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Below is a collection of resources to learn more about the latest innovations in Arthrex Trauma products and techniques.

Arthrex Trauma Innovations

Trauma Upper Extremities

Trauma Lower Extremities

Arthrex.com

Rep Site

Rep App

Surgeon App

Dive into the latest innovations within the Arthrex Trauma portfolio

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video

Animations demonstrating the features and benefits of a specific product.

Animationen, die die Funktionen und Vorteile eines bestimmten Produkts demonstrieren.

Produktdemonstrationen

Animações demonstrando os recursos e benefícios de um produto específico.

Vídeos de demonstração de produtos

Animaciones que demuestran las características y beneficios de un producto específico.

Videos de demostración de productos

Product Demonstrations

Arthrex Trauma Innovations

application/pdf

A document containing information about Arthrex products and product lines.

Ein Dokument mit Informationen über Arthrex Produkte und Produktlinien.

Broschüren

Documento contendo informações sobre produtos e linhas de produtos da Arthrex.

Brochuras

Documento que contiene información sobre los productos y líneas de productos de Arthrex.

Folletos

Brochures

Trauma New Product and Technique Highlights Post-op Compression Without Lateralization Arthrex Trochanteric Nail System: Revolutionizing Hip Fracture Treatment Telescoping Lag Screw Allows for controlled, self-contained collapse within the lag screw Eliminates lateral lag screw protrusion postoperatively Locking ring on lag screw eliminates need for proximal set screw Left-threaded screw option may prevent loss of reduction during insertion in left-sided fractures Featurin Telesco g the p Lag Screing w Right-threaded Left-threaded Antegrade and Retrograde Have It Both Ways With the Arthrex Femoral Nail System Containing unique screw configurations for both antegrade and retrograde nailing, this system incorporates threaded static holes to prevent screw migration. Antegrade Cortical, cancellous, and partially threaded screw options Retrograde Unique intercondylar compression system 6.5 mm screws target posterior condyles FibuLock® Nail and TightRope® XP Implant Combined for the First All-Inside Ankle Fracture Repair FibuLock Nail Innovative proximal talon fixation Minimally invasive Multiplanar, distal 2.7 mm screw fixation TightRope XP Implant Since 2005: Clinically proven via multiple randomized, controlled trials1,2 Faster rehabilitation2 Decreased malreduction1,2 No medial incision Cost-effective vs screws3 Superior biomechanical properties vs DePuy Synthes Fibulink®4 Newtons 350 300 Static Load-to-Failure 321 285 250 200 TightRope XP Implant Fibulink System Increased load to failure4 22% less mediolateral elongation4 #5 suture vs #1 suture References 1. Shimozono Y, et al. Suture button versus syndesmotic screw for syndesmosis injuries: a metaanalysis of randomized controlled trials. Am J Sports Med. 2019;47(11):2764–2771. 2. Sanders D, et al. Improved reduction of the tibiofibular syndesmosis with TightRope compared to screw fixation: results of a randomized controlled study. J Orthop Trauma. 2019;33(11):531-537. 3. Neary KC, et al. Suture button fixation versus syndesmotic screws in supination-external rotation type 4 injuries: a cost-effectiveness analysis. Am J Sports Med. 2017;45(1):210-217. 4. Arthrex, Inc. Data on file (APT-05370). Naples, FL; 2021. Patella SuturePlate™ II Stability, Compression, and Soft-Tissue Repair in One Suture holes for extensor mechanism repair Nearly a decade of clinical evidence1 Hook option for pole fractures Pairs well with the Patellar Fracture System, FiberTape® cerclage, and SutureTape Reference 1. Wurm S, Bühren V, Augat P. Treating patella fractures with a locking patella plate - first clinical results. Injury. 2018;49 Suppl 1:S51-S55. doi:10.1016/S0020-1383(18)30304-8 Works with KreuLock™ locking compression screws Proximal Humeral Plating System ALPHA Plate Anatomic-specific curvature allows for deltoid-sparing approach Sits 1.0 cm to 1.5 cm distal to the greater tuberosity Converging screw pattern helps to increase screw length into subchondral bone Distal bend facilitates easier access to the plate through an extended deltopectoral approach 130° Proximal Humeral Plate 95° Plate Tibial Nail System Designed to provide intramedullary fixation for fractures, malunions, and nonunions of the tibia Flexible soft-tissue guide alleviates pressure on the patellofemoral joint Up to 8 mm intraoperative compression Proximal fixation includes two statically locked threaded holes and one slot for fracture dynamization, apposition, or compression Tibial Nail System Instrument Kit A Campus Designed for Orthopedic Surgical Skills Education The expanded Arthrex world headquarters, located in Naples, FL, is an innovative, 80-acre, university-style campus designed to deliver an immersive and engaging medical education experience for visiting health care professionals. The Arthrex campus provides a one-of-a-kind learning environment for surgeons and health care professionals. arthrex.com © 2023-01 Arthrex, Inc. All rights reserved. evBR1-002495-en-US_C

Trauma New Product and Technique Highlights

A comprehensive overview of a product team’s portfolio.

Ein umfassender Überblick über das Portfolio eines Produktteams.

Kataloge

Visão geral e abrangente do portfólio de produtos de cada segmento.

Catálogos

Descripción general y completa sobre la cartera de productos de cada segmento. 

Catalogs

Trauma: Next Generation in Repair and Reconstruction

ArthrexTV

The Arthrex trochanteric nail is a next-generation hip nail that addresses the remaining shortcomings of current systems such as lateral lag screw irritation, lag screw cut out, workflow inefficiencies, and loss of rotational reduction. The system consists of three nail types—short nails, long nails, and the innovative ES nail.

A general overview including the relevant steps of an Arthrex surgical technique. These animations always include a voice-over explaining the process.

Eine allgemeine Übersicht, einschließlich der relevanten Schritte einer Arthrex Operationsanleitung. Diese Animationen enthalten immer Voice-Overs, die den Prozess erklären.

Operationstechnik-Animationen

Visão geral incluindo as etapas relevantes de uma técnica cirúrgica Arthrex. Essas animações sempre incluem uma narração explicando o processo.

Animações de técnicas cirúrgicas

Descripción general que incluye los pasos relevantes de una técnica quirúrgica de Arthrex. Estas animaciones siempre incluyen una voz en off que explica el proceso.

Animaciones de técnicas quirúrgicas

Surgical Technique Animations

Trochanteric Nail System With Telescoping Lag Screw

The entry point for the nail is typically at the tip of the greater trochanter on the AP x ray, and at the junction of the anterior and middle third of the greater trochanter on the lateral x ray. This point may vary slightly depending on the patient anatomy and fracture pattern. Insert the 3.2mm guide, pin through the soft tissue Protector and aim towards the central axis of the femoral shaft. Advance at least to the level of the lesser trochanter. The pin trajectory is verified through fluoroscopy. Remove the black pin guide and remove the guide pin with the 16.5mm cannulated entry reamer. The entry reamer has grooves which are read from the top of the soft tissue. Protector. The grooves indicate the reaming depth needed to insert the nail flush 5mm or 10mm deep into the femur. The 3.2mm guide pin is removed, and the 3.0mm ball nose guide wire is introduced down the shaft of the femur using the guidewire gripper. The length for the trochanteric nail and long trochanteric nail is determined by sliding the guidewire depth gauge over the guidewire to the greater trochanter, and reading the measurement from the laser mark on the guidewire. Begin reaming with the eight millimeter end cutting reamer over the ball. Nose. Guidewire. Sequentially. Ream larger with the side cutting reamers until cortical chatter is achieved. It is recommended to ream at least 1.0 to 1.5 millimeter over the desired nail diameter. Introduce the nail into the proximal femur over the guidewire using the radiolucent targeting arm to control nail rotation. Complete the insertion with gentle mallet strikes on the impactor pad. Once the desired nail depth has been achieved, insert the lag screw triple sleeve assembly through the targeting arm by pressing the black button. Slide in the assembly until it contacts the lateral cortex of the femur. Remove the obturator and place the 3.2mm lag screw guide pin through the pin guide. Verify the pin depth and trajectory using fluoroscopy. Place the guide pin depth gauge with the flat end against the pin guide under the 3.2mm lag. Screw guide pin and read the measurement. The guide pin is measured to the tip, so at least 5 to 10mm should be subtracted from the measurement when determining drilling depth and lag. Screw length selection. Other factors such as fracture reduction, nail position, and anticipated fracture compression should be accounted for. Remove the 3.2mm pin guide. Set the adjustable stop on the 10.3mm cannulated lag. Screw drill at at least 5 to 10mm less than the measurement, so the tip of the drill does not pass beyond the guide pin. Insert the 10.3mm cannulated lag screw. Drill over the guide pin and drill into the femoral head until the depth stop contacts the sleeve. Slide the lag screw inserter assembly over the guide pin and through the lag screw sheath. Rotate the assembly clockwise with the blue handle. When the black laser marking on the inserter reaches the sheath. The lag screw has exited the other end of the sheath. It is recommended to insert the lag screw further if intraoperative compression is planned. The 10.5mm telescoping lag screw features many innovative internal features and mechanisms, and is locked into the nail via expansion of the circumferential locking ring. The design allows up to ten millimeters of postoperative compression within the lag screw to prevent lateral thigh pain. For initial compression of the fracture. Push the compression sleeve towards the targeting arm and rotate clockwise until the desired compression is achieved. Pull back on the gold knob and turn counterclockwise to disengage the blue handle and engage the black handle. The black line will now be showing to lock the telescoping lag screw. Hold the blue handle stationary and turn the black handle clockwise until the torque limiter clicks. Remove the lag screw capturing rod nut by hand or with the ball hex driver. Pull out the lag screw inserter assembly and unscrew the lag screw capturing rod by hand or with the removal tool. The lag screw guide pin is also removed to allow post-operative compression in the telescoping lag screw. Remove the activation sleeve by inserting the activation tool through the sheath into the lag screw and turning counterclockwise. The activation sleeve will retain the tip of the activation tool. Once disengaged from the lag screw, remove the lag screw sheath to complete the lag screw insertion. For the ES trochanteric nail and short trochanteric nail, distal locking is performed through the targeting module. Place the distal screw triple sleeve assembly through the appropriate distal hole in the targeting module and mark the skin. Make the incision and advance the distal screw. Triple sleeve assembly to the lateral cortex of the bone. Remove the distal drill guide. Obturator drill bicortical using the 4.0mm calibrated drill bit. Determine the screw length using the calibrations on the drill bit. Remove the distal drill guide and insert the 5.0mm captured screw with the 5.0mm hex driver. When the first laser mark reaches the sheath, the bottom of the screw head has reached the other end of the sheath. Unscrew the capturing rod in the hex driver and remove the driver assembly. To remove the targeting arm, unscrew the locking bolt from the jig through either the top hole or impactor pad. Attachment hole. As the fracture begins to heal. The telescoping lag screw is able to compress up to ten millimeters without any lateral protrusion into the surrounding tissue. The Arthrex trochanteric nail system is available in three nail types. The short nail. Long nail. And innovative S nail.

Foot and Ankle

Hand and Wrist

A step-by-step demonstration of how a product would (or could) be used in a surgical technique.

Eine schrittweise Demonstration, wie ein Produkt in einer Operationsanleitung verwendet werden würde (oder könnte).

Operationsanleitungen

Demonstração passo a passo de como um produto seria utilizado em uma técnica cirúrgica.

Guias de técnicas cirúrgicas

Demostración paso a paso de cómo se utilizaría un producto en una técnica quirúrgica.

Guías de técnicas quirúrgicas

Surgical Technique Guides

Mini Fragment System Surgical Technique Mini Fragment System Introduction The Mini Fragment System (or “Mini Frag”) is designed to aid in the reduction and fixation of small and long bone trauma injuries. The tray modularity offers screw and plate options in 2.0 mm, 2.4 mm, and 2.7 mm variants. With a wide array of plates to fit a multitude of trauma needs, the Mini Fragment System is a keystone addition to the Arthrex Trauma portfolio. Features and Benefits Reduction instruments and 6 plate-bending options to meet surgeon and patient needs Reinforced plating options across all 3 plate sizes provide added stability when a stronger construct is desired A wide variety of plates and screws (2.0 mm in lengths up to 40 mm and 2.4 mm and 2.7 mm screws up to 80 mm) The split tray design provides intraoperative efficiency by simultaneously making general instruments and the size-specific caddies immediately available, reducing the overall footprint of the entire system Each caddy features a compact instrumentation drawer with size-specific short instrumentation 02 I Mini Fragment System Indications The Arthrex Mini Fragment System is indicated for fracture fixation, reconstruction, replantation, stabilization, reduction, fusions, osteotomies, malunions, and nonunions of small bones and small bone fragments, including normal and osteopenic bones in adult and adolescent (12 to 21 years) patients. The system is also indicated for non–load-bearing stabilization and reduction of bone fragments in long bones. 2.0 mm Module The 2.0 mm plate module can be used as a standalone system and contains all necessary plates, screws, and instrumentation. The updated caddy contains: Standard AO connect drills and drivers 18 plate options, including reinforced and standard Screws from 6.0 mm to 40 mm in cortical and variable-angle locking (VAL) options Plate Thickness Standard: 1.2 mm Reinforced: 1.3 mm Variable Lengths 36 mm-77 mm (6- to 10-hole) Multiple Screw Options 2.0 Cortical: 6.0 mm-40 mm 2.0 VAL: 6.0 mm-40 mm Mini Fragment System I 03 2.4 mm Module The 2.4 mm module features standard length instrumentation. Long instrumentation and depth gauges for screw lengths up to 80 mm can be found in the general instrument tray. The 2.4 module contains: 19 plate options, including longer 20-hole options in standard and reinforced Cortical and VAL screws from 6.0 mm to 80 mm Standard AO connect drills and drivers Plate Thickness Standard: 1.2 mm Reinforced: 1.5 mm Variable Lengths 40 mm-131 mm (6- to 20-hole) Multiple Screw Options 2.4 Cortical: 6.0 mm-80 mm 04 I Mini Fragment System 2.4 VAL: 6.0 mm-80 mm Compatible with 2.4 mm KreuLock™ screws (ordered separately) 2.7 mm Module The 2.7 mm module houses 2.7 mm plates, screws, and standard instrumentation. The long instrumentation and depth gauges for screw lengths up to 80 mm can be found in the general instrument tray. This caddy contains: 23 plate options, 4 to 20 holes in length, in varying geometries Cortical and VAL screws from 6.0 mm to 80 mm Wide T-plate options (6-, 10-, and 20-hole) 6- and 10-hole tine plate options Standard AO connect drills and drivers Plate Thickness Standard: 1.4 mm Reinforced: 2.2 mm Variable Lengths 29 mm-141 mm (4- to 20-hole) Multiple Screw Options 2.7 Cortical: 6.0 mm-80 mm 2.7 VAL: 6.0 mm-80 mm Compatible with 3.0 mm screws from Comprehensive Fixation System (CFS) (ordered separately) ● 3.0 mm VAL and KreuLock™ screws ● 3.0 mm Hybrid VAL and KreuLock screws Tine plate for additional fragment stabilization Mini Fragment System I 05 Plate Contouring and Modification The Mini Fragment System’s instrumentation aids in plate modification to fit the unique needs of each surgery. Plate Cutters Two plate cutters to cut selected plate to desired length. The straight plate cutter is compatible with all plate families and is used to make straight cuts. Note: This cutter may leave sharp edges at the cut site. The round plate cutter features dedicated slots for 2.0 mm, 2.4 mm, and 2.7 mm plates. These slots protect the screw holes and allow the user to cut a round edge into the plate while preserving the locking features of the hole nearest to the cut. The file on the side of the cutter can be used to remove any sharp ends. Tip: The preserved portion of the plate is on the guarded side of the cutter. After cutting the plate to the desired length, it can be contoured by hand or using needlenose pliers or one of 4 dedicated contouring instruments. Standard Plate Benders Featuring dedicated slots for each plate size, standard plate benders feature a variety of tools to contour plates to the desired shape. Additionally, the grooves on the long axis of the bender can be used for additional leverage. 06 I Mini Fragment System French-Style Plate Benders French benders are an additional option if more leverage is needed. Plates can be loaded in a variety of ways for in-plane and out-of-plane bending to create radial bends, smooth curves, or more acute bends. Bending Pliers Dedicated left- and right-bending pliers protect the locking screw holes when necessary while providing the ability to manipulate the plates in any plane. These pliers are compatible with 2.0 mm, 2.4 mm, and 2.7 mm plates. Bending Towers Each caddy contains bending towers that thread into their respective locking holes. These towers can be used to manipulate the plate to the desired contour. Additionally, these towers can be used for in situ plate contouring when the fracture pattern allows. Note: Be sure to fully engage the threads of the locking tower in the locking hole and avoid crossthreading prior to bending the plate. Mini Fragment System I 07 Surgical Technique This surgical technique can be replicated with the 2.0 mm and 2.4 mm modules using their respective instrumentation If additional instructions for the 2.0 plates are required, refer to the technique guide for the Mini CFS. 1 2 Select the appropriate plate and use the previously described techniques to contour it to the desired shape. 3a Use BB-Taks or K-wires to provisionally fixate the plate. The calibrated, drill-tip K-wires can be used with the 2.4 and 2.7 mm locking towers to simultaneously pin the plate while drilling and measuring for the final screw. Use the double-ended drill guide or extended drill/depth guide to drill for a cortical screw to secure the plate to bone. The doublesided drill guide can also aid in independent lag screw placement. Use the standard drill bit for screws under 50 mm and the long drill bit and extended drill/depth guide for screws over 50 mm. The long instrumentation is only available for the 2.4 mm and 2.7 mm plates and screws. When using the long calibrated drills with the locking towers or the extended drill/depth guide, use the single laser line for screws under 50 mm and the double laser line for screws over 50 mm. Note: The short drill bits do not feature calibration marks. 3b Plate Size Color Short Drill Bit Long Drill Bit Lag Drill Bit Drill-Tip Guidewire 2.0 mm Blue 1.5 mm (AR-18800-01) N/A 2.0 mm (AR-18800-02) 1.25 mm (AR-18800-35) 2.4 mm Green 1.7 mm (AR-18800-49) 1.7 mm (AR-18800-16) 2.4 mm (AR-4160-24) 1.6 mm (AR-18800-36) 2.7 mm Purple 2.0 mm (AR-18800-18) 2.0 mm (AR-18800-19) 2.7 mm (AR-18800-20) 2.0 mm (AR-18800-37) 08 I Mini Fragment System 4 Additionally, the VAL drill guide fully seats into the plate to allow for up to 15° of off-axis locking. 5 If using a noncalibrated technique, use the corresponding depth gauge to determine screw length. Use the long depth gauge for any 2.4 mm or 2.7 mm screw over 60 mm. Insert the appropriate screw using the corresponding screwdriver. Modular, retaining, and nonretaining drivers and solid hand drivers are available. For smaller screws, a capturing guide can be used to stabilize the screw on the driver. For locking screws, a torque-limiting handle or modular torque-limiting adapter is available. Plate Size Driver Size 2.0 mm T6 2.4 mm T8 2.7 mm T10 6 Mini Fragment System I 09 7 Additional options are available for cortical or VAL screw preparation. Calibrated, drill-tipped K-wires (highlighted above) and calibrated AO drills can be used with locking towers and the extended instrumentation to drill for the final screws. Both feature the single and double laser lines for measuring purposes. 8 Repeat steps as needed for the remaining screws. This system can be used in conjunction with other Arthrex Trauma systems. 10 I Mini Fragment System Plate Shape 2.0 mm Plate Thickness: 1.2 mm Reinforced Plate Thickness: 1.3 mm 2.4 mm Plate Thickness: 1.25 mm Reinforced Plate Thickness: 1.5 mm 2.7 mm Plate Thickness: 1.4 mm Reinforced Plate Thickness: 2.2 mm Rotation Correction Plate 5-hole, 37 mm, AR-18720P-48 Straight Plate 6-hole, 36 mm, AR-18720P-03 10-hole, 61 mm, AR-18720P-07 6-hole, 40 mm, AR-18724P-03 10-hole, 68 mm, AR-18724P-07 20-hole, 131 mm, AR-18724P-55 4-hole, 26 mm, AR-18827P-01 6-hole, 43 mm, AR-18827P-03 8-hole, 57 mm, AR-18827P-05 10-hole, 72 mm, AR-18827P-07 20-hole, 141 mm, AR-18827P-08 Reinforced Straight Plate 6-hole, 36 mm, AR-18720P-24 8-hole, 48 mm, AR-18720P-26 6-hole, 40 mm, AR-18724P-17 8-hole, 53 mm, AR-18724P-19 20-hole, 131 mm, AR-18724P-56 4-hole, 26 mm, AR-18827P-09 6-hole, 43 mm, AR-18827P-11 8-hole, 57 mm, AR-18827P-13 10-hole, 72 mm, AR-18827P-15 20-hole, 141 mm, AR-18827P-16 Bridge Plate 6-hole, 40 mm, AR-18720P-55 6-hole, 46 mm, AR-18724P-34 Cage Plate 2 × 5 hole, 35 mm, AR-18720P-49 2 × 5 hole, 45 mm, AR-18724P-54 Hook Plate 6-hole, 44 mm, AR-18827P-38 10-hole, 73 mm, AR-18827P-39 2-Hole T-Plate 6-hole, 42 mm, AR-18720P-17 8-hole, 54 mm, AR-18720P-19 6-hole, 46 mm, AR-18724P-10 8-hole, 60 mm, AR-18724P-12 2-Hole Reinforced T-Plate 6-hole, 42 mm, AR-18720P-31 8-hole, 54 mm, AR-18720P-33 6-hole, 46 mm, AR-18724P-42 8-hole, 60 mm, AR-18724P-44 6-hole, 49 mm, AR-18827P-26 10-hole, 78 mm, AR-18827P-30 3-Hole T-Plate 6-hole, 51 mm, AR-18827P-19 10-hole, 79 mm, AR-18827P-23 3-Hole Reinforced T-Plate 6-hole, 51 mm, AR-18827P-47 10-hole, 79 mm, AR-18827P-48 Mini Fragment System I 11 2.0 mm Plate Thickness: 1.2 mm Reinforced Plate Thickness: 1.3 mm 2.4 mm Plate Thickness: 1.25 mm Reinforced Plate Thickness: 1.5 mm Y-Plate 6-hole, 45 mm, AR-18720P-10 8-hole, 57 mm, AR-18720P-12 6-hole, 50 mm, AR-18724P-49 8-hole, 65 mm, AR-18724P-51 V-Plate 6-hole, 52 mm, AR-18720P-37 10-hole, 77 mm, AR-18720P-41 6-hole, 57 mm, AR-18724P-23 10-hole, 84 mm, AR-18724P-27 Triangular Plate 8-hole, 57 mm, AR-18720P-54 8-hole, 65 mm, AR-18724P-39 6-hole, 54 mm, AR-18827P-33 10-hole, 83 mm, AR-18827P-37 Wide T-Plate 6-hole, 43 mm, AR-18720P-43 10-hole, 68 mm, AR-18720P-47 6-hole, 48 mm, AR-18724P-29 10-hole, 75 mm, AR-18724P-33 6-hole, 51 mm, AR-18827P-41 10-hole, 79 mm, AR-18827P-45 20-hole, 141 mm, AR-18827-46 Plate Shape 12 I Mini Fragment System 2.7 mm Plate Thickness: 1.4 mm Reinforced Plate Thickness: 2.2 mm Mini Fragment System (AR-18800FS) Product Description Implants and Disposables (AR-18800FI) Item Number Instruments, 2.0 mm Drill guide, VAL, cone-shaped, 2.0 mm AR-18700-61 Driver shaft, T6, self-retaining, AO AR-18800-03 Driver shaft, T6, non-retaining, AO AR-18800-04 Screwdriver, T6 hexalobe, solid AR-18800-05 Holding sleeve, 2.0 mm AR-18800-08 Locking bending tower, 2.0 mm AR-18800-09 Depth/drill guide, 2.0 mm AR-18700-37 Depth device, 2.0 mm AR-18800-38 Drill guide, 1.5 mm/2.0 mm AR-18800-48 Instruments, 2.4 mm Drill guide, 1.7 mm/2.5 mm AR-8916-05 Locking bending guide, 2.4 mm AR-8950-08 Holding sleeve, 2.4 mm AR-18700-38 Driver shaft, T8, self-retaining, AO AR-18700-54 Driver shaft, T8, non-retaining, AO AR-18700-55 VAL drill guide, cone-shaped, 2.4 mm AR-18700-62 Screwdriver, T8 hexalobe, solid AR-18800-14 Locking tower, 2.4 mm AR-18800-15 Instruments, 2.7 mm Drill guide, 2.0 mm / 2.7 mm AR-18800-22 Driver shaft, T10, self-retaining AR-18800-24 Driver shaft, T10, non-retaining AR-18800-25 Screwdriver, T10, solid AR-18800-27 Locking tower, 2.7 mm AR-18800-30 VAL guide, cone-style, 2.7 mm AR-18800-31 Holding sleeve, 2.7 mm AR-18800-32 Locking bending tower, 2.7 mm AR-18800-33 General Instruments Product Description Item Number Guidewire w/ trocar tip, 0.062 in AR-8941K Guidewire w/ trocar tip, 1.35 mm Guidewire w/ trocar tip, 0.078 in × 5.91 in (2 mm ×150 mm) Drill bit, 1.7 mm, long AR-8943-01 Drill bit, 2.0 mm, long, AO AR-18800-19 Guidewire, drill tip, 1.25 mm AR-18800-35 Guidewire, drill tip, 1.6 mm AR-18800-36 Guidewire, drill tip, 2.0 mm AR-18800-37 AR-8945K AR-18800-16 Plates, 2.0 mm Straight plate, 2.0 mm, 6H AR-18720P-03 Straight plate, 2.0 mm, 10H AR-18720P-07 Y-plate, 2.0 mm, 6H AR-18720P-10 Y-plate, 2.0 mm, 8H AR-18720P-12 T-plate, 2.0 mm, 6H AR-18720P-17 T-plate, 2.0 mm, 8H AR-18720P-19 Straight plate, 2.0 mm, 6H, reinforced AR-18720P-24 Straight plate, 2.0 mm, 8H, reinforced AR-18720P-26 T-plate, 2.0 mm, 6H, reinforced AR-18720P-31 T-plate, 2.0 mm, 8H, reinforced AR-18720P-33 V-plate, 2.0 mm, 6H AR-18720P-37 V-plate, 2.0 mm, 10H AR-18720P-41 Wide T-plate, 2.0 mm, 6H AR-18720P-43 Wide T-Plate, 2.0 mm, 10H AR-18720P-47 T-plate rotation correction, 2.0 mm, 5H AR-18720P-48 Cage plate, 2.0 mm, 2H × 5H AR-18720P-49 Triangle plate, 2.0 mm, 8H AR-18720P-54 Bridge plate, straight, 2.0 mm, 6H AR-18720P-55 Screws, 2.0 mm Low profile screw, cortical, 2.0 mm × 6.0 mm-15 mm (1.0 mm increments) AR-18720-06-15 VAL screw, Ti, 2.0 mm × 6.0 mm-15 mm (1.0 mm increments) AR-18720V-06-15 Low profile screw, cortical, 2.0 mm × 16 mm-40 mm (2.0 mm increments) AR-18720-16-40 VAL screw, Ti, 2.0 mm × 16 mm-40 mm (2.0 mm increments) AR-18720V-16-40 AR-18700-39 Pointed reduction forceps AR-18700-45 Disposables, 2.0 mm Hohmann retractor, double-ended, 6 mm/10 mm AR-18700-53 BB-Tak, nonthreaded AR-18800-11 AR-18800-13 BB-Tak, threaded AR-18800-11T Driver shaft, T10, long, self-retaining AR-18800-26 Drill bit, 0.059 in (1.5 mm), AO AR-18800-01 Drill/depth guide, 2.7 mm AR-18800-29 Drill bit, 0.079 in (2.0 mm), AO AR-18800-02 Depth device, 2.4 mm/2.7 mm, short AR-18800-39 Countersink, 2.0 mm AR-18800-06 Depth device, 2.4 mm/2.7 mm, long AR-18800-40 Bone tap, 2.0 mm AR-18800-07 T-handle, AO AR-18800-41 Plate cutter, 2.0 mm/2.4 mm/2.7 mm AR-18800-42 Bending pliers, angled, left AR-18800-43 Bending iron, double-ended AR-18800-44 Drill/depth guide, 2.4 mm AR-18800-45 Bending pliers, angled, right AR-18800-46 Bending pliers, French style AR-18800-47 Mini Fragment System 2.0 mm/2.4 mm/2.7 mm case AR-18800C Ratcheting handle, AO, QC AR-8700RH Needlenose pliers AR-8916-24 Torque limiting handle, 0.8 mm, QC AR-8916TL-011 Screw holding forceps, self-retaining AR-8941F Sharp hook AR-8943-21 Lobster claw AR-8943-23 Plate cutter, straight cut AR-8957-06 Torque limiting adapter, AO, 0.8 mm Driver shaft, T8, long, self-retaining Mini Fragment System I 13 Product Description Item Number Plates, 2.4 mm Product Description Item Number Plates, 2.7 mm Straight plate, 2.4 mm, 6H AR-18724P-03 Straight plate, 2.7 mm, 4H AR-18827P-01 Straight plate, 2.4 mm, 10H AR-18724P-07 Straight plate, 2.7 mm, 6H AR-18827P-03 T-plate, 2.4 mm, 6H AR-18724P-10 Straight plate, 2.7 mm, 8H AR-18827P-05 T-plate, 2.4 mm, 8H AR-18724P-12 Straight plate, 2.7 mm, 10H AR-18827P-07 Straight plate, 2.4 mm, 6H, reinforced AR-18724P-17 Straight plate, 2.7 mm, 20H AR-18827P-08 Straight plate, 2.4 mm, 8H, reinforced AR-18724P-19 Straight plate, 2.7 mm, 4H, reinforced AR-18827P-09 V-plate, 2.4 mm, 6H AR-18724P-23 Straight plate, 2.7 mm, 6H, reinforced AR-18827P-11 V-plate, 2.4 mm, 10H AR-18724P-27 Straight plate, 2.7 mm, 8H reinforced AR-18827P-13 Wide T-plate, 2.4 mm, 6H AR-18724P-29 Straight plate, 2.7 mm,10H, reinforced AR-18827P-15 Wide T-plate, 2.4 mm, 10H AR-18724P-33 Straight plate, 2.7 mm, 20H, reinforced AR-18827P-16 Bridge plate, straight, 2.4 mm, 6H AR-18724P-34 T-plate, 2.7 mm, 3H head, 6H AR-18827P-19 Triangle plate, 2.4 mm, 8H AR-18724P-39 T-plate, 2.7 mm, 3H head, 10H AR-18827P-23 T-plate, 2.4 mm, 6H, reinforced AR-18724P-42 T-plate, 2.7 mm, 2H head, 6H AR-18827P-26 T-plate, 2.4 mm, 8H, reinforced AR-18724P-44 T-plate, 2.7 mm, 2H head, 10H AR-18827P-30 Y-plate, 2.4 mm, 6H AR-18724P-49 Triangular plate, 2.7 mm, 6H AR-18827P-33 Y-plate, 2.4 mm, 8H AR-18724P-51 Triangular plate, 2.7 mm, 10H AR-18827P-37 Cage plate, 2.4 mm, 2H × 5H AR-18724P-54 Tine plate, 2.7 mm, 6H AR-18827P-38 Straight plate, 2.4 mm, 20H AR-18724P-55 Tine plate, 2.7 mm, 10H AR-18827P-39 Straight plate, 2.4 mm, 20H, reinforced AR-18724P-56 Wide T-plate, 2.7 mm, 6H AR-18827P-41 Wide T-plate, 2.7 mm, 10H AR-18827P-45 Wide T-plate, 2.7 mm, 20H AR-18827P-46 T-plate, 2.7 mm, 3H head, reinforced, 6H AR-18827P-47 T-plate, 2.7 mm, 3H head, reinforced,10H AR-18827P-48 Screws, 2.4 mm VAL screw, Ti, 2.4 mm × 6.0 mm-15 mm (1.0 mm increments) Cortical screw, 2.4 mm × 6.0 mm-15 mm (1.0 mm increments) VAL screw, Ti, 2.4 mm × 16 mm-50 mm (2.0 mm increments) Cortical screw, 2.4 mm × 16 mm-50 mm (2.0 mm increments) VAL screw, Ti, 2.4 mm × 55 mm-80 mm (5.0 mm increments) Cortical screw, 2.4 mm × 55 mm-80 mm (5.0 mm increments) AR-18724V-06-15 AR-8916CX24-06-15 AR-18724V-16-50 Screws, 2.7 mm BB-Tak, nonthreaded AR-18800-11 BB-Tak, threaded AR-18800-11T Drill bit, ø1.7 mm AR-18800-49 Cortical screw, 2.7 mm × 6.0 mm - 15 mm (1.0 mm increments) VAL screw, 2.7 mm × 6.0 mm - 15 mm (1.0 mm increments) Cortical screw, 2.7 mm × 16 mm - 50 mm (2.0 mm increments) VAL screw, 2.7 mm × 16 mm - 50 mm (2.0 mm increments) Cortical screw, 2.7 mm × 55 mm - 80 mm (5.0 mm increments) VAL screw, 2.7 mm × 55 mm - 80 mm (5.0 mm increments) Drill bit, 2.4 mm AR-4160-24 Disposables, 2.7 mm Bone tap, 2.4 mm AR-18800-17 BB-Tak AR-13226 Countersink, 2.4 mm AR-8950-01 BB-Tak, threaded AR-13226T Drill bit, 2.0 mm, short, AO AR-18800-18 Drill bit, 2.7 mm, AO AR-18800-20 Countersink, 2.7 mm AR-18800-23 Bone tap, 2.7 mm AR-18800-34 AR-8916CX24-16-50 AR-18724V-55-80 AR-8916CX24-55-80 Disposables, 2.4 mm 14 I Mini Fragment System AR-18827-06 - 15 AR-18827V-06 - 15 AR-18827-16 - 50 AR-18827V-16 - 50 AR-18827-55 - 80 AR-18827V-55 - 80 Mini Fragment System I 15 This description of technique is provided as an educational tool and clinical aid to assist properly licensed medical professionals in the usage of specific Arthrex products. As part of this professional usage, the medical professional must use their professional judgment in making any final determinations in product usage and technique. In doing so, the medical professional should rely on their own training and experience, and should conduct a thorough review of pertinent medical literature and the product’s directions for use. Postoperative management is patient-specific and dependent on the treating professional’s assessment. Individual results will vary and not all patients will experience the same postoperative activity level or outcomes. arthrex.com © 2024-01 Arthrex, Inc. All rights reserved. LT1-000269-en-US_E Arthrex manufacturer, authorized representative, and importer information (Arthrex eIFUs) US patent information

Mini Fragment System

Trochanteric Nail System

The Arthrex Femoral Nail System is targeted for use in intramedullary fixation of fractures of the femur. Consisting of antegrade and retrograde femoral options, each nail offers unique screw configurations that provide both versatility and diversity.

Retrograde Femoral Nail System Surgical Technique

Determine the entry point for the nail located in line with the femoral canal in an AP view. And just anterior to where a bloomin sports line intersects the anterior intercondylar notch on a lateral view. Insert the 3.2mm guide. Pin through the soft tissue Protector assembly directed down the central shaft of the femur. Remove the black pin, guide and ream over the guide. Pin with the 13.5mm cannulated entry. Reamer until the groove on the entry reamer is in line with the top of the soft tissue. Protector. The grooves represent how many millimeters the nail will be. Countersunk. The first line represents five millimeters. The 3.2mm guide pin is removed, and the 3.0mm ball nose guide wire is introduced down the shaft of the femur. Using the guide wire gripper, remove the soft tissue Protector and measure the length of the ball nose guidewire with the guidewire depth gauge to determine the nail length. Measurement is taken at the black edge line. The eight millimeter end cutting reamer is used to ream out the central path for the nail, sequentially ream. Until cortical chatter is achieved, it's recommended to ream 1 to 1.5 millimeters over the desired nail diameter. Attach the nail to the retrograde Radiolucent targeting guide. Introduce the nail over the ball nose guidewire. Complete the insertion with gentle mallet strikes on the targeting guide impactor pad. Remove the impactor pad and the ball nose guidewire. When the desired orientation of the targeting guide is achieved, insert the screw sheath, drill guide and obturator assembly through the distal lateral hole until it contacts with the lateral cortex. Optionally, the outer sheath can be locked into place for added stability. Remove the obturator and obturator and drill bicortical with a calibrated 5.5mm drill, using the calibration marks on the drill to determine depth. Do not remove the drill. Assemble the chondola nut, hex driver and condyle locking collet. A washer must be added to the chondola nut on the inside of the targeting guide. Drive the chondola nut through the femoral cortex and over the drill bit until the condyle locking collar is snug in the targeting guide. Remove the obturator drill by cortically with a 5.5mm. Drill and remove the drill guide sleeve. Insert the 6.5mm cancellous, or cortical screw through the distal lateral hole with a washer on the inside of the targeting guide. It is recommended to subtract 5 to 10mm from screw length when using chondola nut to achieve desired chondola compression. The medial t-handle assembly, lateral hex driver, and screw sleeve are removed. Insert the screw sheath, drill guide and obturator assembly through the proximal lateral hole until it contacts with the lateral cortex. Remove the inner trocar and drill bicortical with a 5.5mm drill using the calibration marks on the drill to determine depth. Insert the 6.5mm cortical or cancellous screw using the 5.0mm hex driver. Using the laser mark on the driver to determine depth and remove the screw sleeve. Repeat the screw insertion process through the anteromedial hole in the targeting guide. This process is repeated with the screw sheath, drill guide and obturator assembly through the anterolateral hole on the guide. Remove the obturator drill bicortical with the 5.5mm. Drill and remove the drill guide sleeve. Insert another 6.5mm screw using the 5.0mm hex driver. Using the laser mark for insertion depth and remove the screw sleeve once complete. For a proximal fixation, use the drill sleeve to drill bicortical using a perfect circle technique. Screw length is measured using a measuring sled. Reading off the green stripe, a standard depth gauge may also be used. Insert a 5.0mm screw using the short hex driver. Repeat the process twice to insert another two adjacent 5.0mm cortical screws. Uncouple the targeting guide from the nail with the ball hex driver and remove it to complete the nail implantation.

The FibuLock® fibular nail addresses ankle fractures using a minimally invasive technique that may reduce the risk of wound complications associated with ORIF.1 The innovative proximal talons and distal multiplanar 2.7 mm screws work to maintain length, alignment, and rotation of the fracture. Syndesmosis injuries can be treated through the nail with the Syndesmosis TightRope® XP implant.
1. Walton DM, Adams SB, Parekh SG. Intramedullary fixation for fractures of the distal fibula. Foot Ankle Int. 2016;37(1):115‐123. doi: 10.1177/1071100715622392

FibuLock® Fibular Nail Surgical Technique

Under fluoroscopy. Identify and mark out the long axis of the fibula with the 1.6mm guidewire and the curvature of the distal fibula tip. Reduce the fracture percutaneously or with a mini incision if using reduction forceps. Position the handle's superior to avoid interference with the outrigger. Using the 1.6mm guidewire and soft tissue sleeve determine the correct starting point and trajectory with multiple AP and lateral fluoroscopic images. This is a critical step of the case. On the lateral image, the guidewire should be in line with the center of the canal. On the AP image, the entry point should be medial to the tip of the fibula and the wire aimed towards the center of the canal. Once a good entry point and trajectory are established, advance the guidewire on oscillate to at least 140mm from the distal end of the fibula. For the 130mm nail and 190mm for the 180mm nail. Recheck the wire trajectory and positioning under fluoroscopy. Ream distally through the reamer tissue. Protector with the 6.2mm reamer until the flutes of the reamer are well into the distal fibula. Under fluoroscopy, a laser mark calibrated to the tissue Protector can also be used when the Protector is directly on the bone. Ream proximally with the 3.2mm reamer until the depth collar is well within the distal fibula. The laser marking calibrated to the tissue Protector can also be used. Riemann oscillate to prevent rotation of the fracture. If no chatter is felt, ream with the four millimeter reamer for the 3.8mm nail. Likewise, use the longer reamers if using the 180mm nails. Pass the insertion guide over the guidewire and then remove the inner cannula and guidewire leaving the outer sled. Insert the nail with manual pressure. A mallet should not be required. The outrigger should be directly lateral to the leg. A 1.6mm K wire K-wires is inserted into the hole labeled end to check the insertion depth of the nail under fluoroscopy. The K-wires is also used to check the location of the distal syndesmotic hole. Adjust the nail depth if needed. Remove the impactor cap. Fracture reduction should be checked before deployment of the talons. Actuate the proximal talons. It can take multiple turns and will click when the proper torque is achieved. If not using the compression mechanism, ensure that the outrigger slide is set to the static mode. Insert the drill guide sleeve and two millimeter drill guide into the most distal hole. Drill with a two millimeters drill bit and measure of the calibrated drill guide. Remove the drill guide and insert the 2.7mm screw. Drill. Measure and implant the remaining 2.7mm screws as needed. There are two holes available for Syndesmotic fixation. This animation will show preparation for the Syndesmosis TightRope XP implant. Insert the drill guide sleeve and the 3.7mm drill guide. Drill through the four cortices with the 3.7mm drill. Remove the 3.7mm. Drill guide and sleeve. Unscrew the outrigger. Insert the TightRope XP through the fibula and tibia bone tunnels. Check under fluoroscopy to ensure the medial button exits the tibial cortex. Position the button in the superior or inferior direction. Remove the red safety tab and deploy the black button on the Syndesmosis TightRope XP. Push the Syndesmosis TightRope XP medially to fully flip the oblong button. Pull back on the Syndesmosis TightRope xp inserter and confirm on fluoroscopy that the oblong button is flipped and flush against the medial cortex of the tibia. Remove the Remove the black ring and unwrap the trailing sutures from the TightRope XP inserter to release the round button. Remove the TightRope xp Inserter from the bone tunnel. Tension the lateral button down. Cut the white lateral tensioning sutures flush to the button. Place a 1.35mm wire in the distal end of the nail, and insert the cannulated end cap with the cannulated driver over the wire. The end cap creates a fixed angle construct when the most distal interlocking screw is also used. The FibuLock fibular nail is the only fibular nail on the market that combines secure proximal fixation, multiplanar distal screws, and TightRope or 3.5mm screw syndesmosis fixation.

The Syndesmosis TightRope® XP implant system features a unique delivery mechanism that allows the surgeon to insert a Syndesmosis TightRope implant without pulling a needle through the medial skin. Tensioning handles and a new trocar-tipped drill bit have been added to the implant system. It is available in stainless steel and titanium.

Syndesmosis TightRope® XP Implant System

The Syndesmosis TightRope XP implant system features a unique delivery mechanism that allows the user to insert a Syndesmosis TightRope implant without pulling a needle through the medial skin. The XP gives the user control to flip the medial oblong button below the skin for less soft tissue. Interposition. Stabilize all fractures prior to syndesmosis TightRope XP implant system insertion. Drill all four cortices approximately 1.5cm above the ankle joint in the trans malleolar plane, 30 degrees anterior to the coronal plane, using the 3.7mm XP drill bit, a guidewire and cannulated 3.7mm drill bit can also be used. Insert the TightRope XP through the fibula and tibia bone tunnel. Check under fluoroscopy to ensure the medial button exits the tibial cortex. Position the bluedriver in the coronal plate or inferior superior direction. Remove the red safety tab. Deploy the black button on the Syndesmosis TightRope XP handle important. After deploying the black button, push the Syndesmosis TightRope XP medial. Visualize a t shape on fluoroscopy. Pull back on the Syndesmosis TightRope xp handle to confirm on fluoroscopy, the oblong button is flipped and seated flush against the medial cortex of the tibia. Unwrap the trailing sutures from the TightRope XP driver to release the round button. Remove the TightRope XP inserter from the bone tunnel. Grasp the center sutures of the round button before tensioning. Slide the round button down to the plate. Wrap each suture tale 2 to 3 times around the XP tensioning handles. Pull the sutures straight back, one at a time. The lateral button will sit flush. Fixation is complete.

This animation shows a surgical technique for a primary pilon arthrodesis highlighting the Primary Pilon Fusion Plating System.

Surgical Technique for Primary Pilon Arthrodesis Using the Primary Pilon Fusion Plating System

In this primary pilon ankle arthrodesis surgical technique demonstration, the nine hole right anterior lateral primary pilon fusion plate will be used. Alternatively, the surgeon has multiple left and right anterolateral contoured plate options, including 5 to 18 hole lengths and a posterior contoured plate option with 5 to 15 hole length options. Use an anterior or anterolateral approach, ensuring the neurovascular structures are protected after exposure. An instrument such as a submuscular tissue elevator can be used to create a submuscular pocket proximal to the incision, allowing for ease of plate insertion. The fracture can be addressed with provisional fixation to aid in restoring the articular surface of the distal tibia. The incision can be retracted by the surgical assistant or alternatively with a blunt self-retaining retractor. The ankle joint can now be prepared by denuding articular cartilage using the provided curettes, chisels and osteotomies. Fracture management along with provisional fixation can be addressed while being cognizant of final plate location. Supplementary orthobiologics such as AlloSyncPure demineralized bone matrix can be used, which resists irrigation and can be used in a fluid environment. The proprietary rice shaped fiber technology used to process AlloSyncPure bone matrix increases the Osteoinductive and Osteoconductive surface area to accelerate cellular growth prior to provisional plate fixation. Clinically assessed that the tibiotalar joint is in neutral in all three anatomical planes, and that the talus has been adequately reduced in line with the long axis of the tibia when viewed under Fluoroscopic guidance in the sagittal plane. At this time, the percutaneous insertion handle can be connected to the most distal screw hole in the shaft of the desired plate, and the plate is carefully slid proximally along the diaphysis of the tibia within the previously created submuscular pocket. It is recommended to slide the plate approximately first and then seated distally into the appropriate position, using native anatomic contours as a guide. Bb-tak olive wires are placed centrally in the oblong hole in the tibia, and a second is placed in a distal hole in the talus. The percutaneous insertion handle is removed fully. Insert the 4.5mm locking drill guide into one of the three available Taylor screw holes. Drill with a 3.0mm calibrated drill and measure the screw length off the back of the drill guide. Using the T20 driver, insert the appropriate locking or cortical screw drill and fill the remaining Taylor screw holes with 4.5mm locking screws. 4.5 non-locking screws are inserted into the tibia proximal to the most proximal fracture line, followed by locking screws distal to the most proximal fracture line. Fully insert the 3.5mm locking drill guide and drill with the 2.5mm calibrated drill. Measure the screw length off the back of the drill guide. Or alternatively, use the provided depth gauge. Use a 3.5mm screw to manipulate the bone toward the plate. Or a 3.5mm locking screw to maintain spatial positioning. Once the distal fixation is completed, fully insert the 4.5mm locking drill guide into the kickstand screw hole. Drill with a 3.0mm calibrated drill and measure the screw length off the back of the drill guide. Insert a 4.5mm locking screw to the kickstand screw hole to help provide additional stability across the joint and to help maintain tibiotalar position if an anterior or anterolateral approach is not desired. A posterior plate option is also provided within the primary pilon fusion plating system.

The Arthrex Tibial Nail System features the most distal cluster of screws on the market and a simple, intuitive surgical technique that allows for intraoperative compression.

Tibial Nail System—Standard Surgical Technique

Orient the entry tube and pin guide in the desired position. Insert the 3.2mm guide pin into the proximal tibia so that it reaches the center of the intramedullary canal. Remove the inner pin sleeve and use the 12.0mm reamer to open the canal. Remove the 3.2mm guide pin. After accessing the tibial canal, insert the 3.0mm ball nose guide wire down the shaft of the tibia and pass the fracture using the guide wire gripper with the tip of the guide wire at the desired depth. Measure the length of the nail by sliding the guide wire depth gauge over the guide wire and reading the measurement based on the etched line. Using the cannulated reamers sequentially ream the canal until cortical chatter is obtained, it is recommended to ream 1 to 1.5 millimeters over the desired diameter of nail. Remove the entry tube and insert the nail over the ball nose guide wire and into the canal. Lightly strike the impactor pad with a mallet to complete the nail insertion. Remove the ball nose guidewire. Thread the green locking collar into the locking hole on the targeting module. When compression is desired, be sure to use the hole marked dynamic. Insert the assembled drill sheath, drill guide and obturator into the targeting guide until it rests on the outer cortex of the tibia. Using the calibrated 4.0mm drill, drill through the drill guide and sheath to the desired depth and measure using the calibrations on the drill bit. Next, remove the drill guide. Insert the desired 5.0mm cortical screw through the sheath. Using the captured screwdriver, unscrew the capturing rod on the back of the t handle and remove the screw driver. Remove the sheath and locking collet nut. If using the compression mechanism, fixate the nail distally. Next, for distal fixation, the screws are targeted using fluoroscopy. Drill bicortical through the bone. Using the 4.0mm freehand drill, measure the screw length using the distal depth gauge and the depth mark at the 4.0mm freehand drill. Advance the desired screw to the captured driver until it's secured in the bone. Repeat the steps to place the additional distal screws. For intraoperative fracture compression. Insert the reduction bolt through the locking bolt at the top of the nail using the ball hex driver. Rotate the reduction bolt clockwise until the desired compression is achieved or significant resistance is felt on the screw. Insert the remaining proximal screws by threading in the collet, nut and drill guide sleeve. Drilling to the desired depth and inserting the appropriately sized captured screw. Complete the remaining proximal screw insertion to fully lock the nail in place and maintain compression. Unthread and remove the compression bolt using the hex driver. Finally, unthread the locking bolt using the ball hex driver and remove the targeting arm assembly to complete the procedure.

Arthroplasty Shoulder

Proximal Humeral Plating System

Elbow

Arthrex Elbow Plating System Distal Humerus and Olecranon Plating

KreuLock™ locking compression screws allow surgeons to compress bone fragments and bring the plate to bone while achieving a low-profile construct.

KreuLock™ Locking Compression Screws

KreuLock™ Locking Compression Screws Surgical Technique KreuLock™ Locking Compression Screws Introduction Titanium Locking Head 2.4 mm VAL Compression Screw 3.5 mm 3.0 mm 3.0 mm VAL Hybrid VAL Locking Stainless Steel 2.7 mm Locking 3.5 mm Locking Fully threaded (FT) compression screw with variable-stepped pitch and locking head The KreuLock locking compression screws combine the same proven variable-stepped pitch technology found in the Headless Compression FT screws with a locking head. Compress fractures and bony fragments and bring the plate to the bone while also locking into the plate Six KreuLock screw families available, housed in individual modules with size-specific instrumentation Saves time – May eliminate the need to use a nonlocking screw and later replace it with a locking screw Customizable universal tray can fit two caddies Offered in titanium and stainless steel Compatible with existing plating systems of the same size KreuLock Locking Compression Screws I 03 Surgical Technique After reduction of a fracture or fusion, select the appropriate plate to match the bony anatomy. Position the plate and provisionally fixate with a BB-Tak. 1 Insert the appropriate drill guide into the selected locking hole. Drill using the corresponding drill bit. 2 Prepare the near cortex with 3 to 4 turns of the corresponding KreuLock™ profile drill. The profile drill matches the tapered neck of the KreuLock screws. 3 04 I KreuLock Locking Compression Screws Surgical Technique (Cont.) Use the depth device to determine the necessary screw length. 4 Insert the desired KreuLock™ screw with the appropriate driver. 5 As the screw crosses the fracture or fusion site, it will begin to compress the bone. 6 KreuLock Locking Compression Screws I 05 Surgical Technique (Cont.) Final tightening should be performed by hand. The screw is designed to bring the plate securely to the bone during final tightening. 7 Intraoperative fluoroscopy may be used to verify final plate and screw placement. Note: If screw removal is necessary, use the appropriate solid driver option. 8 06 I KreuLock Locking Compression Screws Caddy Overview – Titanium KreuLock™ Compression Screw System, 2.4, VAL, Ti (AR-8724VCLS) Item Number Description AR-8724VD-01 Profile Drill, VAL, 2.4 mm AR-8950-04 Drill Guide, locking, 2.4 mm, qty. 2 AR-8916-05 Drill Guide, 1.7 mm/2.5 mm AR-8724GV Drill Guide, VAL, 2.4 mm AR-8724GVN Drill Guide, VAL, locking, 2.4 mm, qty. 2 AR-13120G-2 Depth Device, 2.4 mm AR-8916-27 Driver, T8, solid, qty. 2 AR-8916-14 Drill Bit, 1.7 mm, qty. 2 AR-4160-24 Drill Bit, 2.4 mm AR-13226T BB-Tak, threaded, qty. 2 AR-13226 BB-Tak, qty. 2 KreuLock Compression Screw System, 3.0, VAL, Ti (AR-8933VCLS) Item Number Description AR-8933VD-01 Profile Drill, VAL, 3.0 mm AR-8943-31 Drill Guide, 2.0 mm/3.0 mm AR-8950-07 Drill Guide, locking, 3.0 mm, qty. 2 AR-8933GV Drill Guide, VAL, 3.0 mm AR-8933GVN Drill Guide, locking, VAL, 3.0 mm, qty. 2 AR-8944DH Driver, T10, solid, qty. 2 AR-4166 Depth Device, 3.0 mm AR-8944-22 Drill Bit, 2.0 mm, qty. 2 AR-8950-05 Drill Bit, 3.0 mm AR-13226T BB-Tak, threaded, qty. 2 AR-13226 BB-Tak, qty. 2 KreuLock Locking Compression Screws I 07 Caddy Overview – Titanium KreuLock™ Compression Screw System, 3.0, Hybrid, VAL, Ti (AR-8933HVCLS) Item Number Description AR-8933HVD-01 Profile Drill, hybrid, VAL, 3.0 mm AR-8933HGL Drill Guide, hybrid, locking, 3.0, qty. 2 AR-8933HGV Drill Guide, hybrid, VAL, locking, 3.0, qty. 2 AR-8943-03 Drill Guide, 2.6 mm/1.35 mm AR-8944DH Driver, T10, solid, qty. 2 AR-8943-15 Depth Device, hybrid, 3.0 mm/3.5 mm AR-8933HD Drill Bit, 2.5 mm, qty. 2 AR-13226T BB-Tak, threaded, qty. 2 AR-13226 BB-Tak, qty. 2 KreuLock Compression Screw System, 3.5, Ti (AR-8935CLS) 08 I KreuLock Locking Compression Screws Item Number Description AR-8935D-01 Profile Drill 3.5 mm AR-8941DH Driver, T15, solid, qty. 2 AR-8943-43 Drill Guide, locking, 3.5 mm, qty. 2 AR-8943-15 Depth Device, 3.5 mm AR-8943-03 Drill Guide, 2.6 mm/1.35 mm AR-8943-42 Drill Bit, 2.5 mm, qty. 2 AR-4160-35 Drill Bit, 3.5 mm AR-8970-09T BB-Tak, threaded, qty. 2 AR-8970-09 BB-Tak, qty. 2 Caddy Overview – Stainless Steel KreuLock™ Compression Screw System, 2.7, SS (AR-8827CLS) Item Number Description AR-8827D-03 Profile Drill, 2.7 mm AR-8943-17 Drill Guide, locking, 2.7 mm, qty. 2 AR-8963-08 Drill Guide, locking, long, 2.7 mm, qty. 2 AR-8827D-02 Drill Guide, 2.7 mm/2.0 mm AR-8944DH Driver, T10, solid, qty. 2 AR-8943-08 Screwdriver, T10 AR-8943-16 Drill Bit, 2.0 mm, qty. 2 AR-8963-05 Drill Bit, long, 2.0 mm, qty. 2 AR-8827D-01 Drill Bit, 2.7 mm, qty. 2 AR-13226T BB-Tak, threaded, qty. 2 AR-13226 BB-Tak, qty. 2 KreuLock Compression Screw System, 3.5, SS (AR-8835CLS) Item Number Description AR-8935D-01 Profile Drill, 3.5 mm AR-8943-43 Drill Guide, locking, 3.5 mm, qty. 2 AR-8943-10 Screwdriver, T15 AR-8941DH Driver, T15, solid, qty. 2 AR-8943-15 Depth Device, 2.7 mm/3.5 mm/4.0 mm AR-8943-42 Drill Bit, 2.5 mm, qty. 2 AR-8970-09T BB-Tak, threaded, qty. 2 AR-8970-09 BB-Tak, qty. 2 KreuLock Locking Compression Screws I 09 Ordering Information – KreuLock™ Screw System, Titanium KreuLock Screw System (AR-8787CLS) Disposables Product Description Item Number Product Description Item Number KreuLock Compression Screw Case AR-8787CLC Drill Bit, 2.0 mm, qty. 2 AR-8944-22 Ratcheting Handle, AO QC AR-8700RH Drill Bit, 3.0 mm AR-8950-05 Screw Holding Forceps, self-retaining AR-8941F BB-Tak, threaded, qty. 2 AR-13226T BB-Tak, qty. 2 AR-13226 KreuLock Screw System, 2.4, VAL, Ti (AR-8724VCLS) Item Number KreuLock Screw System, 3.0, Hybrid, VAL, Ti (AR-8933HVCLS) Profile Drill, VAL, 2.4 mm AR-8724VD-01 Product Description Drill Guide, locking, 2.4 mm, qty. 2 AR-8950-04 Instruments Drill Guide, 1.7 mm / 2.5 mm AR-8916-05 Profile Drill, hybrid, VAL, 3.0 mm AR-8933HVD-01 Drill Guide, VAL, 2.4 mm AR-8724GV Drill Guide, hybrid, locking, 3.0 mm, qty. 2 AR-8933HGL Drill Guide, VAL, locking, 2.4 mm, qty. 2 AR-8724GVN Drill Guide, hybrid, VAL, locking, 3.0 mm, qty. 2 AR-8933HGV Depth Device, 2.4 mm AR-13120G-2 Drill Guide, 2.6 mm/1.35 mm AR-8943-03 Driver, T8, solid, qty. 2 AR-8916-27 Driver, T10, solid, qty. 2 AR-8944DH KreuLock Compression Screw Caddy AR-8724VCLC Depth Device, hybrid, 3.0 mm/3.5 mm AR-8943-15 KreuLock Compression Screw Caddy AR-8933HVCLC Product Description Instruments Accessories KreuLock Compression Screw Caddy Lid AR-8724VCLC-01 KreuLock Compression Screws, Ti, 2.4 mm × 10 mm-40 mm (2 mm increments) Accessories KreuLock Compression Screw Caddy Lid Implants (order separately) AR-8724VCL-10 - 40 AR-8933HVCLC-01 Implants (order separately) KreuLock Compression Screws, hybrid, VAL, Ti, 3 mm × 12 mm-60 mm (2 mm increments) Disposables Item Number AR-8933HVCL-12 - 60 Product Description Item Number Disposables Drill Bit, 1.7 mm, qty. 2 AR-8916-14 Product Description Item Number Drill Bit, 2.4 mm AR-4160-24 Drill Bit, 2.5 mm, qty. 2 AR-8933HD BB-Tak, threaded, qty. 2 AR-13226T BB-Tak, threaded, qty. 2 AR-13226T BB-Tak, qty. 2 AR-13226 BB-Tak, qty. 2 AR-13226 KreuLock Screw System, 3.0, VAL, Ti (AR-8933VCLS) Product Description Item Number Instruments Profile Drill, VAL, 3.0 mm AR-8933VD-01 Drill Guide, 2.0 mm/3.0 mm AR-8943-31 Drill Guide, locking, 3.0 mm, qty. 2 AR-8950-07 Drill Guide, VAL, 3.0 mm AR-8933GV Drill Guide, locking, VAL, 3.0 mm, qty. 2 AR-8933GVN Driver, T10, solid, qty. 2 AR-8944DH Depth Device, 3.0 mm AR-4166 KreuLock Compression Screw Caddy AR-8933VCLC Accessories KreuLock Compression Screw Caddy Lid AR-8933VCLC-01 Implants (order separately) KreuLock Compression Screws, Ti, 3.0 mm × 12 mm-40 mm (2 mm increments) 10 I KreuLock Locking Compression Screws AR-8933VCL-12 - 40 Ordering Information – KreuLock™ Screw System, Titanium (Cont.) KreuLock Screw System, 3.5, Ti (AR-8935CLS) Disposables Product Description Product Description Item Number Item Number Instruments Drill Bit, 2.5 mm, qty. 2 AR-8943-42 Profile Drill 3.5 mm AR-8935D-01 Drill Bit, 3.5 mm AR-4160-35 Driver, T15, solid, qty. 2 AR-8941DH BB-Tak, threaded, qty. 2 AR-8970-09T Drill Guide, locking, 3.5 mm, qty. 2 AR-8943-43 BB-Tak, qty. 2 AR-8970-09 Depth Device, 3.5 mm AR-8943-15 Drill Guide, 2.6 mm/1.35 mm AR-8943-03 KreuLock Compression Screw Caddy AR-8935CLC Accessories KreuLock Compression Screw Caddy Lid AR-8935CLC-01 Implants (order separately) KreuLock Compression Screws, Ti, 3.5 mm × 12 mm-60 mm (2 mm increments) AR-8935CL-12 - 60 Ordering Information – KreuLock Screw System, Stainless Steel KreuLock Screw System (AR-8787CLS) KreuLock Screw System, 3.5, SS (AR-8835CLS) Product Description Item Number Product Description KreuLock Compression Screw Case AR-8787CLC Instruments Ratcheting Handle, AO QC AR-8700RH Profile Drill, 3.5 mm AR-8935D-01 Screw Holding Forceps, self-retaining AR-8941F Drill Guide, locking, 3.5 mm, qty. 2 AR-8943-43 Screwdriver, T15 AR-8943-10 Driver, T15, solid, qty. 2 AR-8941DH Depth Device, 2.7 mm/3.5 mm/4.0 mm AR-8943-15 KreuLock Compression Screw Caddy AR-8835CLC KreuLock Screw System, 2.7, SS (AR-8827CLS) Product Description Item Number Instruments Item Number Profile Drill, 2.7 mm AR-8827D-03 Accessories Drill Guide, locking, 2.7 mm, qty. 2 AR-8943-17 KreuLock Compression Screw Caddy Lid Drill Guide, locking, long, 2.7 mm, qty. 2 AR-8963-08 Implants (order separately) Drill Guide, 2.7 mm/2.0 mm AR-8827D-02 Driver, T10, solid, qty. 2 AR-8944DH KreuLock Compression Screws, SS, 3.5 mm × 12 mm-50 mm (2 mm increments) Screwdriver, T10 AR-8943-08 KreuLock Compression Screw Caddy AR-8827CLC Accessories KreuLock Compression Screw Caddy Lid AR-8827CLC-01 Implants (order separately) KreuLock Compression Screws, SS, 2.7 mm × 10 mm-60 mm (2 mm increments) AR-8827CL-10 - 60 AR-8835CLC-01 AR-8835CL-12 - 50 Disposables Product Description Item Number Drill Bit, 2.5 mm, qty. 2 AR-8943-42 BB-Tak, threaded, qty. 2 AR-8970-09T BB-Tak, qty. 2 AR-8970-09 Disposables Product Description Item Number Drill Bit, 2.0 mm, qty. 2 AR-8943-16 Drill Bit, long, 2.0 mm, qty. 2 AR-8963-05 Drill Bit, 2.7 mm, qty. 2 AR-8827D-01 BB-Tak, threaded, qty. 2 AR-13226T BB-Tak, qty. 2 AR-13226 KreuLock Locking Compression Screws I 11 This description of technique is provided as an educational tool and clinical aid to assist properly licensed medical professionals in the usage of specific Arthrex products. As part of this professional usage, the medical professional must use their professional judgment in making any final determinations in product usage and technique. In doing so, the medical professional should rely on their own training and experience, and should conduct a thorough review of pertinent medical literature and the product’s directions for use. Postoperative management is patient-specific and dependent on the treating professional’s assessment. Individual results will vary and not all patients will experience the same postoperative activity level and/or outcomes. View U.S. patent information at www.arthrex.com/corporate/virtual-patent-marking arthrex.com © 2021 Arthrex, Inc. All rights reserved. LB1-000259-en-US_A

Arthrex Elbow Plating System Olecranon and Distal Humerus Plating Brochure Introduction Distal humerus and olecranon fractures are frequently complicated by variables such as the amount of comminution, degree of osteoporosis, location of the fracture, and size of the patient. Designed to be the most comprehensive set available for the treatment of these common injuries, the Arthrex Elbow Plating System incorporates an array of lowprofile plates, KreuLock™ locking compression screws, and adjunct fixation tabs. System features include: Titanium medial, lateral, lateral biplanar, posterolateral, Removable tabs on the posterolateral and and extra-articular distal humerus plates lateral biplanar distal humerus plates allow for additional fixation Distal humerus plates allow for orthogonal and parallel constructs Dorsal olecranon and olecranon osteotomy plates T10 2.7 mm or 3.5 mm shaft hybrid screws are interchangeable in all holes All plates have suture eyelets to facilitate softtissue fixation All plates feature an anatomically contoured design that offers optimal fit while remaining malleable for intraoperative customization The extra-articular distal humerus plate has stouter, true 3.5 mm screws in the shaft. The distal humerus fracture plates and olecranon fracture plates are indicated for adult patients. A 180° plate configuration is achieved with a medial plate and a lateral or lateral biplanar plate. A 90° plate configuration is achieved through a posterolateral and medial plate construct. Posterolateral and Medial Dorsal Olecranon 02 | Arthrex Elbow Plating System Lateral and Medial Lateral Biplanar and Medial Olecranon Osteotomy Extra-Articular Screw Options The screws included in the Elbow Plating System are titanium and have a T10 head, allowing each locking and nonlocking hole in the distal humerus and olecranon plating portfolio to accept either a 2.7 mm or a 3.5 mm shaft hybrid screw. The only exception is the extra-articular plate, which has T15 3.5 mm screws in the shaft to provide more stability to the reinforced plate. KreuLock™ screws combine the same proven variablestepped pitch technology found in the Compression FT screws and also have a locking head. Locking Head Compression Screw Compress fractures and bony fragments and bring the plate to the bone while also locking into the plate Saves time—may eliminate the need to use a nonlocking screw and later replace it with a locking screw Fully threaded (FT) compression screw with variable-stepped pitch and locking head Compatible with existing plating systems of the same size Allow for a 24º cone of variable-angle locking fixation 2.7 mm KreuLock Locking Compression Screws (AR-8927VCL-xx) Lengths from 10 mm-80 mm 10 mm-16 mm (1 mm increments) T10 2.7 mm T10 2.7 mm 18 mm-60 mm (2 mm increments) 60 mm-80 mm (5 mm increments) 2.7 mm Cortical Screws (AR-18827-xx) Lengths from 10 mm-80 mm 10 mm-16 mm (1 mm increments) 18 mm-60 mm (2 mm increments) 60 mm-80 mm (5 mm increments) 3.5 mm Shaft Hybrid KreuLock Locking Compression Screws (AR-8933HVCL-xx) Lengths from 12 mm-60 mm 12 mm-60 mm (2 mm increments) 3.5 mm T10 3.5 mm Shaft Hybrid Cortical Screws (AR-8933HY-xx) Lengths from 10 mm-60 mm 10 mm-60 mm (2 mm increments) T10 3.5 mm Arthrex Elbow Plating System | 03 Ordering Information Elbow Plating System Instrument Set AR-7650S Dorsal Olecranon Plates Implants and Disposable Olecranon plate, Ti, left, 2H AR-7651L-02 Distal Humerus Medial Plates Olecranon plate, Ti, left, 6H AR-7651L-06 DH plate, medial, Ti, left, short AR-7654ML-S Olecranon plate, Ti, left, 10H AR-7651L-10 DH plate, medial, Ti, left, medium AR-7654ML-M Olecranon plate, Ti, left, 14H AR-7651L-14 AR-7654ML-L Olecranon plate, Ti, right, 2H AR-7651R-02 DH plate, medial, Ti, right, short AR-7654MR-S Olecranon plate, Ti, right, 6H AR-7651R-06 DH plate, medial, Ti, right, medium AR-7654MR-M Olecranon plate, Ti, right, 10H AR-7651R-10 AR-7654MR-L Olecranon plate, Ti, right, 14H AR-7651R-14 DH plate, medial, Ti, left, long DH plate, medial, Ti, right, long Olecranon Osteotomy Plates Distal Humerus Biplanar Plates DH plate, lateral biplanar, Ti, left, short AR-7654BLL-S Olecranon osteotomy plate, Ti, left AR-7651AL DH plate, lateral biplanar, Ti, left, medium AR-7654BLL-M Olecranon osteotomy plate, Ti, right AR-7651AR DH plate, lateral biplanar, Ti, left, long AR-7654BLL-L Screws DH plate, lateral biplanar, Ti, right, short AR-7654BLR-S DH plate, lateral biplanar, Ti, right, medium AR-7654BLR-M Cortical screw, 2.7 mm × 6 mm-15 mm (1 mm increments), 16 mm-60 mm (2 mm increments), 65 mm, 70 mm, 75 mm, 80 mm AR-18827-06-80 DH plate, lateral biplanar, Ti, right, long AR-7654BLR-L KreuLock™ screw, VAL, Ti, 2.7 mm × 10 mm-60 mm (1 mm increments), 10 mm-60 mm (2 mm increments), 65 mm, 70 mm, 75 mm, 80 mm AR-8927VCL-10-80 Hybrid low-profile cortical screw, 3.5 mm × 10 mm-60 mm (2 mm increments) AR-8933HY-10-60 AR-8933HVCL-10-60 Distal Humerus Posterolateral Plates DH plate, posterolateral, Ti, left, short AR-7654PL-S DH plate, posterolateral, Ti, left, medium AR-7654PL-M DH plate, posterolateral, Ti, left, long AR-7654PL-L DH plate, posterolateral, Ti, right, short AR-7654PR-S VAL KreuLock screw, hybrid, 3.5 mm × 10 mm-60 mm (2 mm increments) DH plate, posterolateral, Ti, right, medium AR-7654PR-M Disposables DH plate, posterolateral, Ti, right, long AR-7654PR-L Guidewire w/ trocar tip, .062 in AR-8941K BB-Tak, MTP AR-13227 Distal Humerus Lateral Plates DH plate, lateral, Ti, left, short AR-7654LL-S 2.7 mm Screw Disposables DH plate, lateral, Ti, left, medium AR-7654LL-M Drill bit, 2.0 mm, short, AO AR-18800-18 DH plate, lateral, Ti, left, long AR-7654LL-L Drill bit, 2.0 mm, long, AO AR-18800-19 DH plate, lateral, Ti, right, short AR-7654LR-S Drill bit, 2.7 mm, AO AR-18800-20 DH plate, lateral, Ti, right, medium AR-7654LR-M 3.5 mm Shaft Hybrid Screw Disposables DH plate, lateral, Ti, right, long AR-7654LR-L Drill bit, 2.5 mm, long, AO AR-8933HD Drill bit, calibrated, 2.5 mm, AO AR-7650-05 AR-7654EL-07S Drill bit, 3.5 mm, AO AR-7650-34 DH plate, EA, Ti, left, 9H, sterile AR-7654EL-09S Drill bit, short, 2.5 mm, AO AR-7650-35 DH plate, EA, Ti, left, 11H, sterile AR-7654EL-11S Compatible Sutures With 22.2 or 17.9 mm Needles DH plate, EA, Ti, left, 13H, sterile AR-7654EL-13S #0 FiberWire®, 97 cm, with tapered needle AR-7250 DH plate, EA, Ti, left, 15H, sterile AR-7654EL-15S AR-7251 DH plate, EA, Ti, left, 17H, sterile AR-7654EL-17S #0 FiberWire, with diamond point needle, 22.2 mm, 1/2 circle, qty. 12 DH plate, EA, Ti, right, 7H, sterile AR-7654ER-07S #2-0 FiberWire, 46 cm, with tapered needle, 17.9 mm, ⅜ circle, qty. 12 AR-7220 DH plate, EA, Ti, right, 9H, sterile AR-7654ER-09S DH plate, EA, Ti, right, 11H, sterile AR-7654ER-11S SutureTape, 0.9 mm, with two 22.2 mm curved needles (white/blue) AR-7570-02 DH plate, EA, Ti, right, 13H, sterile AR-7654ER-13S DH plate, EA, Ti, right, 15H, sterile AR-7654ER-15S DH plate, EA, Ti, right, 17H, sterile AR-7654ER-17S Distal Humerus Extra-Articular Plates DH plate, EA, Ti, left, 7H, sterile This description of technique is provided as an educational tool and clinical aid to assist properly licensed medical professionals in the usage of specific Arthrex products. As part of this professional usage, the medical professional must use their professional judgment in making any final determinations in product usage and technique. In doing so, the medical professional should rely on their own training and experience and should conduct a thorough review of pertinent medical literature and the product’s directions for use. Postoperative management is patient-specific and dependent on the treating professional’s assessment. Individual results will vary and not all patients will experience the same postoperative activity level or outcomes. Arthrex manufacturer, authorized representative, and importer information (Arthrex elFUs) US patent information © 2025-08 Arthrex, Inc. All rights reserved. LB1-000584-en-US_A arthrex.com

Arthrex Elbow Plating System - Olecranon and Distal Humerus Plating

Orthobiologics

Orthobiologics: Next Generation in Biologics Technology

Below is a collection of resources to learn more about the latest innovations in Arthrex Trauma products and techniques.