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LCP Volar Column Distal Radius Plates 2.4 mm. Part of the LCP Distal Radius System 2.4.

Surgical Technique

This publication is not intended for distribution in the USA.

Instruments and implants approved by the AO Foundation.

LCP Volar Column Distal Radius Plates 2.4 mm. Surgical Technique DePuy Synthes 1

Introduction

Surgical Technique

Product Information

MRI Information 35

LCP Volar Column Distal Radius Plates 2.4 mm 2

AO Principles 4

Intended Use and Indications 5

Clinical Cases 6

Introduction 7

Preoperative Planning 8

Implantation 13

Implant Removal 26

Implants 27

Instruments 30

Bibliography 33

Table of Contents

Image intensifier control

This description alone does not provide sufficient background for direct use of DePuy Synthes products. Instruction by a surgeon experienced in handling these products is highly recommended.

Processing, Reprocessing, Care and MaintenanceFor general guidelines, function control and dismantling of multi-part instruments, as well as processing guidelines for implants, please contact your local sales representative or refer to:http://emea.depuysynthes.com/hcp/reprocessing-care-maintenanceFor general information about reprocessing, care and maintenance of Synthes reusable devices, instrument trays and cases, as well as processing of Synthes non-sterile implants, please consult the Important Information leaflet (SE_023827) or refer to: http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance

2 DePuy Synthes LCP Volar Column Distal Radius Plates 2.4 mm. Surgical Technique

LCP Volar Column DistalRadius Plates 2.4 mm

Description

The LCP Volar Column Plate is part of the LCP Distal Radius System 2.4 and is indicated for the fixation of intra- and extra-articular fractures and osteotomies of the distal radius. Multiple locking screw options in the head of the plate pro-vide additional options for fixation of the radial and inter-mediate columns.

Features – Anatomically contoured volar distal radius plates. – Multiple locking screw options in head of plate provide

fixation of the radial and intermediate column. – Choice of 6-, 7-, 8- or 9-hole head configurations. – Available left and right, with 3-, 4-, and 5-hole shaft

length. – Screw sizes:

– Head: locking screws B 2.4 mm – Shaft: locking B 2.4 mm, cortex B 2.4 mm,

or cortex screws B 2.7 mm – Available in stainless steel and pure titanium.

Benefits – Multiple distal locking screw options offer a fixed-angle

construct to support the articular surface, to help reduce the need for bone graft and obtain fixation in osteopo-rotic bone.

– Combi-holes in plate shaft allow locking screw fixation with angular stability in the threaded section, or compres-sion with cortex screws in the DCU section of the hole.

– Low plate and screw profile minimizes potential for tendon adhesions and soft tissue irritation.

– Polished surface and rounded edges minimize potential for tendon adhesion.

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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 fixation1, 2.

1 Müller ME, M Allgöwer, R Schneider, H Willenegger. Manual of Internal Fixation. 3rd ed. Berlin Heidelberg New York: Springer. 1991.

2 Rüedi TP, RE Buckley, CG Moran. AO Principles of Fracture Management. 2nd ed. Stuttgart, New York: Thieme. 2007.

Anatomic reductionFracture reduction and fixation to restore anatomical relationships.

Early, active mobilizationEarly and safe mobilization and rehabilitation of the injured part and the patient as a whole.

Stable fixationFracture fixation providing abso-lute or relative stability, as required by the patient, the injury, and the personality of the fracture.

Preservation of blood supplyPreservation of the blood supply to soft tissues and bone by gentle reduction techniques and careful handling.


AO Principles

1 Müller ME, M Allgöwer, R Schneider, H Willenegger. Manual of Internal Fixation. 3rd ed. Berlin, Heidelberg, New York: Springer. 1991

2 Rüedi TP, RE Buckley, CG Moran. AO Principles of Fracture Management. 2nd ed. Stuttgart, New York: Thieme. 2007

Stable fixationFracture fixation providing absolute or relative stability, as required by the patient, the injury, and the personality of the fracture.

Anatomic reductionFracture reduction and fixation to restore anatomical relationships.

Early, active mobilizationEarly and safe mobilization and rehabilitation of the injured part and the patient as a whole.

Preservation of blood supplyPreservation 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 fixation1,2.


Intended UseThe plate and screw implants included in the Radius Plate product family are intended for temporary fixation, correc-tion or stabilization in the radius anatomical region.

IndicationsThe LCP Volar Column Distal Radius Plate 2.4 mm is indi-cated for the fixation of complex intra- and extra-articular fractures and osteotomies of the distal radius.

Intended Use and Indications


Case 1 – Volar Column Plate

65-year-old female, fallClassification: A2, right handOsteopenic, ulna styloid

Postoperative, AP view

Postoperative, lateral view

Preoperative, lateral view

Postoperative, lateral view

Preoperative, lateral view

Preoperative, AP view

Case 2 – Volar Column Plate

83-year-old female patient, fallStabilization of subcapital ulna and concomitant ulna styloid fracture with LCP Distal Ulna Plate.

LCP Volar Column Plate for fixation of distal radius fracture.

Postoperative, AP view

Preoperative, AP view

Clinical Cases


Radial column

Intermediate column

Ulnar column

Three column theoryExtra-articular fractures require avoidance of malunion with angulation and shortening. Malalignment results in limita-tions of movement, changes of load distribution, mid-carpal instability and increased risk of osteoarthritis in the radiocar-pal joint.

Intra-articular fractures with articular displacement over 2 mm in the radiocarpal joint inevitably result in osteoarthri-tis and functional impairment.

The treatment of distal radius fractures should provide meticulous reconstruction of the joint surface, stable internal fixation and early functional post-operative treatment.

The distal radius and distal ulna form a three-column biomechanical construction: – The ulnar column is the distal ulna, the triangular fibrocar-

tilage and the distal radio-ulnar joint. – The intermediate column is the medial part of the distal

radius, with the lunate fossa and the sigmoid notch. – The radial column is the lateral radius with the scaphoid

fossa and the styloid process.

A dorsally displaced fracture of the distal radius shows not only dorsiflection in the sagittal plane, but also radial devia-tion in the frontal plane and supination in the transverse plane.

Stabilization after reduction requires buttressing of the intermediate column as well as the radial column.

In case of a fractured distal ulna, the ulnar column should be stabilized as well.

Introduction

5°25°25°

0°

0°

5°

5°5°

23°

70°

70°

95°

23°

103°

103°

AB

C

A BC

DF

E D/EF


Preoperative Planning

The LCP Volar Column Plate provides multiple locking screw options in the head of the plate to optimally support the articular surface: – radial screws for the radial column – medial screws – ulnar screws for the intermediate column

The chart below serves as a reference to plan placement of screws.

Screw trajectories in 2.4 mm LCP Volar Column Plates

Radial screws

Ulnar screws

LCP Volar Column Distal Radius Plates with 6 head holes:

5°25°25°

0°

0°

0°

0°

23°

70°

70°

95°

23°85°

0°

5°

5°

5°

23°

103°

103°

A BC

A BC

D

D

E FG

GE/F


Radial screws

Medial screw

Ulnar screws


92°

100°

90°

35°

100°

100°

117°

115°

115°

35°

0°

0°

23° 20° 15°

5°

8°

8°

5°

35°

0°

–8°

AB

CA

BC

D FD

F

E GH

EG

H


Radial screws

Medial screws

Ulnar screws



92°

100°

90°

35°

95°

109°

100°

35°

115°

115°

117°

35°

0°

0°

0°

23° 20° 15°

10°8°

–5° 10°

10°

5°

AB C

ABC

ED FE

DF

GI

H

GIH


Radial screws

Medial screws

Ulnar screws



Screw selection

Determine what screws to use for the fixation of the plate.

Note:Plate shaft – Use locking and/or cortex screws in the shaft of the

plates. If a combination of cortex screws and locking screws is used, a cortex screw should be used first to pull the plate to the bone.

Plate head – Locking screws in the head of the plate support the

articular surface and prevent loss of reduction.

Warning: If a locking screw is used first, ensure that the plate is held securely to the bone, to avoid spinning of the plate.

Note: 2.7 mm cortex screws can only be used in the combi-nation hole of the volar plates.



Left plate

Example of K-wire fixation: AP view

Right plate

Implantation

1 Implant selection

Select the plates according to the fracture pattern and anat-omy of the radius.

Note: Distinguishing left plate from right plate: Rounded side is positioned on the Radial styloid.

2Fracture reduction

Translate the shaft portion of the fracture from the ulnar to radial side at the same time to manipulate the radial column into alignment.

Once the fracture is reduced, insert K-wires or drill bits for preliminary fracture stabilization.

Perform several radiographic views of the distal radius to ensure alignment and reduction.


Plate placement The red line indicates the volar ridge

3Apply plate

Instruments

310.509 Drill Bit B 1.8 mm, with marking

311.430 Handle with Quick Coupling

314.467 Screwdriver Shaft, Stardrive, T8, self-holding

319.005 Depth Gauge for Screws B 2.0 and 2.4 mm

323.202 Universal Drill Guide 2.4

Optional

310.534 Drill Bit B 2.0 mm, with marking

314.468 Holding Sleeve for Screws Stardrive B 2.4 mm, T8, for Screwdriver Shafts B 3.5 mm, for No. 314.467

319.010 Depth Gauge for Screws B 2.7 to 4.0 mm


Implantation


Additional options for preliminary Kirschner wire fixation in 6 and 7 hole plates

If necessary, use 1.25 mm Kirschner wires inserted through the desired Kirschner wire hole to temporarily fi x the plate distally.

Option: Plate reduction wires

Instruments

02.111.500.01(S) Plate Reduction Wire B 1.25 mm, withthread, with Small Stop, length 150 mm,Stainless Steel

02.111.501.01(S) Plate Reduction Wire B 1.25 mm, withthread, with Large Stop, length 150 mm,Stainless Steel

The 1.25 mm plate reduction wires can be used for prelimi-nary plate fi xation. They must be removed when not needed for temporary fi xation anymore.

Note: The plate reduction wires are single use items, do not re-use.


Implantation

Preliminary Kirschner wire fixation with short LCP drill sleeves

After fracture is reduced with Kirschner wires, apply the vo-lar column plate to fit the volar surface and insert a cortex screw B 2.4 mm into the elongated hole in the shaft. Adjust the plate position as necessary, and tighten the screw.

Note: Alternatively, a cortex screw B 2.7 mm may be inserted into the elongated hole.

Precaution: Reverse bending or use of the incorrect instru-mentation 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 plate can be fixed distally with Kirschner wires or drill bits inserted through the short LCP drill sleeves, if desired.

The order of screw insertion and the use of Kirschner wires may vary depending on the fracture pattern and reduction technique.

Perform several radiographic views of the distal radius to ensure alignment and reduction.


4aInsertion of distal screws – standard technique

Instruments

310.509 Drill Bit B 1.8 mm with marking, length 110/85 mm, 2-fluted, for Quick Coupling



323.029 LCP Drill Sleeve 2.4, with scale up to 30 mm, for Drill Bit B 1.8 mm

511.776 Torque Limiter, 0.8 Nm, with AO/ASIF Quick Coupling

Optional

314.468 Holding Sleeve for Screws Stardrive 2.4 mm, T8, for Screwdriver Shafts 3.5 mm, for No. 314.467


Screw length can be measured directly from the mark on the drill bit and scale on the threaded drill guide.

Alternative techniqueScrew length may also be determined by using the depth gauge for screws B 2.4 mm.

Volar Column Distal Radius Plate with long LCP drill sleeves and measuring directly from the mark on the drill bit B 1.8 mm.


Implantation

4bInsertion of distal screws with guiding block

Instruments

03.111.000 Quick Drill Sleeve 2.4 with Scale, for Drill Bits B 1.8 mm, for Guiding Block, for Distal Radius Plates

310.509 Drill Bit B 1.8 mm, with marking, length 110/85 mm, 2-flute, for Quick Coupling




Optional


Guiding blocks 8 and 9 head holes

03.110.011 Screw for Guiding Block, for LCP Volar Column Distal Radius Plate 2.4, head 8 and 9 holes

03.110.016 Guiding Block for LCP Volar Column Distal Radius Plate 2.4, head 8 holes, right

03.110.017 Guiding Block for LCP Volar Column Distal Radius Plate 2.4, head 8 holes, left



Guiding blocks 6 and 7 head holes

03.111.007 Screw for Guiding Block for Distal Radius Plates, head 6 and 7 holes





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2

3


Select the appropriate guiding block and secure it to the plate using the screw for guiding block. The distal end of the guiding block may be used to aid in plate positioning. (Figure 1)

Insert the quick drill sleeve with scale for guiding block into one of the distal plate holes. Ensure that the quick drill sleeve is firmly seated in the hole. Drill with the drill bit B 1.8 mm and measure screw length directly from the gauge on the in-strument. (Figure 2)

Note: Insert a locking screw B 2.4 mm using a screwdriver Stardrive T8 (Figure 3).

Repeat this procedure for the remaining distal holes that will be filled.


Implantation

Remove K-wire and drill sleeve on ulnar side to insert a second locking screw for rotational stability. Proceed the same way on the radial side.

4cInsertion of distal screws with short LCP drill sleeves

Instruments

03.110.006 Direct Measuring Device for Kirschner Wire B 1.8 mm, length 150 mm

02.110.300 Kirschner Wire B 1.8 mm with trocar tip, length 150 mm, Stainless Steel




323.035 LCP Drill Sleeve 2.4, short, for Drill Bits B 1.8 mm, for LCP Distal Radius Plates


Optional


The order of screw insertion in the shaft and metaphysis may vary depending on fractures pattern and reduction technique.

Pick up the short LCP drill sleeves (selfholding) using the screwdriver shaft, Stardrive, self-holding. Insert drill sleeves carefully in line with the axis of the desired screw hole.


Note:The short LCP drill sleeves mounted to the plate before surgery will help reduce surgery time, and they will double as K-wire holes for preliminary plate fixation.

Determine screw length with K-wireIf a K-wire B 1.8 mm is inserted through the short LCP drill sleeve, screw size can be determined using the direct measuring device for K-wires B 1.8 mm.


Implantation

Insert locking screws B 2.4 mm into the distal part of the plate, selecting hole locations appropriate to the particular fracture pattern. For screw insertion, remove K-wires and LCP drill sleeves as needed (see illustration). It is important to ensure the screws do not penetrate the far cortex.

The order of screw insertion and the number of screws used will depend on the fracture pattern.

Precaution: When finished with the fixation, promptly remove all unused short LCP drill sleeves from the plate to ensure that they are not implanted in the patient. The hold-ing sleeve for T8 Stardrive screwdriver shaft can be used for short LCP drill sleeve removal.

RecommendationInsert the locking screws with the torque limiter.


5Insertion of proximal screws

Instruments





323.029 LCP Drill Sleeve 2.4, with scale up to 30 mm, for Drill Bit B 1.8 mm



Optional

310.260 Drill Bit B 2.7 mm, length 100/75 mm, 2-flute, for Quick Coupling


310.534 Drill Bit Depth B 2.0 mm, with marking, length 110/85 mm, 2-flute, for Quick Coupling


319.010 Depth Gauge for Screws B 2.7 to 4.0 mm, measuring range up to 60 mm


Long LCP drill sleeve, inserted into the locking part of the LCP combi-hole


Implantation

Final fixation

Insert additional proximal screws. Determine whether 2.4 mm locking or cortex screws will be used in the shaft of the plate.

For locking screws, carefully insert the LCP drill sleeve 2.4 with scale in line with the hole’s axis until it is seated in the desired locking hole. Drill with the drill bit B 1.8 mm.

Read the screw length directly from the laser mark on the drill bit, or use the corresponding Depth Gauge to determine the screw length.

RecommendationInsert the self-tapping locking screws with the torque limiter.

For cortex screws, use the universal drill guide 2.4. Drill threaded holes with the drill bit B 1.8 mm and gliding holes for compression with the drill bit B 2.4 mm. Then, measure the screw length using the corresponding Depth Gauge.

Note: When cortex screws B 2.7 mm are inserted, use the universal drill guide 2.7. Drill threaded holes with the drill bit B 2.0 mm and gliding holes for compression with the drill bit B 2.7 mm.


20° inclined lateral view

View 10° tilted AP

6Confirm proper joint reconstruction

Confirm proper joint reconstruction, screw placement and screw length using multiple C-arm views. To assure that the most distal screws are not in the joint, use additional views, such as 10° tilted AP, 20° inclined lateral, and 45° pronated oblique.

7Postoperative treatment

Postoperative treatment with Locking Compression Plates (LCP) does not differ from conventional internal fixation procedures.


Instruments



Optional


To remove locking screws, first unlock all screws from the plate; then remove the screws completely from the bone. The last screw removed should be a non-locking screw of the shaft. This guarantees the plate not to spin when locking screws are removed.

Implant Removal


Implants

Locking Screws 2.4

X12.806 – Locking Screw B 2.4 mm, self-tapping X12.830

Cortex Screws 2.4

X01.756 – Cortex Screw B 2.4 mm, self-tapping X01.780

Kirschner wires

0X.110.300.10 Kirschner Wire B 1.8 mm with trocar tip, length 150 mm, pack of 10 units

292.120 Kirschner Wire B 1.25 mm with trocar tip, length 150 mm, Stainless Steel

Optional:

Cortex Screws 2.7

X02.870 – Cortex Screw Stardrive B 2.7 mm,X02.890 self-tapping

X=2: Stainless Steel (SSt)X=4: Titanium Alloy (TAN)


Implants

LCP Volar Column Distal Radius Plates 2.4

Part Number Head Shaft Left/ Length Holes Holes Right (mm)

0x.110.730 6 3 R 45

0x.110.731 6 3 L 45

0x.110.740 6 4 R 54

0x.110.741 6 4 L 54

0x.110.750 6 5 R 63

0x.110.751 6 5 L 63


0x.110.830 7 3 R 45

0x.110.831 7 3 L 45

0x.110.840 7 4 R 54

0x.110.841 7 4 L 54

0x.110.850 7 5 R 63

0x.110.851 7 5 L 63

X=2: Stainless Steel (SSt) X=4: Pure Titanium (TiCp)

R L

R L



0X.110.430 8 3 R 49

0X.110.431 8 3 L 49

0X.110.440 8 4 R 58

0X.110.441 8 4 L 58

0X.110.450 8 5 R 67

0X.110.451 8 5 L 67


0X.110.330 9 3 R 49

0X.110.331 9 3 L 49

0X.110.340 9 4 R 58

0X.110.341 9 4 L 58

0X.110.350 9 5 R 67

0X.110.351 9 5 L 67

X=2: Stainless Steel (SSt)X=4: Pure Titanium (TiCp)

R L

R L


310.509 Drill Bit 1.8 mm with marking, length 110/85 mm, 2-fluted, for Quick Coupling


Instruments



319.005 Depth Gauge for Screws B 2.0 and 2.4 mm, measuring range up to 40 mm

323.029 LCP Drill Sleeve 2.4, with scale up to 30 mm, for Drill Bit 1.8 mm



03.110.011 Screw for Guiding Block, for LCP Volar Col-umn Distal Radius Plate 2.4, head 8 and 9 holes

03.111.007 Screw for Guiding Block for Distal Radius Plates, head 6 and 7 holes

Guiding Block for LCP Volar Column Distal Radius Plate 2.4, head 8 holes

03.110.016 right03.110.017 left


03.110.018 right03.110.019 left

03.111.000 Quick Drill Sleeve 2.4 with Scale, for Drill Bits B 1.8 mm, for Guiding Block, for Distal Radius Plates


03.110.026 right03.110.027 left


03.110.028 right03.110.029 left

R L

R L

R L

R L


Instruments

Optional



310.534 Drill Bit B 2.0 mm, with marking, length 110/85 mm, 2-flute, for Quick Coupling

319.010 Depth Gauge for Screws B 2.7 to 4.0 mm, measuring range up to 60 mm

323.035 LCP Drill Sleeve 2.4, short, for Drill Bits B 1.8 mm, for LCP Distal Radius Plates

311.023 Ratcheting Screwdriver Handle

03.110.007 Screwdriver 2.4, Stardrive, T8, self-holding

03.110.022 Screwdriver Shaft 2.4, Stardrive, T8, self-holding, for Ratcheting Screwdriver Handle, with Hexagonal Coupling

03.110.006 Direct Measuring Device for Kirschner Wire B 1.8 mm, length 150 mm


Plate reduction wires

02.111.500.01(S) Plate Reduction Wire B 1.25 mm, with thread, with Small Stop, length 150 mm, Stainless Steel

02.111.501.01(S) Plate Reduction Wire B 1.25 mm, with thread, with Large Stop, length 150 mm, Stainless Steel


Bibliography

Arora R, Lutz M, Fritz D, Zimmermann R, Oberladstätter J, Gabl M (2005) Palmar locking plate for treatment of unstable dorsal dislocated distal radius fractures. Arch Orthop Trauma Surg 125:399–404

Cassidy C, Jupiter J, Cohen M, Delli-Santi M, Fennell C, Lein-berry C, Husband J, Ladd A, Seitz W and Constanz B (2003) Norian SRS Cement compared with conventional fixation in distal radius fractures – A randomised study. JBJS Vol 85–A, Nr 11, Nov 2003

Fernandez DL (2000) Distal Radius and Wrist. In: Rüedi TP, Murphy WM (editors) AO principles of fracture management. Thieme, Stuttgart New York:355–377

Harness NG, Jupiter JB, Orbay JL, Raskin KB, Fernandez DL (2004) Loss of Fixation of Complex Fractures of the Distal Part of the Radius. J Bone Joint Surg [Am] 84:1900–1908

Hems TE, Davidson H, Nicol AC, Mansbridge D (2000) Open reduction and plate fixation of unstable fractures of the distal radius: A biomechanical analysis and clinical experience. J Bone Joint Surg [Br] 82:83

Jakob M, RikIi DA, Regazzoni P (2000) Fractures of the distal radius treated by internal fixation and early function: A pro-spective study of 73 consecutive patients. J Bone Joint Surg [Br] 82:340–344

Jupiter JB, Ring D (2005) AO Manual of Fracture Manage-ment – Hand and Wrist. Thieme, Stuttgart New York

Nijs S, Broos PLO (2004) Fractures of the distal radius: a contemporary approach. Acta Chir Belg 104:401–404

Rikli DA, Honigmann P, Babst R, Cristalli A, Morlock MM, Mittlmeier T (2007) Intra-articular pressure measurement in the radioulnocarpal joint using a novel sensor: in vitro and in vivo results. J Hand Surg [Am] 32 (1):67–75

Rikli DA, Regazzoni P (1996) Fractures of the distal end of the radius treated by internal fixation and early function. A preliminary report of 20 cases. J Bone Joint Surg [Br] 78 (4):588–592

Zimmerman R, Gabl M, Lutz M, Angermann P, Gschwenter M and Pechlaner S (2003) Injectable calcium phosphate bone cement Norian SRS for the treatment of intra-articular com-pression fractures of the distal radius in osteoporotic women. Arch Orthop Trauma Surg 123:22–27


MRI Information

Torque, Displacement and Image Artifacts according to ASTM F 2213-06, ASTM F 2052-06e1 and ASTM F 2119-07Non-clinical testing of worst case scenario in a 3 T MRI system did not reveal any relevant torque or displacement of the construct for an experimentally measured local spatial gradient of the magnetic field of 3.69 T/m. The largest image artifact extended approximately 169 mm from the construct when scanned using the Gradient Echo (GE). Testing was conducted on a 3 T MRI system.

Radio-Frequency-(RF-)induced heating according to ASTM F 2182-11aNon-clinical electromagnetic and thermal testing of worst case scenario lead to peak temperature rise of 9.5 °C with an average temperature rise of 6.6 °C (1.5 T) and a peak temperature rise of 5.9 °C (3 T) under MRI Conditions using RF Coils (whole body averaged specific absorption rate [SAR] of 2 W/kg for 6 minutes [1.5 T] and for 15 minutes [3 T]).

Precautions: The above mentioned test relies on non-clini - cal testing. The actual temperature rise in the patient will depend on a variety of factors beyond the SAR and time of RF application. Thus, it is recommended to pay particular attention to the following points: – It is recommended to thoroughly monitor patients under-

going MR scanning for perceived temperature and/or pain sensations.

– Patients with impaired thermoregulation or temperature sensation should be excluded from MR scanning proce - dures.

– Generally, it is recommended to use a MR system with low field strength in the presence of conductive implants. The employed specific absorption rate (SAR) should be reduced as far as possible.

– Using the ventilation system may further contribute to reduce temperature increase in the body.

0123

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Not all products are currently available in all markets.

This publication is not intended for distribution in the USA.

All surgical techniques are available as PDF files at www.depuysynthes.com/ifu ©

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