UNIFLEX®

Surgical Technique

The Uniflex® Nailing System was developed in cooperation with the Biomechanics Research Laboratory of Orthopaedic Hospital/USC and the Department of Orthopaedics,University of Southern California School of Medicine. Biomet, as the manufacturer of this device, does not practice medicine and does not recommend this or any othersurgical technique for use on a specific patient. The surgeon who performs any implant procedure is responsible for determining and utilizing the appropriate technique forsuch procedure for each individual patient. Biomet is not responsible for selection of the appropriate surgical technique to be utilized for an individual patient.

UNIFLEX®

IntroductionDesign PrinciplesThe Uniflex® Femoral Nail is primarily indicated in thetreatment of shaft fractures, subtrochanteric fracturesand distal third fractures with proximal and/or distalinterlocking screw fixation. Reconstructive indicationsinclude combination fractures of the shaft and neck,intertrochanteric, or combined intertrochanteric andsubtrochanteric fractures.

The design philosophy of the Uniflex Nailing System wasto develop a single system that could be used for thewidest possible variety of femoral fractures. Based on aclosed interlocking intramedullary rod, the system takesfull advantage of our better understanding of the biologyof fracture healing combined with modern materials andbiomechanical design principles. Primary requirementsof the system were that the number of instruments shouldbe kept to a minimum and that they should be simple touse. It was also desirable to minimize the number ofimplants necessary for a complete size inventory.

Titanium alloy was selected due to its combined propertiesof greater strength and lower modulus of elasticity ascompared to stainless steel. For a given size of implant,the strength should be as high as possible to guardagainst implant failure. On the other hand, it is desirableto maximize the flexibility of the implant a) to facilitateinsertion without comminution, b) to transmit load to thebone to protect the implant while minimizing stress pro-tection resorption and c) to stimulate the natural fracturehealing mechanisms by allowing adequate motion at thefracture interface. The fully-slotted Uniflex titanium alloynail provides the optimum combination of these properties.

The 10mm and 11mm nails provide the option ofunreamed insertion both in open or closed fractures orreconstruction following tumor resection. The use ofthese smaller diameter nails with unreamed techniquein closed fractures should be weighed against the greaterstrength of larger nails with a reamed technique.

1

Distances are from end of the nail to the center of the screw holes.Allowances should be made on X-rays for magnification.

(10 – 14mm Diameter Nails)

(Anterior Bow)

BA C D

Preoperative Postoperative

2

UNIFLEX®

Case History #1

PreoperativePre-op X-ray of a malewho sustained a combi-nation fracture of thefemoral neck and shaft ina motorcycle accident.

Postoperative11 months post-op X-rayshowing the Uniflex recon-structive nail with fracturehealing and no signs ofavascular necrosis.

PreoperativePre-op X-ray of a malewho sustained a grade IIopen fracture in an auto-mobile accident.

Postoperative10 months post-op X-rayshowing ideal reductionand healing with theUniflex interlocking nail.

Case History #2

E F G

Indications

Interlocking Fixation – Interlocking Indications:• Comminuted shaft fractures [B].• Subtrochanteric fractures [C].• Distal third fractures [D].

Reconstructive Fixation – Reconstructive Indications:• Combination fractures of the shaft and neck [E].• Intertrochanteric fractures [F].• Combined intertrochanteric and subtrochanteric

fractures [G].• Reconstruction following tumor resection.

Intramedullary Fixation – Standard Indications:• Non-comminuted mid

shaft fractures [A]. Right and left nail configuration ensure proper screw placement.

Preoperative Postoperative

3

Preoperative PlanningPatient PositioningTo identify the correct diameter and length of the nailrequired, take A/P and lateral X-rays of the fracturedfemur at a distance of one meter with the cassetteplaced against the thigh. When possible, take A/Pand lateral films of the uninjured leg for comparison.

Estimate nail diameter and length by assessingmedullary canal diameter and femur length on preop-erative radiographs. The canal must be reamed to atleast 14mm proximally, for the first 8cm, to acceptthe larger proximal diameter of the nail.

Nail length can be approximated visually by holdingthe nail next to the injured leg. The correctly sized nailwill extend from the tip of the greater trochanter to theintercondylar notch. Final determination of nail sizemust be made intraoperatively.

Interlocking – Lateral Position StandardPlace patient on unaffected side with either tibial orfemoral pin traction image intensifier should bemaneuvered to allow a full view of the femur fromboth the A/P and lateral positions [Figure 1].

Interlocking – Supine Position StandardPlace patient supine on fracture table with the affectedleg neutral or slightly adducted. Either tibial or femoralpin traction is recommended. The unaffected leg islowered to allow visualization with the image intensifierin both A/P and lateral views [Figure 2].

Reconstructive – Supine Position Place patient supine on fracture table with unaffectedleg widely abducted, position image intensifier betweenthe legs to allow for A/P and true lateral projections ofthe hip [Figures 3 and 4].

Surgical ApproachStart incision at the tip of the greater trochanter andextend it proximally in line with the femoral shaft axis[Figure 5].

Figure 1

Figure 2

Figure 3

Figure 4

with Reconstructive – Supine Position

Figure 5

NOTE: This position is forreconstructive nailing only.

UNIFLEX®

4

Figure 6

Figure 7

Figure 8

Nail InsertionCanal LocationSplit muscles and identify the A/P margins of thegreater trochanter [Figure 6]. Insert a sharp awl intothe medullary canal in the region of the piriformis(obturator) fossa. Check position with image intensifier.Insertion point is just medial to the greater trochanterand posterior to the central axis of the femoral neck.Avoid anterior portals of entry [Figure 7].

Ball Tip Guide InsertionBend the guide wire approximately 5–7o 2cm from itstip to facilitate passage across the fracture. Advanceball tipped guide wire to fracture site with a rotatingmotion using a guide pin hand grip. Pass wire acrossfracture using bi-plane image control. The bent tip isturned posteriorly and advanced to the intercondylarnotch [Figure 8].

5

Figure 11

Canal ReamingStart reaming with an 8mm end-cutting reamer. Reamprogressively in .5mm increments until appropriatecanal diameter is reached. Reaming the canal diameter1–1.5mm larger than the nail to be implanted willreduce the driving force on the nail, the potential riskof nail damage and the chance of splitting the femur.When using 10mm – 13mm nails, ream the first8cm proximally to 14mm to accept the largerdiameter proximal end of the nails.

For reconstructive nailing, overreaming the entire canal1.5mm over nail diameter allows for later adjustmentof anteversion without removal of the nail [Figure 9].

Insert medullary alignment tube over ball tipped guidewire. Remove the ball tipped guide wire. Insert andadvance a 4.4mm nail driving guide [Figure 10].Remove alignment tube. A second nail driving guideof equal length is then used to measure the length ofthe medullary canal.

Nail Sizing Using Telescoping GaugeThe telescoping nail measuring gauge is placed over the98cm ball tip guide wire until it rests on the trochanter[Figure 11]. With the ball tip end resting at the desiredlevel, (distal end of nail) the telescoping tube is extendedto the end of the guide wire. To measure nail length, adirect reading can be made at the telescoping point ofthe two tubes [Figure 12].

Figure 9

Figure 10

NOTE: Must use a98cm guide wire.

Figure 12

Nail Length

6

UNIFLEX®

Nail Driving GuideInsertion/Measuring Nail LengthIf a nonreamed technique is used, the 4.4mm diameternail driving guide is inserted into the opening of theproximal femur and advanced past the fracture siteusing image intensification. The guide should advanceto the intercondylar notch. A second nail driving guideof equal length is then used to measure the length ofthe medullary canal. The selected nail should be atleast one cm shorter than the measured medullarycanal to permit countersinking of the proximal end ofthe nail [Figure 13].

Standard DriverInsert driver bolt into driver handle. Slide driver bush-ing over end of driver bolt until flats line up. Lockassembly together by pushing tab on driver handle[Figure 14].

Before threading driver bolt into nail, confirm directionof driver handle for right or left leg. With bow and longi-tudinal slot of the nail facing anteriorly, thread driverbolt into end of nail using either an end wrench oruniversal socket wrench. Engage nail slots with tangson driver bushing to securely lock assembly [Figure 15].

Thread offset driver into driver handle until fully seated.Place nail over nail driving guide. Drive nail until theproximal end is even with the tip of the greater trochanter.If the offset driver handle should loosen slightly duringinsertion, tighten it down before continuing.

The distal nail tip should lie between the superior poleof the patella and the epiphyseal scar [Figure 16].Remove nail driving guide. Unthread offset driver usinga lever bar.

Figure 13

Figure 14

Figure 15

Figure 16

7

High Clearance DriverThe High Clearance Model was developed for usewhen more room is required between incision site andthe head of the driver bolt. It also features a slenderdesign proximal target.

Before threading driver bolt into nail, confirm directionof driver handle for right or left leg. With bow and lon-gitudinal slot of the nail facing anteriorly, thread driverbolt into end of nail using an end wrench or universalsocket wrench. Engage nail slots with tangs on driverbushing to securely lock assembly [Figure 17].

Thread offset driver into driver handle until fully seated.Place nail over nail driving guide. Drive until the proxi-mal end is even with the tip of the greater trochanter.If the offset driver should loosen during insertion,tighten it down before continuing. The distal nail tipshould lie between the superior pole of the patellaand the epiphyseal scar. Remove nail driving guide[Figure 18].

NOTE: Nail curve and longitudinal slot should faceanteriorly. It is essential that the nail locks securelyinto the handle because nail alignment is controlledby this assembly.

Figure 17

Figure 18

8

UNIFLEX®

Proximal Screw Insertions Interlocking Application – Standard Model

Thread drill bushing A into guide tube A. Insert sleevesthrough proximal target on driver handle. Tap lightly torest against bone. NOTE: For accurate screw lengthreadings, drill sleeve must be against the greatertrochanter. Place 5mm calibrated twist drill throughthe sleeves and advance through both cortices. Readscrew length off calibrated drill shaft. Remove drilland bushing A [Figure 19].

Insert 6.0mm diameter fully-threaded screw throughguide tube A and advance with T-wrench until seated.Confirm screw placement with image intensifier beforeremoving T-wrench and guide tube A [Figure 20].

Figure 19

Figure 20

U.S. Patent Number 4,911,153

GuideTube A

Drill Bushing A

T-wrenchShaft

9

Proximal Screw Insertions cont’d

Interlocking Application – High Clearance Model

Slide proximal target over driver handle until restingagainst notch and tighten by turning thumbscrew usingT-wrench. Thread drill bushing A into guide tube A.Insert sleeves through most proximal hole in the proximaltarget arm. Tap lightly to rest against bone. NOTE: Foraccurate screw length readings, drill sleeve must beagainst the greater trochanter. Place 5mm calibratedtwist drill through the sleeves and advance throughboth cortices. Read screw length off calibrated drillshaft. Remove drill and bushing A [Figure 21].

Insert 6mm diameter fully-threaded screw throughguide tube A and advance with T-wrench until seated.Confirm screw placement with image intensifier beforeremoving T-wrench and guide tube A [Figure 22].

End Cap PlacementFollowing proximal screw insertion or standardintramedullary nailing, the driver handle is removedusing the universal socket wrench. Insert end capwith T-wrench into proximal end of the nail [Figure 23].

NOTE: It has been suggested that the end cap maybe placed through the top of the driver handle afterremoving the driver bolt, while applying pressure tothe driver handle.

Figure 21

Figure 22

Figure 23

Screw protective end capinto proximal end of nail.

T-wrench Shaft

Guide Tube ADrill Bushing A

6mm Fully-threaded,Self-tapping Screw

CalibratedDrill Shaft

5mm Twist Drill

10

UNIFLEX®

Proximal Screw Insertions cont’d

Reconstructive Application – Standard Model

Slide proximal target over driver handle until restingagainst soft tissue. Slide proximal target back and eitherextend initial incision or make separate proximal screwincisions. Split the skin, incise the facia lata and care-fully elevate soft tissue from bone. Return proximaltarget into position against soft tissue and tightenthumbscrew using T-wrench. Driver handle is parallelto angle of screw insertion.

Thread the 3 sleeves labeled B into each other andlock by turning clockwise. Insert sleeve assemblythrough proximal target. NOTE: Tap lightly to restagainst the lateral femoral cortex for accurate screwlength readings. Repeat with other sleeve assembly.

Insert guide pins (3.2mm x 305mm) into femoral headand take A/P and lateral X-rays to confirm guide pinpositioning. Pins should be centrally located in the head.If pins are not oriented correctly, the nail may requireadjustment. Remove guide pins before adjusting. Toadvance nail, attach offset driver; to back out nail,attach extractor. A second verification is then requiredby reinserting guide pins to check nail position. Donot proceed until guide pins are correctly positioned[Figure 24].

Remove one guide pin and sleeve. Leave the otherguide pin and sleeves in place to secure positionduring drilling. Place calibrated step drill through thedrill bushing and advance to lateral cortex and into thefemoral neck and head. Use image control to protectagainst femoral head perforation. Read screw length offthe calibrated drill shaft. For accurate screw lengthreadings, drill sleeves must be against lateralfemoral cortex. Remove step drill and drill sleeve[Figure 25].

Insert partially-threaded 6.3mm diameter screw throughguide tube B and advance with T-wrench until seated.Confirm screw placement with X-ray. Repeat steps forother screw placement. Remove T-wrench, guidesleeves and proximal target [Figure 26].

Lateral X-ray view indicates approximately 9o antever-sion with screws centrally positioned in the femoralhead [Figure 27].

Figure 25

Figure 26

Figure 27

6.2mm Drill Bit

Calibrated Drill Shaft

Partially-threaded, Self-tapping Screw

T-wrench Shaft

9°

Prior to drilling holes,both guide pins shouldbe inserted through theguide bushings andadvanced into bone toconfirm placement.

Figure 24

Floor

Driver handle is parallel to angle of screw insertion.

Guide Tube B

Drill Bushing BGuide Bushing B

Guide Pins

ProximalTarget

Figure 31

Proximal Screw Insertions cont’d

Reconstructive Application – High Clearance Model

Slide proximal target over driver handle until restingagainst notch. Slide proximal target back and eitherextend initial incision or make separate proximal screwincisions. Split the skin, incise the fascia lata andcarefully elevate soft tissue from bone. Slide proximaltarget back into position, engage thumb screw intonotch in driver handle, and tighten using T-wrench.

Insert 3 sleeves labeled B into each other and lock byturning clockwise. Insert sleeve assembly throughproximal target. NOTE: Tap lightly to rest against thelateral femoral cortex for accurate screw length read-ings. Repeat with other sleeve assembly.

Insert guide pins (3.2mm x 305mm) into femoral headand take A/P and lateral X-rays to confirm guide pinpositioning. Pins should be centrally located in the head.If pins are not oriented correctly, the nail may requireadjustment. Remove guide pins before adjusting. Useoffset driver to advance nail, or attach extractor toback out nail. A second verification is then required byreinserting guide pins to check nail position. Do notproceed until guide pins are correctly positioned[Figure 28].

Remove one guide pin and sleeve. Leave the otherguide pin and sleeves in place to secure positionduring drilling. Place calibrated step drill through thedrill bushing and advance to lateral cortex and intothe femoral neck and head. Use image control to pro-tect against femoral head perforation. Read screwlength off calibrated drill shaft. For accurate screwlength readings, drill sleeves must be against lateralfemoral cortex. Remove step drill and drill sleeve[Figure 29].

Insert partially-threaded 6.3mm diameter screw throughguide tube B and advance with T-wrench until seated.Confirm screw placement with X-ray. Repeat steps forother screw placement. Remove T-wrench, guidesleeves and proximal target [Figure 30].

Lateral X-ray view indicates approximately 9o antever-sion with screws centrally positioned in the femoralhead [Figure 31].

Figure 30

Figure 29

Figure 28

Partially-threaded, Self-tapping Screw

Floor

Guide Tube B

6.2mm Drill Bit

Calibrated Drill Shaft

ProximalTarget

Drill Bushing BGuide Bushing BPrior to drilling holes, both guide

pins should be inserted through theguide bushings and advanced intobone to confirm placement.

Guide Pins

11

9°

T-wrench Shaft

12

UNIFLEX®

Figure 33

Figure 34

Figure 35*

End Cap PlacementFollowing proximal screw insertion or standardintramedullary nailing, the driver handle is removedusing the universal socket wrench. Insert end capwith T-wrench into proximal end of the nail [Figure 32].

NOTE: It has been suggested that the end cap maybe placed through the top of the driver handle afterremoving the driver bolt, while applying pressure tothe driver handle.

Distal Screw InsertionsPosition C-arm about the distal femur so the distalscrew holes appear as concentric circles under imageintensifier [Figures 33 and 34].

Using the Biomet Radiolucent Targeting Device

The image intensifier is aligned with the distal hole inthe nail, such that the hole appears as a perfect circle.A knife blade is placed on the skin, with the incisionpoint verified on the image intensifier, and a one-cmstab incision is made over the hole in the nail. Theappropriate sized drill bit is inserted into the targetingdevice.* A 5mm drill bit is used in 12mm and larger nails.A 4.3mm drill bit is used in 10mm and 11mm nails.

The tip of the drill bit is placed into the stab incisionsuch that the tip is centered on the hole in the nail, asvisible on the image intensifier. The targeting device istilted until the drill bit appears as a solid circle in thecenter of the screw hole, and the screw hole is centeredin the outer ring of the targeting device. With the drillheld firmly in this position, both cortices are drilledthrough. The position of the drill bit is confirmed onthe intensifier before it is withdrawn [Figure 35].

Figure 32

Screw protective end capinto proximal end of nail.

INCORRECT

CORRECT

13

Distal Screw Insertions cont’d

Using the Freehand Technique

Achieve access to the bone and distal screw holesthrough a 5–6cm incision, or a pair of stab incisions.Elevate soft tissue from bone. Locate the center of oneof the holes with an awl or Steinmann pin, keepinghand well out of the X-ray beam. Turn off the beamand bring the instrument in line with the C-arm. Tapthe awl or pin through the lateral cortex and advanceit through the screw hole. Do not advance through themedial cortex, as this may compromise screw fixation.Confirm engagement of the instrument radiographically.Remove awl or pin [Figure 36] .

A 5mm calibrated twist drill is used in 12mm and largernails. A 4.3mm drill bit is used in 10mm and 11mm nails.Drill through the lateral cortex. As the drill advances,engaging the nail, it is advisable to either reverse orstop the drill and push it across the nail. Once the cut-ting edge is past the nail, forward drilling is resumeduntil the medial cortex is drilled [Figure 37].

Using a depth gauge, determine length of screwrequired [Figure 38].

Insert screw onto T-wrench and advance into bone.A 6mm diameter screw is used with 12mm and largernails. A 5mm diameter screw is used with 10mm and11mm nails. Repeat the steps for other screw place-ment [Figure 39].

Figure 37

Figure 36

Figure 39

Figure 38

14

UNIFLEX®

Distal Screw Insertions cont’d

Using Calibrated Crowe Point Twist Drills

Calibrated Crowe Point Twist Drills were designed forfreehand drilling of the distal holes in locking nails. The50o point angle prevents the drill point from moving orwalking off center. Calibrations have been added to thedrill shank to determine correct screw length, when usedwith the specially designed Depth Gauge (#472080).Position the twist drill point as viewed on image inten-sification at the level you want the screw tip to rest.Slide the depth gauge along the side of the twist drilluntil it contacts the bone for a direct measurement ofthe screw length from the back of the gauge [Figure 40].This calibrated twist drill and gauge combination willsave time by eliminating the need for using a probetype depth gauge. A 4.3mm diameter drill bit is usedwith 10mm and 11mm nails and a 5mm diameter drillbit is used with 12mm and larger nails.

Postoperative CarePatients are started on gentle range-of-motion exercisesof the knee and hip, and as tolerated, non-weightbearing ambulation on crutches is begun. Obviouslimitations to this occur with extremely comminutedfractures or with multi-injured patients who are notcapable of ambulation.

Generally, patients are discharged from 5 to 7 dayspostoperatively depending on associated injuries, andare non-weight bearing for a minimum of 6 to 8 weeks.

Nail RemovalRemove proximal screws and end cap with 5mm T-wrench.Removal of distal screws require a 3.5mm T-wrench for10mm and 11mm nails, and a 5mm T-wrench for 12mmand larger nails. Use universal socket wrench to threadnail extractor adaptor into end of nail. Extractor adaptorencapsulates nail end preventing splaying. Thread nailextractor with slide hammer into extractor adaptor andremove nail [Figure 41].

If end cap was not used or threads are damaged, usehook adaptor. Catch hook in the most proximal screwhole or side with positive slope. Attach nail extractorto slide hammer and remove nail [Figure 42].

Figure 42

Figure 40

Figure 41

Depth Gauge

Calibrated Crowe Point Drill

Uniflex is a registered trademark of Biomet, Inc. Warsaw, Indiana.

15

Titanium Low Profile End Cap

345211

Nailing System Ordering Information

NOTE: When implanting a 10mm to 13mm Uniflex Femoral nail, it is extremely important to reamthe entry portal to 14mm in diameter to a depth of approximately 3" (8cm) below the entry portal.

LengthPart Number

10mm 11mm 12mm 13mm 14mm 15mm 16mmDiameter Diameter Diameter Diameter Diameter Diameter Diameter

32cm 341232 341332 341432 341532 341632 341732 34183234cm 341234 341334 341434 341534 341634 341734 34183436cm 341236 341336 341436 341536 341636 341736 34183638cm 341238 341338 341438 341538 341638 341738 34183840cm 341240 341340 341440 341540 341640 341740 34184042cm 341242 341342 341442 341542 341642 341742 34184244cm 341244 341344 341444 341544 341644 341744 34184446cm 341246 341346 341446 341546 341646 341746 34184648cm 341248 341348 341448 341548 341648 341748 341848

Uniflex ® Titanium Nail Right Interlocking / Left Reconstructive

Primary Femoral Set

Primary Femoral Set

5mm diameter screws are usedonly for the distal holes in the10mm and 11mm diameter nails.

LengthPart Number

10mm 11mm 12mm 13mm 14mm 15mm 16mmDiameter Diameter Diameter Diameter Diameter Diameter Diameter

32cm 342732 342832 342932 343032 343132 343232 34333234cm 342734 342834 342934 343034 343134 343234 34333436cm 342736 342836 342936 343036 343136 343236 34333638cm 342738 342838 342938 343038 343138 343238 34333840cm 342740 342840 342940 343040 343140 343240 34334042cm 342742 342842 342942 343042 343142 343242 34334244cm 342744 342844 342944 343044 343144 343244 34334446cm 342746 342846 342946 343046 343146 343246 34334648cm 342748 342848 342948 343048 343148 343248 343348

Uniflex ® Titanium Nail Left Interlocking / Right Reconstructive

5mm diameter screws are usedonly for the distal holes in the10mm and 11mm diameter nails.

Ti-Screw Buttress Thread5mm * 6mm

Diameter/ Diameter/ Fully Fully

Threaded ThreadedPart Number Part Number Length

33-345420 – 25mm33-345422 33-345520 30mm33-345424 33-345522 35mm33-345426 33-345524 40mm33-345428 33-345526 45mm33-345430 33-345528 50mm33-345432 33-345530 55mm33-345434 33-345532 60mm33-345436 33-345534 65mm33-345438 33-345536 70mm

– 33-345538 75mm– 33-345540 80mm– 33-345542 85mm– 33-345544 90mm– 33-345546 95mm– 33-345548 100mm

Titanium Fixation Screws6.3mm Diameter / Partially-Threaded

Reconstructive OnlyPart Number Length

345620 70mm345622 75mm345624 80mm345626 85mm345628 90mm345630 95mm345632 100mm345634 105mm345636 110mm345638 115mm345640 120mm

Grooves in titanium screwheads distinguish them fromstainless steel screws.

*5mm diameter screws are used only for the distalholes in the 10mm and 11mm diameter nails.

Screws are packaged one each, sterile.

T-Handle Reamer 468138 9mm

Calibrated Crowe Point Twist Drill472068 4.3mm (Sterile)472074 5.0mm (Sterile)

Depth Gauge for Crowe Point Twist Drill472080

Modular Flexible Reamer System(Requires 3.2mm Ball Tip Guide)469060 98cm

Shaft Only467716 40cm467718 52cm

Modular Reamer Sterilization Case593243

467734 8.0mm467736 8.5mm467738 9.0mm467740 9.5mm467742 10.0mm467744 10.5mm467746 11.0mm467748 11.5mm467750 12.0mm467752 12.5mm467754 13.0mm467756 13.5mm467758 14.0mm467760 14.5mm467762 15.0mm467764 15.5mm467766 16.0mm467768 16.5mm467770 17.0mm467772 17.5mm467774 18.0mm467776 18.5mm467778 19.0mm467780 19.5mm467782 20.0mm

467634467636 467638467640467642467644467646467648467650467652467654467656467658467660467662 467664 467666 467668 467670 467672467674467676467678 467680 467682

Standard Ti-Nitrided

Head Only

16

UNIFLEX®

Driver w/Handle 471720 Patent # 4,911,153

Driver Bolt471722

Driver Bushing471723

Offset Driver471730

Plain Bar471731

Universal Hex Socket Wrench 471756 19mm (3⁄4")

Titanium End Wrench 471758 19mm (3⁄4")

Hex Drive T-Wrench 471760 5mm x 280mm

Hex Drive Power Bit 471761 5mm

Nail Extractor w/Slide Hammer471764

Nail Extractor Adaptor471768

Nail Extractor Hook w/Adaptor471770

Medullary Alignment Tubew/Ring (8mm)469388 Pkg./6 (Sterile)

Medullary Alignment Tube w/o Ring (8mm)469392 Pkg./6 (Sterile)

Screw Depth Gauge34-513644

Instrument Case 1592024

Instrument Case 2592025

Radiolucent Distal Targeting 471830 Device 471843 4.3mm Drill Bit471851 5.0mm Drill Bit

Distal Targeting Awl 471794 4.3mm471795 5.0mm

HIGH CLEARANCE ONLY:

High Clearance Driverw/Handle471710

High Clearance Driver Bolt471712

High Clearance Offset Driver 471714

High Clearance Proximal Target471716

INTERLOCKING ONLY:

Interlocking Guide Tube A471732

Interlocking Trocar for Guide Tube A471733

Interlocking Drill Bushing A5mm471734

Interlocking Calibrated Drill 471736 5mm x 254mm(Sterile)

RECONSTRUCTIVE ONLY:

Reconstructive Guide Pin 3.2mm x 305mm27-361681 Pkg./6 (Non-Sterile)25-361681 Pkg./5 (Sterile)

Reconstructive ProximalTarget471740

Reconstructive Guide Tube B471742 (2 Ea. Req’d)

Reconstructive Trocar forGuide Tube B471743

Reconstructive Drill Bushing B 471744 6.2mm (2 Ea. Req’d)

Reconstructive GuideBushing B 471746 3.2mm (2 Ea. Req’d)

Reconstructive Calibrated Step Drill471748 6.2mm x 330mm

(Sterile)

FOR 10MM AND 11MMNAILS (DISTAL HOLESONLY):

Twist Drill472255 4.3mm x 180mm

(Sterile)

Hex Drive T-Wrench 457118 3.5mm

SUGGESTED ADDITIONALINSTRUMENTATION

Nail Driving Guide 467220 4.4mm x 80cm

Telescoping Nail MeasuringGauge469380

Reduction Lever469385

Universal Guide Pin Handgrip469675469685 Collet only

Skin Protector476920

X-Ray Scale475920

Diamond Point Awl – RevHandle470342

Instrumentation

4717

20 4717

2347

1722

4717

40

4717

30

4717

31

4717

56

4717

58

4717

60 –

5.0

mm

4

5711

8 –

3.5m

m

4717

61 –

5.0

mm

4717

7047

1768

4717

10

4717

14

34-5

1364

4

4703

42

4717

48

4717

36 4722

55

4681

38

4717

64

4672

20

4717

12

4717

16

4717

42

4717

43

4717

44

4717

46

27-3

6168

1

4717

34

4717

33

4717

32

4717

94 –

4.3

mm

4717

95 –

5.0

mm

P.O. Box 587, Warsaw, IN 46581-0587 • 219.267.6639 • ©2000 Biomet, Inc. All Rights Reservedweb site: http://www.biomet.com • eMail: biomet@biomet.com

Form No. Y-BMT-492R/022900/K