HPS STG
HPS STG
HPS STG
Table of Contents
hand plating system
System Overview
• 1.2mm Module ........................................................................................................ 2
• Instruments ................................................................................................................. 14
Surgical Technique
• Plating - General ................................................................................................... 18
Plates
333-1204 1.2mm L Plate, Left 333-1209 1.2mm Offset Grid Plate, Right
Screws
page 2
1.2mm
Module
Instruments
page
pg 3
1.6mm
Module
Plates
333-1601 1.6mm 6 Hole Straight Plate, Locking 333-1607 1.6mm 4 x 8 T Plate, Locking
333-1602 1.6mm 12 Hole Straight Plate, Locking 333-1608 1.6mm Offset Grid Plate, Left, Locking
333-1603 1.6mm Y Plate, Locking 333-1609 1.6mm Offset Grid Plate, Right, Locking
333-1604 1.6mm L Plate, Left, Locking 333-1611 1.6mm Condylar Plate, Left, Locking
333-1605 1.6mm L Plate, Right, Locking 333-1612 1.6mm Condylar Plate, Right, Locking
333-1651 1.6mm 6 Hole Straight Plate, Locking, TiA* 333-1652 1.6mm Subcondylar Plate, Locking, TiA*
*Cannot be cut with HPS Plate Cutter
Screws
330-16xx 1.6mm x 6mm - 24mm Fully Threaded Screw, Angled Locking 308-16xx 1.6mm x 6mm - 24mm Lag Screw
page 4
1.6mm
Module
Instruments
page
pg 5
2.0mm
Module
Plates
333-2001 2.0mm 6 Hole Straight Plate, Locking 333-2010 2.0mm Subcondylar Plate, Locking
333-2003 2.0mm Y Plate, Locking 333-2012 2.0mm Condylar Plate, Right, Locking
333-2008 2.0mm Offset Grid Plate, Left, Locking 333-2051 2.0mm 6 Hole Straight Plate, Locking, TiA*
333-2009 2.0mm Offset Grid Plate, Right, Locking 333-2052 2.0mm Subcondylar Plate, Locking, TiA*
page 6
2.0mm
Module
Screws
330-20xx 2.0mm x 6mm - 36mm Fully Threaded Screw, 302-20xx 2.0mm x 6mm - 36mm Lag Screw
Angled Locking
Instruments
page
pg 7
2.4mm
Module
Plates
333-2401 2.4mm 6 Hole Straight Plate, Locking 333-2410 2.4mm Subcondylar Plate, Locking
333-2402 2.4mm 12 Hole Straight Plate, Locking 333-2411 2.4mm Condylar Plate, Left, Locking
333-2403 2.4mm Y Plate, Locking 333-2412 2.4mm Condylar Plate, Right, Locking
333-2405 2.4mm L Plate, Right, Locking 333-2420 2.4mm 4 Hole Straight LCDCP*
333-2408 2.4mm Offset Grid Plate, Left, Locking 333-2451 2.4mm 6 Hole Straight Plate, TiA*
333-2409 2.4mm Offset Grid Plate, Right, Locking 333-2452 2.4mm Subcondylar Plate, TiA*
page 8
2.4mm
Module
Screws
330-24xx 2.4mm x 6mm - 36mm Fully Threaded Screw, 306-24xx 2.4mm x 6mm - 36mm Lag Screw
Angled Locking
331-24xx 2.4mm x 6mm - 36mm Fully Threaded Screw 330-1818 1.8mm x 18mm Locking Buttress Pin
Instruments
page
pg 9
Cannulated
Module
K-Wire
Screws
319-20xx 2.0mm x 6mm - 36mm Cannulated Lag Screw 317-20xx 2.0mm x 10mm - 36mm Cannulated Headless Screw
319-24xx 2.4mm x 6mm - 36mm Cannulated Lag Screw 317-24xx 2.4mm x 10mm - 36mm Cannulated Headless Screw
page 10
Cannulated
Module
Instruments
334-20xx 2.0 x16 - 32mm Fusion Screw 334-24xx 2.4 x 20 - 36mm Fusion Screw
K-Wire
Patent Pending*
page 12
Hand Fusion
Module
Instruments
320-1040 Goniometer
320-1065 HPS™ Hand Fusion Screw & Plate Module
page 13
General Instrumentation Tray
page 14
General Instrumentation Tray
Plate Altering
Designed to easily alter plates to fit varying patient anatomy.
Plate Holding
intended to facilitate implantation by temporarily securing the plate to the bone
page 15
General Instrumentation Tray
Screw Insertion
Precise instrumentation for adequate fixation
page 16
Instrument Tips
• Plate Holding Taks in plate modules can be inserted into plate holes with a wire pin driver to
temporarily fixate plate.
• Plate Holding Forcep and On Bone Plate Holders are available to help stabilize plate.
• Screwdriver shafts are self retaining. Insert Screwdriver straight with force to engage head of
screw. To remove driver tip from screw, rock it slightly from side to side and lift.
• Use Driver Sleeve to protect soft tissue during screw insertion when necessary and to provide
stability while driving in longer screws.
• Countersinks are provided for use when placing a headed screw outside a plate. They are
recommended in cases of dense bone to create recess for head of screw.
• Proximal Cortex Drills are provided for use with Headless Cannulated Screws. They are
recommended to create a larger pilot hole for trailing end of screw.
• Cannulated Depth Gauge has two sides. “On Plate” side has a flat tip and is designed to hit
surface of plate. “On Bone” side is pointed to allow for accurate measurements at any position.
• Hand Fusion Depth Gauge is double sided and calibrated for 2.0mm or 2.4mm fusion screw holes.
• Hold plate securely with one hand and squeeze handles to cut plate.
• Inspect plate for burrs and remove using file located on top of instrument.
• If cutting pins or tines, use middle section of Universal Plate Cutter marked with black circle.
• K-wires .045” (1.2mm) or smaller can be cut using tip of Universal Plate Cutter.
surgical technique
Plating
General
Preparation
2
Select plate
Select appropriate plate size and configuration.
3
Cut plate
If necessary plates may be cut using universal plate
cutter, unless noted with * on pages 4-8.
4 Contour plate
Plates are precontoured to anatomically fit bone. If further
contouring is necessary, plate benders may be used.
NOTE: Bending plate multiple times may weaken
plate and could result in implant failure.
page 18
Plating
General
5 Position plate
Position plate over fracture or osteotomy. Use plate
holding TAKs™ for temporary fixation during procedure.
7 Drill
Select appropriate color coded drill guide and insert
into plate hole nearest fracture or osteotomy site.
Determine desired angle of screw placement. Ensure
that screws do not converge.
Drill a pilot hole using the appropriate pilot drill size.
Note: Use irrigation when drilling. Fluoroscopy is
recommended during drilling. In cases of soft bone
drilling with smaller drill (from module 1 size down) is
recommended.
1.6mm + 22°
2.0mm + 18°
2.4mm + 17°
page 19
Plating
General
8 Measure
Insert depth gauge until it passes through distal
cortex. Retract stem until lip catches against bone to
determine measurement.
Screw Insertion
Close
page 20
Plating
Dual Compression
Using Dual Compression Holes
1.6mm, 2.0mm and 2.4mm plates contain dual-compression holes, allowing for compression regardless
of plate orientation.
Anchor Screw
1
Select hole
Begin with compression holes closest to fracture line.
Compression hole
2
Position drill guide
Place drill guide eccentrically farthest from fracture.
3 Drill
4 Measure
5
Partially insert screw
Do not engage the plate with the screw head.
Compression Screw
6
Prepare Compression
Follow steps 1-4 for compression hole opposite fracture.
7
Fully insert screw
Fully insert screw until head sits in center of
compression hole.
Final Compression
9
Insert remaining screws following the general plating technique.
NOTE: 1mm of compression is available with each
compression hole. If only 1mm is needed, fully insert a
screw on one side of the fracture and follow compression
instructions for second screw (Steps 6-7).
page
pg 21
Plating
Cannulated Screw
Using Cannulated Lag Screws in a plate
If using a cannulated lag screw through a plate, it must be inserted first before any other screw. Only one cannulated
lag screw can be used per plate.
1 Insert K-wire
Insert .035” K-wire through center of desired hole,
perpendicular to fracture or place plate over kwire
already in place. 1.2mm drill guide for 1.0mm pilot drill
can be used as K-wire guide.
NOTE: Do not bend K-wire when inserting into bone.
2 Measure
Slide plate side of cannulated depth gauge over K-wire
until tip bottoms out on plate; end of K-wire
indicates screw length required. Subtract for any
anticipated interfragmentary compression resulting
from screw insertion.
3 Drill
HPS cannulated screws are self drilling and self tapping,
but drilling is recommended in cases of dense bone.
If drilling is desired or necessary, select 1.7mm
cannulated drill and use 2.0/2.4mm drill guide
located in the cannulated block to drill pilot hole.
4 Insert screw
Select diameter and length of screw needed. Verify
screw length with gauge on block. Insert cannulated
screw over K-wire through plate hole to fixate plate
onto bone and compress the fracture.
page 22
Plating
Subcondylar Plate
The Subcondylar Plate
The subcondylar plate is designed with a 12° bend in order to sit below the condyles. The 12° bend allows screws
to be placed at broader angles in order to fixate the fracture.
1 Place plate
Position the plate proximal to the condyle.
Positioning hole
Alternative Condylar Blade Plates are available in 1.6mm, 2.0mm and 2.4mm for indications in
which lateral condylar support and pins/tines are necessary. Instructions for implantation of condylar plates
are as follows:
Drill and measure depth, starting with pin/tine holes first. The 1.6mm and 2.0mm plates have tines
that insert into condyle of bone next to screw. The 2.4mm plates have an angled-locking pin. Cut
pin/tine to desired length using middle section of plate cutter marked by a dark circle.
page 23
Screw Fixation
Lag Screws
Compression with Lag Screws
Lag screws are provided for applications where compression across the fracture line by a screw is advantageous.
Overdrills are also provided to create a gliding hole in the proximal fragment to achieve a lag effect with a
fully threaded screw. To achieve compression, the screw must be placed perpendicular to the fracture line, and
threads must pass into the distal fragment.
1 Drill
Create pilot hole using the appropriate color coded drill
guide and the appropriate pilot drill.
2 Countersink
Countersink to create a recess for screw head.
NOTE: If using a lag screw through a plate, countersink
is not needed.
3 Measure
4 Insert screw
Select appropriate screw diameter and length. Verify
length with gauge on block. Insert screw into hole
perpendicular to fracture/osteotomy. Repeat steps 2 – 5
for additional screw placement.
page 24
Screw Fixation
Cannulated Screws
Cannulated Compression Screws - Headed and Headless
HPS has 2.0mm and 2.4mm headed cannulated and 2.0mm, 2.4mm and 3.0mm headless cannulated
compression screws. Headless screws provide between 1-2mm of compression. Tapered tri-lobe
driver stems allow headless screws to be inserted below the surface of the bone.
Screw Preparation
1 Insert K-wire
Insert the K-wire to the appropriate depth under
fluoroscopy. Do not bend the K-wire when placing it in
the bone.
2 Measure
Slide on bone side of cannulated depth gauge over
K-wire until tip bottoms out on bone; end of K-wire
will indicate screw length required. Subtract
appropriately for any anticipated interfragmentary
compression resulting from screw insertion.
3 Drill (optional)
HPS cannulated screws are self drilling and self
tapping, but drilling is recommended in cases of
dense bone. If drilling is desired or necessary,
select the appropriate cannulated drill and use the
cannulated drill guide located in the cannulated
block to drill a pilot hole.
NOTE: Use irrigation when pilot drilling.
page 25
Screw Fixation
Cannulated
Insert Screw
5 Insert screw
Select screw diameter and length. Verify screw length
with gauge on block. Place screw over K-wire and
use the screwdriver to drive cannulated screw into
bone until desired compression is achieved. Headless
screws will provide 1-2mm of compression.
Closure
page 26
Hand Fusion
Hand Fusion
Hand fusion allows for stable fixation of a joint at a natural resting angle between 20-55°. It combines the
locking plate stability from HPS with the compression provided by the headless screws.
Joint Preparation
1 Expose joint
Make incision on dorsal surface of
proximal bone of PIP joint.
page
pg 27
Hand Fusion
5
Place K-wire to determine plate
placement
From center of joint, drive Ø.045” x
4” K-wire into proximal bone through
dorsal cortex at desired angle.
page 28
Hand Fusion
Plate Placement
page
pg 29
Hand Fusion
11 Measure
Slide cannulated depth gauge over K-wire
until tip reaches plate; end of K-wire
will indicate screw length required.
12 Drill (optional)
If drilling is desired, slide drill guide over K-wire
into transfix hole. Drill hole using appropriate drill
size. Fusion screws are self-drilling and self-tapping
but drilling is recommended in dense bone.
page 30
Hand Fusion
Insert Fusion Screw
Close
WARNING: In patients with a large intramedullary canal, the diameter length of the Fusion screw provided
may not provide adequate compression of the MCP joint.
page
pg 31
OSTEOMED
3885 Arapaho Rd.
Addison, TX 75001
Customer Service: 800.456.7779
Outside the U.S.: 001.972.677.4600
Fax: 800.390.2620
Fax Outside the U.S.: 001.972.677.4709
E-mail: customer.service@osteomed.com
www.osteomed.com
p/n 030-1616 Rev.C