andlunate bonePostoperative X-rayswww.medartis.com/products/aptus/wrist

Arthrodesis System 2.0/2.3, 2.5 | 21Case 3 – SLAC WristPreoperative X-raysCompression of the carpal bones, using corticalscrewsResult after wrist fusion with 4CF plate. Theinternal plate hole row is equipped with 4 goldencortical screws, the external plate hole row with4 blue TriLock screws.Postoperative X-raysClinical cases by kind permission of:Dr. Arnold-Peter Weiss, Providence , USA I Prof. Dr. Hermann Krimmer, Ravensburg, Germanywww.medartis.com/products/aptus/wrist

22 | Arthrodesis System 2.0/2.3, 2.5Clinical ExamplesArthrodesis Set 2.5Case 1 – Advanced radial and mediocarpal arthrosisPreoperative X-raysResult after wrist fusion with TWF Plate long bendPostoperative X-raysCase 2 – Arthrosis in the left wrist, necrotic lunatePreoperative X-rayComplete removal of the lunate and triquetrumResult after wrist fusion with TWF Plate long bendPostoperative X-raysCase 3 – Chondrocalcinosis, big cyst in the distal radiusPreoperative X-RayPostoperative X-RayResult after wrist fusion with TWF Plate longbendwww.medartis.com/products/aptus/wrist

Arthrodesis System 2.0/2.3, 2.5 | 23Case 4 – Plate removal approx. 1 year after surgery due to screw cut-outIntraoperative imageIntraoperative X-rayThe iliac graft was pulled to the plate andfixated with two lag screws inserted in thepre-contoured plate holesCase 5 – Removal of wrist prosthesis approx. 3 years after surgeryIntraoperative imageInsertion of a bone graftResult after wrist fusion with TWF Plate,straightCase 6 – Fusion with interpositioned cortico-spongious iliac crest graftIntraoperative imagesClinical cases by kind permission of:Prof. Dr. Hermann Krimmer, Ravensburg, Germany I Prof. Dr. Michael Sauerbier, Bad Soden, Germany I Dr. Nicola Borisch, Baden-Baden, Germany IDr. Christoph Eicker, Essen, Germany I Dr. Alfons Erdmann, Köln, Germanywww.medartis.com/products/aptus/wrist

WRIST-08000001_v1 / © 08.2012, Medartis AG, Switzerland. All technical data subject to alteration.HEADQUARTERSMedartis AG | Hochbergerstrasse 60E | 4057 Basel/SwitzerlandP +41 61 633 34 34 | F +41 61 633 34 00 | www.medartis.comSUBSIDIARIESAustralia | Austria | France | Germany | Mexico | New Zealand | Poland | UK | USAFor detailed information regarding our subsidiaries and distributors, please visit www.medartis.com