al femur plate 4.5 open access -...
TRANSCRIPT
Distal Lateral Femur Plate 4.5 Surgical Technique – Open Access
Locking Compression Technology by aap
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Disclaimer
This surgical technique is exclusively intended for medical professionals, especially physicians, and thereforemay not be regarded as a source of information for non-medical persons. The description of this surgicaltechnique does not constitute medical advice or medical recommendations nor does it convey any diagnostic ortherapeutic information on individual cases. Therefore, the attending physician is fully responsible for providingmedical advice to the patient and obtaining the informed consent of the patient which this surgical techniquedoes not supersede.The description of this surgical technique has been compiled by medical experts and trained staff of aapImplantate AG with utmost diligence and to the best of their knowledge. However, aap Implantate AG excludesany liability for the completeness, accuracy, currentness, and quality of the information as well as for materialor immaterial damages arising from the use of this information.
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Content •
• Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4• Material . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
• Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
• Indications/Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
• Processing (Sterilization & Cleaning) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
• Surgical Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6• Positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
• Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
• Preoperative Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
• Repositioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
• Positioning and fixation of the plate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
• Insertion of screws in the head of the plate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
• Insertion of screws in the shaft of the plate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
• Placing periprosthetic screws . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
• Compression of a shaft fracture with the gliding-locking hole
technology from aap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
• Explantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
• Trays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19• LOQTEQ® Distal Lateral Femur Plate 4.5, Tray C Implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
• LOQTEQ® Large Fragment Set, Instruments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
• LOQTEQ® Large Fragment Set, Screw rack complete, basic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5
Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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• Introduction
The distal lateral femur plate 4.5 is part of the LOQTEQ® plate system and unifies angular stability with modern plate
design.
Material
For the manufacture of angle stable plate systems, materials are used which have been proven to be successful
in medical technology for decades. The anatomical plates and bone screws are made of titanium alloy.
All materials employed comply with national and international standards. They are characterized by good
biocompatibility, a high degree of reliability against allergic reactions and good mechanical properties.
Description
• The distal plate contour is adapted to the anatomy of the lateral condyle of
the distal femur
• The plate design follows the natural antecurvature of the femur
• A high shaft profile without undercuts guarantees excellent stability
• The flattened end of the plate shaft enables the tissue-conserving,
submuscular insertion of the plate
• Periprosthetic screws in various lengths allow monocortical fixation in the
presence of an intramedullary implant
• Gliding-locking holes in the shaft area allow compression and angular
stability with LOQTEQ® technology
• Various holes for K-wires and an oblong hole facilitate the primary fixation
of the plate
• Available as right and left version
• Standard sizes include 4-13 holes in the plate shaft
• Long sizes available sterile with 15 and 17 holes
Indications/Contraindications
Indications
• Intra-articular and extra-articular fractures
• Non-unions
• Periprosthetic fractures
• Corrections of distal femoral fractures healed in malposition
• Stabilization of distal diaphyseal fractures of the femur
Contraindications
• Infection or inflammation (localized or systemic)
• Allergies against the implant material
• Acute and chronic osteomyelitis at or close to the surgical field
• High anesthesia risk patients
• Severe soft tissue swelling impacting normal wound healing
• Insufficient soft tissue coverage
• Fractures in children and adolescents with epiphyseal plates not yet ossified
Processing (Sterilization & Cleaning)
Implants are supplied non-sterile and sterile.
Non-sterile supplied implants and instruments must be processed before every use.
Reference is here made to the Instructions for Use enclosed to the plates, instruments und trays.
Implants (sterile) out of damaged or open inner packages must not be used.
Implant components that have come or might have come into contact with infectious fluids (e.g. blood)
must not be resterilized and reused in another surgery. They must be returned to the manufacturer.
Resterilization is prohibited in this case (see Instructions for Use).
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Introduction•
Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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•Surgical Technique
Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5
4 holes 17 holes15 holes13 holes11 holes9 holes7 holes
o153mm
o207mm
o243mm
o279mm
o314mm
o350mm
o386mm
Positioning
• Position patient in supine position on a
radiolucent operating table. The patient´s
leg must be freely moveable in such a
way that the knee can be flexed and
lateral X-rays of the leg can be taken.
Access
• The incision for open surgery is deter-
mined by the fracture site and the length
of the plate. The distal lateral femur plate
can be placed between the periosteum
and the vastus lateralis.
Anterolateral arthrotomy is recommended
for intra-articular fractures.
Preoperative Planning
• Evaluation of the fracture situation on
the basis of the X-ray and selection of
the appropriate plate length and screw
positions. Also plan the insertion of lag
screws, if necessary.
Surgical Technique•
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
7Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5
Repositioning • Reduce fracture fragments and joint surface and temporarily fix
in place with K-wires. When applying temporary fixation with
K-wires, consider the later position of the plate. If necessary, use
lag screws to compress the fracture outside of the later plate
position.
• Check the reduction results using fluoroscopy.
N NOTE:
Please ensure that outer lag screws do not interfere with the
plate screws.
N CAUTION:
The LOQTEQ® distal lateral femur plate is meant to be used
only in combination with standard screws and angle stable
LOQTEQ® locking screws (red). Do not use the blue round hole
screws for this plate!
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Positioning and Fixation ofthe plate
•Surgical Technique
Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5
• After correct reduction, properly position the plate on the lateral
condyle.
• For the temporary fixation of the plate, 2.0mm K-wires can be used.
• After placing the K-wires, use fluoroscopy to check the plate position
as well as length and rotation.
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Surgical Technique•
Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5
INSTRUMENTS ART.-NO.Twist drill ø3.2, L 195, coil 50, quick coupling IU 7432-30Screwdriver hexagonal, ø3.5, quick coupling IU 7835-00Double drill guide ø3.2/4.5, with spring aided centering IU 8117-50Depth gauge for locking screws, large IS 7905-00
• As an alternative to primary fixation using K-wires, a standard
screw can be inserted into the oblong hole to pull the plate to
the bone. For this purpose, use a double drill guide 3.2/4.5 and a
twist drill 3.2mm. Then determine the screw length using the
depth gauge and insert the appropriate standard screw 4.5mm.
N NOTE:
The plate must be pulled to the bone before placing angle
stable screws. Do not use standard screws after angle stable
screws have been placed.
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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•Surgical Technique
Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5
Insertion of screws in thehead of the plate
• In the distal lateral femur plate, only LOQTEQ® locking screws (red
head) are used in the shaft and for the angle stable round holes in
the distal plate portion. Therefore, use only the red drill guide for all
screw holes.
• Drill to the desired depth using a drill ø3.8 (marked in blue-red), if
necessary under fluoroscopic monitoring.
• The screw length can be determined with the aid of a depth gauge.
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Surgical Technique•
Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5
INSTRUMENTS ART.-NO.Twist drill ø3.8, L 180, coil 50, quick coupling IU 7438-18Screwdriver Duo, T25, quick coupling IU 7835-55Torque limiter 3.5 m, quick coupling IU 7870-35Drill guide for gliding hole LOQTEQ® 4.5, I-ø 3.9, red IU 8167-10K-wire with trocar point, ø2.0, L 250 NK 0020-25Large handle, cannulated, quick coupling IU 7706-00
• Select a LOQTEQ® locking screw
(red head) of the proper length and
loosely insert using the self-retaining
screwdriver T25.
• Then manually tighten the screw
using the torque limiter. Optimal
fixation is reached once an audible
click is heard.
N NOTE:
It is recommended to use a torque limiter as soon as the screw
head reaches the plate hole.
N CAUTION:
Do not use the torque limiter in automated mode;
instead, use only with the enclosed handle.
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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•Surgical Technique
Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5
Insertion of screws in theshaft of the plate
INSTRUMENTS ART.-NO.Depth gauge for locking screws, large IS 7905-00Drill guide for gliding hole LOQTEQ® 4.5, I-ø 3.9, red IU 8167-10Twist drill ø3.8, L 180, coil 50, quick coupling IU 7438-18
• Once all required screws have been placed in the distal area, the
shaft area can be secured.
• Insert drill guide (red).
• Drill to the desired depth using a drill bit ø3.8 (marked in
blue-red), if necessary under fluoroscopic monitoring.
• Remove the drill guide.
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Surgical Technique•
• The screw length can be determined with the aid of a depth gauge.
• Select a LOQTEQ® locking screw (red head) of the proper length,
and loosely insert it using the self-retaining screwdriver T25.
Then manually tighten the screw using the torque limiter.
Optimal fixation is reached once an audible click is heard.
N NOTE:
As soon as the head of the screw reaches the plate hole, it is
compulsory to switch to the torquc limiter.
In cases of very hard bone in the diaphyseal bone, it is neces-
sary to make sure that the screw head is flush to the plate.
Therefore it is permissible in exceptionally hard bone of the
diaphysis to finish the screw without the torquc limiter.
N CAUTION:
Do not use the torque limiter in automated mode; instead, use
only with the enclosed handle.
• Once all screws have been placed, check the final positioning
once more under fluoroscopy and close the wound.
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Placement of periprosthetic screws
•Surgical Technique
Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5
Compression of a shaft fracture with the gliding-locking hole technology from aap
• If an intramedullary nail or a prosthesis interferes with bicortical
screw placement, special screws for periprosthetic fractures can
be used. These periprosthetic screws feature a blunt, very short
tip. The LOQTEQ® periprosthetic screws are similar in design to
the LOQTEQ® locking screws (red) but feature a gold head(see image). They allow the plate to be fixed to the near cortex.
N NOTE:
LOQTEQ® periprosthetic screws are available in 14 and 18mm
lengths. The femur plate has a shaft thickness of 6mm.
• If compression in the shaft area is desired, it can be achieved with
standard screws, with LOQTEQ® locking screws (red) or, in cases of
an intramedullary implant, with LOQTEQ® periprosthetic screws
(view figure).
• Screw the holding pin (IU 8167-05) into an appropriate shaft
hole or, if necessary, above the fracture line. Choose a compres-
sion drill guide in accordance with the compression distance
(1mm or 2mm) and position on the holding pin, away from the
fracture gap.
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Surgical Technique •
Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5
INSTRUMENTS ART.-NO.Twist drill ø3.8, L 180, coil 50, quick coupling IU 7438-18Load Drill guide LOQTEQ® 4.5, compression 1mm IU 8167-01Load Drill guide LOQTEQ® 4.5, compression 2mm IU 8167-02Basic insert for load drill guide LOQTEQ® 4.5 IU 8167-05
OPTIONALLoad drill guide LOQTEQ® 4.5, adjustable up to 2mm IU 8167-03
• Drill to the desired depth using a drill bit ø3.8 (marked blue-red) and
determine the depth with the depth gauge. Select a LOQTEQ® locking
screw (red) of the proper length and insert. In the event of a peri-
prosthetic implant (view figure), drill monocortical and select a
LOQTEQ® periprosthetic screw (14 or 18mm).
• Alternatively, the adjustable compression drill guide (IU 8167-03)
can be used. The fracture gap serves as orientation in the setting of
the compression distance (max. 2mm). For this purpose, turn the
wheel of the compression drill guide until an appropriate gap forms
in the upper part of the instrument. Position the drill guide on the
holding pin, away from the fracture gap, and drill through the drill
guide’s open guide.
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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•Surgical Technique
Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5
N CAUTION:
Be sure to select the proper compression distance (1 or 2mm).
If the fracture gap is too small and the bone very hard, excessive
compression may prevent full locking of the angle stable screw.
N NOTE:
It is recommended to use a torque limiter as soon as the screw
head reaches the thread in the plate hole.
N NOTE:
In cases of very hard bone in the diaphysis it is necessary to
make sure that the screw head is flush to the plate. Therefore
it is permissible in exceptionally hard bone of the diaphysis to
finish the screw without the torquc limiter.
N CAUTION:
Do not use the torque limiter in automated mode;
instead, use only with the enclosed handle.
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Surgical Technique•
Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5
Explantation INSTRUMENTS ART.-NO.Screwdriver, T25, Round Handle IU 7811-25Screwdriver, hexagonal, SW 3.5 IU 7865-00
N NOTE:
The screwdrivers in the set (T25) are self-retaining. To achive
maximum torque during screw removal, we recommend
using the appropriate explantation screwdriver, which can be
ordered separately.
• Place an incision on the old scar. Manually undo all screws
and sequentially remove them.
N NOTE:
After manually undoing all screws, the removal can be
performed in automated mode in the second step.
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Trays •
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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LOQTEQ®
Distal Femur Plate 4.5, Implants IC 6943-40
Large Fragment Set, Instruments IC 6941-10
Large Fragment Set, Screw rack, basic IC 6941-30
Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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•Trays
Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5
LOQTEQ® Distal Femur Plate 4.5, Tray C Implants IC 6943-40
ARTICLE QUANTITY ART.-NO.Tray C for implants LOQTEQ® DF 4.5, empty 1 IC 6943-01Lid for trays, large 1 IC 2008-00
LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/7 holes, L 207, R 1 PF 4510-07-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/9 holes, L 243, R 1 PF 4510-09-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/11 holes, L 279, R 1 PF 4510-11-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/13 holes, L 314, R 1 PF 4510-13-2
LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/7 holes, L 207, L 1 PF 4511-07-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/9 holes, L 243, L 1 PF 4511-09-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/11 holes, L 279, L 1 PF 4511-11-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/13 holes, L 314, L 1 PF 4511-13-2
OPTIONALLOQTEQ® Dist. Lateral Femur Plate 4.5, 7/4 holes, L 153, R PF 4510-04-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/15 holes, L 350, R, sterile PF 4510-15-2SLOQTEQ® Dist. Lateral Femur Plate 4.5, 7/ 17 holes, L 386, R, sterile PF 4510-17-2S
LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/4 holes, L 153, L PF 4511-04-2LOQTEQ® Dist. Lateral Femur Plate 4.5, 7/15 holes, L 350, L, sterile PF 4511-15-2SLOQTEQ® Dist. Lateral Femur Plate 4.5, 7/17 holes, L 386, L, sterile PF 4511-17-2S
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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LOQTEQ® Screw Rack for Extension Screw DF 4.5
Trays •
Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5
ARTICLE QUANTITY ART.-NO.Screw rack LOQTEQ® DF 4.5 for extension screw set, empty 1 IC 6943-02
LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 75 6 SK 4525-75-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 80 6 SK 4525-80-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 85 6 SK 4525-85-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 90 6 SK 4525-90-2
LOQTEQ® Periprosthetic Screw 4.5, T25, self-tapping, L 14 10 SK 4527-14-2LOQTEQ® Periprosthetic Screw 4.5, T25, self-tapping, L 18 10 SK 4527-18-2
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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•Trays
Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5
LOQTEQ® Large Fragment Set, Instruments IC 6941-10
LOQTEQ® Large Fragment Set, Screw rack complete, basic IC 6941-30*
ARTICLE QUANTITY ART.-NO.Tray for instruments LOQTEQ® Large Fragment, empty 1 IC 6941-11Lid for trays, large 1 IC 2008-00
Depth gauge for locking screws, large 1 IS 7905-00Twist drill ø3.2, L 195, coil 50, quick coupling 1 IU 7432-30Twist drill ø3.8, L 180, coil 50, quick coupling 1 IU 7438-18Twist drill ø3.8, L 250, coil 50, quick coupling 1 IU 7438-25Twist drill ø4.5, L 145, coil 50, quick coupling 1 IU 7445-00Handle for quick coupling, large, cannulated 1 IU 7706-00Tap for cortical screw ø4.5, L 125/70 1 IU 7745-00Screwdriver T25, short, quick coupling 1 IU 7810-26Screwdriver hexagonal, ø3.5, quick coupling 1 IU 7835-00Screwdriver Duo, T25, quick coupling 1 IU 7835-55Torque limiter 3.5 nm, quick coupling 1 IU 7870-35Screw forceps, self-holding 1 IU 8004-00Double drill guide ø3.2/4.5 with spring aided centering 1 IU 8117-50Load drill guide LOQTEQ® 4.5, compression 1mm 1 IU 8167-01Load drill guide LOQTEQ® 4.5, compression 2mm 1 IU 8167-02Basic insert for load drill guide LOQTEQ® 4.5 1 IU 8167-05Drill guide for gliding hole LOQTEQ® 4.5, I-ø 3.9, red 2 IU 8167-10Reduction sleeve for K-wire ø2.0 2 IU 8167-15Drill guide for round hole LOQTEQ® 4.5, I-ø 3.9, blue 2 IU 8167-20K-wire with trocar point, ø2.0, L 250 5 NK 0020-25
OPTIONALLoad drill guide LOQTEQ® 4.5, adjustable up to 2mm 1 IU 8167-03
ARTICLE QUANTITY ART.-NO.Screw rack LOQTEQ® Large Fragment, empty 1 IC 6941-31
N CAUTION: Do not use blue screws in femur!
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Trays •
Surgical Technique – Open AccessDistal Lateral Femur Plate 4.5
Screws for gliding-locking hole
Standard screws
ARTICLE QUANTITY ART.-NO.LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 14 3 SK 4525-14-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 16 3 SK 4525-16-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 18 3 SK 4525-18-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 20 3 SK 4525-20-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 22 3 SK 4525-22-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 24 3 SK 4525-24-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 26 3 SK 4525-26-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 28 3 SK 4525-28-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 30 3 SK 4525-30-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 32 4 SK 4525-32-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 34 4 SK 4525-34-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 36 4 SK 4525-36-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 38 4 SK 4525-38-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 40 4 SK 4525-40-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 42 3 SK 4525-42-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 45 3 SK 4525-45-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 50 3 SK 4525-50-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 55 3 SK 4525-55-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 60 3 SK 4525-60-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 65 3 SK 4525-65-2LOQTEQ® Cortical Screw 4.5, T25, self-tapping, L 70 3 SK 4525-70-2
ARTICLE QUANTITY ART.-NO.Cortical Screw 4.5, self-tapping, L 14 3 SK 4512-14-2Cortical Screw 4.5, self-tapping, L 16 3 SK 4512-16-2Cortical Screw 4.5, self-tapping, L 18 3 SK 4512-18-2Cortical Screw 4.5, self-tapping, L 20 3 SK 4512-20-2Cortical Screw 4.5, self-tapping, L 22 3 SK 4512-22-2Cortical Screw 4.5, self-tapping, L 24 3 SK 4512-24-2Cortical Screw 4.5, self-tapping, L 26 3 SK 4512-26-2Cortical Screw 4.5, self-tapping, L 28 3 SK 4512-28-2Cortical Screw 4.5, self-tapping, L 30 3 SK 4512-30-2Cortical Screw 4.5, self-tapping, L 32 4 SK 4512-32-2Cortical Screw 4.5, self-tapping, L 34 4 SK 4512-34-2Cortical Screw 4.5, self-tapping, L 36 4 SK 4512-36-2Cortical Screw 4.5, self-tapping, L 38 4 SK 4512-38-2Cortical Screw 4.5, self-tapping, L 40 4 SK 4512-40-2Cortical Screw 4.5, self-tapping, L 42 3 SK 4512-42-2Cortical Screw 4.5, self-tapping, L 45 3 SK 4512-45-2Cortical Screw 4.5, self-tapping, L 50 3 SK 4512-50-2Cortical Screw 4.5, self-tapping, L 55 3 SK 4512-55-2Cortical Screw 4.5, self-tapping, L 60 3 SK 4512-60-2Cortical Screw 4.5, self-tapping, L 65 3 SK 4512-65-2Cortical Screw 4.5, self-tapping, L 70 3 SK 4512-70-2
aap Implantate AGLorenzweg 5 • 12099 Berlin • Germany
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Surgical Technique - Open AccessDistal Lateral Femur Plate 4.5
•Notes
aap Implantate AGLorenzweg 5 • 12099 BerlinGermany
Phone +49 30 75019-0Fax +49 30 75019-111
Technische Änderungen, Irrtümer und Druckfehler vorbehalten.
© aap Implantate AGWM 2005-76 / 0513
Layout, Satz: deSIGN graphic - Wolfram Passlack
Illustrationen: Karen Hilberg
WM 2005-76 / 0513
aap Implantate AGLorenzweg 5 • 12099 BerlinGermany
Phone +49 30 75019-0Fax +49 30 75019-111