The Mayo Clinic Congruent Elbow Plates - ShoulderDoc.co.uk

THEFOR THE TREATMENT OF DISTAL HUMERUS AND OLECRANON FRACTURESPrinciple Based Internal FixationDesigned in conjunction with Shawn O’Driscoll, M.D. and the Elbow Service at the Mayo Clinic, the Mayo Clinic CongruentElbow Plates by Acumed incorporate Dr. O’Driscoll’s fracture fixation principles, which have been proven successful with over12 years of clinical experience. The principles center around rigidly securing the articular fracture fragments and compressingthem to the shaft with plates that are pre-contoured to match the anatomy. Current complications, including elbow stiffness,hardware failure, hardware prominence and delayed union or non-union, can be minimized with the successful application ofthese new, next-generation implants.Seven Technical Objectives1) Every screw goes througha plate.2) Each screw engages a fragmenton the opposite side, that is alsofixed to a plate.3) Place as many screws as possible.4) Screws should be as long aspossible.5) Screws should engage as manyfragments as possible.6) Compression is achievedbetween the fragments andthe shaft.7) The plates should be strongand stiff to resist bending priorto union.Both the lateral epicondylar (green) and medial epicondylar (fuscia)plates are pre-contoured to match the bone with little or no bendingwhile achieving a low profile result and cortical screw interdigitation.The olecranon plates provide multiple fixation options in theproximal fragment with 2.7mm or 3.5mm cortical screws whileallowing for compression in the slots shown above.• Plates are pre-contoured to match the anatomy• Tubular undersurface for plate/bone stability• Low-profile screw plate interface• Peri-articular holes clustered for maximum fragment fixation• 2.7mm or 3.5mm screws for interdigitation• Compression slots• Slight under-contour• Plate thickness optimized for each regionMedial Epicondyle (Fuscia)Extra long (EL) • Long (L) • Short (S) • Medium (M) • Extended (EX)Lateral EpicondyleLeft (L)- BlueRight (R)- GreenShort (S)Long (L)LXLLLLSRS RLRXLELLSMEXLSXLOLXLORXLOlecranon (Aqua)Long (L)Standard (S)Extra Long (XL)Extra Long, Left (OLXL)Extra Long, Right (ORXL)Extra Long (XL)LCCoronoidPosterior (P)- GoldPRCLeft (LC)Right (RC)

11) The articular fragments, which tend to be rotatedtoward each other in the axial plane, are reducedanatomically and provisionally held with 0.035” or 0.045”smooth Kirschner wires. It is essential that the wires beplaced close to the subchondral level to avoid interferencewith later screw placement, and away from wherethe plates will be placed on the lateral and medialcolumns (see Fig. 2A). One or two strategically placedpins can be used to provisionally hold the distalfragments aligned with the shaft.2A2A) Medial and lateral precontoured plates are placed andheld apposed to the distal humerus, while one smooth2.0mm Steinmann pin is inserted through hole #2 (numberedfrom distal to proximal) of each plate through theepicondyles and across the distal fragments, to maintainprovisional fixation of the plates to the distal fragments.32B2B) A screw is placed in the slotted hole (#5) of eachplate, but not fully tightened, leaving some freedom for theplate to move proximally during compression later.Because the under surface of each plate is tubular in themetaphyseal and diaphyseal regions, the screw in the slottedhole only needs to be tightened slightly to provideexcellent provisional fixation of the entire distal humerus.3) Screws are inserted through hole #3 (numbered fromdistal to proximal) of the medial plate and across the distalarticular fragments from medial to lateral, and tightened.This step is repeated on the lateral side, using hole #1. Inyoung patients, 3.5mm cortical screws are used (to preventbreakage), whereas long 2.7mm screws are used in patientswith osteoporotic bone. The distal screws should be aslong as possible, passing through as many fragments as possible,and engaging the condyle or epicondyle of the oppositecolumn.

AcUMED®Copyright © 2002 Acumed, Inc.All rights reserved. Acumed is a registeredtrademark of Acumed. All other namesand brands are the property of theirrespective owners. Printed in the USA.AcUMED®5885 NW Cornelius Pass Rd.Hillsboro, OR 97124 USA1-888-627-9957 • www.acumed.netFBPL-07-04 • Effective 05/07/2002Patents Pending