TOMOFIX
®
Osteotomy System.
A comprehensive plating system for
stable fixation of osteotomies around
the knee.
Technique Guide
DePuy Synthes Trauma
Image intensifier control
Table of Contents
Introduction
Surgical Technique
Product Information
TOMOFIX
®
Osteotomy System 2
AO Principles 4
Indications 5
Clinical Cases 6
Medial High Tibia 9
Lateral High Tibia 15
Lateral Distal Femur 20
Implants 25
Instruments 30
Set List 34
IMPORTANT: This device has not been evaluated for safety
and compatibility in the MR environment. This device has not
been tested for heating or migration in the MR environment.
TOMOFIX lateral high tibiaTOMOFIX medial high tibia
2 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
The TOMOFIX Osteotomy System provides stable fi xation of
osteotomies close to the knee, and consists of fi ve plates
designed for specifi c parts of the anatomy: TOMOFIX Medial
High Tibia Plate, TOMOFIX Medial High Tibia Plate, small,
TOMOFIX Lateral High Tibia Plate, TOMOFIX Lateral Distal
Femur Plate, and TOMOFIX Medial Distal Femur Plate.
All of the plates in the TOMOFIX Osteotomy System are
designed according to locking compression plate (LCP)
principles. The fi xed-angle locking holes provide multiple
fi xed-angle constructs throughout the plate, improving
retention of screws in the plate and in cortical bone.
Dynamic compression can be achieved by eccentric insertion
of 4.5 mm titanium cortex screws in the dynamic compression
unit (DCU) portion of the hole. The plates are available
in titanium, range in length from 102 mm to 141 mm, and
accept 5.0 mm titanium locking screws and 4.5 mm titanium
cortex screws.
TOMOFIX Osteotomy System. A comprehensive plating system for
stable fi xation of osteotomies around the knee.
TOMOFIX lateral distal femur
DePuy Synthes Trauma 3
– Plates are anatomically contoured, eliminating the need
for intraoperative contouring and minimizing soft tissue
irritation
– Long shaft to support and deflect forces in the diaphysis
– Plates have tapered ends allowing submuscular plate
insertion
– Locking screws create a fixed-angle construct, providing
angular stability
– Spacers reduce plate-to-bone contact. Reduced plate-to-
bone contact may minimize disruption of the periosteal
blood supply
In 1958, the AO formulated four basic principles which have
become the guidelines for internal fixation.
1
Those principles,
as applied to the DePuy Synthes Trauma TOMOFIX Osteotomy
System, are:
Anatomic reduction
Facilitates restoration of the articular surface by exact screw
placement using threaded drill sleeves.
Stable fixation
Locking screws create a fixed-angle construct, providing
angular stability.
Preservation of blood supply
Tapered ends on the plates allow submuscular plate insertion.
Early, active mobilization
Plate features combined with AO technique create an
environment for bone healing, expediting a return to
optimal function.
4 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
AO Principles
1. M.E. Müller, M. Allgöwer, R. Schneider, and H. Willenegger: Manual of Internal
Fixation, 3rd Edition. Berlin: Springer-Verlag. 1991.
Indications
TOMOFIX Osteotomy System
The DePuy Synthes Trauma TOMOFIX Osteotomy System
consists of four plates designed for specific parts of the
anatomy: TOMOFIX Medial High Tibia Plate, TOMOFIX
Lateral High Tibia Plate, TOMOFIX Lateral Distal Femur Plate,
and TOMOFIX Medial Distal Femur Plate.
The TOMOFIX Osteotomy System is intended for osteotomies,
treatment of bone and joint deformities, fixation of fractures,
and malalignment caused by injury or disease, such as
osteoarthritis, of the distal femur and proximal tibia.
Specifically,
− The TOMOFIX Medial Proximal Tibia Plates are indicated for
open- and closed-wedge osteotomies, fixation of fractures,
and malalignment caused by injury or disease, such as
osteoarthritis, of the medial proximal tibia
− The TOMOFIX Lateral Proximal Tibia Plates are indicated for
open- and closed-wedge osteotomies, fixation of fractures,
and malalignment caused by injury or disease, such as
osteoarthritis, of the lateral proximal tibia
− The TOMOFIX Lateral Distal Femur Plates are indicated for
open- and closed-wedge osteotomies, fixation of fractures,
and malalignment caused by injury or disease, such as
osteoarthritis, of the lateral distal femur
− The TOMOFIX Medial Distal Femur Plates are indicated
for closed-wedge osteotomies, fixation of fractures,
and malalignment caused by injury or disease, such as
osteoarthritis, of the medial distal femur
DePuy Synthes Trauma 5
6 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
Clinical Cases
Case 1
Open-wedge high tibia valgus
osteotomy (HTO)
48-year-old woman with medial
gonarthrosis.
Case studies are not necessarily
predictive of results in other cases.
Results in other cases may vary.
Postoperative, lateralPostoperative, APPreoperative
6 months postoperative Following implant removal (15 months postoperative)
DePuy Synthes Trauma 7
Case 2
Open-wedge high tibia valgus
osteotomy (HTO)
23-year-old man, with posttraumatic
medial, chondral gonarthrosis, medial
meniscopathy, varus-morphotype.
Preoperative Postoperative, AP Postoperative, lateral
3 months postoperative Following implant removal (12 months postoperative)
Clinical Cases
8 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
PostoperativePreoperative
3 months postoperative 3 months postoperative
Case 3
Closed-wedge high tibia valgus
osteotomy (HTO)
52-year-old woman with medial
gonarthrosis.
DePuy Synthes Trauma 9
Surgical Technique—Medial High Tibia
Front View
Side View
A
D
1
2
3
4
C
B
Plate Shaft
TOMOFIX Medial High Tibia Plate (440.834)
– Three Combi holes (1, 2 and D) provide the fl exibility
of axial compression and locking capability.
– Holes 3, 4, A, B and C accept locking screws.
Surgical Technique—Medial High Tibia
10 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
1
Attach drill guides to plate
Instruments
312.926 TOMOFIX Guiding Block, for Medial High Tibia
323.042 4.3 mm Threaded LCP Drill Guide
Place the TOMOFIX guiding block for medial high tibia against
the top side of the plate. Push the guiding block as far as
possible toward the proximal end of the plate
(Figures 1 and 2).
Thread the first 4.3 mm threaded LCP drill guide into the
center proximal plate hole B (Figure 3). Thread the two
remaining 4.3 mm threaded LCP drill guides into the
adjacent proximal plate holes A and C (Figure 4).
Remove the guiding block.
2
Install spacers
Instrument
413.309 5.0 mm Titanium Spacer
Place 5.0 mm titanium spacers into Combi hole D and
locking hole 3 or locking hole 4.
Figure 1
Figure 2
Figure 3
Figure 4
new image needed
DePuy Synthes Trauma 11
3
Opening the osteotomy
After performing the osteotomy, open and adjust the
correction using the TOMOFIX osteotomy chisels or the
TOMOFIX bone spreader.
Option A: Chisels
Instrument
397.992 – TOMOFIX Osteotomy Chisels
397.995
Insert an osteotomy chisel into the osteotomy up to the
lateral bone bridge. The insertion depth corresponds with
the cutting depth; mark it on the fi rst osteotomy chisel. Then
gently insert (by slowly hammering, if necessary) a second
osteotomy chisel distal to the fi rst chisel about 10 mm
shallower than the fi rst chisel. If necessary, continue with
subsequent chisels between the fi rst two chisels to gradually
spread open the osteotomy until the desired opening height
is reached. Open the osteotomy slowly over a period of
several minutes to prevent fracturing the lateral cortex.
Option B: Bone spreader
Instruments
324.052 3.5 mm Torque Limiting Screwdriver
395.000 TOMOFIX Bone Spreader
399.097 Bone Spreader with 8 mm blade,
medium handle
Alternatively, the TOMOFIX bone spreader can be used for
opening and measuring the osteotomy gap in degrees. Insert
the spreader gently into the osteotomy site until the tip of
the instrument reaches the hinge point of the osteotomy.
Use a 3.5 mm hexagonal screwdriver to open the bone
spreader and the osteotomy. The osteotomy depth can be
read from the scale on the spreader blade. When the desired
correction has been achieved, remove the TOMOFIX bone
spreader and insert the 8 mm adjustable bone spreader
into the open wedge to maintain the correction.
4
Determine plate position
Center the plate, with the 4.3 mm threaded LCP drill guides
installed, over the osteotomy and place onto the bone.
The three holes in the head and the most proximal Combi
hole on the shaft should be positioned proximal to the
correction gap. The solid midsection of the plate should be
placed over the osteotomy.
12 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
Surgical Technique—Medial High Tibia
Opening the osteotomy continued
Instrument
395.001 TOMOFIX Osteotomy Gap Measuring Device
If desired, the TOMOFIX gap measuring device can be used
to measure the height of the open wedge in millimeters.
Insert the gap measuring device into the open wedge until
the device is gripped. Move the slider toward the gap, until
the slider reaches the near cortex. The height of the open
wedge can be confi rmed in millimeters on the scale of the
device.
DePuy Synthes Trauma 13
5
Secure plate to bone
Instruments
310.430 4.3 mm Drill Bit
324.052 3.5 mm Torque Limiting Screwdriver
324.168 2.0 mm TOMOFIX Guide Sleeve
Important: If the fi rst screw to be inserted is a locking
screw, it is important to provisionally hold the plate securely
on the bone. Otherwise, the plate and screw may rotate
simultaneously when locking the screw, possibly causing
soft-tissue damage. When removing the plate, it is strongly
recommended to manually unlock all screws fi rst and then
remove them. Always use the torque limiting screwdriver to
lock the locking screws.
Perform a secure temporary fi xation of the plate. Insert the
2.0 mm TOMOFIX guide sleeve into the middle threaded LCP
drill guide and insert a Kirschner wire.
The K-wire will aid in positioning the screw, which should be
parallel to the articular surface. The wire also allows confi r-
mation of screw position under radiographic imaging.
Use the calibrated 4.3 mm drill bit to determine screw
lengths for holes A, B and C. To ensure optimal support
of the tibia plateau, insert the longest possible fi xed-angle
self-tapping locking screws.
Note: The calibrated drill bit is read at the bottom of the
slider; the point closest to the drill guide.
Surgical Technique—Medial High Tibia
14 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
6
Insert screws into holes 1, 2, 3, 4 and D
Instrument
314.152 3.5 mm Hexagonal Screwdriver Shaft
323.500 5.0 mm/4.5 mm LCP Universal Drill Sleeve
The Combi holes allow use of a lag screw for indirect
reduction of the dislocated shaft, and compression of the
fractures. Insert a lag screw into hole 1. The spacers maintain
adequate distance between the plate and the periosteum,
help minimize damage to the blood supply, and allow the
pes anserinus to move freely under the plate.
To secure the shaft portion of the plate onto the tibia, insert
unicortical self-drilling locking screws into holes 2 and 3.
Replace the lag screw in hole 1 with a bicortical self-tapping
locking screw. Remove the spacer in hole 4, and replace it
with a unicortical self-drilling locking screw.
Note: To predrill for locking screws, insert the self-retaining
3.5 mm hexagonal screwdriver shaft into the 3.5 mm hex
recess of the 5.0 mm/4.5 mm LCP universal drill sleeve.
Center the integral 4.3 mm drill bit in the locking hole
to ensure proper engagement of the fi xed-angle,
self-drilling locking screws. (Figure 1 and 2)
Replace the spacer in hole D with a self-tapping locking screw
of suffi cient length, appropriate to the patient’s anatomy.
Do not lock the screws with power tools, as their maximum
torque is higher than the recommended torque, and com-
pletely tightening the screw with power tools could result in
damage to the locking screw. Always use the self-retaining
3.5 mm torque limiting screwdriver for fi nal tightening. To
prevent damage to the hexagonal recess of the screw, be
certain that the screwdriver properly seats in the screwhead.
Note: Use the 3.5 mm torque limiting screwdriver, 4 Nm
torque limit, for fi nal seating of all locking screws. Do not
fully insert any locking screw under power.
D
1
3
2
4
Figure 1
Figure 2
DePuy Synthes Trauma 15
Surgical Technique—Lateral High Tibia
TOMOFIX Lateral High Tibia Plate
– Hole E accepts 4.5 mm titanium cortex screws or 5.0 mm
locking head screws. Holes A, B, C and D accept fi xed-
angle 5.0 mm locking head screws.
– 1, 2 and 3 are Combi holes in the shaft and provide the
fl exibility of axial compression or fi xed-angle locking.
1
B
C
A
D
E
2
3
Plate Shaft
16 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
1
Attach drill guides to plate
Instruments
312.930 TOMOFIX Guiding Block, for Lateral High Tibia,
right
312.931 TOMOFIX Guiding Block, for Lateral High Tibia,
left
323.042 4.3 mm Threaded LCP Drill Guide
To facilitate insertion of the proximal locking screws, place
the appropriate TOMOFIX guiding block for the lateral high
tibia, right or left, on the proximal part of the plate. The
three-point seating ensures correct positioning (Figure 1).
Insert a 4.3 mm threaded LCP drill guide through the drill
guide of the guiding block into hole A of the plate (1).
Tighten the locking nut of the guiding block by turning it
clockwise, to lock the drill guide (2) (Figure 2).
Thread a 4.3 mm threaded LCP drill guide into an additional
proximal plate hole (D or E).
1
2
Figure 1
Figure 2
Surgical Technique—Lateral High Tibia
DePuy Synthes Trauma 17
2
Install spacer
Instrument
413.309 5.0 mm Titanium Spacer
Place a 5.0 mm titanium spacer into hole 3.
3
3
Determine plate position
Instrument
324.168 2.0 mm TOMOFIX Guide Sleeve
After performing the osteotomy, situate the prepared implant
parallel to the tibial shaft. To temporarily affi x the plate,
insert the 2.0 mm TOMOFIX guide sleeve through the 4.3 mm
threaded LCP drill guide and insert the 2.0 mm Kirschner
wire. The Kirschner wire helps to determine screw position
and length under the image intensifi er.
Surgical Technique—Lateral High Tibia
18 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
4
Secure plate to bone
Instruments
310.430 4.3 mm Drill Bit
324.052 3.5 mm Torque Limiting Screwdriver
Important: If the fi rst screw to be inserted is a locking
screw, it is important to provisionally hold the plate securely
on the bone. Otherwise, the plate and screw may rotate
simultaneously when locking the screw, possibly causing
soft-tissue damage. When removing the plate, it is strongly
recommended to manually unlock all screws fi rst and then
remove them. Always use the 3.5 mm torque limiting
screwdriver to lock the locking screws.
Use the calibrated 4.3 mm drill bit to determine screw
lengths for holes D and E. To ensure optimal support of the
tibia plateau, insert the longest possible fi xed-angle self-
tapping locking screws. Insert another self-tapping locking
screw into hole A or C, as desired.
To compress the osteotomy, insert a 4.5 mm titanium cortex
screw into hole 1, angled distally. The spacer maintains
adequate distance between the plate and the periosteum
and helps minimize damage to the blood supply.
A
D E
C
B
D+E
C
1
DePuy Synthes Trauma 19
3
2
1
3
To secure the shaft portion of the plate onto the tibia, insert
a unicortical self-drilling locking screw into hole 2. Replace
the spacer in hole 3 with a unicortical self-drilling locking
screw. Replace the cortex screw in hole 1 with a bicortical
self-tapping locking screw.
For maximum stability, insert three locking screws into the
proximal part of the osteotomy, and be sure to use all of the
plate holes in the shaft. The first screw inserted on the distal
part of the correction must be a bicortical locking screw,
while it is sufficient for the two most distal screws to be
unicortical locking screws.
Do not lock the screws with power tools, as their maximum
torque is higher than the recommended torque, and com-
pletely tightening the screw with power tools could result in
damage to the locking screw. Always use the self-retaining
3.5 mm torque limiting screwdriver for final tightening. To
prevent damage to the hexagonal recess of the screw, be
certain that the screwdriver seats properly in the screwhead.
Note: Use the 3.5 mm torque limiting screwdriver, 4 Nm
torque limit, for final seating of all locking screws. Do not
fully insert any locking screw under power.
20 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
Surgical Technique—Lateral Distal Femur
1
B
C
A
G
G
E
F
2
3
4
Plate Shaft
TOMOFIX Lateral Distal Femur Plates, left (440.874) and
right (440.864)
– Holes A, B, and 1 through 4 are Combi holes and provide
the fl exibility of axial compression or fi xed-angle locking.
– Holes C, E, F and G are fi xed-angle locking holes.
DePuy Synthes Trauma 21
1
2
Figure 1
Figure 2
1
Attach drill guides to plate
Instruments
312.932 TOMOFIX Guiding Block, for Lateral Distal
Femur, right
312.933 TOMOFIX Guiding Block, for Lateral Distal
Femur, left
323.042 4.3 mm Threaded LCP Drill Guide
Place the appropriate TOMOFIX guiding block for the lateral
distal femur, left or right, on the proximal part of the plate.
The three-point seating ensures correct positioning
(Figure 1).
Insert a 4.3 mm threaded LCP drill guide through the drill
guide of the guiding block into hole A (1). Tighten the
locking nut of the guiding block by turning it clockwise,
to lock the drill guide (2) (Figure 2).
Thread another 4.3 mm threaded LCP drill guide into an
additional plate hole (F or E).
Surgical Technique—Lateral Distal Femur
22 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
4
2
Install spacer
Instrument
413.309 5.0 mm Titanium Spacer
Place a 5.0 mm titanium spacer into hole 4.
3
Determine plate position
Instrument
324.168 2.0 mm TOMOFIX Guide Sleeve
After performing the osteotomy, adjust the prepared implant
parallel to the femoral shaft. To temporarily affix the plate,
insert the guide sleeve for 2.0 mm Kirschner wires into the
threaded LCP drill guide, then insert the 2.0 mm Kirschner
wire. The Kirschner wire helps to determine screw position
and length under image intensification.
DePuy Synthes Trauma 23
1
B
G
F E A C
4
Secure plate to bone
Instruments
310.430 4.3 mm Drill Bit
324.052 3.5 Torque Limiting Screwdriver
Important: If the fi rst screw to be inserted is a locking
screw, it is important to provisionally hold the plate securely
on the bone. Otherwise, the plate and screw may rotate
simultaneously when locking the screw, possibly causing
soft-tissue damage. When removing the plate, it is strongly
recommended to manually unlock all screws fi rst and then
remove them. Always use the 3.5 mm torque limiting
screwdriver to lock the locking screws.
Use the calibrated 4.3 mm drill bit to determine screw
lengths for holes C, E, F and G and insert four self-tapping
locking screws.
Opening the correction gap can break the far cortex,
therefore, use a cranially ascending lag screw in hole 1.
To achieve reduction and compression of the osteotomy,
insert a 4.5 mm titanium cortex screw into hole 1, angled
proximally. The spacer will maintain adequate distance
between the plate and the periosteum. This helps minimize
damage to the periosteal blood supply.
24 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
Surgical Technique—Lateral Distal Femur
4. Secure plate to bone continued
To secure the shaft portion of the plate onto the femur,
insert unicortical self-drilling locking screws into holes 2
and 3. Replace the 4.5 mm titanium cortex screw in hole
1 with a bicortical self-tapping locking screw. Remove the
spacer in hole 4, and replace it with a unicortical self-drilling
locking screw.
For maximum stability, insert four locking screws distal to the
correction gap, and be sure to use all of the plate holes in
the shaft. The first screw inserted proximal to the correction
must be a bicortical locking screw, while it is sufficient for the
three most proximal screws to be unicortical locking screws.
Note: Use the 3.5 mm torque limiting screwdriver, 4 Nm
torque limit, for final seating of all locking screws. Do not
fully insert any locking screw under power.
4
3
2
1
DePuy Synthes Trauma 25
Implants
Front View
A
D
1
2
3
4
C
B
Plate Shaft
Side View
115 mm
TOMOFIX Medial High Tibia Plate (440.834)
– Precontoured to fi t the medial proximal tibia. The
proximal screws are angled for better purchase in the
tibial plateau.
– The solid midsection provides the strength necessary
to sustain the osteotomy. The tapered end facilitates
minimally invasive insertion.
– Three Combi holes (1, 2 and D) provide the fl exibility
of axial compression and locking capability
– Holes 3, 4, A, B and C accept locking screws
– Made of commercially pure titanium
26 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
Front View
A
D
1
2
3
4
C
B
Plate Shaft
TOMOFIX Medial High Tibia Plate, small (440.831)
– Precontoured to fi t the medial proximal tibia. The proximal
screws are angled for better purchase in the tibial plateau.
– The solid midsection provides the strength necessary
to sustain the osteotomy. The tapered end facilitates
minimally invasive insertion.
– Three Combi holes (1, 2 and D) provide the fl exibility
of axial compression and locking capability
– Holes 3, 4, A, B and C accept locking screws
– Made of commercially pure titanium
Implants
Side View
112 mm
DePuy Synthes Trauma 27
TOMOFIX Lateral High Tibia Plate, left (440.853) and
right (440.843)
– Precontoured to fi t the anatomy of the lateral
proximal tibia
– Plate thickness between 3.1 mm and 4.5 mm ensures
the strength necessary to sustain the osteotomy, without
causing soft-tissue irritation. The tapered end facilitates
minimally invasive insertion.
– Hole E accepts 4.5 mm titanium cortex screws or 5.0 mm
locking head screws. Holes A, B, C and D accept fi xed-
angle 5.0 mm locking head screws.
– Three Combi holes in the shaft provide the fl exibility
of axial compression or fi xed-angle locking
– Made of Ti-6Al-7Nb
102 mm
1
B
C
A
D
E
2
3
Plate Shaft
141 mm
28 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
TOMOFIX Lateral Distal Femur Plates, left (440.874) and
right (440.864)
– Precontoured to fi t the lateral distal femur
– The tapered end facilitates minimally invasive insertion
– Holes A, B, and 1 through 4 are Combi holes and provide
the fl exibility of axial compression or fi xed-angle locking
– Holes C, E, F and G are fi xed-angle locking holes
– Made of Ti-6Al-7Nb
Implants
1
B
C
A
G
G
E
F
2
3
4
Plate Shaft
DePuy Synthes Trauma 29
TOMOFIX Medial Distal Femur Plate, left (440.895) and
right (440.885)*
– Precontoured to fi t the medial distal femur
– Tapered end facilitates insertion
– Combi holes provide the fl exibility of axial compression
and locking capability
– Fixed-angle locking holes provide multiple fi xed-angle
constructs throughout the plate, improving the retention
of the screws in the plate and in cortical bone
– Made of commercially pure titanium
* To learn more about the TOMOFIX Medial Distal Femur Plate and its surgical
technique, please refer to the TOMOFIX Medial Distal Femur Plate Technique Guide.
121 mm
30 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
Selected Instruments
310.430 4.3 mm Drill Bit, quick coupling, 221 mm
03.108.030 Alignment Rod
03.108.031 Stand for Alignment Rod (large)
03.108.032 Small Stand for Alignment Rod
DePuy Synthes Trauma 31
312.926 TOMOFIX Guiding Block, for Medial High Tibia
312.930 TOMOFIX Guiding Block, for Lateral High Tibia,
right
312.931 TOMOFIX Guiding Block, for Lateral High Tibia,
left
312.932 TOMOFIX Guiding Block, for Lateral Distal
Femur, right
312.933 TOMOFIX Guiding Block, for Lateral Distal
Femur, left
312.924 TOMOFIX Guiding Block, for Medial High Tibia,
small
Selected Instruments
32 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
324.168 2.0 mm TOMOFIX Guide Sleeve
324.052 3.5 mm Torque Limiting Screwdriver,
self-retaining
323.042 4.3 mm Threaded LCP Drill Guide
323.500 5.0 mm/4.5 mm LCP Universal Drill Sleeve,
with 4.3 mm Drill Bit
314.152 3.5 mm Hexagonal Screwdriver Shaft,
self-retaining
DePuy Synthes Trauma 33
395.000 TOMOFIX Bone Spreader
395.001 TOMOFIX Osteotomy Gap Measuring Device
399.097 Bone Spreader with 8 mm blade,
medium handle, soft ratchet
413.309 5.0 mm Titanium Spacer, 2 mm
TOMOFIX Osteotomy Chisels
397.992 10 mm width
397.993 15 mm width
397.994 20 mm width
397.995 25 mm width
34 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
Graphic Case
60.120.050 TOMOFIX Instrument and Titanium Implant Set
Graphic Case
Instruments
02.108.200 3.0 mm Drill Tip Guide Wire with Threads,
230 mm, 10 ea.
03.108.030 Alignment Rod
03.108.031 Stand for Alignment Rod
03.108.032 Small Stand for Alignment Rod
292.699 2.0 mm Kirschner Wire, threaded spade
point tip, 280 mm, 10 ea.
310.243 2.5 mm Drill Tip Guide Wire, 200 mm, trocar
point, 10 ea.
310.31 3.2 mm Drill Bit, quick coupling, 145 mm, 2 ea.
310.430 4.3 mm Drill Bit, quick coupling, 221 mm, 2 ea.
311.44 T-Handle, with quick coupling
312.46 4.5 mm/3.2 mm Double Drill Sleeve
312.48 4.5 mm/3.2 mm Insert Drill Sleeve
TOMOFIX Guiding Blocks
312.924 for Medial High Tibia, small
312.926 for Medial High Tibia
312.930 for Lateral High Tibia, right
312.931 for Lateral High Tibia, left
312.932 for Lateral Distal Femur, right
312.933 for Lateral Distal Femur, left
312.934 for Medial Distal Femur, right
312.935 for Medial Distal Femur, left
314.152 3.5 mm Hexagonal Screwdriver Shaft,
self-retaining, 2 ea.
319.10 Depth Gauge, for large screws
323.042 4.3 mm Threaded LCP Drill Guide, 4 ea.
323.500 5.0 mm/ 4.5 mm LCP Universal Drill Sleeve,
with 4.3 mm Drill Bit
324.052 3.5 mm Torque Limiting Screwdriver,
self-retaining
TOMOFIX Instrument and Implant Set (01.108.000)
324.168 2.0 mm TOMOFIX Guide Sleeve
395.000 TOMOFIX Bone Spreader
395.001 TOMOFIX Osteotomy Gap Measuring Device
For detailed cleaning and sterilization instructions, please refer to:
www.synthes.com/cleaning-sterilization
In Canada, the cleaning and sterilization instructions will be provided with
the Loaner shipments.
DePuy Synthes Trauma 35
440.831 Titanium TOMOFIX Medial High Tibia Plate,
small, 4 holes, 112 mm, 2 ea.
440.834 Titanium TOMOFIX Medial High Tibia Plate,
4 holes, 115 mm, 2 ea.
440.843 Titanium TOMOFIX Lateral High Tibia Plate,
3 holes, right, 102 mm
440.853 Titanium TOMOFIX Lateral High Tibia Plate,
3 holes, left, 102 mm
440.864 Titanium TOMOFIX Lateral Distal Femur Plate,
4 holes, right, 141 mm
440.874 Titanium TOMOFIX Lateral Distal Femur Plate,
4 holes, left, 141 mm
440.885
◊
Titanium TOMOFIX Medial Distal Femur Plate,
4 holes, right, 121 mm
440.895
◊
Titanium TOMOFIX Medial Distal Femur Plate,
4 holes, left, 121 mm
Instruments continued
TOMOFIX Osteotomy Chisels
397.992 10 mm width
397.993 15 mm width
397.994 20 mm width, 2 ea.
397.995 25 mm width
399.097 Bone Spreader with 8 mm blade, medium
handle, soft ratchet
413.309 5.0 mm Titanium Spacer, 2 mm, 3 ea.
Implants
5.0 mm Titanium Locking Head Screws, self-tapping, 3 ea.
Length (mm) Length (mm)
413.324 24 413.346 46
413.326 26 413.348 48
413.328 28 413.350 50
413.330 30 413.355 55
414.332 32 413.360 60
415.334 34 413.365 65
413.336 36 413.370 70
413.338 38 413.375 75
413.340 40 413.380 80
413.342 42 413.385 85
413.344 44 413.390 90
413.426 5.0 mm Titanium Locking Head Screw,
self-drilling, 26 mm, 6 ea.
4.5 mm Titanium Cortex Screws, self-tapping, 2 ea.
Length (mm) Length (mm)
414.824 24 414.840 40
414.826 26 414.842 42
414.828 28 414.844 44
414.830 30 414.846 46
414.832 32 414.848 48
414.834 34 414.850 50
414.836 36 414.852 52
414.838 38
◊ Available nonsterile or sterile-packed. Add “S” to catalog number to order sterile product.
36 DePuy Synthes Trauma TOMOFIX Osteotomy System Technique Guide
Also Available
292.21 2.0 mm Kirschner Wire with trocar point,
285 mm, 10/pkg.
292.76 2.5 mm Kirschner Wire with 15 mm thread
trocar point, 200 mm, 10/pkg.
321.12 Articulated Tension Device, with gauge,
span 20 mm
511.771 Torque Limiting Attachment, 4 Nm
Legal manufacturer in Canada:
Synthes (Canada) Ltd.
2566 Meadowpine Boulevard
Mississauga, Ontario L5N 6P9
Telephone: (905) 567-0440
To order: (800) 668-1119
Fax: (905) 567-3185
Manufactured or distributed
in the United States by:
Synthes, Inc.
1301 Goshen Parkway
West Chester, PA 19380
Telephone: (610) 719-5000
To order: (800) 523-0322
www.depuysynthes.com
© DePuy Synthes Trauma, a division of DOI 2014. All rights reserved.
DSUS/ TRM/ 0414/ 0024 6/14 DV
CAUTION: USA Law restricts these devices to sale by or on the order of a physician.
