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    Tipsan - DHC Plate Surgical Guide

    Uploaded by

    eugenetbk
    The document provides information about condylar plates used to treat supracondylar and intercondylar fractures of the femur. It describes the plate details, screws, and surgical technique for implanting the condylar plate. Key steps in the technique include determining guide pin placement, reaming, tapping if needed, inserting the lag screw, placing the plate, and securing it with compression and cortex screws. The document also lists the available plate sizes and screw lengths and materials.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Tipsan - DHC Plate Surgical Guide

    Uploaded by

    eugenetbk
    270 views9 pages
    The document provides information about condylar plates used to treat supracondylar and intercondylar fractures of the femur. It describes the plate details, screws, and surgical technique for implanting the condylar plate. Key steps in the technique include determining guide pin placement, reaming, tapping if needed, inserting the lag screw, placing the plate, and securing it with compression and cortex screws. The document also lists the available plate sizes and screw lengths and materials.

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    Tipsan- DHC Plate Surgical Guide

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    The document provides information about condylar plates used to treat supracondylar and intercondylar fractures of the femur. It describes the plate details, screws, and surgical technique for implanting the condylar plate. Key steps in the technique include determining guide pin placement, reaming, tapping if needed, inserting the lag screw, placing the plate, and securing it with compression and cortex screws. The document also lists the available plate sizes and screw lengths and materials.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    270 views9 pages

    Tipsan - DHC Plate Surgical Guide

    Uploaded by

    eugenetbk
    The document provides information about condylar plates used to treat supracondylar and intercondylar fractures of the femur. It describes the plate details, screws, and surgical technique for implanting the condylar plate. Key steps in the technique include determining guide pin placement, reaming, tapping if needed, inserting the lag screw, placing the plate, and securing it with compression and cortex screws. The document also lists the available plate sizes and screw lengths and materials.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    P

    DCS
    L A T E

    The key in

    orthopaedic

    sciences

    SURGICAL TECHNIQUE
    IMPLANTS & INSTRUMENTS
    D C S
    P L A T E

    Introduction
    Condylar plate is indicated primarly for the fixation of supracondylar fractures and
    for intercondylar. T and Y fractures. There are certain occasion when a proximal femoral
    fractures may be treaded with the sliding condylar screw, such as a complex proximal
    spiral fracture.

    Please Note : This document is intended as a guide for the surgeon only. There are multiple
    techniques for the insertion of Modular Straight Stem (Cemented) and, as with any surgical
    procedure, a surgeon should be thoroughly trained and beware that this procedure is
    appropriate for the patient before proceeding.

    Plate details : Designed for maximum strenght from one piece, forged.
    Plate thickness : 6.5 mm
    Plate width : 16.0 mm
    Hole spacing : 16.0 mm
    Screws to be used : All holes accept diam. 4.5 mm cortical screws. End of
    holes also accept diam. 6.5 mm cancellous screws. All plates are slotted to accept a
    tension device.
    Material
    C e r t i f i e d Stainless Steel according to ASTM F.138 - ISO 5832/1.
    Ref. Number Length
    Stainless Steel Holes Lmm
    10403001001 2 44
    10403001002 3 60
    10403001003 4 76
    10403001004 5 92
    10403001005 6 108
    10403001006 7 124
    95º 10403001007 8 140
    10403001008 9 156
    10403001009 10 172
    10403001010 11 188
    10403001011 12 204
    10403001012 13 220
    10403001013 14 236

    SURGICAL TECHNIQUE
    IMPLANTS & INSTRUMENTS 2
    D C S
    P L A T E

    DHS/DCS Lag Screw


    To be used in case of intracapsular and
    intercervical fractures, and some types of
    interochanteric fractures. Cannulated
    to receive the guide wires with a slot to make
    rotation impossible. Partially threaded heavy
    duty lag screw for use with DHS and DCS
    plates. Buttress thread from provides
    enhanced pull-out resistance in cancellous
    bone. Opposing flats along shark engage
    with machined flats within plate barrel to
    prevent rotation. Tappered tip permits
    easier insertion. Thread diameter 12.5 mm,
    thread length 22 mm.
    DHS/DCS Compression Screw
    Provides mechanical compression at
    the fracture site when used in conjuction with
    DHS and DCS compression lag screws. It is
    socket head screws.
    Material
    C e r t i f i e d Stainless Steel according to ASTM F.138 - ISO 5832/1.

    DHS/DCS Lag Screw DHS/DCS Compression Screw


    Ref. Number Ref. Number Length Ref. Number Ref. Number Length
    Stainless Steel Titanium Lmm Stainless Steel Titanium Lmm

    10801141001 10801142001 50 10808051001 10808052001 31


    10401141002 10401142002 55
    10401141003 10401142003 60
    10401141004 10401142004 65
    10401141005 10401142005 70
    10401141006 10401142006 75
    10401141007 10401142007 80
    10401141008 10401142008 85
    10401141009 10401142009 90
    10401141010 10401142010 95
    10401141011 10401142011 100
    10401141012 10401142012 105
    10401141013 10401142013 110
    10401141014 10401142014 115
    10401141015 10401142015 120
    10401141016 10401142016 125
    10401141017 10401142017 130

    SURGICAL TECHNIQUE
    3 IMPLANTS & INSTRUMENTS
    D C S
    P L A T E

    Reduce the fracture. The fracture can


    be temporarily stabilized with Guide Pins
    (Ref:10807091102) or Steinmann pins. Place
    these pins so they do not interfere with
    subsequent positioning of the DCS implant
    assembly. (See illustrations accompanying
    step 3 for proper implant positioning.) In
    intercondylar fractures, the pins should be
    replaced with independent 6.5 mm
    Cancellous Bone Screws with washers.

    To determine direction of the central


    guide pin, flex the knee to 90°, and mark the
    axis of the knee joint by placing a K-wire
    (Ref:10807031301) distally over the condyles
    (A). Place a second K-wire anteriorly over the
    condyles (B).

    Note: Placement of the Guide Pin determines


    placement of the DCS implant assembly.
    Misplacement of the guide pin can result in
    varus/valgus or rotational malalignment of
    the fracture fragments.

    Using the DCS Drill Guide, insert the


    central guide pin (C) parallel to the distal K-
    wire (A) in the A-P view, and parallel to the
    anterior K-wire (B) in the axial view. Do not
    insert the guide pin too far medially; consider
    the inclination of the medial wall of the distal
    femur. In the sagittal plane, the central guide
    pin enters the distal femur at a point anterior
    to the midline between the condyles, and in
    line with the shaft axis, approximately 2 cm
    from the knee joint. Confirm placement of
    the central guide pin under image
    intensification. If it is not parallel to the knee
    joint axis, insert a new Guide Pin.
    Slide the Direct Measuring Device
    (Ref:10608061002) over the guide pin, and
    determine guide pin insertion depth.
    Calibration on the measuring device provides
    a direct reading.

    SURGICAL TECHNIQUE
    IMPLANTS & INSTRUMENTS 4
    D C S
    P L A T E

    To calculate reaming depth, tapping depth


    and lag screw length, subtract 10 mm from the
    reading. For example:

    a. Direct reading . . . . . . . . . .80 mm


    b. Reamer setting . . . . . . . . .70 mm
    c. Tapping depth (optional) . . 70 mm
    Lag screw length . . . . . . . . . . . . . . . . 70 mm*

    *If the Compression Screw will be used, allow


    for additional compression of the fracture by
    selecting a lag screw 5 mm shorter (in this case,
    65 mm) and inserting it an additional 5 mm.
    Assemble the DCS Triple Reamer
    (Ref:10610051001). Set the reamer to the correct
    depth. Insert the DCS Triple Reamer into the
    Power Drive using the Large Quick Coupling
    attachment. Slide the reamer over the guide
    pin to simultaneously drill for the lag screw, ream
    for the plate barrel, and countersink for the
    plate/barrel junction to the preset depth. When
    reaming in dense bone, continuously irrigate
    the DCS Triple Reamer to prevent thermal
    necrosis.

    If necessary, use the Tap Assembly to tap


    to the predetermined depth, which can be
    seen through the window in the Guide Sleeve
    Short (Ref:10606125011-10606121001-
    10604071001).

    Select the correct length DHS/DCS Lag


    Screw and assemble the Lag Screw Insertion
    Assembly (Ref:10601071004-10601071003-
    10601071001). Slide the assembly over the guide
    pin and into the reamed hole. Seat the Guide
    Sleeve Long in the hole to center and stabilize
    the assembly.

    Note: Keep continuous forward pressure on the


    DHS/DCS Wrench while advancing the lag
    screw.

    SURGICAL TECHNIQUE
    5 IMPLANTS & INSTRUMENTS
    D C S
    P L A T E

    Insert the lag screw by turning the handle


    clockwise until the 0 mark on the assembly
    aligns with the lateral cortex. The threaded tip
    of the lag screw now lies 10 mm from the medial
    cortex. The lag screw may be inserted an
    additional 5 mm in porotic bone, for increased
    holding power.

    Note: If a lag screw 5 mm shorter than reaming


    and tapping depth is used (in this case, 65 mm),
    insert it an additional 5 mm, until the 5 mark on
    the assembly aligns with the lateral cortex.

    Before removing the assembly, align the


    handle so it is parallel with the femoral shaft
    axis when viewed laterally. This allows proper
    placement of the DCS Plate onto the lag screw.

    Remove the DHS/DCS Wrench and


    Guide Sleeve Long. Slide the appropriate DCS
    Plate onto the guide shaft/lag screw assembly.
    Loosen and remove the Coupling Screw and
    Guide Shaft.

    Gently seat the plate with the Impactor


    (Ref:10607081001).

    SURGICAL TECHNIQUE
    IMPLANTS & INSTRUMENTS 6
    D C S
    P L A T E

    If the joint fragments were not previously


    reduced with independent 6.5 mm Cancellous
    Bone Screws, the DHS/DCS Compressing Screw
    may be inserted into the lag screw. In porotic
    bone, insert the screw very carefully to avoid
    stripping the lag screw thread.

    Further interfragmentary compression


    can be achieved by using two 6.5 mm
    Cancellous Bone Screws through the distal
    round holes of the DCS Plate.

    Fix the DCS Plate to the femur with 4.5 mm


    Cortex Screws.

    SURGICAL TECHNIQUE
    7 IMPLANTS & INSTRUMENTS
    D C S
    P L A T E

    Instruments

    10601071001 Wrench Screw for DHS & DCS Plate

    10601071002 Coupling Screw for DHS & DCS Plate

    10601071003 Guide Shaft for DHS & DCS Plate

    10601075011 Guide Sleeve Long for DHS & DCS Plate

    10601071004 Coupling Screw

    10604071001 T-Handle with Chuck

    10606121001 Tap for DHS & DCS Plate

    10606125011 Guide Sleeve Short for DHS & DCS Plate

    10607081001 Impactor for DHS & DCS Plate

    10608061001 Drill Guide for DHS

    10608061002 Measuring Device for DHS & DCS Plate

    10608061095 Angled Guide for DCS 95 °

    10608061135 Angled Guide for DHS 135 °

    10610051001 DCS Triple Reamer

    10610051002 DHS Triple Reamer

    10807031201 Trocar Kirschner Wire


    for DHS & DCS Plate and Canullated Screw
    10807091102 Calibrated Threaded Kirschner Wire

    SURGICAL TECHNIQUE 8
    IMPLANTS & INSTRUMENTS
    Revision 00 / Printed in TURKEY - 05/09 - TIPSAN Design

    The products being manufactured by TIPSAN A.S. has been certified from TÜV PRODUCT SERVICE
    GMBH for EC certificate (CE 0123) according to Annex II. 3 of Council Directive 93/42/EEC
    concerning medical devices

    Kemalpasa Cd. 404/1 Sk. No: 3 Pinarbasi - IZMIR - TURKEY


    Tel: +90 232 479 56 54 Fax: +90 232 479 58 27
    marketing@tipsan.com.tr www.tipsan.com.tr

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