A dedicated System for Reconstructive Pelvic and Acetabular Surgery

Pelvic Implants and

Instruments

Surgical Technique

Image intensiﬁer control

MR Information

The Low Proﬁle Pelvic System has not been evaluated for

safety and compatibility in the MR environment. It has

not been tested for heating, migration or image artifact in

the MR environment. The safety of the Low Proﬁle Pelvic

System in the MR environment is unknown. Scanning a

patient who has this device may result in patient injury.

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 1

Table of Contents

Introduction Implant Specifications 4

AO Principles 6

Intended Use, Indications and Contraindications 7

Instruments 8

• Standard 8

• Retractors 10

• Reduction 12

Surgical Technique Plate Contouring 14

• In-situ Plate Contouring 16

Fracture Fixation 18

• A. Pubic Symphysis Fractures 18

• B. Iliac Fractures 22

• C. Acetabulum Two Column Fractures 28

Implant Removal 38

Product Information Product Overview 39

Also Available 52

Other Available Pelvic Instruments and Implants

from DePuy Synthes 55

2 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Essential equipment for the surgical treatment

of pelvic and acetabular fractures

The complex anatomy of the pelvic ring and acetabulum

involve complex surgical exposures and demands exact

anatomical reduction to achieve positive functional results.

The AO and Synthes took this into consideration in devel-

oping the Pelvic Implant and Instrument Sets.

Reconstruction Plate and Screw Set

The pelvic and acetabular low proﬁle implants offer pre-

shaped plate designs. Additional trays with locking com-

pression, wide angle (acetabular) and J-plates (pelvic brim)

are also available. All plates can be three-dimensionally

contoured allowing them to be closely adapted to pelvic

bone surfaces. Bending templates allow for easy manual

adap tation of the plates.

Pelvic Standard Instrument Set

The Pelvic Instrument Set has a wide range of standard

instruments for screw insertion, plate adaptation (bending

instruments) and ﬁxation during reduction for preliminary

and deﬁnitive stabilization of pelvic and acetabular fractures.

The Pelvic Implant and Instrument Sets contain a wide

range of implants, reduction instruments, retractors and

instruments for screw and plate ﬁxation for the operative

treatment of pelvic and acetabular fractures. All implants

are available in 316L implant stainless steel.

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 3

Pelvic Retractor Set

A wide range of retractors (pelvic, Hohmann, sciatic nerve

and malleable) within the Pelvic Retractor Set provide

more options to aid the surgeon in achieving good visibil-

ity within the chosen approach.

Pelvic Reduction Instrument Set

The pelvic reduction forceps and other reduction instru-

ments within the Pelvic Reduction Instrument Set are

designed to aid the surgeon with fracture reduction of

pelvic injuries.

Introduction

4 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Implant Speciﬁcations

Reconstruction Plates

Occasionally, pelvic osteosyntheses can be carried out us-

ing screws alone, but in the majority of cases lag screw

ﬁxations must be supplemented by one or more plates.

The bone surfaces in the pelvic region have a very com-

plex topography. In order to achieve accurate ﬁxation, the

plates should be contoured to the bone surface. Poorly

contoured plates can lead to fracture displacement when

the screws are fully tightened through the plate.

The design of the reconstruction plates allow for contour-

ing in all three planes.

Uniform cross-section

Improved contourability

• Proﬁle: 3.7 mm

• Screw angulation: up to 30°

• Holes: 3 –20 (straight)

• Allow the use of cortex screws

and/or pelvic cortex screws

3.5 mm

3.5 mm Reconstruction Plates with low profile

3.5 mm Reconstruction Plates

with wide Angle

• Low proﬁle: 2.7 mm

• Screw angulation: up to 25°

• Holes: 3 –20 (straight),

6 –16 (curved), 10 –16 (J-shaped)

• Reconstruction Plate with low

proﬁle, curved:

– Available in two radii (88 mm

and 108 mm) to ﬁt the average

pelvis of a female or male,

respectively

– Allows the use of cortex screws

and/or pelvic cortex screws

3.5 mm

• Reconstruction Plate with low

proﬁle, J-shaped: hybrid of curved

and straight:

– One leg of the plate is straight,

while the other leg is bent with

a radius of 88 mm

– Left and right

– Fits along pelvic brim, from

thepubic rami (curved part of

the plate) to the SI joint

(straight end of the plate)

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 5

Low profile and rounded edges

Reduce the risk of soft tissue irritation.

Coaxial combi-holes in locking plates

Allow the use of locking screws or cortex

screws in the same round conical plate hole.

• Proﬁle: 3.7 mm

• Screw angulation:

up to 12° (cortex screws)

• Holes: 3–20 (straight),

10–16 (J-shaped)

• Features coaxial combi-holes

(this means the plate can be

used with standard cortex screws

3.5 as well as with 3.5 locking

screws)

• Fits the anatomy of the pubic

symphysis

• Coaxial combi-holes accept

3.5 locking screws as well

as standard/pelvic cortex

screws (3.5)

• Radius of 60 mm

• Reinforced midsection of plate

• 3 small holes in midsection can

be used to attach sutures

• 4 versions:

– 4 coaxial combi-holes

– 6 coaxial combi-holes

– 2 DCU holes and 2 coaxial

combi-holes*

– 2 DCU holes and 4 coaxial

combi-holes*

* DCU: Dynamic Compression Unit

• Reduces and stabilizes small bone

fragments that are too small for

screws.

• Can be used individually or with

a 3.5 mm reconstruction plate.

• Pre-bent convex shape with two

sharp spikes on the bottom sur-

face. Reduction is achieved by

sinking spikes into small frag-

ments while tightening a screw

through one of the screw holes.

• Convex shape for better bone

retention. Small fragments are

preloaded once a screw is inserted

which allows the plate to adapt

better to bony, uneven surfaces.

• Allows the use of cortex screws

and/or pelvic cortex screws

3.5 mm.

3.5 mm Locking Reconstruction

Plate

3.5 mm Pubic Symphysis Plate 3.5 mm Spring Plate

6 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

AO Principles

4_Priciples_03.pdf 1 05.07.12 12:08

4 DePuy Synthes Expert Lateral Femoral Nail Surgical Technique

AO PRINCIPLES

In 1958, the AO formulated four basic principles, which

have become the guidelines for internal ﬁxation

1, 2

Müller ME, M Allgöwer, R Schneider, H Willenegger. Manual of Internal

Fixation. 3rd ed. Berlin Heidelberg New York: Springer. 1991.

Rüedi TP, RE Buckley, CG Moran. AO Principles of Fracture Management.

2nd ed. Stuttgart, New York: Thieme. 2007.

Anatomic reduction

Fracture reduction and ﬁxation to

restore anatomical relationships.

Early, active mobilization

Early and safe mobilization and

rehabilitation of the injured part

and the patient as a whole.

Stable fixation

Fracture ﬁxation providing abso-

lute or relative stability, as

required by the patient, the injury,

and the personality of the

fracture.

Preservation of blood supply

Preservation of the blood supply

to soft tissues and bone by

gentle reduction techniques and

careful handling.

In 1958, the AO formulated four basic principles, which

have become the guidelines for internal ﬁxation.

1, 2

Anatomic reduction

Fracture reduction and ﬁxation to

restore anatomical relationships.

Early, active mobilization

Early and safe mobilization and

rehabilitation of the injured part

and the patient as a whole.

Stable fixation

Fracture ﬁxation providing absolute

or relative stability, as required by

the patient, the injury, and the

personality of the fracture.

Preservation of blood supply

Preservation of the blood supply

to soft tissues and bone by gentle

reduction techniques and

careful handling.

1. Müller ME, Allgöwer M, Schneider R, Willenegger H. Manual of Internal Fixation.

3rd ed. Berlin, Heidelberg, New York: Springer-Verlag; 1991.

Rüedi TP, RE Buckley, CG Moran. AO Principles of Fracture Management.

2nd ed. Stuttgart New York: Thieme; 2007.

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 7

Intended Use, Indications and Contraindications

Intended Use

Pelvic implants are intended for temporary ﬁxation,

correction or stabilization of bones in the pelvis.

Indications

Symphysis fractures

• Pubic Symphysis Plates

Pelvic brim fractures

• Reconstruction Plates

– Straight Plates

– Curved Plates (88 mm radius, 108 mm radius)

– J-Plates

• 3.5 mm Locking Reconstruction Plate

– Straight Plates

– J-Plates

• 3.5 mm Wide Angle Reconstruction Plates

– Straight Plates

Ilium/Iliac wing fractures

• Reconstruction Plates

– Straight Plates

– Curved Plates (88 mm radius, 108 mm radius)

• 3.5 mm Locking Reconstruction Plates

– Straight Plates

• 3.5 mm Low Proﬁle Reconstruction Plates with

wide Angle

– Straight Plates

Acetabulum fractures

• Reconstruction Plates

– Straight Plates

– Curved Plates (88 mm radius, 108 mm radius)

• 3.5 mm Reconstruction Plates with wide Angle

– Straight Plates

Contraindications

No speciﬁc contraindications.

Intended use for in-situ plate contouring:

Refer to page 16.

8 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Instruments

Standard

Instruments for screw fixation

Screw ﬁxation of the pelvis requires the use of extra-long

screws and corresponding instruments. The following

instruments are part of the Pelvic Instrument Set:

• Extra-long 3-uted calibrated drill bit

• Extra-long taps, calibrated with depth markings

• Extra-long screwdrivers (hexagonal and StarDrive

recess) and screwdriver shafts (hexagonal and

StarDrive recess)

• Extra-long depth gauge

Bending instruments

• The bending pliers should be used as the primary

bending instrument.

• A smooth bend is best achieved by the introduction

of many small bends.

• Bending irons, designed speciﬁcally for use with

the reconstruction plates, are also available.

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 9

In-situ bending instruments

• In-situ bending instruments allow precise intraoperative

adaptation of the pre-bent reconstruction plate to the

bone anatomy.

• The in-situ bending and twisting handles with different

tips (straight, 90°, 120°) allow use in different surgical

approaches.

In-situ Bender

In-situ Bending and Twisting Handles

Bending templates

Malleable bending templates are available for all recon-

struction plate shapes (straight, curved, J-shaped). These

can be ﬁ tted to the reduced bone and then a plate is

shaped to ﬁ t the template.

Precaution: Reverse bending or use of the incorrect

instrumentation for bending may weaken the plate

and lead to premature plate failure (e.g. breakage).

Do not bend the plate beyond what is required to

match the anatomy.

The templates can also be used to determine plate

lengths.

10 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Retractors

A wide range of malleable, blunt, spoon shaped, pelvic,

Hohmann and sciatic nerve retractors provide more

options to aid the surgeon with the chosen approach.

Instruments

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 11

Radiolucent retractors

Radiolucent retractors allow for the passage of x-rays

without having to remove the instrumentation in order

to visualize the implant underneath. Another advantage

of these retractors is their light weight.

In an effort to accommodate the surgeon needs,

DePuy Synthes hasredesigned several retractors in alu-

minum, thus making them radiolucent.

12 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Pelvic reduction forceps

The pelvic reduction forceps are designed to maximize

the potential of the ilioinguinal and Kocher-Langenbeck

approaches. The jaws of all the larger forceps are long

enough to accommodate the innominate bone, from the

iliac crest to the pelvic brim, and can be used without

exerting excess pressure on the iliac vessels.

Pelvic reduction forceps are equipped with features to

improve handling characteristics during reduction

maneuvers.

• Pointed-ball tips prevent penetration of bone with

a thin cortex.

• Longer spikes with sharper points provide a secure

hold on the pelvic surfaces.

Increased selection of forceps, including

• Handles and jaws of different lengths

• Straight and oblique versions

Ball spikes with pointed ball tip

The straight ball spikes facilitate reduction of bone frag-

ments. They feature a spike to reduce the risk of the

instrument slipping off the bone and a pointed-ball tip

to prevent penetration of bone with a thin cortex.

Round and rectangular disks

Disks can be used in conjunction with the reduction for-

ceps with pointed ball-tips or the ball spike instruments.

In poorquality bone (osteoporotic), they can aid in dis-

tributing the applied forces over a larger surface area in

effort to prevent iatrogenic or compression fractures.

Reduction

Instruments

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 13

Pelvic reduction forceps for screws

All forceps have been designed for use with 3.5 mm/

4.5 mm screws inserted on opposite sides of a fracture

line, which allows the application of considerable reduc-

tion forces and manipulation in all three planes.

The large forceps have long handles for the transferal

of large forces. The Farabeuf forceps can be either used

with screws or as general bone forceps, i.e. to grasp and

manipulate the iliac wing.

• Jungbluth large (330 mm), small (250 mm),

for B3.5 mm screws

• Farabeuf medium (250 mm), small (190 mm),

for Cortex Screws B3.5 and 4.5 mm

Reduction forceps with points

These standard forceps can be applied directly to the

bone’s surface, or be used with shallow drill holes or

anchoring rings and hooks.

Medium and large bone hooks

The bone hooks are designed to allow the surgeon to

mani pulate the bone or bone fragments in order to

ensure proper alignment and to achieve an anatomical

reduction.

14 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Plate Contouring

Surgical Technique

1. Contour plate

Instruments

03.100.031 Bending Pliers for 3.5 mm Low Proﬁle

Reconstruction Plates

329.08 Bending Iron for 3.5 mm and 4.5 mm

Reconstruction Plates

For plate contouring, place a plate between the ledge

and the groove of the bending pliers. Place the concave

surface on the side of pliers with the ledge. Squeeze the

handles gradually and bend the plate as appropriate. (1)

For in-plane bending, place a plate into the groove of the

bending pliers. Squeeze the handles gradually and bend

the plate as appropriate. (2)

Precautions:

• Instruments and screws may have sharp edges

or moving joints that may pinch or tear user’s

glove or skin.

• Handle devices with care and dispose worn bone

cutting instruments in an approved sharps

container.

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 15

2. Twist plate

Instruments

03.100.031* Bending Pliers for 3.5 mm Low Proﬁle

Reconstruction Plates

329.08 Bending Iron for 3.5 mm and 4.5 mm

Reconstruction Plates

Hold the plate using the plier grips and twist the plate by

using an additional bending iron.

Precaution: Reverse bending or use of the incorrect

instrumentation for bending may weaken the plate

and lead to premature plate failure (e.g. breakage).

Do not bend the plate beyond what is required to

match the anatomy. For reconstruction plates with

coaxial combi-holes: use threaded pin to avoid screw

hole deformation during bending.

Note: The bending pliers (03.100.031)* are intended

for use with the 3.5 mm Reconstruction Plates

contained in the 3.5 mm Low Profile Pelvic System.

16 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Plate Contouring

In-situ Plate Contouring

In-situ bending instruments adjust the pre-bent, recon-

struction plates on the bone to match relevant patient

anatomy during a surgical procedure. Using these instru-

ments helps decrease the surgical time by reducing the

need for repeated cycles of plate positioning and removal

until the plate has been sufﬁciently shaped.

The instruments are intended for use with the following

plate systems:

• 3.5 mm Reconstruction Plates with low proﬁle

(straight, curved and J-shaped)

• 3.5 mm Reconstruction Plates with wide Angle

• 3.5 mm DCP Reconstruction Plates, straight and curved

These instruments are not intended for plates with lock-

ing and coaxial Combi holes. In particular:

• 3.5 mm Locking Reconstruction Plates

• 3.5 mm Pubic Symphysis Plates

• 3.5 mm Spring Plates

• 3.5 mm Reconstruction Plates with coaxial combi-holes

• Other plate sizes than 3.5 mm

Note: Preoperative pre-bending of the reconstruction

plates is always required before in-situ plate bend-

ing. The in-situ bending instruments are intended for

detailed and accurate adaptation of the plates to the

local anatomy.

Precautions:

• Do not bend the plate at the level of the holes.

• Reverse bending or use of the incorrect instrumen-

tation for bending may weaken the plate and lead

to premature plate failure (e.g. breakage). Do not

bend the plate beyond what is required to match

the anatomy.

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 17

1. Contour plate: in-situ bending

or correction of the bending radius

Instrument

03.100.090 In-situ Bending Pliers for use with

Pelvic Reconstruction Plates

Grasp the preliminary ﬁxated plate with the in-situ

bender. The nose and counter-bearing mouth of the

bender must sit in the notches of the reconstruction

plate.

Squeeze the handles and bend the plate as required.

2. Bend or twist plate

Instruments

03.100.091 In-situ Bending and Twisting Handle,

straight

03.100.092 In-situ Bending and Twisting Handle, 90°

03.100.093 In-situ Bending and Twisting Handle,

120°

Use two straight In-situ Bending and Twisting Handles.

Place the tip of each handle in the plate hole. One handle

is used for holding the plate while the second handle is

mani pulated to bend or twist the plate accordingly.

Note: The In-situ Bending and Twisting Handle,

straight can be combined with the In-situ Bending

and Twisting Handle, 90° or 120° where appropriate.

Precaution: Ensure that the tip of the instrument is

properly attached to the plate to prevent slippage.

18 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Note: The following cases of fracture fixation repre-

sent possible uses of pelvic instruments. Several

applications are shown but other applications are

possible.

1. Approach

Use an anterior approach (e.g. Pfannenstiel or Stoppa).

A. Pubic Symphysis Fractures

Fracture Fixation

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 19

2. Reduce fracture

Instruments

399.98 Reduction Forceps, with Points,

Ratchet, 200 mm

398.75 Medium Pelvic Forceps, 250 mm

398.88 Pelvic Reduction Forceps

Achieve reduction of the pubic symphysis by using the

large reduction forceps with points. (1)

Alternatively, achieve reduction by inserting two screws

anteriorly and using pelvic reduction forceps

(398.75/398.88). (2,3)

20 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Fracture Fixation

3. Fix plate

Instruments

03.100.032 Ratcheting Handle with Quick Coupling

03.100.033 3.5 mm Screwdriver Shaft, hexagonal,

long

324.214 2.8 mm Percutaneous Drill Bit Quick

Coupling, 200 mm, 100 mm Calibration

311.31 Tap for 3.5 mm Cortex Screws,

175 mm/140 mm calibrated

312.648 2.8 mm Threaded Drill Guide

314.09 Holding Sleeve

314.57 Small Hexagonal Screwdriver, long

315.92 2.5 mm three-uted Drill Bit,

QC/230 mm/200 mm Calibration

319.091 Depth Gauge for 3.5 mm Cortex Screws

511.773 Torque Limiting Attachment,

1.5 Nm, Quick Coupling

Alternative instruments

03.100.045 StarDrive Screwdriver Shaft T15,

250 mm, long

314.115 StarDrive Screwdriver T15

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 21

Place the 3.5 mm Pubic Symphysis Plate over the symphy-

sis joint and make a temporary ﬁxation (e.g. with plate

holding forceps).

According to preoperative planning and plate selection

(locking/non-locking), use B3.5 mm cortex screws and/or

B3.5 mm locking screws to ﬁx the plate. If compression

isneeded between the symphysis joint, use the plate with

DCU holes.

Insert the ﬁrst cortex screw in the lateral part of DCU hole

(eccentric). Insert the second cortex screw eccentrically

into the DCU hole of the contralateral side of the pubic

symph ysis. (1,2)

Precaution: Check appropriate length and position

of screw under image intensifier control.

Alternate tensioning of the screws results in compression

of the symphysis.

Additional locking screws should be inserted according to

the LCP

Locking Compression Plate surgical technique

DSUS/TRM/1016/1165. (3)

Notes:

• Refer to the LCP Locking Compression Plate

DSUS/TRM/1016/1165 surgical technique for

lag screw placement and plating.

• StarDrive Screwdriver Shaft T15 (03.100.045)

and StarDrive Screwdriver T15 (314.115) are

used for B3.5 mm StarDrive screws.

22 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

1. Approach

Use an anterior or posterior approach appropriate for the

fracture pattern. The following example of an iliac frac-

ture shows a possible fracture treatment using a posterior

(Kocher– Langenbeck) approach.

2. Reduce fracture

Instruments

398.74 Small Pelvic Forceps, 200 mm

399.98 Reduction Forceps, with Points,

Ratchet, 200 mm

Conﬁrm anatomical reduction of the anterior aspect of

the iliac wing by ﬁnger palpation.

To reduce the iliac bone, use reduction forceps on the iliac

crest and the posterior iliac wing.

Fracture Fixation

B. Iliac Fractures

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 23

Alternative technique

Instruments

311.31 Tap for 3.5 mm Cortex Screws,

175 mm/140 mm, calibrated

314.57 Small Hexagonal Screwdriver, long

315.92 2.5 mm three-uted Drill Bill,

QC/230 mm/200 mm Calibration

319.091 Depth Gauge for 3.5 mm Cortex Screws

398.75 Medium Pelvic Forceps, 250 mm

398.88 Pelvic Reduction Forceps

399.98 Reduction Forceps, with Points,

Ratchet, 200 mm

Alternatively, insert two temporary cortex screws on

either side of the fracture line and gain compression using

pelvic reduction forceps: 398.75 Farabeuf (1) or

398.88, Jungbluth (2).

24 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

3. Fix plate on posterior inferior ilium

Instruments

03.100.032 Ratcheting Handle with Quick Coupling

03.100.033 3.5 mm Screwdriver Shaft, hexagonal,

long

311.31 Tap for 3.5 mm Cortex Screws,

175 mm/140 mm, calibrated

314.09 Holding Sleeve

314.57 Small Hexagonal Screwdriver, long

315.92 2.5 mm three-uted Drill Bit,

QC/230 mm/200 mm Calibration

319.091 Depth Gauge for 3.5 mm Cortex Screws

399.091 Bone Holding Forceps, soft,

Ratchet, F/Plates to 9 mm wide

399.98 Reduction Forceps, with Points,

Ratchet, 200 mm

Alternative instruments

03.100.045 StarDrive Screwdriver Shaft T15

250 mm, long

314.115 StarDrive Screwdriver T15

Fracture Fixation

1 2

3 4

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 25

Insert a screw through the 4-hole low proﬁle pelvic recon-

struction plate into the body of the ilium, close to the

sciatic notch. (1)

Precaution: Check appropriate length and position

of screw under image intensifier control.

To reduce the posterior iliac fragment, insert a temporary

screw into the posterior superior iliac spine. (2)

Compress the fracture using the bone holding forceps.

The forceps istherefore hooked into the most posterior

plate hole and the temporary screw on the other side of

the fracture line isused as a counter bearing. (3)

After additional screw ﬁxation through the plate, remove

thetemporary screw. (4)

Precaution: During fixation close to the greater

sciatic notch, control drill bit penetration and screw

lengths with two-finger palpation to prevent damage

to the nerve or vessels.

Note: Refer to the LCP Locking Compression Plate

DSUS/TRM/1016/1165 surgical technique for lag

screw placement and plating.

26 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

4. Fix plate on iliac crest

Instruments

03.100.018 Straight Ball Spike, 6.5 mm ball diameter,

320 mm

03.100.032 Ratcheting Handle with Quick Coupling

03.100.033 3.5 mm Screwdriver Shaft, hexagonal,

long

311.31 Tap for 3.5 mm Cortex Screws,

175 mm/140 mm, calibrated

314.09 Holding Sleeve

314.57 Small Hexagonal Screwdriver, long

315.92 2.5 mm three-uted Drill Bit,

QC/230 mm/200 mm Calibration

319.091 Depth Gauge for 3.5 mm Cortex Screws

399.98 Reduction Forceps, with Points,

Ratchet, 200 mm

Alternative instruments

03.100.045 StarDrive Screwdriver Shaft T15,

250 mm, long

314.115 StarDrive Screwdriver T15

Fracture Fixation

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 27

Place a low proﬁle pelvic reconstruction plate posterior to

the iliac crest, and ﬁx it with B3.5 mm cortex screws.

The ball spike with pointed ball tip may also be used to

achieve reduction.

Precaution: Check appropriate length and position of

screw under image intensifier control.

Note: Refer to the LCP Locking Compression Plate

DSUS/TRM/1016/1165 surgical technique for lag

screw placement and plating.

28 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

1. Approach

Use an ilioinguinal approach.

C. Acetabulum Two Column Fractures

Fracture Fixation

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 29

2. Reduce fracture in iliac crest

Instruments

03.100.019 Straight Ball Spike, long,

6.5 mm Ball Diameter, 420 mm

294.68 6.0 mm Schanz Screw, Spade Point,

190 mm

398.74 Small Pelvic Forceps, 200 mm

399.98 Reduction Forceps, with Points,

Ratchet, 200 mm

Insert a Schanz screw into the proximal femur to allow

intraoperative manual traction. (1)

Conﬁrm anatomic reduction of the different fracture

fragments. Fragments may be temporarily ﬁxated with

Kirschner wires. (2)

Different reduction instruments (e.g. ball spike, reduction

forceps) may aid in achieving appropriate reduction. (2,3)

Note: For a detailed handling description of the

Schanz screws, refer to the corresponding surgical

technique for the Large External Fixator – Pelvic

Frame (DSUS/TRM/0814/0215).

30 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

3. Insert screw in iliac crest

Instruments

03.100.032 Ratcheting Handle with Quick Coupling

03.100.033 3.5 mm Screwdriver Shaft, hexagonal,

long

310.37 3.5 mm Drill Bit, QC/195 mm

311.31 Tap for 3.5 mm Cortex Screws,

175 mm/140 mm, calibrated

314.09 Holding Sleeve

314.57 Small Hexagonal Screwdriver, long

315.92 2.5 mm three-uted Drill Bit,

QC/230 mm/200 mm Calibration

319.091 Depth Gauge for 3.5 mm Cortex Screws

398.74 Small Pelvic Forceps, 200 mm

399.98 Reduction Forceps, with Points,

Ratchet, 200 mm

Alternative instruments

03.100.045 StarDrive Screwdriver Shaft T15,

250 mm, long

314.115 StarDrive Screwdriver T15

Fracture Fixation

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 31

Insert a B3.5 mm cortex screw (lag screw) into the iliac

crest perpendicular to the fracture line.

Precaution: Check appropriate length and position

of screw under image intensifier control.

Use the pelvic reduction forceps and/or the large

reduction forceps with points to maintain reduction.

Precaution: Use oscillating mode while drilling to

avoid soft tissue damage and penetration of the ante-

rior or posterior iliac cortex.

4. Insert screw in body of ilium

Instrument

03.100.023 Reduction Forceps for Low Proﬁle

Pelvic System, 400 mm

Insert a second lag screw into the body of the ilium

perpendicular to the fracture line.

Precaution: Check appropriate length and position

of screw under image intensifier control.

Use the pelvic reduction forceps to maintain reduction.

32 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

5. Reduce posterior column

Instrument

399.98 Reduction Forceps, with Points,

Ratchet, 200 mm

Use the reduction forceps with points to reduce the

fragment of the quadrilateral surface. The forceps bridge

from the pelvic brim to the quadrilateral surface.

Alternative technique

Instruments

03.100.020 Pelvic Reduction Forceps, straight,

with pointed ball tips B6.5 mm

03.100.022 Pelvic Reduction Forceps, angled,

with pointed ball tips B6.5 mm

03.100.029 Bone Hook, medium, long,

length 330 mm

03.100.120 Spiked Round Disk for 6.5 mm Ball

314.291 Sliding Mechanism for Collinear

Reduction Clamp

398.753 Pelvic Arm, 225 mm, for Collinear

Reduction Clamp

Alternatively the pelvic reduction forceps with pointed

ball tips (straight or angled) can be used to reduce the

fracture.

If necessary, spiked discs can be used with all pelvic

reduction forceps with ball tips. (1)

Fracture Fixation

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 33

The collinear reduction clamp with pelvic arm is useful

to reduce the posterior column. (2)

The bone hook placed beneath the ischial spine may

also be used to reduce the posterior column. (3)

Note: For a detailed handling description of the col-

linear reduction clamp, refer to the corresponding

surgical technique (DSUS/TRM/0417/1437).

34 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

6. In-situ plate contouring

If preoperative bending is insufﬁcient after plate position-

ing, insertion and tightening of the ﬁrst screws, the in-situ

bending instruments can be used to further adapt the

plate to the local anatomy.

Instruments

03.100.090 In-situ Bending Pliers for use

with Pelvic Reconstruction Plates

03.100.091 In-situ Bending and Twisting Handle,

straight

03.100.092 In-situ Bending and Twisting Handle, 90°

03.100.093 In-situ Bending and Twisting Handle,

120°

If in-situ plate adaptation is required, use the in-situ

bending instruments as described on page 16.

Fracture Fixation

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 35

If plate needs to be bent or twisted to ﬁt the local anat-

omy, the in-situ bending and twisting handles should be

used as described on page 16.

36 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

7. Fix plate on pelvic brim

Instruments

03.100.019 Straight Ball Spike, long,

6.5 mm Ball Diameter, 420 mm

03.100.032 Ratcheting Handle with Quick Coupling

03.100.033 3.5 mm Screwdriver Shaft, hexagonal,

long

311.31 Tap for 3.5 mm Cortex Screws

175 mm/140 mm, calibrated

314.09 Holding Sleeve

314.291 Sliding Mechanism for Collinear

Reduction Clamp

314.57 Small Hexagonal Screwdriver, long

315.92 2.5 mm three-uted Drill Bit,

QC/230 mm/200 mm Calibration

319.091 Depth Gauge for 3.5 mm Cortex Screws

398.753 Pelvic Arm, 225 mm, for Collinear

Reduction Clamp

Alternative instruments

03.100.045 StarDrive Screwdriver Shaft T15,

250 mm, long

314.115 StarDrive Screwdriver T15

Fracture Fixation

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 37

Fix a J-plate with B3.5 mm cortex screws on the pelvic

brim. Lagscrews through the plate help to achieve a sta-

ble ﬁxation between the anterior and posterior column.

Precaution: Check appropriate length and position of

screw under image intensifier control.

8. Fix plate on pubic rami

Insert additional screws through the plate into the pubic

ramito maintain reduction and stable ﬁxation of the

anterior column.

Precaution: Check appropriate length and position

of screw under image intensifier control.

Note: Refer to the LCP Locking Compression Plate

DSUS/TRM/1016/1165 surgical technique for lag

screw placement and plating.

38 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Unlock all screws from the plate, then remove the screws

completely from the bone. This prevents simultaneous

rotation of the plate when unlocking the last locking

screw.

For details regarding implant removal refer to the surgical

technique “Screw Removal Set” DSUS/TRM/1016/1197.

Implant Removal

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 39

Graphic Case Components

690.426 Lid for 3.5 mm Low Proﬁle Pelvic

System Implant Set

690.436 Tray for 3.5 mm Low Proﬁle

Reconstruction Plates

690.437 Tray for 3.5 mm Low Proﬁle Pelvic

System Cortex Screws

690.438 Screw Rack for 3.5 mm Low Proﬁle

Locking Screws

690.912 Two Level Graphic Case Base

Instruments

03.100.034 Bending Template, 20 holes, 260 mm

03.100.036 Bending Template for 3.5 mm

Low Proﬁle Reconstruction Plate,

88 mm radius, 16 holes

03.100.037 Bending Template for 3.5 mm

Low Proﬁle Reconstruction Plate,

108 mm radius, 16 holes

319.97 Screw Forceps

3.5 mm Low Proﬁle Pelvic System Implant Set

(01.100.002)

Product Overview

Product Information

Implants

3.5 mm Pelvic Cortex Screws, self-tapping

Length

(mm) Qty.

204.640 40 4

204.645 45 4

204.650 50 4

204.655 55 4

204.660 60 4

204.665 65 4

204.670 70 4

204.675 75 2

204.680 80 2

204.685 85 2

204.690 90 2

204.695 95 2

Length

(mm) Qty.

204.700 100 2

204.705 105 2

204.710 110 2

204.715 115 2

204.720 120 2

204.725 125 2

204.730 130 2

204.735 135 2

204.740 140 2

204.745 145 2

204.750 150 2

For detailed cleaning and sterilization instructions, please refer to

www.depuysynthes.com/hcp/cleaning-sterilization or sterilization instructions, if provided.

40 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Implants continued

3.5 mm Cortex Screws, self-tapping

Length

(mm) Qty.

204.810 10 4

204.812 12 4

204.814 14 4

204.816 16 4

204.818 18 4

204.820 20 4

204.822 22 4

204.824 24 4

Length

(mm) Qty.

204.826 26 4

204.828 28 4

204.830 30 4

204.832 32 4

204.834 34 4

204.836 36 4

204.838 38 4

3.5 mm Locking Screws, self-tapping, with StarDrive recess

Length

(mm) Qty.

212.101 10 4

212.102 12 4

212.103 14 4

212.104 16 4

212.105 18 4

212.106 20 4

212.107 22 4

212.108 24 4

212.109 26 4

212.110 28 4

212.111 30 4

212.112 32 4

212.113 34 4

212.115 36 4

Length

(mm) Qty.

212.116 38 4

212.117 40 4

212.119 45 2

212.121 50 2

212.123 55 2

212.124 60 2

212.125 65 2

212.126 70 2

212.127 75 2

212.128 80 2

212.129 85 2

212.130 90 2

212.131 95 2

219.98 Washer, 7.0 mm, 4 ea.

Product Overview

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 41

3.5 mm Low Proﬁle Reconstruction Plates, 2 ea.

Holes Length

(mm)

245.023 3 39

245.024 4 52

245.025 5 65

245.026 6 78

245.027 7 91

245.028 8 104

245.029 9 117

245.030 10 130

Holes Length

(mm)

245.031 11 143

245.032 12 156

245.033 13 169

245.034 14 182

245.035 15 195

245.036 16 208

245.038 18 234

245.039 20 260

3.5 mm Low Proﬁle Curved Reconstruction Plates, 2 ea.

88 mm 108 mm

radius radius Holes Length (mm)

245.906 245.876 6 78

245.908 245.878 8 104

245.910 245.880 10 130

245.912 245.882 12 156

245.914 245.884 14 182

245.916 245.886 16 208

Implants continued

3.5 mm Pubic Symphysis Plates, with coaxial Combi holes,

2 ea.

Holes Length (mm)

02.100.004 4 57

02.100.006 6 78

Also Available

3.5 mm Pubic Symphysis Plates, with 2 central DCP Holes

Holes Length (mm)

02.100.014 4 57

02.100.016 6 78

3.5 mm Spring Plates*

Holes

02.100.301 1

02.100.302 2

02.100.303 3

* These implants are available nonsterile or sterile-packed.

Add “S” to product number for sterile product.

42 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Additional Implant Trays – 3.5 mm Locking Low Proﬁle

Reconstruction Plate Tray (01.100.042)

Tray

690.435 Tray for 3.5 mm Locking Low Proﬁle

Reconstruction Plates

Instruments

02.200.003 3.5 mm Threaded Plug, StarDrive, 4 ea.

03.100.034 Bending Template, 20 holes, 260 mm

03.100.040 2.8 mm Threaded Drill Guide, short,

35 mm long, 2 ea.

03.100.045 3.5 mm StarDrive Screwdriver Shaft, T15,

250 mm long, 2 ea.

310.288 2.8 mm Drill Bit, quick coupling, 165 mm,

2 ea.

312.648 2.8 mm Threaded Drill Guide, 2 ea.

324.031 Threaded Plate Holder, long

324.214 2.8 mm Percutaneous Drill Bit, quick

coupling, 200 mm, 100 mm calibration,

2 ea.

511.773 Torque Limiting Attachment, 1.5 Nm,

quick coupling

Implants

3.5 mm Pubic Symphysis Plates, with coaxial Combi holes,

2 ea.

Holes Length (mm)

02.100.004 4 57

02.100.006 6 78

3.5 mm Locking Low Proﬁle Reconstruction Plates, 2 ea.

Holes Length

(mm)

02.100.103 3 39

02.100.104 4 52

02.100.105 5 65

02.100.106 6 78

02.100.107 7 91

02.100.108 8 104

02.100.109 9 117

02.100.110 10 130

Holes Length

(mm)

02.100.111 11 143

02.100.112 12 156

02.100.113 13 169

02.100.114 14 182

02.100.115 15 195

02.100.116 16 208

02.100.118 18 234

02.100.120 20 260

Product Overview

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 43

Also Available

3.5 mm Pubic Symphysis Plates, with 2 central DCP holes

Holes Length (mm)

02.100.014 4 57

02.100.016 6 78

44 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Additional Implant Trays – 3.5 mm Wide Angle Low

Proﬁle Reconstruction Plate Tray (01.100.022)

Tray

690.424 Tray for 3.5 mm Low Proﬁle Wide Angle

Reconstruction Plates

Instruments

03.100.034 Bending Template, 20 holes, 260 mm

Wide angle plates feature larger diameter holes in

a thicker plate, allowing maximum screw angulation.

Implants

3.5 mm Wide Angle Low Proﬁle Reconstruction Plates,

2 ea.

Holes Length

(mm)

02.100.203 3 39

02.100.204 4 52

02.100.205 5 65

02.100.206 6 78

02.100.207 7 91

02.100.208 8 104

02.100.209 9 117

02.100.210 10 130

Holes Length

(mm)

02.100.211 11 143

02.100.212 12 156

02.100.213 13 169

02.100.214 14 182

02.100.215 15 195

02.100.216 16 208

02.100.218 18 234

02.100.220 20 260

28°

Product Overview

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 45

Additional Implant Trays – 3.5 mm Low Proﬁle

Reconstruction J-Plate Tray (01.100.032)

Tray

690.423 Tray for 3.5 mm Low Proﬁle Recon -

struction J-Plates

Instruments

03.100.035 Bending Template for 3.5 mm Low Proﬁle

Reconstruction J-Plates, 16 holes, 2 ea.

03.100.036 Bending Template for 3.5 mm Low Proﬁle

Curved Reconstruction Plate, 88 mm

radius, 16 holes, 2 ea.

Implants

3.5 mm Low Proﬁle Reconstruction J-Plates, 88 mm

radius, 2 ea.

Locking Non-locking Holes Length (mm)

02.100.360 245.920 10 130 right

02.100.362 245.922 12 156 right

02.100.364 245.924 14 182 right

02.100.366 245.926 16 208 right

02.100.361 245.930 10 130 left

02.100.363 245.932 12 156 left

02.100.365 245.934 14 182 left

02.100.367 245.936 16 208 left

3.5 mm Low Proﬁle Curved Reconstruction Plates, 88 mm

radius, 2 ea.

Holes Length (mm)

245.906 6 78

245.908 8 104

46 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Additional Implant Trays – 3.5 mm Low Proﬁle Pelvic

System StarDrive Screw Tray, without Locking Screws

(01.100.132)

Tray

690.439 Tray for 3.5 mm Low Proﬁle Pelvic System

StarDrive Cortex Screws

Instruments

314.116 StarDrive Screwdriver Shaft, T15,

quick coupling

319.97 Screw Forceps

Implants

3.5 mm Cortex Screws, self-tapping,

with T15 StarDrive recess

Length

(mm) Qty.

02.200.010 10 4

02.200.012 12 4

02.200.014 14 4

02.200.016 16 4

02.200.018 18 4

02.200.020 20 4

02.200.022 22 4

02.200.024 24 4

02.200.026 26 4

02.200.028 28 4

02.200.030 30 4

02.200.032 32 4

02.200.034 34 4

02.200.036 36 4

02.200.038 38 4

02.200.040 40 4

02.200.042 42 4

02.200.044 44 4

02.200.045 45 4

02.200.046 46 4

02.200.048 48 4

Length

(mm) Qty.

02.200.050 50 4

02.200.055 55 4

02.200.060 60 4

02.200.065 65 4

02.200.070 70 4

02.200.075 75 2

02.200.080 80 2

02.200.085 85 2

02.200.090 90 2

02.200.095 95 2

02.200.100 100 2

02.200.105 105 2

02.200.110 110 2

02.200.115 115 2

02.200.120 120 2

02.200.125 125 2

02.200.130 130 2

02.200.135 135 2

02.200.140 140 2

02.200.145 145 2

02.200.150 150 2

Product Overview

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 47

Additional Implant Trays – 3.5 mm Low Proﬁle Pelvic

System Screw Rack for Locking Screws

(01.100.122)

Screw Rack

690.438 Screw Rack for 3.5 mm Low Proﬁle

Locking Screws

Implants

3.5 mm Locking Screws, self-tapping,

with StarDrive recess

Length

(mm) Qty.

212.101 10 4

212.102 12 4

212.103 14 4

212.104 16 4

212.105 18 4

212.106 20 4

212.107 22 4

212.108 24 4

212.109 26 4

212.110 28 4

212.111 30 4

212.112 32 4

212.113 34 4

212.115 36 4

Length

(mm) Qty.

212.116 38 4

212.117 40 4

212.119 45 2

212.121 50 2

212.123 55 2

212.124 60 2

212.125 65 2

212.126 70 2

212.127 75 2

212.128 80 2

212.129 85 2

212.130 90 2

212.131 95 2

48 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Additional Instrument Sets – 3.5 mm Low Proﬁle

Pelvic System Instrument Set (01.100.013)

Graphic Case Components

690.427 Lid for 3.5 mm Low Proﬁle Pelvic System

Instruments

690.431 Tray for 3.5 mm Low Proﬁle Pelvic System

Instruments

690.912 Two Level Graphic Case Base

Instruments

03.100.031 Bending Pliers for 3.5 mm

Reconstruction Plates

03.100.032 Ratcheting Handle with quick coupling

03.100.033 3.5 mm Screwdriver Shaft, hexagonal,

250 mm length, 2.5 mm width across ats,

2 ea.

03.100.045 3.5 mm StarDrive Screwdriver Shaft, T15,

250 mm length

310.37 3.5 mm Drill Bit, quick coupling, 195 mm,

2 ea.

311.31 Tap for 3.5 mm Cortex Screws, 175 mm,

140 mm, calibrated, 2 ea.

314.09 Holding Sleeve

314.57 Small Hexagonal Screwdriver,

270 mm length

315.92 2.5 mm three-uted Drill Bit,

quick coupling, 230 mm/200 mm calibra-

tion, 2 ea.

319.091 Depth Gauge

324.210 2.5 mm Percutaneous Drill Bit,

quick coupling, 300 mm, 200 mm calibra-

tion, 2 ea.

329.08 Bending Iron, for 3.5 mm and 4.5 mm

Reconstruction Plates, 190 mm length,

2 ea. (2 required)

Also Available

311.431 Large Handle with quick coupling

Product Overview

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 49

Additional Instrument Sets – 3.5 mm Low Proﬁle

Pelvic System Retractor Set (01.100.004)

Graphic Case Components

690.421 Lower Tray for 3.5 mm Low Proﬁle Pelvic

Retractors

690.422 Lid for 3.5 mm Low Proﬁle Pelvic Retractors

690.432 Upper Tray for 3.5 mm Low Proﬁle Pelvic

Retractors

690.913 Three Level Graphic Case Base

Instruments

03.100.011 Spoon Retractor, medium, 268 mm

03.100.012 Spoon Retractor, large, 323 mm

03.100.013 Sciatic Nerve Retractor

03.100.014 Sciatic Nerve Retractor, long

Malleable Retractors

03.100.015 20 mm width, 330 mm length

03.100.016 30 mm width, 330 mm length

03.100.017 40 mm width, 330 mm length

398.55 Blunt Pelvic Retractor, 2 ea.

399.27 Hohmann Retractor, 18 mm width,

242 mm length, long narrow tip

Also Available

03.100.107 Aluminum Blunt Pelvic Retractor

Aluminum Hohmann Retractors

03.100.108 35 mm width

03.100.109 18 mm width

03.100.110 24 mm width

03.100.111 Aluminum Spoon Retractor, medium

03.100.112 Aluminum Spoon Retractor, large

Graphic Case Components

690.428 Lid for 3.5 mm Low Proﬁle Pelvic System

Reduction Instruments

690.433 Lower Tray for 3.5 mm Low Proﬁle

for Pelvic Reduction Instruments

690.434 Upper Tray for 3.5 mm Low Proﬁle

for Pelvic Reduction Instruments

690.913 Three Level Graphic Case Base

Instruments

294.68 6.0 mm Schanz Screw, 190 mm length,

spade point, 4 ea.

03.100.018 Straight Ball Spike, 6.5 mm ball diameter,

320 mm

03.100.019 Straight Ball Spike, long, 6.5 mm ball

diameter, 420 mm

03.100.020 Straight Reduction Forceps with pointed

ball tips, 6.5 mm ball diameter

03.100.021 Angled Forceps, small, with pointed ball

tips, 6.5 mm ball diameter, 195 mm

03.100.022 Angled Forceps, large, with pointed ball

tips, 6.5 mm ball diameter

03.100.023 Reduction Forceps with pointed ball tips,

6.5 mm ball diameter, 400 mm

03.100.024 Asymmetric Reduction Forceps, with

pointed ball tips, 6.5 mm diameter

03.100.025 Reduction Forceps for 3.5 mm Screws,

250 mm

03.100.027 Round Disc, 6.5 mm hole diameter, 2 ea.

03.100.028 Rectangular Disc, 6.5 mm hole diameter,

2 ea.

03.100.029 Medium Bone Hook, long, 330 mm

03.100.030 Large Bone Hook, long, 330 mm

393.10 Universal Chuck with T-Handle

398.65 Forceps, for broken screw removal

398.74 Small Pelvic Forceps, 200 mm

398.75 Medium Pelvic Forceps with jaws,

for large screws, 250 mm length

398.88 Pelvic Reduction Forceps, speed lock,

330 mm length

399.98 Reduction Forceps, with Points,

Ratchet, 200 mm

50 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Additional Instrument Sets – 3.5 mm Low Proﬁle

Pelvic System Reduction Instrument Set (01.100.003)

Product Overview

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 51

Also Available

03.100.120 Spiked Round Disk

03.100.121 Spiked Rectangular Disk

398.52 Medium Bone Hook, 230 mm length,

for tibia and pelvis

398.53 Large Bone Hook, 200 mm

52 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

The 3.5 mm Low Proﬁle Pelvic System is modular and can

be customized to match the customer’s needs.

Trays (with Trays

implants) (without implants)

01.100.005 60.100.002 4.5 mm Cortex Screws

and Instrument Set,

with self-tapping screws

01.100.006 60.100.002 4.5 mm Cortex Screws

and Instrument Set, with

non-self-tapping screws

01.100.012 690.436 Tray for 3.5 mm Low

Proﬁle Reconstruction

Plates

01.100.022 690.424 Tray for 3.5 mm Low

Proﬁle Wide Angle

Reconstruction Plates

01.100.032 690.423 Tray for 3.5 mm Low

Proﬁle Reconstruction

J-Plates

01.100.042 690.435 Tray for 3.5 mm

Locking Low Proﬁle

Reconstruction Plates

01.100.122 690.438 Screw Rack for 3.5 mm

Low Proﬁle Locking Screws

01.100.132 690.439 Tray for 3.5 mm Low

Proﬁle Pelvic System

StarDrive Cortex Screws

(Locking screws sold

separately)

Note: These implant trays do not include graphic

cases or lids, which must be ordered separately.

Each tray occupies one level in a graphic case;

the trays can be combined, as required, in one, two

or three level graphic cases.

Graphic Cases and Lid

690.911 Single Level Graphic Case Base

690.912 Two Level Graphic Case Base

690.913 Three Level Graphic Case Base

690.429 Lid for 3.5 mm Low Proﬁle Pelvic System

Note: For the set contents of these implant trays,

see previous pages.

Also Available

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 53

Configuration examples

Ordering only the wide angle plate set

01.100.022 3.5 mm Wide Angle Low Proﬁle

Reconstruction Plate Tray

690.911 Single Level Graphic Case Base

690.429 Lid for 3.5 mm Low Proﬁle Pelvic System

Ordering the wide angle plate set and J-plate set

01.100.022 3.5 mm Wide Angle Low Proﬁle

Reconstruction Plate Tray

01.100.032 3.5 mm Low Proﬁle Reconstruction

J-Plate Tray

690.912 Two Level Graphic Case Base

690.429 Lid for 3.5 mm Low Proﬁle Pelvic System

Ordering the wide angle plate set, J-plate set

and reconstruction plate set

01.100.022 3.5 mm Wide Angle Low Proﬁle

Reconstruction Plate Tray

01.100.032 3.5 mm Low Proﬁle Reconstruction

J-Plate Tray

01.100.042 3.5 mm Locking Low Proﬁle

Reconstruction Plate Tray

690.913 Three Level Graphic Case Base

690.429 Lid for 3.5 mm Low Proﬁle Pelvic System

54 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Also Available

Instruments

03.100.038 Curved Pelvic Osteotome, 15 mm

blade width

03.100.039 Curved Pelvic Osteotome, 20 mm

blade width

Periosteal Elevators

03.100.041 6 mm width, curved blade

03.100.042 14 mm width, curved blade

03.100.043 14 mm width, straight blade

03.100.044 20 mm width, straight blade

03.100.107 Aluminum Blunt Pelvic Retractor

Aluminum Hohmann Retractors

03.100.108 35 mm width

03.100.109 18 mm width

03.100.110 24 mm width

03.100.111 Aluminum Spoon Retractor, medium

03.100.112 Aluminum Spoon Retractor, large

03.100.120 Spiked Round Disk

03.100.121 Spiked Rectangular Disk

03.100.140 Handle, for Cannulated Percutaneous

Guiding System

03.100.141 2.5 mm Drill Sleeve, for Cannulated

Percutaneous Guiding System

03.100.142 3.5 mm Drill Sleeve, for Cannulated

Percutaneous Guiding System

311.431 Large Handle with quick coupling

314.052 Trocar for 6.5 mm and 7.3 mm

Cannulated Screws, 300 mm

314.054 Trocar for 6.5 mm and 7.3 mm

Cannulated Screws, long, 350 mm

397.341 3.5 mm Cleaning Brush

397.342 2.5 mm Drill Bit, Jacobs chuck, 400 mm,

140 mm calibration

397.343 3.5 mm Drill Bit, Jacobs chuck, 380 mm

398.52 Medium Bone Hook, 230 mm length,

for tibia and pelvis

398.53 Large Bone Hook, 200 mm length,

for femur and pelvis

Trays

60.100.002 Tray for 4.5 mm Cortex Screws and

Instruments

690.916 Full Tray (Blank)

690.917 Full Tray Finger Mat

Sets

01.100.005 4.5 mm Cortex Screw and Instrument

Set with Self-tapping Screws

01.100.006 4.5 mm Cortex Screw and Instrument

Set

* These implants are available nonsterile or sterile-packed.

Add “S” to product number for sterile product.

Implants

3.5 mm Pubic Symphysis Plates with DCP Holes

Holes Length (mm)

02.100.014 4 57

02.100.016 6 78

3.5 mm Spring Plates*

Holes

02.100.301 1

02.100.302 2

02.100.303 3

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 55

Collinear Reduction Clamp Set

The Collinear Reduction Clamp assists in achieving and

maintaining fracture reduction in minimally invasive tech-

niques. The system consists of sliding mechanism, attach-

able arms and reduction attachments according to the

clinical needs.

Refer to surgical technique DSUS/TRM/0417/1437.

Cannulated Percutaneous Guiding System Set

The Cannulated Percutaneous Guiding System is a soft

tissue protector to assist in pelvic and acetabular recon-

structive surgery. It allows for less invasive placement

of 3.5 mm cortex or pelvic screws as well as 4.0 cancel-

lous screws. It accepts temporary ﬁxation with Kirschner

wires/guide wires up to B2.8 mm.

Refer to surgical technique DSUS/TRM/0916/1023.

Other Available Pelvic Instruments and Implants

from DePuy Synthes

56 DePuy Synthes Pelvic Implants and Instruments Surgical Technique

Other Available Pelvic Instruments and Implants from DePuy Synthes

Pelvic C-Clamp

The Pelvic C-Clamp is an emergency stabilization instru-

ment for unstable injuries and fractures of the pelvic ring.

Unstable pelvic ring fractures can be associated with

massive loss ofblood that can cause terminal shock. The

Pelvic C-Clamp allows rapid reduction and stabilization of

these unstable pelvic ring fractures, thus assisting the sur-

geon to gain control of the shock reaction. This neither

delays nor hinders subsequent diagnosis and therapy.

Refer to surgical technique DSUS/TRM/0117/1316.

Large External Fixator

Indications for stabilizing the anterior pelvic ring with a

largeexternal ﬁxator are: Unstable fractures in the ante-

rior pelvic ring, or symphysis fractures with or without

participation of the posterior pelvic ring. This type of

stabilization isalso possible in emergencies such as poly-

trauma, open wounds and, where appropriate, as an

alternative to internal osteosynthesis.

The pelvis can be stabilized with an external ﬁxator both

at the iliac crest and the supraacetabular region.

The clamps are magnetic resonance conditional. This

allows magnetic resonance examinations of patients who

have been stabilized with the external ﬁxator.

Refer to surgical technique DSUS/TRM/0814/0215.

Pelvic Implants and Instruments Surgical Technique DePuy Synthes 57

Sacral Bars

The DePuySynthes 6.0 mm Threaded Sacral Bars offer an

additional option for stabilization of the posterior pelvic

ring.

Two threaded bars are therefore drilled through the pos-

terior iliac crests and by compression of the nuts, bridging

and compression of the posterior pelvic ring is achieved.

Refer to surgical technique DSUS/TRM/0916/1022.

3.5 mm Spring Plate

The DePuySynthes 3.5 mm Spring Plate is intended for

reduction and ﬁxation of small bone fragments.

In pelvic and acetabular surgery, it is often difﬁcult to

reduce and ﬁx small bone fragments with screws because

the fragments may break into even smaller pieces. Mainly

in the joint areas (acetabulum) it is essential that even

small fragments are anatomically reduced and help to

achieve again a homogenous joint congruency. The

3.5 mm Spring Plates are intended to reduce and stabilize

bone fragments that are toosmall for screws. They can be

used individually or in con-junction with a 3.5 mm recon-

struction plate.

Refer to surgical technique 103488055.

103488070 10/18 STä

Synthes USA, LLC

1101 Synthes Avenue

Monument, CO 80132

Manufactured or distributed by:

Synthes USA Products, LLC

1302 Wrights Lane East

West Chester, PA 19380

To order (USA): 800-523-0322

To order (Canada): 800-946-8999

Note: For recognized manufacturer, refer to the product label.

www.depuysynthes.com

Limited Warranty and Disclaimer: DePuy Synthes products are sold with a limited warranty to the original purchaser against defects in workmanship

and materials. Any other express or implied warranties, including warranties of merchantability or ﬁtness, are hereby disclaimed.

Please also refer to the package insert(s) or other labeling associated with the devices identiﬁed in this surgical technique for additional information.

CAUTION: Federal Law restricts these devices to sale by or on the order of a physician.

Some devices listed in this surgical technique may not have been licensed in accordance with Canadian law and may not be for sale in Canada.

Please contact your sales consultant for items approved for sale in Canada.

Not all products may currently be available in all markets.