Zimmer® Periarticular Elbow Locking Plate System Surgical ... · Instrument and Implant Case Screw Caddy 36 Zimmer Periarticular Elbow Locking Plate System Surgical Technique. 2

The Right Solutions for Fractures Around the Elbow

Zimmer® Periarticular

Elbow Locking Plate System

Surgical Technique

DisclaimerThis document is intended exclusively for physicians and is not intended for laypersons.

Information on the products and procedures contained in this document is of a general nature and does not represent and does not constitute medical advice or recommendations. Because this information does not purport to constitute any diagnostic or therapeutic statement with regard to any individual medical case, each patient must be examined and advised individually, and this document does not replace the need for such examination and/or advice in whole or in part.

Information contained in this document was gathered and compiled by medical experts and qualified Zimmer personnel. The information contained herein is accurate to the best knowledge of Zimmer and of those experts and personnel involved in its compilation. However, Zimmer does not assume any liability for the accuracy, completeness or quality of the information in this document, and Zimmer is not liable for any losses, tangible or intangible, that may be caused by the use of this information.

1Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique

Table of Contents

Introduction, Indications, Contraindications 2Bone Void Fillers 2Required Instrumentation 3Preoperative Preparation and Surgical Approach 3Section 1: Distal Humerus – Two Plate Technique 90 Degree Plate Placement 4

Determine Posterolateral Plate Length 4

Fracture Reduction and Temporary Fixation 4Assemble Jig to Posterolateral Plate 5

Position Posterolateral Plate 6

Screw Trajectories and Lengths 7

Insert Distal Screws 8

Assemble Jig to Medial Plate 8

Position Medial Plate 9


Fix Shaft of Posterolateral Plate 10

Fix Shaft of Medial Plate 10

Section 2: Distal Humerus – Two Plate Technique 180 Degree Plate Placement 11

Determine Plate Length 11

Assemble Jig to Plate 12

Screw Trajectories and Lengths 13

Position Plate 12


Assemble Jig to Medial Plate 15

Position Medial Plate 16

Section 3: Olecranon Plate Technique 17Surgical Approach 17

Fracture Reduction 17

Determine Plate Length 17

Assemble Jig to the Olecranon Plate 18

Position the Olecranon Plate 19

Insert Proximal Screws 20

Insert Shaft Screws 20

Wound Closure 20

Postoperative Treatment 20

Implant Removal 20

Zimmer Periarticular Elbow Locking Plates – Information 21Plates for Distal Humerus – Two Plates Technique 90° Plate Placement 21

Plates for Distal Humerus – Two Plates Technique 180° Plate Placement 22

Plates for Proximal Ulna 23

Periarticular Elbow Locking Plates System 24Kit and Item Information 24

Graphic Cases 31General Instrument Case 31

Instrument and Implant Case –Tray 1 32



Instrument and Implant Case Base 35

Instrument and Implant Case Screw Caddy 36

Zimmer Periarticular Elbow Locking Plate System Surgical Technique

2 Zimmer® Periarticular Elbow Locking Plate System – Surgical Technique

Introduction

The Zimmer Periarticular Locking Plate System combines locking screw tech-nology with periarticular plates to cre-ate fixed-angle constructs for use in multifragmentary fractures or where de-ficient bone stock or poor bone quality is encountered. The fixed-angle plate/screw device can be used in osteopenic bone and other areas where traditional screw fixation may be compromised.

The Periarticular Locking Plates will ac-commodate standard screws, as well as locking screws with threaded heads that allow the screw to be locked into position to facilitate proper plate/screw placement. When necessary, interfrag-mentary compression can be achieved with lag screws.

The plates contain locking screw holes in the plate head and Universal Locking System (ULS) holes in the shaft. The ULS holes are figure-8 shaped and will accommodate standard or locking screws on either side of the hole.

The ULS holes enable the surgeon to:

• Treatfracturesusingcompressionplating techniques with standard cortical or cancellous screws

• Applytheimplantasaninternalfixator to bridge highly comminuted zones while providing stable fixation

• Utilizebothstandardandlockingscrews in the same construct

• Applybi-directionalaxialcompres-sion within the construct

• Utilizeunicorticallockingfixationasnecessary

CopiOs® Bone Void Filler*

• Osteoconductive/CarrierTechnologyprovides a 3-D collagen scaffold that resembles human cancellous bone for guided bone formation.

• Uniquemineralchemistryofdiba-sic calcium phosphate provides an abundance of localized minerals to promote bone healing.

• AvailableinbothSpongeandPasteformations.

Indications

The Periarticular Locking Plate System is indicated for temporary internal fixa-tion and stabilization of osteotomies and fractures, including:

• Comminutedfractures

• Supracondylarfractures

• Intra-articularandextra-articularcon-dylar fractures

• Fracturesinosteopenicbone

• Nonunions

• Malunions

Bone Void Fillers

Autograft,allograft,orsyntheticbonevoid fillers are indicated for use in bony voids or gaps created surgically or through traumatic injury, that are not intrinsic to the stability of the bone struc-ture.

Contraindications

Contraindicationsinclude:

•Infection

•Sternalorspinalfracturesordefects

* CopiOs®isaregisteredtrademarkofZimmer,Inc.oritsaffiliates. Manufacturer:KenseyNashCorporation.Distributor:Zimmer,Inc.


Required Instrumentation

The following sets may be required for application of the Periarticular Elbow Locking Plates:

– Zimmer Periarticular Elbow Locking ImplantandInstrumentSet

– Zimmer Periarticular Elbow Locking GeneralInstrumentSet

Additional Instrumentation

The following sets may also be useful:

– Herbert™ Bone Screws, 3.0mm diam-eter

– Herbert/Whipple®CannulatedBoneScrews

– HerbertMiniBoneScrews

Preoperative Preparation

Afterassessingthefractureradiograph-ically and preparing a preoperative plan, consider the patient’s positioning as supine, lateral and prone positions are all possible. The lateral decubitus position is the most versatile. Resting the arm on a padded bar will allow up to 120° of elbow flexion.

Be sure that the fluoroscope can be po-sitioned to visualize the distal humerus and/or proximal ulna in both the lateral andanterior/posterior(A/P)viewstoensure adequate reduction of the joint surface, overall alignment of the limb and positioning of the implants.

Surgical Approaches

PosteriorApproach,TricepsSparingorSplittingorPosteriorApproach,OlecranonOsteotomy

Armholder

Bag

Bag


Fracture Reduction and Temporary Fixation

It is imperative that accurate reduction of the fracture be obtained prior to and maintained during application of the distal humeral and proximal ulnar lock-ing plates.

Reduce the intra-articular fragments usinglinearboneclampsorKirschnerwires to temporarily hold the reduction. Use lag screws to secure the intra-ar-ticular fragments as necessary. To help avoid inserting the lag screws where they will interfere with the plate place-ment, hold the plate(s) on the bone(s) in its approximate position. Then insert the lag screws as needed.

Extra-articular reduction may be accom-plished by indirect means (e.g. external fixator, traction, joysticks, bumps, etc.).

Section 1:

Distal Humerus – Two Plate Technique 90 Degree Plate Placement

Determine Plate Length Chooseplatelengthsthatoffersuf-ficient fixation proximal to the fracture(s).

Ifdesired,plateprovisionalsmaybeused to determine the appropriate platelength.DoNOTbendthepro-visionalduringuse.Itisintendedto be used as a template only, and ben-ding it may cause the provisional to break.

Note: To avoid unnecessary stress on the diaphysis of the bone, use medial and posterolateral plates of different lengths.

Distal Posteriolateral

Humeral Locking Plate

Distal Posteriolateral

Humeral Plate Jig

DistalMedialHumeralPlate Jig

DistalMedialHumeral

Locking Plate

DistalMedialHumeral Plate Jig(Short)

DistalMedialHumeral

Locking Plate(Short)


Assemble the Jig to the Posterolateral Plate Hold the Jig on the plate in the appro-priate location – a feature on the Jig will fit into the first ULS hole in the plate shaft. The Jig is designed to allow the surgeon to thread the cannulas into the plate at the appropriate angles to ensure proper engagement of the cannula with the plate and help prevent cross threading of the cannulas in the plate holes. The Cannula Inserter may used to ensure that the cannulas are fully seated in the plate hole. Once a cannula is threaded into the plate hole through the Jig, a Blue Stop Ring may be used to hold the Jig in place.


Position the Posterolateral Plate Place the plate on the bone in the proper position.

Use anatomic landmarks and fluoros-copic images as guides. Because the hu-meral shaft may not be aligned with the distal fragment, the plate head should be used to determine the appropriate placement of the plate. The plate head should conform to the shape of the distal humerus. This will deter -mine the align-ment of the shaft.

Inserta3.5mmCorticalScrewwith2.7mmHead,a2.7mmConicalScrewora2.7mmCorticalScrewintheSECOND slot using the appropriate ULS Green/Gold Drill Guide and Drill Bit.

DoNOTfullytightenthescrew.Thiswillallow for some adjustment of the plate position prior to final fixation.

Note: A screwdriver shaft can be used to loosely insert the screw under pow-er but final seating MUST be accom-plished by hand to avoid cross-thread-ing of the screws in the plate or failure of the screw or driver.

Tapping is not typically necessary as the flutes of the screws are self-tap-ping.Iftheboneisdense,thelateralcortex can be tapped.

GOLDcoloredDrillGuide–2.7mmScrews

SILVERcolorDrillGuide–3.5mmScrews w/2.7mm Head


Screw Trajectories and Lengths

Standard Medial Plate

Use of the Homerun Screw in hole #2 pre-vents insertion of a screw in hole #7

12

3

4

5

6

7

8

9

Ascrewplacedinhole#1mustbeapproximately10mm in length to avoid interference with screws placed in holes #3 and #4

Hole #9 is the Second Slot

I

H

G

F

E

D

C

BA

Use of the Homerun Screw in hole B prevents insertion of3.5mmscrewsinholesDandE.Itmaybepossibletouse 2.7mm screws in holes C,D,andE.

HoleIistheSecond Slot

Posterior Plate


Insert the Distal Screws Thread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrew with 2.7mm Head, 2.7mm Locking Screw,3.5mmCorticalScrewwith2.7mmhead,2.7mmConicalScrew,2.7mmCorticalScrewor4.0mmCancellousScrew. Use the appropriate depth gauge to measure screw length.

Note: A Screw/Cannula/Drill Bit Chart is provided on the lid of the screw caddy for reference.

Insertthescrewsusingthe2.5mmHexScrewdriver or Screwdriver Shaft.

Screw length measurement: MetaphysealScrews–thelengthmea-surement for screws in the metaphyseal region of the plate is measured line-to-line – from the base of the screw head to the tip of the screw. Placement of the tip of the Guide Wire will determine place-ment of the tip of the screw.

Diaphyseal Screws – the length measure-ment for screws in the diaphyseal region of the plate is also measured line-to-line – from the base of the screw head to the tipofthescrew.Inordertoachievefullcortical purchase with these screws, it is recommended that 2mm be added to the screw length measurement to allow for the self-tapping flutes to penetrate the far cortex.

Note: If lag screw reduction is necessary for any fragment, the lag screw must be inserted before inserting locking screws into that fragment.

CheckthealignmentoftheshaftwithA/Pandlateralfluoroscopicviews.

Note: In comminuted fractures, it may not always be possible or desirable to achieve anatomic reduction of the frac-ture.

Note: In the distal portion of the plates, pay close attention during drilling and screw insertion. Confirm screw place-ment and length using image intensifi-cation to ensure screws do not enter the joint.

Assemble the Jig to the Medial Plate Hold the Jig on the plate in the appropri-ate location – a feature on the Jig will fit into the first ULS hole in the plate shaft. The Jig is designed to allow you to thread the cannulas into the plate at the appro-priate angles to ensure proper engage-ment of the cannula with the plate and help prevent cross threading of the can-nulas in the plate holes. Once a cannula is threaded into the plate hole through the Jig, a Blue Stop Ring may be used to hold the Jig in place.


Position the Medial Plate Place the plate on the bone in the proper position.

Use anatomic landmarks and fluoroscop-ic images as guides. Because the hu-meral shaft may not be aligned with the distal fragment, the plate head should be used to determine the appropriate placement of the plate. The plate head should conform to the shape of the distal humerus. This will determine the align-ment of the shaft.


Note: This portion of the SHORT Distal Medial Humeral Locking Plate should ALWAYS point TOWARD the Olecranon Fossa

Note: This portion of the STANDARD Distal Medial Humeral Locking Plate should ALWAYS point TOWARD the Olecranon Fossa



SILVERcolorDrillGuide–3.5mmScrews w/2.7mm Head


NOTE: A screwdriver shaft can be used to loosely insert the screw under pow-er but final seating MUST be accom-plished by hand to avoid cross-thread-ing of the screws in the plate or failure of the screw or driver.

Tapping is not typically necessary as the flutes of the screws are self-tap-ping.Iftheboneisdense,thelateralcortex can be tapped.

Insert the Distal Screws Thread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrew with 2.7mm Head, 2.7mm LockingScrew,3.5mmCorticalScrewwith2.7mmHead,2.7mmConicalScrew,2.7mmCorticalScrewor4.0mmCancellousScrew.

Drill carefully as interference with screws in the posterolateral plate is possible. In case of interference, stop drilling and use a screw of appropriate length.

Use the appropriate depth gauge to measure screw length.


Screw length measurement: MetaphysealScrews–thelengthmea-surement for screws in the metaphyseal region of the plate is measured line-to-line – from the base of the screw head to the tip of the screw. Placement of the tip of the Guide Wire will determine placement of the tip of the screw.

Diaphyseal Screws – the length mea-surement for screws in the diaphyseal region of the plate is also measured line-to-line – from the base of the screw headtothetipofthescrew.Inorderto achieve full cortical purchase with these screws, it is recommended that 2mm be added to the screw length measurement to allow for the self-tap-ping flutes to penetrate the far cortex.

Note: If lag screw reduction is neces-sary for any fragment, the lag screw must be inserted before inserting lock-ing screws into that fragment.


Note: In comminuted fractures, it may not always be possible or desirable to achieve anatomic reduction of the fracture.

Fix the Shaft of the Posterolateral Plate Determine where locking and/or cortical screws will be used in the shaft of the plate. Use the appropriate screws to fix the shaft of the plate to the bone.

Note: If lag screw reduction is neces-sary for any fragment, the lag screw must be inserted before inserting lock-ing screws into that fragment.

Fix the Shaft of the Medial Plate Determine where locking and/or corti-cal screws will be used in the shaft of the plate. Use the appropriate screws to fix the shaft of the plate to the bone.


Section 2:

Distal Humerus – Two Plate Technique 180 Degree Plate Placement

Determine Plate Length Chooseplatelengthsthatoffersufficientfixation proximal to the fracture(s).

Ifdesired,plateprovisionalsmaybeused to determine the appropriate plate length.DoNOTbendtheprovisionalduringuse.Itisintendedtobeused as a template only, and bending it may cause the provisional to break.

Note: To avoid unnecessary stress on the diaphysis of the bone, use medial and lateral plates of different lengths.

Distal Lateral

Humeral Locking Plate

Distal Lateral

Humeral Plate Jig

DistalMedialHumeralPlate Jig

DistalMedialHumeral Plate Jig(Short)

DistalMedialHumeral

Locking Plate

DistalMedialHumeral

Locking Plate(Short)


Assemble the Jig to the Lateral PlateHold the Jig on the plate in the appropri-atelocation–afeatureontheJigwillfitintothefirstULSholeorslotintheplateshaft. The Jig is designed to allow you to thread the cannulas into the plate at the appropriate angles to ensure proper engagement of the cannula with the plate and help prevent cross threading ofthecannulasintheplateholes.Oncea cannula is threaded into the plate hole through the Jig, a Blue Stop Ring may be used to hold the Jig in place.

Position the Lateral PlatePlace the plate on the bone in the proper position.

Use anatomic landmarks and fluoro-scopic images as guides. Because the humeral shaft may not be aligned with the distal fragment, the plate head should be used to determine the appro-priate placement of the plate. The plate head should conform to the shape of the distal humerus. This will determine the alignment of the shaft.



Standard Medial Plate

Use of the Homerun Screw in hole #2 pre-vents insertion of a screw in hole #7

12

3

4

5

6

7

8

9

Ascrewplacedinhole#1mustbeapproximately10mm in length to avoid interference with screws placed in holes #3 and #4


F

E

D

C

B

A

Distal Lateral Plate


SILVERcoloredDrillGuide–3.5mmScrews w/2.7mm Head

Screw Trajectories and Lengths

DoNOTfullytightenthescrew.Thiswillallow for some adjustment of the plate positionpriortofinalfixation.

NOTE: A screwdriver shaft can be used to loosely insert the screw under power but final seating MUST be accomplished by hand to avoid cross-threading of the screws in the plate or failure of the screw or driver.

Tapping is not typically necessary as the flutesofthescrewsareself-tapping.Ifthe bone is dense, the lateral cortex can be tapped.

F

E

D

C

B

A

G

H

12

3BA

12


Insert the Distal ScrewsThread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrew with 2.7mm Head, 2.7mm Locking Screw,2.7mmConicalScrew,2.7mmCorticalScrewor4.0mmCancellousScrew.



Screwlengthmeasurement:Metaphy-seal Screws – the length measurement for screws in the metaphyseal region of the plate is measured line-to-line – from the base of the screw head to the tip of the screw. Placement of the tip of the Guide Wire will determine placement of the tip of the screw.

Diaphyseal Screws – the length measure-ment for screws in the diaphyseal region of the plate is also measured line-to-line – from the base of the screw head to the tipofthescrew.Inordertoachievefullcortical purchase with these screws, it is recommended that 2mm be added to the screw length measurement to allow for the self-tapping flutes to penetrate the far cortex.

Note: If lag screw reduction is necessary for any fragment, the lag screw must be inserted before inserting locking screws into that fragment.


Note: In comminuted fractures, it may not always be possible or desirable to achieve anatomic reduction of the fracture.

Note: In the distal portion of the plates, pay close attention during drilling and screw insertion. Confirm screw place-ment and length using image intensifi-cation to ensure screws do not enter the joint.


Assemble the Jig to the Medial PlateHold the Jig on the plate in the appropri-ate location – a feature on the Jig will fitintothefirstULSholeintheplateshaft. The Jig is designed to allow you to thread the cannulas into the plate at the appropriate angles to ensure proper engagement of the cannula with the plate and help prevent cross threading of the cannulas in the plate holes. Once a cannula is threaded into the plate hole through the Jig, a Blue Stop Ring may be used to hold the Jig in place.


Note: This portion of the STANDARD Distal Medial Humeral Locking Plate should ALWAYS point TOWARD the Olecranon Fossa

Position the Medial PlatePlace the plate on the bone in the proper position.

Use anatomic landmarks and fluoro-scopic images as guides. Because the humeral shaft may not be aligned with the distal fragment, the plate head should be used to determine the appro-priate placement of the plate. The plate head should conform to the shape of the distal humerus. This will determine the alignment of the shaft.


DoNOTfullytightenthescrew.Thiswillallow for some adjustment of the plate positionpriortofinalfixation.

NOTE: A screwdriver shaft can be used to loosely insert the screw under power but final seating MUST be accomplished by hand to avoid cross-threading of the screws in the plate or failure of the screw or driver.

Tapping is not typically necessary as the flutesofthescrewsareself-tapping.Ifthe bone is dense, the lateral cortex can be tapped.

Note: This portion of the SHORT Distal Medial Humeral Locking Plate should ALWAYS point TOWARD the Olecranon Fossa

Insert the Distal ScrewsThread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrew with 2.7mm Head, 2.7mm Locking Screw,3.5mmCorticalScrewwith2.7mmHead,2.7mmConicalScrew,2.7mmCor-ticalScrewor4.0mmCancellousScrew.

Drill carefully as interference with screws in the lateral plate is possible. In case of interference, stop drilling and use a screw of appropriate length.




Section 3:

Olecranon Plate Technique

Surgical Approach The incision is made on the posterior side of the elbow, and it is typically slightly curved toward the radial side to protect the ulnar nerve. The incision extends from the supracondylar area to apoint4–5cmdistaltothefracture.

Ifnecessary,performanolecranonos-teotomy, using the chevron technique, when articular visualization is needed.

Fracture Reduction Use direct or indirect reduction tech-niques to restore the fracture fragments to their normal anatomic position. Take care to ensure that the coronoid is appro-priately reduced before fixation.

Determine Plate Length Chooseplatelengthsthatoffersufficientfixation proximal to the fracture(s).

Ifdesired,plateprovisionalsmaybeused to determine the appropriate plate length.DoNOTbendtheprovisionaldur-inguse.Itisintendedtobeusedasatemplate only, and bending it may cause the provisional to break.

Proximal UlnarLocking Plate

Proximal UlnarLocking Plate

Jig


Assemble the Jig to the Olecranon Plate Hold the Jig on the plate in the appropri-ate location – a feature on the Jig will fit into the first slot in the plate shaft. The Jig is designed to allow you to thread the cannulas into the plate at the appropri-ate angles to ensure proper engagement of the cannula with the plate and help prevent cross threading of the cannulas intheplateholes.Onceacannulaisthreaded into the plate hole through the Jig, a Blue Stop Ring may be used to hold the Jig in place.


Hole #2 is the Homerun Screw, and itisNON-LOCKING

12

3

4

5

6

7

8

9

10


1

2

3 4 5

Maxlengthforscrew#1 is 26mm

To use both screws 3 and 4, the screw shafts must be 2.7mm

1 2 Homerun

5

4

6


Position the Olecran Plate Place the plate on the bone in the proper position.

Use anatomic landmarks and fluoroscop-ic images as guides. Because the ulnar shaft may not be aligned with the proxi-mal fragment, the plate head should be used to determine the appropriate place-ment of the plate. The plate head should conform to the shape of the olecranon. This will determine the alignment of the shaft.

Inserta3.5mmCorticalScrewwith2.7mmHead,a2.7mmConicalScrewora2.7mmCorticalScrewintheSECOND Slot using the appropriate Double Drill Sleeve.


Insert the Proximal Screws Thread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrewwith2.7mmHead,3.5mmCorticalScrew with 2.7mm Head, 2.7mm Locking Screw,2.7mmConicalScrew,or2.7mmCorticalScrew.

Use the appropriate depth gauge to mea-sure screw length.


Insert the Shaft Screws Thread the appropriate cannulas into the plate and use the appropriate drill bit to drill and insert any of the follow-ingscrewsasneeded:3.5mmLockingScrew with 2.7mm Head, 2.7mm Locking Screw,3.5mmCorticalScrewwith2.7mmHead,2.7mmConicalScrew,or2.7mmCorticalScrew.

Use the appropriate depth gauge to mea-sure screw length.


BE SURE THAT ALL SCREWS ARE SECURELY TIGHTENED.

Make a final check of the limb align-ment and fracture reduction. Then make sure that ALL LOCKING SCREWS ARE SECURELY TIGHTENED by hand before closing.

Wound Closure Use the appropriate method for surgical closure of the incisions.

Postoperative treatment Postoperative treatment with locking plates does not differ from conventional openreductioninternalfixation(ORIF)procedures.

Implant Removal To remove locking screws, use the 2.5mmHexScrewdrivertofirstunlockallscrews from the plate and then remove the screws completely.

Please refer to the package insert for product information, including contraindications, warnings, and precau-tionary information.


DistalPosterolateralHumeralLockingPlate,Right,5Hole,98mm

Distal Posterolateral Humeral Locking Plate, Right, 7 Hole, 124mm

DistalPosterolateralHumeralLockingPlate,Right,9Hole,150mm

DistalPosterolateralHumeralLockingPlate,Left,5Hole,98mm

Distal Posterolateral Humeral Locking Plate, Left, 7 Hole, 124mm

DistalPosterolateralHumeralLockingPlate,Left,9Hole,150mm

DistalPosterolateralHumeralLockingPlate,Right,3Hole,72mm,STERILE




DistalPosterolateralHumeralLockingPlate,Left,3Hole,72mm,STERILE




DistalMedialHumeralLockingPlate,Right,3Hole,78mm



DistalMedialHumeralLockingPlate,Left,3Hole,78mm



DistalMedialHumeralLockingPlate,Right,11Hole,182mm,STERILE


DistalMedialHumeralLockingPlate,Left,11Hole,182mm,STERILE


DistalMedialHumeralLockingPlate,Short,Right,3Hole,74mm



DistalMedialHumeralLockingPlate,Short,Left,3Hole,74mm



DistalMedialHumeralLockingPlate,Short,Right,11Hole,178mm,STERILE


DistalMedialHumeralLockingPlate,Short,Left,11Hole,178mm,STERILE


Zimmer Periarticular Elbow Locking Plates – Information

Implants

Plates for Distal Humerus – Two Plate Technique 90° Plate Placement


Implants

Plates for Distal Humerus – Two Plate Technique 180° Plate Placement

DistalLateralHumeralLockingPlate,Right,5H,87mm

Distal Lateral Humeral Locking Plate, Right, 7H, 113mm

Distal Lateral Humeral Locking Plate, Right, 9H, 139mm

DistalLateralHumeralLockingPlate,Left,5H,87mm

Distal Lateral Humeral Locking Plate, Left, 7H, 113mm

Distal Lateral Humeral Locking Plate, Left, 9H, 139mm

DistalLateralHumeralLockingPlate,Right,5H,87mm,Sterile

Distal Lateral Humeral Locking Plate, Right, 7H, 113mm, Sterile

Distal Lateral Humeral Locking Plate, Right, 9H, 139mm, Sterile

DistalLateralHumeralLockingPlate,Left,5H,87mm,Sterile

Distal Lateral Humeral Locking Plate, Left, 7H, 113mm, Sterile

Distal Lateral Humeral Locking Plate, Left, 9H, 139mm, Sterile


























Implants

Plates for Proximal Ulna

Proximal Ulna Locking Plate, Right, 3 Hole, 77mm

ProximalUlnaLockingPlate,Right,5Hole,103mm

Proximal Ulna Locking Plate, Right, 7 Hole, 129mm

ProximalUlnaLockingPlate,Right,9Hole,155mm

Proximal Ulna Locking Plate, Left, 3 Hole, 77mm

ProximalUlnaLockingPlate,Left,5Hole,103mm

Proximal Ulna Locking Plate, Left, 7 Hole, 129mm

ProximalUlnaLockingPlate,Left,9Hole,155mm

ProximalUlnaLockingPlate,Right,11Hole,181mm,STERILE



ProximalUlnaLockingPlate,Left,11Hole,181mm,STERILE




ZS 02.00026.100 Elbow Locking Plate Set

ZS 02.00026.200 Elbow Locking Plate Set Sterile

ZS 02.00026.300 Elbow Locking Plate Screw Set

ZS 02.00026.400 Elbow Locking Plate Screw Set Sterile

KT-2360-000-06 ElbowLockingPlateGeneralInstrumentSet

KT-2360-000-07 ElbowLockingPlateInstrumentSet

ZS 02.00026.100 ZS 02.00026.200 Periarticular Elbow Locking Plate Set

00-2358-005-05 47-2358-005-05 DistalPosterolateralHumeralLockingPlate,Right,5Hole,98mm 1

00-2358-005-07 47-2358-005-07 Distal Posterolateral Humeral Locking Plate, Right, 7 Hole, 124mm 1

00-2358-005-09 47-2358-005-09 DistalPosterolateralHumeralLockingPlate,Right,9Hole,150mm 1

00-2358-006-05 47-2358-006-05 DistalPosterolateralHumeralLockingPlate,Left,5Hole,98mm 1

00-2358-006-07 47-2358-006-07 Distal Posterolateral Humeral Locking Plate, Left, 7 Hole, 124mm 1

00-2358-006-09 47-2358-006-09 DistalPosterolateralHumeralLockingPlate,Left,9Hole,150mm 1

00-2358-007-03 47-2358-007-03 DistalMedialHumeralLockingPlate,Right,3Hole,78mm 1



00-2358-008-03 47-2358-008-03 DistalMedialHumeralLockingPlate,Left,3Hole,78mm 1



00-2358-107-03 47-2358-107-03 DistalMedialHumeralLockingPlate,Short,Right,3Hole,74mm 1



00-2358-108-03 47-2358-108-03 DistalMedialHumeralLockingPlate,Short,Left,3Hole,74mm 1



00-2358-023-05 47-2358-023-05 DistalLateralHumeralLockingPlate,Right,5Hole,87mm 1

00-2358-023-07 47-2358-023-07 Distal Lateral Humeral Locking Plate, Right, 7 Hole, 113mm 1

00-2358-024-05 47-2358-024-05 DistalLateralHumeralLockingPlate,Left,5Hole,87mm 1

00-2358-024-07 47-2358-024-07 Distal Lateral Humeral Locking Plate, Left, 7 Hole, 113mm 1

00-2358-009-03 47-2358-009-03 Proximal Ulna Locking Plate, Right, 3 Hole, 77mm 1

00-2358-009-05 47-2358-009-05 ProximalUlnaLockingPlate,Right,5Hole,103mm 1

00-2358-009-07 47-2358-009-07 Proximal Ulna Locking Plate, Right, 7 Hole, 129mm 1

00-2358-009-09 47-2358-009-09 ProximalUlnaLockingPlate,Right,9Hole,155mm 1

00-2358-012-03 47-2358-012-03 Proximal Ulna Locking Plate, Left, 3 Hole, 77mm 1

00-2358-012-05 47-2358-012-05 ProximalUlnaLockingPlate,Left,5Hole,103mm 1

00-2358-012-07 47-2358-012-07 Proximal Ulna Locking Plate, Left, 7 Hole, 129mm 1

00-2358-012-09 47-2358-012-09 ProximalUlnaLockingPlate,Left,9Hole,155mm 1

REF Description Qty

Periarticular Elbow Locking Plate System – KitandItemInformation

REF Nonsterile REF Sterile Description Qty


ZS 02.00026.300 ZS 02.00026.400 Periarticular Locking Elbow Screw Set

00-2348-010-35 47-2348-010-35 3.5mmPeriCorticalScrewwith2.7mmHead,10mmLong 2































00-2359-014-26 47-2359-014-26 2.7mmConicalScrew,14mmLong 2
















00-2359-010-38 47-2359-010-38 3.5mmLockingScrewwith2.7mmHead,10mmLong 2

























00-4827-008-01 47-4827-008-01 2.7mmCorticalSelf-tappingScrew,8mmLong 2

























00-4828-010-02 47-4828-010-02 2.7mm Locking Screw, 10mm Long 2






















KT-2360-000-07 Periarticular Elbow Locking Instrument Set

00-2360-020-16 1.6mmD-DriveCannulafor2.7mmLockingHole 4

00-2360-021-20 2.0mmD-DriveCannulafor2.7mmLockingHole 4

00-2360-088-02 2.7mmD-DriveCannulaInserter 1

00-2360-102-01 Distal Posterolateral Humeral Locking Plate Jig, Right 1

00-2360-102-02 Distal Posterolateral Humeral Locking Plate Jig, Left 1

00-2360-103-01 DistalMedialHumeralLockingPlateJig,Right 1

00-2360-103-02 DistalMedialHumeralLockingPlateJig,Left 1

00-2360-103-03 DistalMedialHumeralLockingPlateJig,Short,Right 1

00-2360-103-04 DistalMedialHumeralLockingPlateJig,Short,Left 1

00-2360-104-01 Proximal Ulnar Locking Plate Jig, Right 1

00-2360-104-02 Proximal Ulnar Locking Plate Jig, Left 1

00-2360-105-01 Distal Lateral Humeral Locking Plate Jig, Right 1

00-2360-105-02 Distal Lateral Humeral Locking Plate Jig, Left 1

00-2360-065-00 2.5mmScrewdriverStopRing 1pkgof5

00-1147-071-00 CleaningStylet 1

00-1147-076-00 CleaningBrush 1

00-2360-023-27 2.7mmStandardCannula(for3.5mmlockingscrewwith2.7mmhead) 4

00-2360-080-00 TorqueLimitingAttachment 1

00-2360-153-27 2.7mmStandardTap,QC 2

00-2360-153-35 3.5mmStandardTap,QC 2

00-2360-165-25 2.5mmHexQCStandardScrewdriverBit 2

00-2360-175-20 2.0mmStandardDrill,QC,175mmlong 2

00-2360-205-27 2.7mmStandardDrill,QC,205mmlong 2

00-4828-050-02 47-4828-050-02 2.7mmLockingScrew,50mmLong 2

00-4828-055-02 47-4828-055-02 2.7mmLockingScrew,55mmLong 2


00-4840-020-01 47-4840-020-01 4.0mmCancellousScrew,PartiallyThreaded,20mmLong 2











00-4900-040-51 47-4900-040-51 SmallWasher,for2.7mm,3.5mm,and4.0mmScrews 2



KT-2360-000-06 Periarticular Elbow Locking General Instrument Set

00-4816-001-00 ReductionForceps,Ratchet,Serratedw/Points,Narrow,133mmlength 1

00-4816-002-00 ReductionForceps,Ratchet,Serratedw/Points,Broad,133mmlength 1

00-4816-006-00 ReductionForceps,Ratchet,w/Points,205mmlength 2

00-4816-007-00 ReductionForceps,Ratchet,SerratedJaws,145mmlength 1

00-4816-008-00 ReductionForceps,Speed-Lock,180mmLength 1

00-4816-009-00 ReductionForceps,Speed-Lock,withNarrowSerratedJaws,245mmLength 1

00-4819-002-00 BendingIron,Left,2.7/3.5Plates 1

00-4819-003-00 BendingIron,Right,2.7/3.5Plates 1

00-4813-008-00 HohmannRetractor,8mmwidth,ShortNarrowTip,165mmlength 2

00-4813-015-00 HohmannRetractor,15mmwidth,160mmlength 2

00-4811-035-00 QCTHandle 1

00-1147-053-00 CannulatedRatchetHandle,AOConnection 1

00-4812-035-00 2.5mmHexStandardScrewdriver,QC 1

00-4810-002-01 SmallDepthGauge,Measuresupto60mm 1

00-4810-002-02 SmallDepthGauge,Measuresupto150mm 1

00-4901-012-15 Kwires,1.25mmdiameter,150mmlong,10perbox 1 box



00-4806-100-20 2.0mmDrill,QC,100mmlong 2





00-4808-027-01 2.7mm/2.0mm Double Drill Sleeve 1

00-4808-035-01 3.5mm/2.5mmDoubleDrillSleeve 1

00-4811-100-27 2.7mmTap,QC 2

00-4811-110-35 3.5mmTap,QC 2

00-4812-035-05 Small Holding Sleeve 1

00-4812-000-00 ScrewHoldingForceps 1

00-4828-027-05 2.7mmULSCompressionDrillGuide 1

00-4828-035-05 2.7mmULSCompressionDrillGuidefor3.5mmScrew 1

00-4809-035-00 Countersink 1

00-4808-035-02 3.5/2.5InsertDrillSleeve 1

00-2358-005-00 PeriElbowLockingInstrumentBaseandTray 1

00-5900-099-00 CaseLid 1

Prod. No. Description Qty


Optional Sterile Plates Qty

47-2358-005-03 Distal Posterolateral Humeral Locking Plate, Right, 3 Hole, 72mm N/A


47-2358-005-15 DistalPosterolateralHumeralLockingPlate,Right,15Hole,228mm N/A


47-2358-006-03 Distal Posterolateral Humeral Locking Plate, Left, 3 Hole, 72mm N/A


47-2358-006-15 DistalPosterolateralHumeralLockingPlate,Left,15Hole,228mm N/A


47-2358-007-11 DistalMedialHumeralLockingPlate,Right,11Hole,182mm N/A

47-2358-007-15 DistalMedialHumeralLockingPlate,Right,15Hole,234mm N/A

47-2358-008-11 DistalMedialHumeralLockingPlate,Left,11Hole,182mm N/A

47-2358-008-15 DistalMedialHumeralLockingPlate,Left,15Hole,234mm N/A

47-2358-107-11 DistalMedialHumeralLockingPlate,Short,Right,11Hole,178mm N/A

47-2358-107-15 DistalMedialHumeralLockingPlate,Short,Right,15Hole,230mm N/A

47-2358-108-11 DistalMedialHumeralLockingPlate,Short,Left,11Hole,178mm N/A

47-2358-108-15 DistalMedialHumeralLockingPlate,Short,Left,15Hole,230mm N/A

47-2358-023-09 Distal Lateral Humeral Locking Plate, Right, 9 Hole, 139mm N/A

47-2358-023-11 DistalLateralHumeralLockingPlate,Right,11Hole,165mm N/A

47-2358-023-15 DistalLateralHumeralLockingPlate,Right,15Hole,217mm N/A

47-2358-024-09 Distal Lateral Humeral Locking Plate, Left, 9 Hole, 139mm N/A

47-2358-024-11 DistalLateralHumeralLockingPlate,Left,11Hole,165mm N/A

47-2358-024-15 DistalLateralHumeralLockingPlate,Left,15Hole,217mm N/A

47-2358-009-11 Proximal Ulna Locking Plate, Right, 11 Hole, 181mm N/A

47-2358-009-13 Proximal Ulna Locking Plate, Right, 13 Hole, 207mm N/A

47-2358-009-15 ProximalUlnaLockingPlate,Right,15Hole,233mm N/A

47-2358-012-11 Proximal Ulna Locking Plate, Left, 11 Hole, 181mm N/A

47-2358-012-13 Proximal Ulna Locking Plate, Left, 13 Hole, 207mm N/A

47-2358-012-15 ProximalUlnaLockingPlate,Left,15Hole,233mm N/A

00-4814-006-00 Periosteal Elevator, curved blade, round edge, 6mm blade width 1

00-4817-001-00 Sharp Hook 1

00-4819-014-00 WireBendingPliers,155mm 1

00-2347-052-00 LinearBoneClamp,Medium 1

00-2347-057-00 MediumClampFoot 4

00-2347-060-00 ExtendedClampFoot(20mm) 4

00-2358-000-00 PeriElbowLockingGeneralInstCase 1

00-5900-099-00 CaseLid 1

Prod. No. Description Qty


Graphic Cases

00-2358-000-00 Periarticular Locking Elbow General Instrument Case

1

2

3

4

5

6

7

8 9 10

11

12

13

14

15

16

No. Prod. No. Description

1 00-4814-006-00 Pariosteal Elevator, 6mm

2 00-4813-006-00 Retractor, 8mm (2)

3 00-4813-015-00 Retractor,15mm(2)

4 00-4817-001-00 Sharp Hook

5 00-4816-006-00 ReductionForceps,Ratchet,withPoints,205mm(2)

6 00-4819-003-00 BendingIron,Right,2.7-3.5Plates

7 00-4819-002-00 BendingIron,Left,2.7-3.5Plates

8 00-4816-001-00 ReductionForceps,withPoints,Narrow


9 00-4816-002-00 ReductionForceps,withPoints,Broad

10 00-4816-007-00 ReductionForceps,withSerratedJaws

11 00-2347-057-00 MediumClampFoot(4)

12 00-2347-060-00 ExtendedClampFoot(4)

13 00-4818-009-00 ReductionForceps,Speed-Lockwith

14 00-2347-052-00 MediumLinearBoneClamp

15 00-4819-014-00 WireBendingPliers,155mm

16 00-4816-008-00 ReductionForceps,Speed-Lock


00-2358-009-00 Periarticular Locking Elbow Instrument and Implant Case –Tray 1


1 00-4808-035-02 3.5/2.5InsertDrillSleeve

2 00-4828-035-05 2.7mmCompressionDrillGuideFor3.5mmScrew

3 00-4828-027-05 2.7mmCompressionDrillGuide

4 00-4808-035-01 3.5/2.5DoubleDrillSleeve

5 00-4808-027-01 2.7/2.0 Double Drill Sleeve

6 00-4901-012-15 K-Wires1.25x150mm(.049”),10x

7 00-4901-016-15 K-Wires1.60x150mm(.062”),10x

8 00-4901-020-15 K-Wires2.0x150mm(.078”),10x

9 00-4806-100-20 DrillBitQ.C.2.0x100mm,10x

10 00-4806-110-27 DrillBitQ.C.2.5x110mm,2x

11 00-4836-205-25 DrillBitQ.C.2.5x205mm,2x

12 00-4806-100-27 DrillBitQ.C.2.7x100mm,2x

13 00-4806-110-35 DrillBitQ.C.3.5x110mm,2x

14 00-4811-100-27 TapQ.C.2.7x100mm,2x

15 00-4811-110-35 TapQ.C.3.5x110mm,2x

16 00-2360-175-20 2.0mmSTDDrill,QC,2.0x175mm,2x


17 00-2360-205-27 2.7mmSTDDrill,QC,2.7x205mm,2x

18 00-2360-153-27 2.7mmSTDTap,QC,2x

19 00-2360-153-35 3.5mmSTDTap,QC,2x

20 00-2360-165-25 2.5mmHexSTDDriver,QC,2x

21 00-2348-1xx-35 3.5mmCorticalScrewwith2.7mmhead,Self-Tap,4x,100mm,105mm,110mm Screws

22 00-4809-035-00 Countersink

23 00-2360-020-16 1.6mmD-DriveCannual,4x



26 00-2360-103-03 04DistalMedialHumeralLockingPlate Jigs, Short

27 00-2360-104-XX Proximal Ulnar Locking Plate Jigs

28 00-2360-105-XX Distal Lateral Humeral Locking Plate Jigs

29 00-2360-103-01 02DistalMedialHumeralLockingPlate Jigs

30 00-2360-102-XX Distal Posterior/Lateral Humeral Locking Plate Jigs

1

2 3 4 5

67

8

9

10

11

12

13

14

1516

17

18

19

20

22

21

23

24

25

26

27

28 30

29




1 00-2358-006-05 Distal Posterior/Lateral Humeral LockingPlates5H,98mm(2),Left

2 00-2358-005-05 LockingPlates5H,98mm(2),Right

3 00-2358-006-07 Locking Plates 7H, 124mm (2), Left

4 00-2358-005-07 Locking Plates 7H, 124mm (2), Right

5 00-2358-006-09 LockingPlates9H,150mm,Left

6 00-2358-005-09 LockingPlates9H,150mm,Right

7 00-2358-024-03 Distal Lateral Humeral Locking Plates 3H, 88mm (2), Left

8 00-2358-023-03 3H, 88mm (2), Right

9 00-2358-024-05 5H,112mm(2),Left

10 00-2358-023-05 5H,112mm(2),Right

11 00-2358-024-07 7H, 138mm, Left

12 00-2358-023-07 7H, 138mm, Right

13 00-2358-012-03 Proximal Ulna Locking Plates 3H, 77mm (2), Left

14 00-2358-009-03 77mm (2), Right

15 00-2358-012-05 ProximalUlnaLockingPlates5H,103mm (2), Left

16 00-2358-009-05 103mm (2), Right

1 2

3 4

5 6

7 8

9 10

11 12

13 14

15 16

17 18

19 20

2221

23 24

25 26

3230

28

3129

27


17 00-2358-012-07 Proximal Ulna Locking Plates 7H, 129mm (2), Left

18 00-2358-009-07 129mm (2), Right

19 00-2358-012-09 Proximal Ulna Locking Plates 9H, 155mm,Left

20 00-2358-009-09 155mm,Right

21 00-2358-008-03 DistalMedialHumeralLockingPlates3H, 78mm (2), Left

22 00-2358-007-03 3H, 78mm (2), Right

23 00-2358-008-05 5H,104mm,Left

24 00-2358-007-05 5H,104mm,Right

25 00-2358-008-07 7H, 130mm, Left

26 00-2358-007-07 7H, 130mm, Right

27 00-2358-108-03 DistalMedialHumeralLockingPlates, Short 3H, 74mm (2), Left

28 00-2358-107-03 Plates, Short 3H, 74mm (2), Right

29 00-2358-108-05 Plates,Short5H,100mm,Left

30 00-2358-107-05 Plates,Short5H,100mm,Right

31 00-2358-108-07 Plates, Short 7H, 128mm, Left

32 00-2358-107-07 Plates, Short 7H, 128mm, Right




1 00-4811-035-00 QCT-Handle

2 00-2360-065-00 2.5mmScrewdriverStopRing(5)

3 00-4812-035-05 Small Holding Sleeve

4 00-4812-035-00 Small Hex Screwdriver

5 00-1147-078-00 CleaningBrush

6 00-1147-071-00 CleaningStylet

7 00-4810-002-02 SmallDepthGauge,150mm(DisassembleBeforeAutoclave)

1

2

3

4

5

6

78

9

1011

12

1314


8 00-4810-002-01 Small Depth Gauge, 60mm (DisassembleBeforeAutoclave)

9 00-4812-000-00 ScrewHoldingForceps

10 00-2360-088-02 D-DriveCannulaInserter

11 00-2360-088-01 3.5/2.7mmCannulaInserter(Optional)

12 00-2360-080-00 TorqueLimitingAttachment

13 00-1147-053-00 CannulatedRatchetHandle

14 00-4811-035-01 QCHandle(Optional)


00-2358-006-00 Periarticular Locking Elbow Instrument and Implant Case Base

1

2

3

4

5

6

7

8


1 00-2360-005-19 Distal Posterior/Lateral Humeral Locking Plate Provisionals, Right

2 00-2360-006-19 Distal Posterior/Lateral Humeral Locking Plate Provisionals, Left

3 00-2360-007-07 DistalMedialHumeralLockingPlateProvisionals, Right and Left

4 00-2360-107-07 DistalMedialHumeralLockingPlateProvisionals, Right and Left Short

5 00-2360-009-15 Proximal Ulnar Locking Plate Provisionals, Right


6 00-2360-012-15 Proximal Ulnar Locking Plate Provisionals, Left

7 00-2360-023-19 Distal Lateral Humeral Locking Plate Provisionals, Right

8 00-2360-024-19 Distal Lateral Humeral Locking Plate Provisionals, Left


00-2358-006-50 Periarticular Locking Elbow Instrument and Implant Case Screw Caddy


1 00-4827-0xx-01 2.7mmCorticalSelf-TapScrews

2 00-4828-0xx-02 2.7mm Locking Self-Tap Screws

3 00-2359-0xx-26 2.7mmConicalSelf-TapScrews

4 00-4840-0xx-01 4.0mmCancellousPartiallyThreadedScrews

5 00-2348-0xx-35 3.5mmCorticalw/2.7mmHeadSelf-Tap Screws

6 00-2359-0xx-38 3.5mmLockingw/2.7mmHeadSelf-Tap Screws

1

2

3 4

5

6

7


7 00-4900-040-51 SmallWashersfor2.7mm,3.5mm,&4.0mm Screws (6)

Contact your Zimmer representative or visit us at www.zimmer.com

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+H84406016790121/$091001J09A

Lit. No. 06.01679.012–Ed.10/2009ZHUB

Please refer to package insert for complete product information, including contraindications, warnings, precautions, and adverse effects.

Documents

Zimmer® Periarticular Elbow Locking Plate System Surgical ... · Instrument and Implant Case Screw Caddy 36 Zimmer Periarticular Elbow Locking Plate System Surgical Technique. 2