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Dedicated instruments for reconstructive foot surgeryOrthopedic FootInstrumentsSurgical Technique
Image intensifier controlThis description alone does not provide sufficient background for direct useof DePuy Synthes products. Instruction by a surgeon experienced in handlingthese products is highly recommended.Processing, Reprocessing, Care and MaintenanceFor general guidelines, function control and dismantling of m ulti-partinstruments, as well as processing guidelines for i mplants, please contact yourlocal sales representative or refer are-maintenanceFor general information about reprocessing, care and maintenance ofSynthes reusable devices, instrument trays and cases, as well as processing ofSynthes non-sterile implants, please consult the Important Information leaflet(SE 023827) or refer are-maintenance
Table of ContentsIntroductionHandling TechniquesProduct InformationOrthopedic Foot Instruments 2Features and Benefits 3Indications and Contraindications 4Compression/Distraction Device Set 5Bone Harvesting Set 11Chisel Set 18Instruments 21Sets 24Replacement Articles Surgical TechniqueOrthopedic Foot Instruments DePuy Synthes271
Orthopedic Foot Instruments. Dedicated instrumentsfor reconstructive foot surgery.System OverviewThe Orthopedic Foot Instrumentshave been designed to performspecific procedures on the foot moreefficiently.The system consists of three modular sets: Compression/DistractionDevice Set, Bone Harvesting Set andChisel Set.2Compression/Distraction DeviceSet, in modular trayFields of application Compression and distractionof joints or bones Fracture treatment Arthrodeses(e.g. subtalar arthrodesis) Osteotomies (e.g. lateral calcaneallengthening osteotomy)DePuy Synthes Orthopedic Foot Instruments Surgical TechniqueBone Harvesting Set,in modular trayFields of application Bone harvesting(e.g. from the calcaneus, proximaltibia or iliac crest) Bone biopsies
Features and BenefitsChisel Set, in modular trayFields of application Preparation of joints forarthrodeses Removal of joint cartilage andbone Removal of exostoses Removal of osteophytesCompression/Distraction Device Set Placement of 2.0, 2.5 and 3.0 mm Kirschnerwires at various angles Precise compression/distraction mechanism Two extra Kirschner wire holes for more stabilityBone Harvesting Set Different trephine diameters enable accuratelocal bone grafting Corresponding extraction attachmentsenable the correct removal of bone graftChisel Set Different shapes of chisels and a cartilageremover facilitate proper joint preparation Silicon handles for optimal gripSurgical TechniqueOrthopedic Foot Instruments DePuy Synthes3
Indications andContraindicationsIndications Fractures in the foot and ankle Skeletal deformities and/or skeletal defects in the footand ankle Instability of the foot and ankle Tumors in bones and cartilage in the foot and ankle Non-unions of small and large bones in the foot andankle Pseudoarthrosis in the foot and ankle Osteoarthritis in the foot and ankle Rheumatoid arthritis in the foot and ankle Exostoses in the foot and ankleContraindicationsNo specific contraindications.4DePuy Synthes Orthopedic Foot Instruments Surgical Technique
Handling TechniquesCompression/Distraction Device SetSet01.111.476Compression/Distraction Device Set forOrthopedic Foot Instruments, with Lid,with ContentsSet content03.111.021Compression/Distraction Device forFoot and Ankle03.111.022Holding Sleeve B 2.0 mm forCompression/Distraction Device forFoot and Ankle03.111.023Holding Sleeve B 2.5 mm forCompression/Distraction Device forFoot and Ankle03.111.024Holding Sleeve B 3.0 mm forCompression/Distraction Device forFoot and Ankle292.250Kirschner Wire B 2.5 mm with trocartip, length 150 mm, Stainless Steel292.750Kirschner Wire B 2.5 mm with threadedtip, length 150/15 mm, Stainless Steel292.790Kirschner Wire B 2.0 mm with threadedtip, length 150/15 mm, Stainless Steel292.820Kirschner Wire B 3.0 mm with threadedtip, length 150/15 mm, Stainless Steel03.111.041Holding Sleeve Tightening Device forCompression/Distraction DeviceSurgical TechniqueOrthopedic Foot Instruments DePuy Synthes1
Handling TechniquesCompression/Distraction Device Set1. PreparationExpose the indicated area. The approach will depend onthe surgical procedure.2. P repare Compression/Distraction Device forFoot and Ankle03.111.022Holding Sleeve B 2.0 mm forCompression/Distraction Device forFoot and Ankle03.111.023Holding Sleeve B 2.5 mm forCompression/Distraction Device forFoot and Ankle03.111.024Holding Sleeve B 3.0 mm forCompression/Distraction Device forFoot and AnkleThread the corresponding holding sleeves into thethreaded fixation holes of the fixation arms.For 2.0 mm Kirschner wires use 2.0 mm holding sleeves.For 2.5 mm Kirschner wires use 2.5 mm holding sleeves.For 3.0 mm Kirschner wires use 3.0 mm holding sleeves.Note: Do not tighten holding sleeves at this point.6DePuy Synthes Orthopedic Foot Instruments Surgical Technique
Open all locking-clamps of the compression/distractiondevice.Adjust the rotation and distance of the arms until initialalignment for the surgical procedure is defined.Notes: lock the rotational mechanism first lock both arms adjust space between the armsNote: A range of different adjustment approachesmay be used.Surgical TechniqueOrthopedic Foot Instruments DePuy Synthes7
Handling TechniquesCompression/Distraction Device Set3. Insert Kirschner wiresInstruments292.250Kirschner Wire B 2.5 mm with trocartip, length 150 mm, Stainless Steel292.750Kirschner Wire B 2.5 mm with threadedtip, length 150/15 mm, Stainless Steel292.790Kirschner Wire B 2.0 mm with threadedtip, length 150/15 mm, Stainless Steel292.820Kirschner Wire B 3.0 mm with threadedtip, length 150/15 mm, Stainless Steel03.111.041Holding Sleeve Tightening Device forCompression/Distraction DevicePosition the device in such a way that the ends of theholding sleeves are as close to the bone as possible.Drill two Kirschner wires through the correspondingholding sleeves into the bone.8DePuy Synthes Orthopedic Foot Instruments Surgical Technique
Finger-tighten the holding sleeves. This will fix the deviceto the Kirschner wires.The blue tightening device may be used to achieve astronger fixation between the holding sleeve and theKirschner wire.Precaution: Apart from the blue tightening device,do not use any other instruments to tighten orloosen the holding sleeves as they may causedamage.If more stability is desired, additional 2.0 mm or 2.5 mmKirschner wires can be drilled through the extraKirschner wire holes of the arms.Surgical TechniqueOrthopedic Foot Instruments DePuy Synthes9
Handling TechniquesCompression/Distraction Device Set4. Compress or distractPerform the surgical procedure once the Kirschner wireshave been inserted.Choose whether compression or distraction is desired byadjusting the switch mechanism.Turn the wing bolt to compress or distract.Warning: Avoid excessive distraction. Too much distraction can damage the surrounding soft tissue.5. R emove compression/distractiondeviceLoosen the holding sleeves first, then open the lockingclamps.Note: Use the blue tightening device to loosen theholding sleeves.Carefully remove the device.Remove Kirschner wires.11DePuy Synthes Orthopedic Foot Instruments Surgical Technique
Handling TechniquesBone Harvesting SetSet01.111.477Bone Harvesting Set for OrthopedicFoot Instruments, with Lid, withContentsSet content03.111.012or03.111.013Handle, long, with Quick Coupling02.111.001Guide Wire B 3.2 mm with Stop, tip1.6 mm, Stainless Steel03.111.030Shaft for Trephine and ExtractionAttachment03.111.031Stylet for Trephine and ExtractionAttachment03.111.025Trephine Attachment B 5.5 mm03.111.026Trephine Attachment B 7.0 mm387.659Trephine Attachment B 8.5 mm387.660Trephine Attachment B 9.5 mm387.661Trephine Attachment B 10.5 mm387.662Trephine Attachment B 12.5 mm387.663Trephine Attachment B 14.0 mm03.111.027Extraction Attachment B 5.5 mm03.111.028Extraction Attachment B 7.0 mm387.669Extraction Attachment B 8.5 mmHandle, short, with Quick CouplingSurgical TechniqueOrthopedic Foot Instruments DePuy Synthes11
Handling TechniquesBone Harvesting Set387.670Extraction Attachment B 9.5 mm387.671Extraction Attachment B 10.5 mm387.672Extraction Attachment B 12.5 mm387.673Extraction Attachment B 14.0 mmWarnings: Trephines have sharp cutting edges that may causeinjury. Handle the attachments with care. Damage to thecutting edges may cause failure and will alter theprecision of the instrument. Only use instruments with sharp edges.11DePuy Synthes Orthopedic Foot Instruments Surgical Technique
1. PreparationExpose the indicated area. The approach will depend onthe surgical procedure.2. Place guide wireInstrument02.111.001Guide Wire B 3.2 mm with Stop, tip1.6 mm, Stainless SteelDrill the guide wire into the location where bone removal is required.Precaution: Drill the 3.2 mm guide wire until thestop at the end of the 1.2 mm tip.Note: In case that insertion of the guide wire byhand is not possible, use a power tool to drill theguide wire into the bone.Surgical TechniqueOrthopedic Foot Instruments DePuy Synthes11
Handling TechniquesBone Harvesting Set3. Cut bone graftInstruments03.111.012or03.111.013Handle, long, with Quick Coupling03.111.030Shaft for Trephine and ExtractionAttachment03.111.025Trephine Attachment B 5.5 mm03.111.026Trephine Attachment B 7.0 mm387.659Trephine Attachment B 8.5 mm387.660Trephine Attachment B 9.5 mm387.661Trephine Attachment B 10.5 mm387.662Trephine Attachment B 12.5 mm387.663Trephine Attachment B 14.0 mmHandle, short, with Quick CouplingAttach the shaft for trephine and extraction attachmentsto a handle.Select the preferred trephine size and attach it to theshaft.Slide the trephine over the guide wire to the bone.Note: The trephine cannot be disengaged from theshaft when it is inserted over the guide wire.11DePuy Synthes Orthopedic Foot Instruments Surgical Technique
Use gentle rotational movements to cut into the bone.Use the guide wire to read the length of the bone graft.Cut to the desired depth.The extracted bone graft should remain in the trephine.Note: If the bone graft cannot be removed with thetrephine, use the bone extraction attachment to remove the bone graft from the bone. This technique isdescribed on page 18.Surgical TechniqueOrthopedic Foot Instruments DePuy Synthes11
Handling TechniquesBone Harvesting Set4. Remove bone graft from trephineInstrument03.111.031Stylet for Trephine and ExtractionAttachmentRemove the handle and insert the stylet into the back ofthe trephine shaft (1).Push the bone graft carefully out from the front of the trephine along with the guide wire (2).1211DePuy Synthes Orthopedic Foot Instruments Surgical Technique
Removal of bone graft with the bone 013Handle, long, with Quick Coupling03.111.030Shaft for Trephine and ExtractionAttachment03.111.027Extraction Attachment B 5.5 mm03.111.028Extraction Attachment B 7.0 mm387.669Extraction Attachment B 8.5 mm387.670Extraction Attachment B 9.5 mm387.671Extraction Attachment B 10.5 mm387.672Extraction Attachment B 12.5 mm387.673Extraction Attachment B 14.0 mmHandle, short, with Quick CouplingNote: All trephines have a corresponding size extraction attachment.Slide the extraction attachment over the guide wire andinsert it until you reach the limited depth (the handleshould not rotate).To break the graft dowel free, turn the holder slowly until you hear a cracking noise or feel no more resistance inturning. Remove the holder. Both the bone dowel andthe guide wire remain in the extraction attachment.The technique to remove the bone graft is the same aswhen using a trephine.Note: It is possible to use a hammer in combinationwith the handles. Use light, controlled hammerblows.Surgical TechniqueOrthopedic Foot Instruments DePuy Synthes11
Handling TechniquesChisel SetSet01.111.475Chisel Set for Orthopedic FootInstruments, with Lid, with ContentsSet content03.111.012or03.111.013Handle, long, with Quick Coupling03.111.014Cartilage Remover, for Foot03.111.015Chisel, for Foot, straight, narrow, width10 mm, length 124 mm03.111.016Chisel, for Foot, straight, wide, width15 mm, length 124 mm03.111.017Chisel, for Foot, 20 bend, narrow,width 10 mm, length 124 mm03.111.018Chisel, for Foot, 20 bend, wide,width 15 mm, length 124 mm03.111.019Chisel, for Foot, curved, narrow, width10 mm, length 124 mm03.111.020Chisel, for Foot, curved, wide, width15 mm, length 124 mmHandle, short, with Quick CouplingPrecautions: Chisels and cartilage remover have sharp cuttingedges that may cause injury. Handle the instruments with care. Damage to thecutting edges may cause failure and will alter theprecision of the instrument. Only use instruments with sharp edges.11DePuy Synthes Orthopedic Foot Instruments Surgical Technique
1. PreparationExpose the indicated area. The approach will depend onthe surgical procedure.2. Choose instrumentInstruments03.111.012or03.111.013Handle, long, with Quick Coupling03.111.014Cartilage Remover, for Foot03.111.015Chisel, for Foot, straight, narrow, width10 mm, length 124 mm03.111.016Chisel, for Foot, straight, wide, width15 mm, length 124 mm03.111.017Chisel, for Foot, 20 bend, narrow,width 10 mm, length 124 mm03.111.018Chisel, for Foot, 20 bend, wide, width15 mm, length 124 mm03.111.019Chisel, for Foot, curved, narrow, width10 mm, length 124 mm03.111.020Chisel, for Foot, curved, wide, width15 mm, length 124 mmHandle, short, with Quick CouplingAttach the desired chisel or the cartilage remover to a handle.Surgical TechniqueOrthopedic Foot Instruments DePuy Synthes11
Handling TechniquesChisel Set3. Prepare joints and/or bonesNotes: It is possible to use a hammer in combination withthe handles. Use light, controlled hammer blows.22DePuy Synthes Orthopedic Foot Instruments Surgical Technique
Instruments03.111.021Compression/Distraction Device forFoot and Ankle03.111.022Holding Sleeve B 2.0 mm forCompression/Distraction Device forFoot and Ankle03.111.023Holding Sleeve B 2.5 mm forCompression/Distraction Device forFoot and Ankle03.111.024Holding Sleeve B 3.0 mm forCompression/Distraction Device forFoot and Ankle292.250*Kirschner Wire B 2.5 mm with trocartip, length 150 mm, Stainless Steel292.750*Kirschner Wire B 2.5 mm with threadedtip, length 150/15 mm, Stainless Steel292.790*Kirschner Wire B 2.0 mm with threadedtip, length 150/15 mm, Stainless Steel292.820*Kirschner Wire B 3.0 mm with threadedtip, length 150/15 mm, Stainless Steel03.111.012Handle, long, with Quick Coupling03.111.041Holding Sleeve Tightening Devicefor Compression/Distraction Device*Add suffix «S» to article number to order sterile product.Surgical TechniqueOrthopedic Foot Instruments DePuy Synthes21
Instruments03.111.013Handle, short, with Quick Coupling03.111.014Cartilage Remover, for Foot03.111.015Chisel, for Foot, straight, narrow,width 10 mm, length 124 mm03.111.016Chisel, for Foot, straight, wide,width 15 mm, length 124 mm03.111.017Chisel, for Foot, 20 bend, narrow,width 10 mm, length 124 mm03.111.018Chisel, for Foot, 20 bend, wide,width 15 mm, length 124 mm03.111.019Chisel, for Foot, curved, narrow,width 10 mm, length 124 mm03.111.020Chisel, for Foot, curved, wide,width 15 mm, length 124 mm03.111.030Shaft for trephine and extractionattachment02.111.001*Guide Wire B 3.2 mm with Stop,tip 1.6 mm, Stainless Steel03.111.031Stylet for trephine and extractionattachment*Add suffix «S» to article number to order sterile product.22DePuy SynthesOrthopedic Foot Instruments Surgical Technique
Trephine Attachments03.111.025Trephine Attachment B 5.5 mm03.111.026Trephine Attachment B 7.0 mm387.659Trephine Attachment B 8.5 mm387.660Trephine Attachment B 9.5 mm387.661Trephine Attachment B 10.5 mm387.662Trephine Attachment B 12.5 mm387.663Trephine Attachment B 14.0 mmExtraction Attachments03.111.027Extraction Attachment B 5.5 mm03.111.028Extraction Attachment B 7.0 mm387.669Extraction Attachment B 8.5 mm387.670Extraction Attachment B 9.5 mm387.671Extraction Attachment B 10.5 mm387.672Extraction Attachment B 12.5 mm387.673Extraction Attachment B 14.0 mmSurgical TechniqueOrthopedic Foot InstrumentsDePuy Synthes23
Sets01.111.476Compression/Distraction Device Set for Orthopedic Foot Instruments, with Lid,with ContentsArt. no.Description03.111.021Compression/Distraction Device for Foot and Ankle103.111.022Holding Sleeve B 2.0 mm for Compression/Distraction Device for Foot and Ankle203.111.023Holding Sleeve B 2.5 mm for Compression/Distraction Device for Foot and Ankle203.111.024Holding Sleeve B 3.0 mm for Compression/Distraction Device for Foot and Ankle2292.250.10Kirschner Wire B 2.5 mm with trocar tip, length 150 mm, Stainless Steel, pack of 10 units1292.750.10Kirschner Wire B 2.5 mm with threaded tip, length 150/15 mm, Stainless Steel, pack of 10 units1292.790.10Kirschner Wire B 2.0 mm with threaded tip, length 150/15 mm, Stainless Steel, pack of 10 units1292.820.10Kirschner Wire B 3.0 mm with threaded tip, length 150/15 mm, Stainless Steel, pack of 10 units168.000.102Lid for Instrument Tray, size ¼168.111.466Tray for Compression/Distraction Device, for Orthopedic Foot Instruments, without Lid, without Contents 124DePuy SynthesOrthopedic Foot InstrumentsQuantitySurgical Technique
01.111.475Chisel Set for Orthopedic Foot Instruments,with Lid, with ContentsArt. no.Description03.111.013Handle, short, with Quick Coupling103.111.014Cartilage Remover, for Foot103.111.015Chisel, for Foot, straight, narrow, width 10 mm, length 124 mm103.111.016Chisel, for Foot, straight, wide, width 15 mm, length 124 mm103.111.017Chisel, for Foot, 20 bend, narrow, width 10 mm, length 124 mm103.111.018Chisel, for Foot, 20 bend, wide, width 15 mm, length 124 mm103.111.019Chisel, for Foot, curved, narrow, width 10 mm, length 124 mm103.111.020Chisel, for Foot, curved, wide, width 15 mm, length 124 mm168.000.102Lid for Instrument Tray, size ¼168.111.465Tray for Chisel, for Orthopedic Foot Instruments, without Lid, without Contents168.111.475Module for Chisels, for Orthopedic Foot Instruments, without Lid, without Contents2QuantitySurgical TechniqueOrthopedic Foot Instruments DePuy Synthes22
Sets01.111.477Bone Harvesting Set for OrthopedicFoot Instruments, with Lid, with ContentsArt. no.Description03.111.012Handle, long, with Quick Coupling103.111.030Shaft for Trephine and Extraction Attachment102.111.001Guide Wire B 3.2 mm with Stop, tip 1.6 mm, Stainless Steel103.111.031Stylet for Trephine and Extraction Attachment103.111.025Trephine Attachment B 5.5 mm103.111.026Trephine Attachment B 7.0 mm1387.659Trephine Attachment B 8.5 mm1387.660Trephine Attachment B 9.5 mm1387.661Trephine Attachment B 10.5 mmOptional387.662Trephine Attachment B 12.5 mmOptional387.663Trephine Attachment B 14.0 mmOptional03.111.027Extraction Attachment B 5.5 mm103.111.028Extraction Attachment B 7.0 mm1387.669Extraction Attachment B 8.5 mm1387.670Extraction Attachment B 9.5 mm1387.671Extraction Attachment B 10.5 mmOptional387.672Extraction Attachment B 12.5 mmOptional387.673Extraction Attachment B 14.0 mmOptional68.111.46768.000.10268.111.476Tray for Hollow Reamer and Instruments for Bone Graft Harvesting,for Orthopedic Foot Instruments, without Lid, without Contents1Lid for Instrument Tray, size ¼1Module for Bone Harvesting Trephines, for Orthopedic Foot Instruments, without Lid,without Contents68.111.4772Module for Bone Harvesting Instruments, for Orthopedic Foot Instruments, without Lid,without Contents22QuantityDePuy Synthes Orthopedic Foot Instruments Surgical Technique1
Replacement Articles60043900Spring for Handles60030145Spring for Compression/DistractionDeviceFor detailed information ask your Synthes salesrepresentative.Surgical TechniqueOrthopedic Foot Instruments DePuy Synthes22
036.001.030 DSEM/TRM/0815/0491(1) 03/17Not all products are currently available in all markets.This publication is not intended for distribution in the USA.All surgical techniques are available as PDF files atwww.depuysynthes.com/ifu0123 DePuy Synthes Trauma, a division of Synthes GmbH. 2017. All rights reserved.Synthes GmbHEimattstrasse 34436 OberdorfSwitzerlandTel: 41 61 965 61 11Fax: 41 61 965 66 00www.depuysynthes.com
Surgical Technique Orthopedic Foot Instruments DePuy Synthes 11 Set 01.111.477 Bone Harvesting Set for Orthopedic Foot Instruments, with Lid, with Contents Set content 03.111.012 Handle, long, with Quick Coupling or 03.111.013 Handle, short, with Quick Coupling 02.111.001 Guide Wire B 3.2 mm with Stop, tip 1.6 mm, Stainless Steel
