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DePuy Synthes

LISS DF

Technique Guide

2

Fixate LISS temporarily with Kirschner wires

Instrument

292.699 Kirschner Wire

⭋

2.0 mm

with threaded tip

For preliminary fixation of the plate, use 2.0 mm Kirschner
wires through the fixation and stabilization bolts.

Carefully check the position of the plate and the length of
the reduced injured limb. Once the reduction has been
successfully completed and the plate has been positioned
correctly, the locking screws can be inserted.

Plate Insertion

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Summary of Contents for LISS DF

Page 1: ...S DF The less invasive stabilization system for distal femur fractures Technique Guide This publication is not intended for distribution in the USA Instruments and implants approved by the AO Foundati...

Page 2: ......

Page 3: ...emoval 33 Tips 35 Instruments for Minimally Invasive Surgery 36 Implants 37 Instruments 39 Sets 42 Image intensifier control Warning This description is not sufficient for immediate application of the...

Page 4: ...he plate Angular stability Prevents screw loosening as well as primary and secondary loss of reduction Allows early functional mobilization As an internal fixator the plate preserves bone vascularizat...

Page 5: ...DePuy Synthes 3 LISS instrumentation for Stardrive and Hex drive The torque limiting screwdriver the screwdriver shaft and the cleaning instrument are available for screws with Stardrive and Hex drive...

Page 6: ...o porotic bone and multifragment fractures where traditional screw purchase is compromised Preservation of blood supply The LISS approach with its proven success preserves the blood supply through a m...

Page 7: ...5 Indications LCP DF is indicated for the stabilization of fractures of the distal femur These include Distal shaft fractures Supracondylar fractures Intra articular fractures Periprosthetic fracture...

Page 8: ...6 DePuy Synthes LISS DF Technique Guide Case 1 Male 20 years old poly trauma fracture 33 C3 Clinical Cases Preoperative Follow up after 6 weeks Follow up after 3 months Follow up after 5 months...

Page 9: ...DePuy Synthes 7 Case 2 Male 76 years old isolated fracture 33 B2 Preoperative Postoperative Follow up after 4 weeks...

Page 10: ...3 4 5 6 7 8 9 10 11 12 13 D B A E C G F Titanium St Steel Holes Length mm 422 251 222 251 5 156 422 253 222 253 7 196 422 255 222 255 9 236 422 257 222 257 11 276 422 259 222 259 13 316 04 124 031S 0...

Page 11: ...re the width of the x ray calibrator XRC on the radiograph 4 Measure the maximum condyle width MCW on the radiograph 5 Determine the real condyle width RCW 6 Determine the screw lengths for the screw...

Page 12: ...um condyle width on the radiograph MCW amounts to 91 mm Preoperative Planning RCW 50 55 91 83 mm The real condyle width RCW is therefore 83 mm The screw lengths are therefore Screw hole Screw length m...

Page 13: ...io Case System 68 122 052 Modular Insert for Modular Screw Rack for Screws 6 5 mm size 1 3 without Contents Vario Case System 68 122 054 Modular Screw Rack with Drawer Measuring Block and Lid length 2...

Page 14: ...e table to allow flexion of the knee during surgery Avoid too strong a traction and a fully extended knee as the forces of the gastrocnemius muscle would draw the distal fragment into recurvatum This...

Page 15: ...rtion Guide 4 324 043 Fixation Bolt for LISS Insertion Guide 5 Note In certain cases e g distal fracture treated with a short plate it may be advantageous to do the surgery without using the LISS inse...

Page 16: ...ation of the plate on the insertion guide during insertion introduce the stabilization bolt with the drill sleeve in hole B and thread it into the plate Note To prevent tissue ingrowth and facilitate...

Page 17: ...distal fragment manipulation 5 Surgical approaches Extra articular fractures Perform a skin incision from Gerdy s tubercle about 80 mm in a proximal direction Split the iliotibial tract in the direct...

Page 18: ...d the proximal end of the handle and the soft tissues impair the insertion of the plate it is possible to remove the radiolucent proximal part of the handle for insertion Plate Insertion Due to its we...

Page 19: ...or by direct palpation Option Check plate position with a Kirschner Wire Instrument 292 699 Kirschner Wire 2 0 mm with threaded tip Use a Kirschner wire to check the correct position of the proximal...

Page 20: ...ip For preliminary fixation of the plate use 2 0 mm Kirschner wires through the fixation and stabilization bolts Carefully check the position of the plate and the length of the reduced injured limb On...

Page 21: ...dis tance between bone and plate should be kept as short as possible when inserting the wires as they are arranged in a convergent way After the insertion of the Kirschner wires the distance between p...

Page 22: ...nserted in each main fragment length and rotation are defined Ante and recurvatum deformities can still be manipulated relatively well whereas there are only limited correction possibilities for varus...

Page 23: ...th The length of the condylar screws can be deduced from the table on page 9 Use screws of 26 mm length in the diaphyseal region Options In case of very thick cortex pre drill by using the pulling dev...

Page 24: ...laced through the centering sleeve Using image intensification insert the Kirschner wire to the desired depth leaving at least 5 mm between the tip of the Kirschner wire and the medial cortex Measure...

Page 25: ...324 019 Stopper To insert the locking screw using a power tool fit a torque limiter to the power tool and insert the screwdriver shaft into the torque limiter Insert the locking screw into the plate h...

Page 26: ...e power tool without high axial forces 3 to 5 kg To prevent heat necrosis it is important to cool the screw with saline solution during the drilling procedure through the drill sleeve If the screw is...

Page 27: ...rill sleeve for LISS insertion guide 2 Predrill screw hole Instruments 324 007 Drill Sleeve 7 2 4 3 length 130 mm 310 423 Drill Bit 4 3 mm length 280 mm Remove the trocar and thread the drill sleeve 7...

Page 28: ...the drilled depth directly from the laser mark on the drill bit Remove both drill bit and drill sleeve 7 2 4 3 Note Replacement stop rings can be ordered from the local Synthes representative Option T...

Page 29: ...w according to the meas ured length To insert the locking screw using a power tool fit a torque limiter to the power tool and insert the screw driver shaft into the torque limiter Insert the locking s...

Page 30: ...make it difficult to remove the implant For long screws and thick cortical bone ensure sufficient cooling during insertion Option B Insertion of Self Tapping Bicortical Locking Screws Option Manual in...

Page 31: ...on of the plate on the diaphysis They are available in five lengths of 8 10 12 14 and 18 mm and allow the thread to engage in the near cortex Option C Insertion of Self Tapping Locking Screws for Peri...

Page 32: ...intensifier control Drill as close to the prosthesis or intramedullary implant as possible to allow for the placement of the longest periprosthetic screw possible 3 Determine screw length Slide the s...

Page 33: ...ording to the measured length Insert and lock the screw with the torque limiting screwdriver through the drill sleeve for LISS insertion guide Insert a stopper into the LISS insertion guide after scre...

Page 34: ...crew Stop the power tool before the entire screw length of the pulling device is inserted Remove the power tool and the drill sleeve Screwing the knurled nut onto the pulling device allows the bone to...

Page 35: ...nal length 158 mm or 324 250 Screwdriver Shaft Stardrive T25 length 158 mm 324 052 Torque limiting Screwdriver 3 5 hexagonal or 314 163 Torque limiting Screwdriver Stardrive T25 Remove the implant onl...

Page 36: ...s manually with the torque limiting screwdriver In a second step completely remove all screws with a power tool If the screws cannot be removed with the screwdriver please consult the separate Synthes...

Page 37: ...nd remove the drill sleeve After reconnecting the screwdriver to the power tool withdraw the screwdriver from the screw Standard 4 5 mm cortex screws can be used through the in sertion guide if requir...

Page 38: ...Hohmann retractor holder allows better visualization of the inserted plate Serves as a guide for the inserted plate Ensures that the inserted plate is centered on the bone For additional information s...

Page 39: ...222 256 422 256 11 276 right 222 257 422 257 11 276 left 222 258 422 258 13 316 right 222 259 422 259 13 316 left 02 124 030S 04 124 030S 15 356 right 02 124 031S 04 124 031S 15 356 left 02 124 034S...

Page 40: ...g X13 390 X12 227 length 14 90 mm 0X 221 458 0X 221 508 for periprosthetic 0X 221 460 0X 221 510 fractures 0X 221 462 0X 221 512 self tapping X22 402 0X 221 514 length 8 18 mm X22 404 0X 221 518 X 2 s...

Page 41: ...Fixation Bolt for LISS Insertion Guide length 151 mm 321 170 Pin Wrench 4 5 mm length 120 mm 324 022 Drill Sleeve for LISS Insertion Guide length 130 mm 324 044 Stabilization Bolt for LISS Insertion G...

Page 42: ...ng Screws 5 0 mm 324 050 Screwdriver Shaft 3 5 hexagonal length 158 mm 324 250 Screwdriver Shaft Stardrive T25 length 158 mm 324 055 Centering Sleeve for Kirschner Wire length 161 mm for No 324 022 32...

Page 43: ...034 Centering Sleeve for Kirschner Wire length 184 mm for No 324 048 292 699 Kirschner Wire 2 0 mm with threaded tip length 280 mm Stainless Steel 324 037 LISS Measuring Device for Kirschner Wires 2...

Page 44: ...rdrive 68 120 040 Vario Case LCP DF 4 5 5 0 in Vario Case 01 120 332 Stainless steel 01 120 334 Titanium Alloy TAN 68 120 330 Insert Note on long plates The LCP DF plates with 15 to 19 holes are avail...

Page 45: ...dular Insert for Modular Screw Rack for Screws 6 5 mm size 1 3 without Contents Vario Case System 68 122 054 Modular Screw Rack with Drawer Measuring Block and Lid length 200 mm height 115 mm size 1 2...

Page 46: ...14 Injury 2001 Int J Care Injured 32 S C Kobbe P Hockertz TJ Reilmann H 2006 Periprothetische Frakturen Periprosthetic Fractures OP Journal 22 22 26 Schandelmaier P et al 1999 LISS Osteosynthese von d...

Page 47: ......

Page 48: ...965 66 00 www depuysynthes com 0123 This publication is not intended for distribution in the USA All surgical techniques are available as PDF files at www synthes com lit DePuy Synthes Trauma a divis...

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