lcp dynamic helical hip system (dhhs)synthes.vo.llnwd.net/o16/llnwmb8/us mobile/synthes... · mage...

SURGICAL TECHNIQUE

LCP® DYNAMIC HELICAL HIP SYSTEM (DHHS) Part of the DePuy Synthes Large Fragment LCP® System

Image intensifier control

LCP® Dynamic Helical Hip System (DHHS) Surgical Technique DePuy Synthes Companies

LCP Dynamic Helical Hip System (DHHS) 2 AO Principles 4

Indications 5

Place Guide Wire 6

Determine Helix Blade Length 8

Ream 9

Assemble Helix Blade Inserter 10

Insert Helix Blade 12

Position Sideplate/Key Alignment Shaft 15

Position Sideplate/Plate Impactor (optional) 16

Insert Screws 17

Lock Rotation/Key Impactor 17

Intraoperative Compression (optional) 18

Confirm Implant Placement 18

Implant Removal 19

Implants 20

Instruments 21

Set Lists 27

INTRODUCTION

SURGICAL TECHNIQUE

PRODUCT INFORMATION

TABLE OF CONTENTS

1. Sommers M, Roth C, Hall H, Ehmke L, Krieg J, Madey S, and Bottlang M: Cut-Out Resistance of Implants for Intertrochanteric Fracture Fixation. JOT, Vol 18, Number 6, July 2004.

The LCP® (Locking Compression Plate) Dynamic Helical Hip System (DHHS) provides strong and stable internal fixation of a variety of intertrochanteric, subtrochanteric and basilar neck fractures in which a stable medial buttress can be reconstructed. Additionally, implantation methods are simplified by minimized instrumentation.

DHHS Helix BladeThe LCP DHHS Helix Blades easily glide within the LCP DHHS Plate Barrel for controlled collapse and impaction of fragments.

When the fracture requires additional intraoperative compression, the LCP DHHS Compression Screw (211.890) can be used.

The LCP DHHS Plates are low profile and have a limited-contact undersurface for minimal soft tissue irritation.

The LCP DHHS Plates are made of cold-worked 316L stainless steel.

Construct stabilityThe helix blade improves resistance to cut-out and increases the rotational stability of the femoral head fragment when compared to traditional intertrochanteric lag screws.1

COMBI® Bone Plate holes

Limited-contact undersurface

LCP DHHS Compression Screw

2 DePuy Synthes Companies LCP® Dynamic Helical Hip System (DHHS) Surgical Technique

LCP DYNAMIC HELICAL HIP SYSTEM (DHHS)

Ease of usex Single-piece reamer does not need

adjustment prior to usex The helix blade does not have

screw threads and creates its own path as it is inserted, eliminating the need for a tap and reducing overall torsional forces on the femoral head during implantation

x Use of the helix blade inserter assembly reduces the overall operative time to implant the helix blade when compared to implanting conventional hip lag screws

x The self-contained, user-activated key mechanism of the LCP DHHS Sideplate eliminates the need for additional instrumentation for intraoperative insertion of separate antirotational locking devices within the barrel

Plate barrel Internal key mechanism

The COMBI Bone Plate holes in the LCP DHHS Sideplate:x Combine a dynamic compression

unit (DCU) hole with a locking screw hole, allowing compression in the DCU section of the hole or locking screw fixation in the threaded section

x Provide directional compression and fixed-angle screw purchase

x Allow longitudinal screw angulation for lag screw fixation of medial fragments

x Allow 14° of transverse screw angulation

x Are uniformly spaced to provide greater intraoperative flexibility for screw and/or wire or cable fixation

The LCP DHHS Plate Barrel contains a locking key. Two flats within the key correspond with the flats of the helix blade shaft. This enables the surgeon to manipulate the position of the sideplate prior to final fixation. Once the plate is positioned appropriately, the key may be advanced, making the helix blade rotationally stable within the barrel.

No bone is removed from the femoral head before implantation of the helix blade. This creates a more stable and mechanically sound interface between the helix blade and bone.

The number of screw holes per plate length is maximized, without compromising plate strength. This allows an increased number of fixation points with a smaller incision.

LCP® Dynamic Helical Hip System (DHHS) Surgical Technique DePuy Synthes Companies 3

LCP Dynamic Helical Hip System (DHHS)

AO PRINCIPLES

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4_Priciples_03.pdf 1 05.07.12 12:08

4 DePuy Synthes Expert Lateral Femoral Nail Surgical Technique

AO PRINCIPLES

In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation1, 2.

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

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

Anatomic reductionFracture reduction and fixation to restore anatomical relationships.

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

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

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

The AO has formulated the following four four basic principles for internal fixation:1, 2

Anatomic reductionFracture reduction and fixation to restore anatomical relationships.

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

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

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

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

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


INDICATIONS

The LCP DHHS is indicated for the following fractures of the proximal femur:

x Intertrochanteric fracturesx Subtrochanteric fractures*x Basilar neck fractures

LCP DHHS is indicated for stable and unstable fractures in which a stable medial buttress can be reconstructed.

* For certain subtrochanteric fractures, a 95° device is the implant of choice. Please refer to the DHS/DCS Dynamic Hip and Condylar Screw System Technique Guide, section “Using the DCS for Subtrochanteric Fractures.”


PLACE GUIDE WIRE

Barrel angle

3. Regazzoni P, Rüedi Th, Winquist R, Allgöwer M, The dynamic hip screw implant system. Berlin: Springer-Verlag, 1985.

1Place guide wire

Instruments

338.044 Dynamic Helical Hip System Angle Guide, variable

900.723 2.5 mm Threaded Guide Wire, spade point, 230 mm

Optional instrument

310.19 2.0 mm Drill Bit

Fracture reduction should be done in the same manner as for a standard DHS Dynamic Hip System procedure.

Determine anteversion by placing a guide wire anteriorly along the femoral neck. Insert the wire into the femoral head. The anteversion wire will later assist in correct placement of the central guide wire in the center of the femoral head.

The angle subtended between the femoral neck and shaft axis (C.C.D., or collum-center-diaphysis, angle) of the uninjured femur will aid in selection of the most appropriate barrel angle. The 135° barrel angle is most commonly indicated. The LCP DHHS Plates are available with barrel angles of 130°, 135°, 140°, 145°, and 150°.

Note: Greater barrel angles may produce biomechanical advantages in unstable cases; ie, better gliding characteristics and reduced bending stresses on the plate/barrel junction, although correct placement of the implant becomes technically more difficult as barrel angle increases.3

Position the DHHS® Bone Plates variable angle guide at the desired angle.

Align the variable angle guide parallel to the axis of the femoral shaft and place it on the lateral cortex of the femur.

Note: The T-handle of the DHHS® Bone Plates variable angle guide rotates 90° to a locked position, for easier use.


Insert a 2.5 mm threaded guide wire through the variable angle guide, parallel to the anteversion wire and toward the center of the femoral head. The entry point varies with barrel angle. When the 135° barrel angle is used, the guide wire enters the proximal femur approximately 2.5 cm distal to the vastus ridge.

Predrilling of the lateral cortex with the 2.0 mm drill bit is recommended in dense bone.

Confirm placement of the guide wire under image intensifi cation. It must lie along the axis of the femoral neck in both the anteroposterior (AP) and lateral views. The appropriate final position is in the center of the femoral head in both AP and lateral views. The tip of the guide wire should be a few millimeters short of the subchondral bony plate. When inserted, the tip of the helix blade will coincide with the tip of the guide wire.

Note: This guide wire remains in place throughout the procedure. If the guide wire position is incorrect, remove the wire and insert a new 2.5 mm threaded guide wire.

Remove and discard the anteversion wire.


Place Guide Wire

DETERMINE HELIX BLADE LENGTH

2Determine helix blade length

Instrument

338.329 Depth Gauge, for LCP DHHS Angle Guide, variable

Attach the depth gauge to the angle guide. Read the required helix blade length directly from the depth gauge. No subtraction is necessary, a direct measurement should be used for best results.

When the proper helix blade length, position, and plate angle have been determined, remove the angle guide.

Select a standard- or short-barrel plate, with an appro priate number of shaft holes, based on the requirements dictated by the fracture pattern. The standard 38 mm barrel length is most commonly indicated.

Choose the 25 mm short barrel for specific clinical situations, including:x Use of a helix blade shorter than 85 mmx Cases in which the standard barrel may not provide

sufficient glide for the helix blade; ie, a long impaction distance is expected

x A medial displacement osteotomyx An unusually small femur

Combine these selections with the required plate angle as determined in Step 1.

Note: The short-barrel plate MUST be used with helix blades shorter than 85 mm to allow for proper sliding of the helix blade in the plate barrel, and for fracture compression.

38 mm

25 mm


REAM

3Ream

Instruments

338.332 Contoured Reamer, 60 mm

511.761 Large Quick Coupling

The contoured reamer does not ream into the femoral head and is designed to prevent over-reaming.

Insert the 60 mm contoured reamer into the Compact Air Drive (or similar drill) using the large quick coupling attachment.

Slide the reamer over the guide wire to ream for the helix blade inserter assembly and countersink for the plate/barrel junction.

When reaming in dense bone, use of continuous irrigation is recommended to prevent thermal necrosis.

Alternative instrument

338.442* Contoured Reamer, 56 mm

For smaller stature patients, the 56 mm contoured reamer may be used for standard- and short-barrel plates with barrel angles up to 135°.

*Also available.


ASSEMBLE HELIX BLADE INSERTER

4Assemble helix blade inserter

Instruments

338.341 LCP DHHS Inserter Guide

338.345 LCP DHHS Coupling Screw, 324 mm

338.346 LCP DHHS Inserter Shaft

Place the LCP DHHS Inserter Shaft fully into the LCP DHHS Inserter Guide.

When assembling the helix blade inserter, align the flats of the helix blade with the flats on the sides of the inserter guide. Insert the shaft (back end) of the selected helix blade into the tip of the inserter guide and orient the hexagonal recess of the helix blade onto the hexagonal tip of the inserter shaft.

Align flats


Insert the LCP DHHS Coupling Screw into the back of the inserter shaft (Figure 1) until the coupling screw knob is visible in the window at the back of the inserter shaft (Figure 2). Finger-tighten the coupling screw.

Technique tip: Hold the helix blade and inserter assembly together with one hand, tilting the assembly downward. Use the free hand to insert and tighten the coupling screw.

Helix blade Inserter guide Coupling screw Inserter shaft

Figure 1

Figure 2


Assemble Helix Blade Inserter

5Insert helix blade

Instruments



399.43 Hammer, 700 grams

Before placing the insertion instrument into the reamed cavity, pull back on the LCP DHHS Inserter Shaft so that only the helix is exposed. This ensures the helix blade is inserted to the proper depth and orientation. Place the inserter assembly over the guide wire and into the reamed cavity.

Note: Depending on whether the left or right hip is being treated, the corresponding “etch” on the helix inserter instrumentation should be visible.

Important: The swivel plate on the LCP DHHS Inserter Guide must be parallel with, and flush to, the shaft of the femur. This will determine the final position and depth of the helix blade.

Swivel plateHelix, starting position



Drive the helix blade into position using even and steady blows with the 700 gram hammer. The inserter shaft assembly controls the depth and rotation of the helix blade.

Monitor the advancement of the helix blade under image intensification to ensure proper placement. When the helix blade is fully inserted, the inserter assembly will prevent any further advancement. Additionally, the circumferential etch around the inserter shaft will align with the back edge of the inserter guide sleeve when the helix blade is fully implanted (Figure 1).

Etch

Figure 1



After full insertion of the helix blade, the inserter assembly can be removed by unscrewing the coupling screw and retracting the inserter assembly. The guide wire and the helix blade remain in the femur.

Optional instrument

314.27 Large Hexagonal Screwdriver

The coupling screw may be loosened with a large (3.5 mm) hexagonal screwdriver, if necessary.

Insert Helix Blade


POSITION SIDEPLATE/KEY ALIGNMENT SHAFT

6Position sideplate/key alignment shaft

Instruments

338.28* DHS/DCS Impactor

338.342 LCP DHHS Key Alignment Shaft

338.347 LCP DHHS Key Impactor

338.348 LCP DHHS Impactor Cap

To place the LCP DHHS Sideplate over the helix blade, the LCP DHHS Key Alignment shaft must be used. Align the flats on the alignment shaft with the flats of the internal key of the sideplate, then insert the alignment shaft through the plate barrel.

Slide the sideplate and key alignment shaft over the 2.5 mm threaded guide wire. Insert the alignment shaft into the back of the helix blade. The alignment shaft has a hexagonal tip that mates with the end of the helix blade to ensure that the internal sideplate key and the helix blade shaft are properly aligned.

Slide the sideplate down the key alignment shaft and onto the shaft of the helix blade.

After the plate has been fully seated into the reamed cavity, it may be aligned with the axis of the femur as needed. The internal plate key is free to rotate with no movement of the helix blade, until keyed.

When the barrel of the plate is fully inserted in the reamed cavity, remove the alignment shaft.

If the sideplate is not completely flush against the lateral cortex, use of the LCP DHHS Impactor with plastic cap may be necessary.

*Also available.


Technique tip: If the plate does not slide easily into the reamed cavity, gently moving the alignment shaft up and down can assist in the placement. If the plate still will not slide into the reamed cavity, the DHS/DCS Impactor may be used.

POSITION SIDEPLATE/PLATE IMPACTOR (OPTIONAL)

7 Position sideplate/plate impactor (optional)

Instruments




Alternative instruments

338.28* DHS/DCS Impactor


To use the impactor cap, slide it onto the tip of the cannulated LCP DHHS Key Impactor until fully seated. A positive “click” will be noticed when assembling.

Place the impactor cap and shaft assembly over the 2.5 mm guide wire and seat it directly into the barrel hole of the sideplate.

Use of light blows with the hammer is recommended until the sideplate is seated completely against the lateral cortex.

Caution • Do not use the impactor cap and shaft to seat the

plate if the plate is more than 5 mm off the bone.• If the plate appears to be more than 5 mm off the

bone, the flats on the helix blade and the internal flats on the key may not be properly aligned.

• Impacting the plate in this condition could cause further unwanted advance ment of the helix blade. In this situation, reinsertion of the LCP DHHS Key Alignment Shaft and use of the DHS/DCS Impactor may be necessary to seat the plate against the lateral cortex.

*Also available.


8Insert screws

Remove the 2.5 mm threaded guide wire. Affix the LCP DHHS Sideplate to the bone with 4.5 mm cortex screws, 5.0 mm locking screws, or a combination of both.*

9Lock rotation/key impactor

Instruments



Once the desired placement of the LCP DHHS Sideplate has been achieved, the surgeon can use the cannulated LCP DHHS Key Impactor to advance the internal sideplate key and to stabilize rotation of the helix blade.

Note: Make sure to remove the plastic impactor tip before proceeding.

Insert the 300 mm cannulated LCP DHHS Key Impactor into the barrel of the sideplate until it is fully seated. Moderate taps with the hammer will lock rotation, rendering the helix blade rotationally stable, but still allow dynamic collapse.

INSERT SCREWS AND LOCK ROTATION/KEY IMPACTOR

* For information on fixation principles using conventional and locked plating techniques, please refer to the Large Fragment Locking Compression Plate (LCP) Technique Guide.


INTRAOPERATIVE COMPRESSION (OPTIONAL) AND CONFIRM IMPLANT PLACEMENT

4.5 mm cortex screw

5.0 mm locking screw

10Intraoperative compression (optional)

For further intraoperative compression of the trochanteric fracture, the LCP DHHS Compression Screw may be inserted in the helix blade. The LCP DHHS Compression Screw may be used in unstable fractures to prevent disengagement of the helix blade from the plate barrel in non-weight-bearing patients.

Note: Use of the compression screw may cause the helix blade to pull out of osteoporotic bone.

11Confirm implant placement

Take final C-arm images or x-rays to confirm proper implant placement.


IMPLANT REMOVAL

Implant removal

Instruments

03.010.058* Slide/Fixed Hammer, 400 grams

03.010.059* Hammer Guide, for Slide/Fixed Hammer

314.118 StarDrive Screwdriver, T25


338.313 Solid Coupling Screw, for removal only

Use either the 3.5 mm hexagonal or T25 StarDrive Screwdriver to remove any 4.5 mm cortex screws or 5.0 mm locking screws from the LCP DHHS Sideplate.

Remove the LCP DHHS Sideplate to expose the end of the helix blade. Once the Sideplate has been removed, thread the Solid Coupling Screw onto the end of the shaft of the helix blade. Thread the Hammer Guide for Slide/Fixed Hammer onto the Solid Coupling Screw. Use the Slide/Fixed Hammer to extract the helix blade.

* The slide/fixed hammer and hammer guide can be found in the Titanium Humeral Nail–EX Instrument and Titanium Implant Set (01.001.300).

** The inserter-extractor and slotted hammer can be found in the Titanium Tibial Nail Insertion Set (105.570 and 105.572).

Instrument options for removal

System Will remove:

DHS System DHS DHS One-Step DHHS – Wrench (338.06) – Long Coupling Screw (338.22)DHS One-Step System DHS One-Step DHHS – Insertion Wrench (338.302) – Coupling Screw (338.31)DHHS® Instruments DHHS – Slide/Fixed Hammer, 400 grams (03.010.058) – Hammer Guide (03.010.059) – Solid Coupling Screw w/internal threads (338.313)

Note: If the DHHS Solid Coupling Screw has external threads on the back-end, for removal use: Inserter-Extractor (356.490)** and Slotted Hammer (332.20)**


IMPLANTS

◊Available nonsterile and sterile-packed. Add “S” to catalog number to order sterile product. Items listed with catalog numbers ending with “S” are available sterile only.

38 mm

25 mm

LCP DHHS Sideplates, standard barrel (38 mm barrel)◊

Shaft Shaft length Barrel Angle holes (mm) 130° 135° 140° 145° 150° 2 54 282.600 282.610 282.630 282.640 282.650 3 72 282.601 282.611 282.631 282.641 282.651 4 90 282.602 282.612 282.632 282.642 282.652 5 108 282.603 282.613 282.633 282.643 282.653 6 126 282.604 282.614 282.634 282.644 282.654 8 162 282.605S 282.615S 282.635S 282.645S 282.655S10 198 282.606S 282.616S 282.636S 282.646S 282.656S12 234 282.607S 282.617S 282.637S 282.647S 282.657S14 270 282.608S 282.618S 282.638S 282.648S 282.658S16 306 N/A 282.619S 282.639S 282.649S 282.659S18 342 N/A 282.620S N/A N/A 282.660S20 378 N/A 282.621S N/A N/A 282.661S

LCP DHHS Sideplates, short barrel (25 mm barrel)◊

Shaft Shaft length Barrel Angleholes (mm) 130° 135° 140° 145° 150°2 54 282.670 282.676 282.681S 282.686S 282.6913 72 282.671S 282.677S 282.682S 282.687S 282.692S4 90 282.672 282.678 282.683 282.688 282.6935 108 282.673S 282.679S 282.684S 282.689S 282.694S6 126 282.674S 282.680S 282.685S 282.690S 282.695S

Helix Blades◊

Length Length (mm) (mm)282.234 75 282.242 115282.235 80 282.243 120282.236 85 282.244 125282.237 90 282.245 130282.238 95 282.246S 135282.239 100 282.247S 140282.240 105 282.248S 145282.241 110 282.249S 150


LCP DHHS Compression Screws02.224.030S LCP DHHS Enhanced Compression

Screw, sterile211.890◊ LCP DHHS Compression Screw

02.102.001 Universal Locking Trochanter Stabilization Plate, 131 mm

Implants

◊Available nonsterile and sterile-packed. Add “S” to catalog number to order sterile product. Items listed with catalog numbers ending with “S” are available sterile only.


310.31 3.2 mm Drill Bit, quick coupling, 145 mm



311.44 T-Handle, with quick coupling

311.46 Tap for 4.5 mm screws

312.449 4.3 mm Threaded Drill Guide

INSTRUMENTS


312.46 4.5 mm/3.2mm Double Drill Sleeve

312.48 4.5 mm/3.2 mm Insert Drill Sleeve

314.11 Holding Sleeve

314.118 StarDrive Screwdriver, T25

314.119 StarDrive Screwdriver Shaft, T25, quick coupling

314.15 Large Hexagonal Screwdriver Shaft

Instruments


319.10 Depth Gauge, for large screws

319.97 Screw Forceps

323.46 4.5 mm Universal Drill Guide

338.044 Dynamic Helical Hip System Angle Guide, variable



Instruments

338.329 Depth Gauge, for LCP DHHS Angle Guide, variable

338.332 Contoured Reamer, 60 mm



338.345 LCP DHHS Coupling Screw, 324 mm

338.313 Solid Coupling Screw, for removal only

Instruments



338.347 LCP DHHS Key Impactor, cannulated, 300 mm



511.761 Large Quick Coupling

900.723 2.5 mm Threaded Guide Wire, spade point, 230 mm

Instruments


Graphic Case690.326 Graphic Case, for Dynamic Helical Hip

System Implant Set

Implants*211.890◊ LCP DHHS Compression Screw, 2 ea

Helix Blades*◊

Length (mm) Qty282.234 75 2282.235 80 2282.236 85 2282.237 90 3282.238 95 3282.239 100 3

LCP DHHS Sideplates, standard barrel*◊

Barrel Shaft Shaft length angle holes (mm) Qty282.602 130° 4 90 1282.603 130° 5 108 1282.604 130° 6 126 1282.610 135° 2 54 3282.611 135° 3 72 2282.612 135° 4 90 3282.613 135° 5 108 2282.614 135° 6 126 2282.630 140° 2 54 1282.631 140° 3 72 1282.632 140° 4 90 1282.633 140° 5 108 1282.634 140° 6 126 1282.640 145° 2 54 1282.641 145° 3 72 1282.642 145° 4 90 1282.643 145° 5 108 1282.644 145° 6 126 1

Length (mm) Qty282.240 105 3282.241 110 2282.242 115 2282.243 120 2282.244 125 2282.245 130 2

For detailed cleaning and sterilization instructions, please refer to: www.synthes.com/cleaning-sterilization In Canada, the cleaning and sterilization instructions will be provided with the Loaner shipments.

◊Available nonsterile and sterile-packed. Add “S” to catalog number to order sterile product.*Also available.

LCP DHHS IMPLANT SET (105.387)


LCP DHHS BASIC SET (105.388)

Graphic Case 690.325 Graphic Case, for Dynamic Helical Hip

System Basic Set

Instruments310.31 3.2 mm Drill Bit, quick coupling, 145 mm310.431 4.3 mm Drill Bit, quick coupling, 180 mm,

2 ea310.44 4.5 mm Drill Bit, quick coupling, 145 mm311.44 T-Handle, with quick coupling311.46 Tap for 4.5 mm Cortex and Shaft Screws,

130 mm, 57 mm tap depth312.449 4.3 mm Threaded Drill Guide, 2 ea312.46 4.5 mm/3.2 mm Double Drill Sleeve312.48 4.5 mm/3.2 mm Insert Drill Sleeve314.11 Holding Sleeve314.118 StarDrive Screwdriver, T25314.119 StarDrive Screwdriver Shaft, T25,

quick coupling314.15 Large Hexagonal Screwdriver Shaft314.27 Large Hexagonal Screwdriver319.10 Depth Gauge, for large screws319.97 Screw Forceps323.46 4.5 mm Universal Drill Guide338.044 Dynamic Helical Hip System Angle

Guide, variable338.313 Solid Coupling Screw, for removal only338.329 Depth Gauge, for LCP DHHS Angle

Guide, variable338.332 Contoured Reamer, 60 mm338.341 LCP DHHS Inserter Guide338.342 LCP DHHS Key Alignment Shaft338.345 LCP DHHS Coupling Screw, 324 mm338.346 LCP DHHS Inserter Shaft338.347 LCP DHHS Key Impactor, cannulated,

300 mm338.348 LCP DHHS Impactor Cap, 2 ea399.43 Hammer, 700 grams511.761 Large Quick Coupling900.723 2.5 mm Threaded Guide Wire, spade

point, 230 mm, 10 ea


Implants5.0 mm Locking Screws, self-tapping, with T25 StarDrive Recess Length (mm) Qty212.201 14 4212.202 16 4212.203 18 2212.204 20 2212.205 22 2 212.206 24 2212.207 26 2212.208 28 2212.209 30 2212.210 32 4212.211 34 4

4.5 mm Cortex Screws, self-tapping, with 3.5 mm Hexagonal Recess Length (mm) Qty214.828 28 3214.830 30 3214.832 32 6214.834 34 6214.836 36 6214.838 38 6214.840 40 6

Also Available01.102.001 Universal Locking Trochanter Stabilization

Plate Set02.102.001 Universal Locking Trochanter Stabilization

Plate, 131 mm02.224.030S LCP DHHS Enhanced Compression Screw,

sterile03.010.058 Slide/Fixed Hammer, 400 grams03.010.059 Hammer Guide, for Slide/Fixed Hammer338.28 DHS/DCS Impactor338.333 DHHS Reaming Head338.442 Contoured Reamer, 56 mm

Length (mm) Qty214.842 42 6214.844 44 6214.846 46 3214.848 48 3214.850 50 3214.852 52 3214.854 54 3

Length (mm) Qty212.212 36 4212.213 38 4212.214 40 4212.215 42 4212.216 44 4212.217 46 2212.218 48 2212.219 50 2212.220 55 2212.221 60 2


LCP DHHS Basic Set (105.388)

Limited Warranty and Disclaimer: DePuy Synthes Trauma products are sold with a limited warranty to the original purchaser against defects in workmanship and materials. Any other express or implied warranties, including warranties of merchantability or fitness, are hereby disclaimed.

See package insert for complete information.

Federal Law restricts these devices to sale by or on the order of a physician.

Some devices listed in this technique guide may not have been licensed in accordance with Canadian law and may not be for sale in Canada. Please contact your sales consultant for items approved for sale in Canada.

Not all products are currently available in all markets.

© DePuy Synthes 2016. All rights reserved.DSUS/TRM/1215/0781 2/16 DV

Manufactured or distributed by:Synthes USA Products, LLC 1302 Wrights Lane EastWest Chester, PA 19380To order (USA): 800-523-0322 To order (Canada): 800-946-8999

www.depuysynthes.com

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