VariAxDistal Radius Locking Plate System - Stryker

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SmartLock <strong>Locking</strong> Technology Overview• Fixed Angle Drill Guide (56-01255)This drill guide will ensure the sameplacement of screw options in everycase and therefore does not allow theflexibility of choosing an angle. It isdesigned to fit in the pre-tilted lipswithin the holes on the plate by simplypressing the drill guide in to the hole.Note:In order to prevent toggling, thisdrill guide is designed to fit verytightly into the holes of the plate.When utilizing this instrumentfollow the same trajectory ofthe pre-tilted lips to facilitate itsplacement.18° distal12° lateral15° distal15° lateral15° distal15° lateral0° 5° proximal0°18° distal12° lateral12° proximal5° proximalPre-determined Screw Pattern0°10° proximal5° proximal• SmartLock Polyaxial Drill Guide(56-01250)Allows for ±15 degrees of customangulation and may be used for morecomplex fractures. A lip on the drillsleeve will engage and allow togglingin the hole. The range in which thedrill guide toggles will create a 30degrees cone and every angle in thisrange will be a locking position. Thismay allow for the surgeon to aimwhere the screw/peg should be placed.Also, depending on the placement ofthe plate, there may be a need to anglea screw/peg out of the fracture line.• 2.3mm Drill Guide/K-Wire Guide(56-01260)The K-Wire guide provides an optionto assess potential screw positions byinserting a 1.1mm K-Wire prior to anydrilling or screw insertion. By usingthe same technique, this K-Wire guideoffers the same 30 degrees lockingcone as the SmartLock PolyaxialDrill Guide. It may also be utilized toprovide temporary fixation to smallerNote:First fully engage the drill guidein the hole and then aim the drillin the desired direction.fragments, while catching these withadjacent locking screws.The 2.3mm drill guide can be usedas an overdrill to lag 2.3mm screwsif compression is desired or as a pilothole for 2.7mm screws if the insertionis hindered. This drill guide can onlybe used in a fixed angle.• Depth GaugesSilver (62-00016) Black (62-00018)A choice of 2 Depth Gauge designs isoffered that allows for a reliable screwmeasurement even when using onehanded technique.Note:Using one of the provided drillguides for screw hole preparationis mandatory. Not using a drillguide may lead to drilling outof specified locking range andseverely compromise the lockingcapabilities.6
Operative TechniqueAnatomical Volar <strong>Plate</strong>1. An incision is made approximately8cm long just radial to the FCRtendon. If more exposure is necessary,the incision can be extended radiallyat 45 degrees along the wrist flexioncreases.2. The FCR tendon is retractedulnarly and dissection is carried downthrough the floor of the FCR sheath.This exposes the FCR muscle belly,which may be retracted ulnarly as well.3. The Pronator Quadratus is identifiedand dissected in its entirety off ofthe volar surface of the radius as anulnarly based flap.4. The insertion of the Brachioradialismay be released.5. The fracture is visualized and reduced.6. The use of external traction, and/orthe use of K-Wires for temporary fixationmay be helpful. If necessary, bone graftmaterials may be used as an adjunct tothe plate to provide an optimal bone voidfiller. The use of AP/Lateral fluoroscopyis helpful to determine correct fracturereduction and plate position.7. Choose the appropriate implantaccording to patient anatomy andfracture pattern.8. The plate should be placed slightlybelow the distal edge of the radius tosupport the volar articular fracturefragments and also to avoid insertingscrews or pegs into the joint.9. Zebra striped K-Wires and/or OliveK-Wires can be used for temporaryfixation while evaluating theplacement of the plate.10. The first pilot hole should bedrilled in the oval gliding hole usingthe appropriate drill guide.11. Use the depth gauge to determinescrew length.12. A non-locking screw is placed inthe oval gliding hole but not completelytightened to allow adjustment of the platein distal or proximal directions.13. After confirmation of the correctpositioning of the anatomic volar plate byuse of fluoroscopy, tighten the first screw.14. Once the position of the plate has beendetermined, it is time to decide which drillguide to use based upon preference and/orfracture pattern.15. Using the desired drill guide, repeatdrilling, measuring and placement ofscrews/pegs in the distal holes.16. Place locking or non-locking screwsin the proximal end of the plate.Note:If the insertion of the 2.7mm screw is hindered, it is recommended to use the2.7mm tap (62-27010) or the 2.3mm cortical drill bit (60-23341) to reducethe risk of screw breakage during insertion.717. Verify proper placement of screws/pegs by use of fluoroscopy to ensurethat neither penetrate the joint.18. Close the incision.
Page 3 and 4: ContentsPage1. Introduction 42. Ove
Page 5: OverviewPlate OptionsLeftRightAnato
Page 10 and 11: Operative TechniqueLateral Distal R
Page 12 and 13: Ordering Information - PlatesDorsal
Page 14 and 15: Ordering Information - T7 Drive Scr
Page 16 and 17: Ordering Information - Plate Trials
Page 18 and 19: Notes18
Page 20: Stryker Leibinger GmbH & Co. KGBöt

VariAxDistal Radius Locking Plate System - Stryker

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