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Polyaxial Locking Plate System for the Proximal Lateral Tibia

NCB® Proximal Tibia

Surgical Technique

NCB Proximal Tibia – Surgical Technique �

Surgical Technique

NCB Locking Plate System for the Proximal Tibia

Table of Contents

Introduction 4

Plate Design 5

Screw Selection 5

MIS Radiolucent Targeting Device 6

System Features 6

Indications 7

Fracture Classification 7

Sample Cases 8

Preoperative Planning and Patient Positioning 10

Open Technique 11

Incision 11

Fracture Reduction 11

Optional: Bone Spacers 11

Insertion of NCB-PT Plate 12

Insertion of NCB Screws 12

MIS Technique 17

Plate Hole Numbering System 17

Incision and Fracture Reduction 17

Targeting Device Assembly 18

Insertion and Preliminary Fixation of NCB-PT Plate 18

Insertion of NCB Screws in the Proximal Area 20

Insertion of NCB Screws in the Shaft 21

Implant Removal 23

Ordering Information 24

Implants 24

Graphic Case 26

Standard Instruments 27

MIS Instruments 28

Cannulated Option (Screws and Instruments) 30

� NCB Proximal Tibia – Surgical Technique

Introduction The NCB-PT Plate (Non-Contact Bridging for the Proximal Tibia) is an optimal plate solution for the treatment of complex fractures of the proximal tibia.

The system allows for polyaxial screw placement (30°) with subsequent screw locking. Before locking, the screws can act as lag screws and be used for fracture reduction; a benefit which is not offered with standard locking systems.

In the locked mode, the NCB-PT Plate acts as an internal fixator without contact between the plate and the bone surface reducing the risk of periosteal blood supply impairment.

The surgical technique is based on the well-known standard plate osteo-synthesis technique which gives the surgeon the feeling for bone quality during drilling and tightening of the screws. In the last step, all screws can be locked and made angularly stable.

The instrumentation includes a fully radiolucent targeting device for a minimally invasive surgical technique (MIS).

Materials: NCB plates and screws are made of ProtasulProtasul®-64 titanium alloy Ti�l�, IS�� 3�-3,titanium alloy Ti�l�, IS�� 3�-3, �STM F136

Blind screw insert

Implants are available with � or 3 proximal holes, left and right. Plate length varies from � to 9 shaft holes for the �-proximal hole plate and between � and 13 shaft holes for the 3-proxi-mal hole plate.

Polyaxial screw placement with subsequent locking option for optimal system stability. Fracture reduction with a lag screw possible.

Non-Contact Bridging osteosynthesis reduces the risk of periosteal blood impairment.

�natomically-contoured plate.

Noncontact

Locking cap ∅ � mm

Spacer 1 to 3 mm �ngular stability of one NCB-locked screw

6NmFastening torque

225 NSD±10N

Anterior

Posterior

NCB Proximal Tibia – Surgical Technique


Standard Screws (included in the screw set)

Cannulated Screws(option)

Cancellous screw ∅ �.0mm self tapping, L �0–90mm; �mm

Cortical screw ∅ 4.0mm self tapping, �0–�0mm; �mm, �0–90mm; �mm

Plate DesignTwo versions of the NCB-PT Plate are available: �-proximal and 3-proximal holes.

Due to the angular freedom of the screws the whole plateau area can be covered with both plates. The �-proximal holes plate is recommended when soft tissue coverage is a greater concern. The 3-proximal holes plate is recom-mended when there is a higher concern for supporting the tibial plateau (e.g. severe intra-articular comminution).

Plate head has 6˚ posterior tilt to match the lateral tibial contour.

Screw Selection• Spherical screw head with standard

3.�mm hexagonal drive• Self-tapping screw tip (solid screws)• Self-drilling and self-tapping screw

tip (cannulated screws)• Double-lead thread for fast screw

insertion in cortical bone

Cannulation for 1.6mm K-wire

Cancellous screw ∅ 4.� self drill L �0–90mm; �mm

3-proximal holes plate

�-proximal holes plate

30°

6°

30°

6°


MIS Radiolucent Targeting DeviceMIS surgical technique with a fully radiolucent targeting device.

In the metaphyseal region the targeting device ensures divergent screw align-ment for increased pull-out resistance.

System Features

• Polyaxial screw placement with subsequent locking option;• �natomically contoured plate with asymmetrical plate cross section to facilitate anterolateral soft tissue coverage; • Plate head has 6˚ posterior tilt to match the lateral tibial contour;• Placement of divergent screws to increase pull-out resistance;• MIS �pproach with a fully radiolucent targeting device; • NCB Cancellous Screws can be used as lag screws to improve fracture reduction;• Use of conventional plating technique;• Feeling of bone quality during inserting and tightening of screws;• The �-proximal holes tibial plate is available in 3 lengths, from � holes (13�mm) to 9 holes (�1�mm);• The 3-proximal holes tibial plate is available in 4 lengths, from � holes (13�mm) to 13 holes (�9�mm).

Divergent screw alignment achieved using the targeting device

NCB-PT Plate System


Indications

The NCB Plating System is indicated for temporary internal fixation and stabilization of fractures and osteo-tomies of long bones.

Fracture ClassificationComprehensive classifications for proximal tibial fractures are the ��T� and the Schatzker classifications.

Stabilization with locking plates is recommended for most of the 41-� and C type of fracture according to the ��T� classification for long bones.This includes comminuted fractures and intra-articular and extra-articular condylar fractures.

A1 A2 A3

B1 B2 B3

C1 C2 C3

Typ I Typ II Typ III Typ IV Typ V Typ VI

OTA Classification

Schatzker Classification


Sample Cases

Case 1: 41-C1 fracture (��T� classification)

Postoperative

Preoperative

Preoperative

Postoperative


Case 2: 41-�� fracture(��T� classification, MIS surgical procedure)

PostoperativePreoperative

10 NCB Proximal Tibia – Surgical Technique

Preoperative Planning and Patient Positioning

Select the appropriate length and type of the NCB-PT Plate using X-rays and the X-ray template.

Based on the fracture type and the specific patient condition determine the surgical approach (i.e., open technique or MIS) to be performed.

Place the patient in a supine position. Lower the contralateral leg slightly to make sure that lateral and �P X-ray views can be obtained clearly.

Support the knee while allowing the leg to move freely.

NCB Proximal Tibia – Surgical Technique 11

Open Technique

Incision� lateral incision is recommended for extra-articular and laterally-based type 41-B fractures, according to the ��T� classification.

For ��T� type 41-C fractures with a complete articular fracture, a straight anterolateral incision or short medial and lateral incisions are recommended.

To facilitate fracture healing do not strip the periosteum.

Fracture ReductionRestore the articular surface (if needed) and reduce the fracture prior to inserting the plate. Bone fragments can be secured with �.0mm K-wires. Make sure that K-wires do not interfere with the future location of the plate and screws.

Note: Check fragment position with an image intensifier.

Optional: Bone SpacersTwo bone spacers can be used in the diaphysis to avoid contact of the plate with the bone surface reducing the risk of periosteal blood supply impairment.

The spacers are available in sizes of 1mm, �mm and 3mm.

Note: Insert adequate bone spacers into the plate before plate insertion.Spacers are single use only and they can be removed after locking the screws.

3mm

�mm

1mm

Temporary stabilization of the fracture

Use of bone spacers for non-contact bridging

Incision


Screw Type

Cancellous Cortical Cancellous cannulated

REF 0�.031��.0xx REF 0�.031��.0xx REF 0�.031��.0xx

∅ �mm ∅ 4mm ∅ 4.�mm

L �0–90 mm L 14–90 mm L �0–90 mm

Drill

REF 103.��.1�0 REF 0�.000�4.11� REF 0�.000�4.�33

∅ �.�mm ∅ 3.3mm ∅ 3.3mm

K-wire REF 0�.0136�.116

∅ 1.6mm, L 190mm

Insertion of NCB-PT PlateInsert the plate between the anterior tibialis muscle and the periosteum.

The plate should be placed as close as possible to the cartilage.

Temporarily fix the plate proximally and distally with �.0mm K-wires through the small holes in the plate.

Check the plate position and the fracture alignment with an image intensifier in both planes. Make sure the leg axis has been restored.

Note: The plate is anatomically shaped. Do not bend or contour the plate to avoid damage of the locking mechanism.

Insertion of NCB Screws � maximum of thirty degrees of screw angulation is allowed in all plate holes. Use the NCB Drill Guide to avoid exces-sive screw angulation with consequen-tial failure of the locking mechanism.

Cancellous ScrewsFor the �.0mm cancellous screws, use the NCB Drill Guide �.�mm. To ensure correct use of the drill guide, press the drill guide into the plate hole in a perpendicular position and then tilt it into the preferred position. The drill guide needs to be in constant contact with the bottom ring of the hole.

Use the �.�mm drill bit for the �.0mm cancellous screws.

Use the NCB Drill Guide to avoid an inclination > 30°

Drilling

Temporarily fixation of the plate

NCB Proximal Tibia – Surgical Technique 1�

Use the NCB Depth Gauge to determine the appropriate screw length.

Insert NCB Cancellous Screws using the NCB-PT Hexagonal Screwdriver, and apply compression if needed. Cancellous screws are partially threaded and can be used as lag screws.

Depending on fracture type, in the epiphyseal and metaphyseal areas, screws should be tightened to reduce the fracture and obtain close contact between the plate and the bone in order to buttress the fracture.

Note: Tighten the bone screws by hand only.

Repeat this procedure to insert all the necessary NCB Cancellous Screws.

It is recommended that the most proximal cancellous screws be placed parallel to the tibia plateau.

Check the fracture reduction, plate position and the leg axis with an image intensifier.

To secure the angular stability insert the NCB Locking Caps on all the cancellous screws used. Tighten the locking caps with the NCB Torque Screwdriver 6Nm, until a clicking sound is heard.

Note: �lways use the torque screwdriver to tighten the locking caps and make sure the screwdriver is not tilted during its usage. Failure to do so could damage the hex drive and might complicate extraction of the implant.

Remove the proximal K-wire.

Determine screw length with the NCB Depth Gauge

Use the NCB-PT Hexagonal Screwdriver to hand tighten the screw and apply compression (if needed)

Possible setting of the most proximal cancellous screws

Insert the locking caps using the NCB Torque Screwdriver to achieve 6Nm

1� NCB Proximal Tibia – Surgical Technique

Optional Cannulated Cancellous ScrewsNCB Cannulated Cancellous Screws are self-drilling and self-tapping. These screws can be precisely placed over the NCB Guide Wire, ∅ 1.6mm. � cannulated drill bit can be used to pre-drill hard cortical bone.

Insertion of the ∅ 1.6mm NCB Guide Wire Use the NCB Drill Guide to avoid excessive angulation of the cannulated screws with consequential failure of the locking mechanism.

For the 4.�mm cannulated cancellous screws insert the NCB-PT Drill Guide ∅ 3.3/1.6mm into the NCB Drill Guide ∅ 3.3mm.

Press the drill guide into the plate hole, tilt it into the preferred position and insert the NCB Guide Wire with threaded tip.

Note: Use only the NCB Guide Wire ∅ 1.6mm, L = 190mm.Failure to do so misleads the screw length measurement.

Use the NCB Drill Guides to avoid an inclination > 30° when inserting the NCB ∅ 1.6 guide wire


Insertion of the Cannulated Cancellous Screws Remove the NCB Drill Guide ∅ 3.3mm and NCB-PT Drill Guide ∅ 3.3/1.6mm and determine the screw length from the measurement with the NCB-PH/PT Measuring Device along the NCB Guide Wire.

For hard cortical bone it is possible to use the ∅ 3.3mm NCB-PT Cannulated Drill Bit.

Note: Use the ∅ 3.3mm NCB-PT Cannulated Drill Bit only for the lateral cortex to make sure that the NCB Guide Wire does not fall out.

Use the cannulated hexagonal screwdriver to insert the cannulated self-drilling screws over the 1.6mm NCB Guide Wire.

To achieve the final angular stability, remove the NCB Guide Wire and tighten the locking cap with the torque screwdriver 6Nm, until the clicking sound is heard.

Note: It is important to remove the NCB Guide Wire prior to inserting the locking cap because the axial directions for the cannulated screws and locking cap may be different.

Measure the screw length with the NCB-PH/PT Measuring Device

Insert the cannulated screw with thehexagonal cannulated screw driver


Cortical ScrewsBicortical insertion is recommended. For the 4.0mm cortical screws use the NCB Drill Guide 3.3mm with the 3.3mm drill bit. In case of hard cortical bone, tap the cortex with the NCB Tap. Remove the NCB drill guide 3.3mm when using the NCB Tap.

Measure the screw length and insert NCB Cortical Screw using the NCB Hexagonal Screwdriver.

Note: Tighten the bone screws by hand only.

Repeat this procedure to insert all the needed NCB Cortical Screws.

Insert the NCB Locking Caps to secure the angular stability as described for the cancellous screws.

Remove the distal K-wire after completing screw insertions.

Insert cortical screws

Possible final screw settingInsert the locking caps using the NCB Torque Screwdriver to achieve 6Nm


MIS Technique

MIS is recommended for simple and/ or extra-articular fractures. �n open approach is recommended in the proxi-mal area to restore the articular surface.

Plate Hole Numbering SystemTo target the correct plate holes there is a numbering system on the targeting devices.

Screw holes in the proximal and meta-physeal areas are indicated with Greek letters (α, β, γ, δ and ε). Screw holes in the shaft area are indicated with Roman numbers (1 to 13 according to plate length).

Incision and Fracture Reduction� lateral incision should start proximal to Gerdy’s tubercle and should be extended for about �0mm distally.

Note: Incision length will vary according to the type of fracture.

Reduce the fracture as described in the open technique. Take care that K-wires used to temporarily stabilize the fracture do not interfere with the future plate location.

Incision

45

67

5 ho

les

7 ho

les

9 ho

les

13 h

oles

δε

12

38

910

1112

13

α β γ

NCB screw hole numbering system


Targeting Device AssemblyUse the NCB-PT Right Targeting Device for NCB-PT Right Plates and the NCB-PT Left Targeting Device for NCB-PT Left Plates.

Center the targeting device in the specific indentations on the plate.

Insert and thread the NCB-PT Connection Bolt into the “δ” hole of the targeting device.

Note: To guarantee accurate assembly of the plate/targeting device, insert the NCB-PT Stabilization Bolt into the target-ing device hole corresponding to the last plate hole. Screw the NCB Stabilization Bolt into the plate and insert the Safety Lock Pin from the anterior side.

��nce the assembly of the plate/targeting device has been accomplished, tighten the NCB Connection Bolt with the screwdriver.

Remove the safety lock pin and the NCB-PT Stabilization Bolt in order to insert the plate.

Insertion and Preliminary Fixation of NCB-PT PlateUnder the image intensifier insert the plate between the anterior tibialis muscle and the periosteum: keep the distal end of the plate in continuous contact with the bone surface during insertion.

The plate should be placed as close toto the joint line as possible.as possible.

Connection Bolt

Safety Lock Pin

Stabilization Bolt

�ssembly of the targeting device prior insertion

Slide the plate between the anterior tibialis muscle and the periosteum


Insert a �.0mm K-wire through one of the small proximal holes for temporary fixation of the plate.

Make a stab incision at the most distal plate hole.

Insert the NCB-PT Stabilization Bolt, the NCB-PT K-wire Guide and the NCB-PT Trocar into the corresponding hole on the targeting device.

Screw the NCB-PT Stabilization Bolt into the plate and insert the safety lock pin as described previously.

Center the distal part of the plate on the bone using the image intensifier, remove the NCB-PT Trocar and insert a �.0mm K-wire to fix the plate.

Close the plate targeting device configuration to guarantee correct correspondence between the targeting device and plate holes

Center the distal part of the plate Temporary fixation of the plate

Anterior

Posterior


Insertion of NCB Screws in the Proximal AreaUse the same procedure as described in the open technique.

Repeat the procedure to insert the appropriate number of proximal screws.

Note: Check the fracture reduction and plate position under an image intensifier.

Lock the screws as described in the open technique.

��nly the most proximal screws can be inserted with open technique when the targeting device is on.

The screw numbered “δ” needs to be inserted when the targeting device is removed at the end of surgery.

The screw numbered “ε” can be inserted using the corresponding hole on the targeting device following the procedure described below.

Use the drill guide and drill bit to insert cancellous screws as described in the open technique

Screw hole numbering system

45

67

5 ho

les

7 ho

les

9 ho

les

13 h

oles

δε

12

38

910

1112

13

α β γ

NCB Proximal Tibia – Surgical Technique 21

Insert the tissue protection sleeve

Insertion of NCB Screws in the ShaftMake a stab incision to access the plate hole and insert the tissue protection sleeve assembly.

Screw the NCB-PT Drill Guide into the plate and then the NCB-PT soft tissue protection sleeve into the targeting device.

Remove the NCB-PT Trocar and NCB-PT K-wire Guide and insert the NCB-PT Drill Bit 3.3mm when the 4.0mm cortical screw is used.

Use the scale on the drill bit shaft or the NCB-PT Depth Gauge to determine the appropriate screw length.

�lternative measuring of the screw length with the NCB Depth Gauge

Drill the screw hole in the bone shaft


Remove the NCB-PT Drill Guide and insert the appropriate screw using the NCB-PT Hexagonal Screwdriver.

Note: The screw is completely inserted when the marker on the screwdriver reaches the soft tissue protection sleeve.

Insert and tighten the locking cap with the NCB Torque Screwdriver 6Nm, until a clicking sound is heard.

Note: �lways use the torque screwdriver to tighten the locking caps and make sure the screwdriver is not tilted during its usage. Failure to do so could damage the hex drive and might complicate extraction of the implant.

Remove the NCB-PT Soft Tissue Protec-tion and insert the NCB Screw Marker to indicate that the screw is placed and locked in the hole.

Repeat the described procedure to insert additional screws.

Insert the screw in the bone shaft

Use the screw marker to indicate that the screw is inserted and locked in the hole and proceed to insert additional screws

Insert the locking caps using the NCB Torque Screwdriver to achieve 6Nm


To place the most distal screw, exchange the NCB Stabilization Bolt with the NCB-PT Drill Guide and protection sleeve and follow the procedure described above.

Unscrew the connecting bolt to remove the targeting device.

Note: when using the long plate (i.e. 13 holes) the last three distal screws may interfere with the Superficial Peroneal nerve. Therefore, a slightly longer stab incision is recommended to visualize and avoid damage to the Superficial Peroneal nerve.

Implant Removal

To remove the NCB-PT Plate, first remove all the locking caps. Then loosen all the NCB Bone Screws without completely removing them (this prevents rotation of the bone plate when removing the last screw). Then, completely remove all the bone screws.

Note: Make sure that the tip of the NCB-PT Screwdriver is correctly placed in the hex drive of the locking caps and/or NCB Screws. Failure to do so could damage the hex drive and complicate the extraction of the implant.

Removal Tips• Re-assemble the NCB Targeting Device to remove the shaft screws if the MIS approach was used for implantation. The targeting device ensures that the axial direction used during implantation is considered.

• In case of difficulties in loosening the NCB Screws, tighten the screws slightly before loosening them.

Take care to avoid damageof the Superficial Peroneal nerve when using long plates

Remove the NCB Stabilization Bolt and insert the NCB Protection Sleeve to insert the most distal cortical screw

Possible final screw setting


Ordering Information – Implants

*Indicates the quantity in the plate sets.

Materials: NCB plates and screws are made of Protasul-64 titanium alloy Ti�l�, IS�� 3�-3,titanium alloy Ti�l�, IS�� 3�-3, �STM F136

NCB-PT 3-proximal hole plate set sterile-packed

Quantity* Holes mm Side REF

1 � 13� left 0�.0��61.30�1 7 17� left 0�.0��61.3071 9 �1� left 0�.0��61.309

1 � 13� right 0�.0��61.�0�1 7 17� right 0�.0��61.�071 9 �1� right 0�.0��61.�09

NCB-PT 3-proximal hole plate 13 holes

sterile-packed

Quantity* Holes mm Side REF

– 13 �9� left 0�.0��61.313– 13 �9� right 0�.0��61.�13

NCB Tibia Plate Set 00-2370-401-00


NCB Cancellous Screw, thread length3�mm

Quantity* L mm ∅ mm mm REF

� �0 �.0 3.� 0�.031��.0�0� �� .0 3.� 0�.031��.0��3 60 �.0 3.� 0�.031��.0603 6� �.0 3.� 0�.031��.06�3 70 �.0 3.� 0�.031��.0703 7� �.0 3.� 0�.031��.07�3 �0 �.0 3.� 0�.031��.0�0� �� .0 3.� 0�.031��.0�� 90 �.0 3.� 0�.031��.090

NCB Screw, self-tapping

Quantity* L mm ∅ mm mm REF

� 14 4.0 3.� 0�.031��.014� 16 4.0 3.� 0�.031��.016� 1� 4.0 3.� 0�.031��.01�� 0 4.0 3.� 0�.031��.0�0� �� 4.0 3.� 0�.031��.0�� 4 4.0 3.� 0�.031��.0�4� �6 4.0 3.� 0�.031��.0�64 �� 4.0 3.� 0�.031��.0��4 30 4.0 3.� 0�.031��.0304 3� 4.0 3.� 0�.031��.03�4 34 4.0 3.� 0�.031��.0344 36 4.0 3.� 0�.031��.0364 3� 4.0 3.� 0�.031��.03�� 40 4.0 3.� 0�.031��.040� 4� 4.0 3.� 0�.031��.04�� 44 4.0 3.� 0�.031��.044� 46 4.0 3.� 0�.031��.046� 4� 4.0 3.� 0�.031��.04�� 0 4.0 3.� 0�.031��.0�0� �� 4.0 3.� 0�.031��.0�� 60 4.0 3.� 0�.031��.060� 6� 4.0 3.� 0�.031��.06�� 70 4.0 3.� 0�.031��.070� 7� 4.0 3.� 0�.031��.07�� 0 4.0 3.� 0�.031��.0�0� �� 4.0 3.� 0�.031��.0�� 90 4.0 3.� 0�.031��.090

NCB Blind Screw Quantity* ∅ mm mm REF

� � 3.� 0�.031�0.310

NCB Spacer(red, blue, green)

Quantity* L mm mm Color REF

� 1 3.� red 0�.031�0.311� � 3.� blue 0�.031�0.31�� 3 3.� green 0�.031�0.313

L4.

�

M� × 0.7�

∅ 6.�∅ 4∅ 3.4

L1.7�

∅ 6.�∅ 4.�∅ �

L

1.7�

∅ �.9

33

NCB Locking Cap

Quantity* ∅ mm mm REF

1� � 3.� 0�.031�0.300

3.9

M� × 0.7�

* Indicates the quantity in the standard graphic case.

Materials: NCB plates and screws are made of Protasul-64 titanium alloy Ti�l�, IS�� 3�-3,Protasul-64 titanium alloy Ti�l�, IS�� 3�-3,titanium alloy Ti�l�, IS�� 3�-3, �STM F136

NCB Tibia Screw Set 00-2370-402-00


Graphic Case

NCB-PT Standard Graphic Casefor open technique; includes REF 0�.000�4.�01/.�0�/.�03/.�04/.�0� REF

with content ZS 02.00024.800empty ZS 0�.000�4.�10

NCB-PT Graphic Case, module cannulated screws and implants REF 0�.000�4.�04

NCB-PT Graphic Case, module screw rack REF 0�.000�4.�0�

NCB-PT Graphic Case, lid REF

0�.000�4.�01

NCB-PT Graphic Case base (Inox) REF

0�.000�4.�0�

NCB-PT Graphic Case, module instruments REF 0�.000�4.�03

*Indicates the quantity in the standard graphic case.


NCB Drill Bit, with quick couplingQuantity* L mm ∅ mm REF

1 19� 4.3 0�.000�4.00�

Standard Instruments

NCB Drill Guide ∅ �.�mm for screws∅ �.0 cancellousQuantity* ∅ mm REF

1 �.� 0�.000�4.010

NCB Drill Guide ∅ 4.3 screws ∅ �.0Quantity* ∅ mm REF

1 4.3 0�.000�4.011

NCB Torque Screwdriver, 6NmQuantity* L mm ∅ mm REF

1 ��0 3.� 0�.000�4.0�1

NCB Depth GaugeQuantity* L mm ∅ mm REF

1 110 �.0/4.�/4.0 0�.000�4.00�

NCB-PT Hexagonal Screwdriver, longQuantity* L mm mm REF 1 �7� 3.� 0�.000�4.1�4

Two-fluted drill bit, with quick couplingQuantity* L mm l mm ∅ mm REF

1 1�0 1�4 �.� 103.��.1�0

l

L ▲

▲

▲

▲

T-handle, with quick couplingQuantity* REF

1 100.90.�10

NCB-PT Tab ∅ 4mm, with quick couplingQuantity* ∅ mm REF

1 4.0 0�.000�4.040

Screw forceps self-holdingQuantity* REF

1 100.90.00�

NCB Drill Guide ∅ 3.3mm for screws ∅ 4.0/4.�Quantity* ∅ mm REF 1 3.3 0�.000�4.111

NCB Drill Bit, with quick couplingQuantity* L mm ∅ mm REF 1 19� 3.3 0�.000�4.11�

NCB-PT Hexagonal Screwdriver, shaftQuantity* L mm mm REF 1 – 3.� 0�.000�4.0�7

Kirschner wire, stainless steelQuantity* L mm ∅ mm REF

� ��0 �.0 �90.�0.��0

NCB Tibia Standard Instrument (NCBS) 00-2370-400-00 (includes Graphic Case shown on previous page)


NCB-PT Graphic Case, for MIS instruments REF

with content ZS 02.00024.850empty 0�.000�4.�06

�ssembly pinQuantity** REF

1 0�.0000�.001

NCB-PT Depth GaugeQuantity** REF

1 0�.000�4.007

NCB Screw Marker for targeting deviceQuantity** REF

� 0�.000�4.077

Safety lock pin for targeting device Quantity** REF � 0�.000�4.076

MIS Instruments

**Indicates the quantity in the MIS graphic case module.

NCB Tibia MIS Instrument Set 00-2370-400-01


NCB-PT Targeting DeviceQuantity** Side REF

1 right 0�.000�4.0�01 left 0�.000�4.0�1

NCB-PT Stabilization Bolt for targeting deviceQuantity** REF

1 0�.000�4.0�4

NCB-PT K-Wire Guide ∅ �.�/� mm Quantity** REF

� 0�.000�4.09�

NCB-PT TrocarQuantity** ∅ mm REF

� � 0�.000�4.093

NCB-PT Drill Bit with quick coupling Quantity** ∅ mm REF 1 �.� 0�.000�4.1��1 3.3 0�.000�4.1331 4.3 0�.000�4.143

NCB-PT Soft Tissue Protection sleeve ∅ 10.0/�.� mm Quantity** REF

� 0�.000�4.090

NCB-PT Connection BoltQuantity** REF

1 0�.000�4.0�3

NCB-PT Drill Guide ∅ �.�/�.� mm Quantity** REF

� 0�.000�4.091

**Indicates the quantity in the MIS graphic case module.

�0 NCB Proximal Tibia – Surgical Technique

Cannulated Options (Screws and Instruments)

NCB-PH Guide Wire with threaded tipQuantity*** L mm ∅ mm REF

� 190 1.6 0�.0136�.116

NCB-PH/PT Measuring Device for cannulated screwsQuantity*** REF 1 0�.000�4.�19

NCB-PH Hexagonal Screwdriver cannulated short hexQuantity*** L mm mm REF 1 �4� 3.� 0�.000�4.1�0

NCB-PT Cannulated Drill Bit with quick couplingQuantity*** ∅ mm REF

1 3.3 0�.000�4.�33

*** Indicates the quantity included in the Ref. Number 0�.000�4.�40

NCB Cannulated Cancellous Screw ∅ 4.�mm, self-drill �4mm thread length Protasul-64 �lloy

Quantity*** L mm ∅ mm mm REF

� �0 4.� 3.� 0�.031��.0�0� �� 4.� 3.� 0�.031��.0��3 60 4.� 3.� 0�.031��.0603 6� 4.� 3.� 0�.031��.06�3 70 4.� 3.� 0�.031��.0703 7� 4.� 3.� 0�.031��.07�3 �0 4.� 3.� 0�.031��.0�0� �� 4.� 3.� 0�.031��.0�� 90 4.� 3.� 0�.031��.090

∅ 3.�∅ 1.7�

∅ 3.� ∅ 4.� ∅ 6.�

1.7�

L�4

NCB-PT Drill Guide ∅ 3.3/1.6 mmQuantity*** REF

� 0�.000�4.19�

Cannulated Screws and Instrument Set REF ZS 02.00024.840

Materials: NCB plates and screws are made of Protasul-64 titanium alloy Ti�l�, IS�� 3�-3,Protasul-64 titanium alloy Ti�l�, IS�� 3�-3,titanium alloy Ti�l�, IS�� 3�-3, �STM F136

+H124972370002001/$080710R1G08S

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

97-�370-00�-00 Rev. 1 3.�ML Printed in US� ©�007, �00� Zimmer, Inc.

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

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