1. Implants & Instruments
Small Fragment LCP Set
Implants & Instruments

2. Objectives
Describe the implants found in the Small Fragment Locking Compression Plate (LCP) Set
Identify the standard and new instruments that are used with locking screws & plates

3. Small Fragment LCP Set
Used on small bone fractures -- ankle, forearm, humerus, pelvis
Instruments same as standard Small Fragment plus more
Available in graphic cases with stainless steel or titanium implants

4. Implants Standard Screws
3.5mm Cortex
3.5mm Shaft (Cortex)
4.0mm Cancellous
Fully threaded
Partially threaded
All with standard small fragment hex head
2.7mm Cortex Screw also in set (not shown)

5. Screw Characteristics
Head
Shaft
Thread
Core
Dimensions determine drill bit sizes
Core of all screws = 2.5mm drill bit
Thread diameter of cortex screws = 3.5mm drill bit

6. Implants 3.5mm Locking Screw
StarDrive™ recess
Threaded underside of head
Locks screw to locking plate
Small thread pitch
Large 2.8mm core diameter

7. Implants Straight Plates
3.5mm Locking Compression
One Third Tubular
3.5mm Straight Reconstruction
3.5mm Curved Reconstruction

8. Implants Specialty Plates
3.5mm Oblique T-Plate, L & R
3.5mm T-Plate
3.5mm Locking Proximal Humeral Plate

9. Locking Plate Features Combination “Combi” Hole
Smooth side accepts cortex, shaft & cancellous screws
Threaded side accepts locking screws
Plate is contourable

10. Standard Instruments Same as other Small Fragment Sets: Exposure
Reduction
Screw insertion
Plate bending
Plate application

11. Exposure Instruments
Periosteal Elevator
Hohmann Retractors

12. Reduction Instruments
Forceps
With points -- narrow & broad
Serrated forceps

13. Screw Insertion Instruments
Drill Bits
3.5mm
2.5mm
2.0mm (not shown)

14. Screw Insertion Instruments
Universal Drill Guide
Spring loaded side accepts 2.5mm drill bit
Opposite side accepts 3.5mm drill bit & taps
Must be used with locking plates
2.5mm
3.5mm

15. Screw Insertion Instruments
3.5mm Universal Drill Guide
Spring loaded end allows precise placement of screw in non-threaded end of plate hole
Spring activated = “neutral” position
Spring not activated = “load” or “compression” position (away from fracture line)

16. Screw Insertion Instruments
Countersink
Use with quick connect Tap Handle

17. Screw Insertion Instruments
Depth Gauge
Calibrations in 2mm increments
Measures to 50mm length screws
Hook on same side as calibrations

18. Screw Insertion Instruments
Taps
3.5mm cortex
4.0mm cancellous
Used w/QC Tap Handle
Always pass with Tap Sleeve

19. Screw Insertion Instruments
Small Fragment Hex Screwdriver
Hints:
Screw driver shaft + tap handle = back-up screwdriver
Use holding sleeve to remove screws from screw rack

20. 3.5mm Cortex Lag Technique Steps
Drill 3.5mm
Drill 2.5mm
Countersink
Measure
Tap sometimes – 3.5mm
Insert 3.5mm Cortex Screw

21. 4.0mm Cancellous Lag Technique Steps
Drill 2.5mm
Measure
Tap – rarely
Insert 4.0mm Cancellous Screw

22. Plate Bending Instruments
Bending Pliers
Bending Irons
Bending Templates

23. Instruments for Locking Plates
2.8mm Drill Bit
Used to drill for 3.5mm Locking Screws

24. LCP Instruments 2.8mm Threaded Drill Guide Correct Incorrect
Ensures proper drilling angle
Not for use as a plate bender
Correct Incorrect

25. LCP Instruments 1.6mm Wire Sleeve
Inserts into Threaded Drill Guide to accept 1.6mm Guide Wire
Screw placement can be checked under image

26. LCP Instruments Direct Measuring Device
Used over 1.6mm K-wires to measure for locking screw length

27. LCP Instruments StarDrive Screwdrivers Self-retaining
StarDrive Shaft used with Torque Limiting Attachment

28. LCP Instruments Torque Limiting Attachment
Allows power insertion of locking screws
No further tightening of screws necessary

29. LCP Instruments Threaded Plate Holder Non-cannulated
Used as handle to position plate and insert plate in percutaneous technique
Can be used to bend T-plates and One-third Tubular Plates when used in pairs

30. LCP Instruments Push-Pull Reduction Device (Whirly-Bird)
Secures plate to bone
Guards against “helicopter effect” of the plate
Hole can be used for cortex screw insertion (same 2.5mm diameter as drill bit)

31. Care & Maintenance Keep drill bits & taps sharp Clean cannulations
Disassemble instruments
Lubricate

32. Care & Maintenance Tighten screwdriver holding sleeve
Clean graphic cases

33. Care & Maintenance
Inspect threads on Threaded Drill Guides

35. Quiz Question
True or false? You must remember to pull the Small Fragment locking screw rack in addition to the instrument and plate set.
False. Small fragment instruments, plates & screws are in the same graphic case.

36. What is the drill bit size used to drill for the core of the 3
What is the drill bit size used to drill for the core of the 3.5mm cortex screw?
2.5mm
What is the drill bit size used to drill for the core of the 3.5mm locking screw?
2.8mm

37. For what types of procedures might you have the LCP Small Fragment Set in the room?
Older patients (osteoporosis)
Re-operation on a non-union
Replacing broken hardware
Other ?

38. Now you should be able to:
Describe the implants (screws & plates) in the LCP Small Fragment Set
Identify the instruments that are used with standard and locking screws & plates