Beruflich Dokumente
Kultur Dokumente
CONTENTS
Introduction
Features & Benefits
Indications & Contraindications
4
5
6
9
11
15
16
18
21
22
24
28
30
32
33
36
37
37
38
39
Ordering Information
Instruments
Implants
41
41
44
INTRODUCTION
Minimized disruption
The smooth profile of the implant allows the
Hansson Twin Hook to slide into place without
turning or hammering, minimizing dislocation.
INDICATIONS / CONTRAINDICATIONS
Indications
The Omega 2 Compression Hip Screw is indicated for fractures of the Proximal Femur which may include:
Intertrochanteric Fractures
Contraindications
The physicians education, training and professional judgement must be relied upon
to choose the most appropriate device and treatment. Conditions presenting an increased
risk of failure include:
Any active or suspected latent infection or marked local inflammation in or about the
affected area.
Compromised vascularity that would inhibit adequate blood supply to the fracture or
the operative site.
Bone stock compromised by disease, infection or prior implantation that can not provide
adequate support and/or fixation of the devices.
Material sensitivity, documented or suspected.
Obesity. An overweight or obese patient can produce loads on the implant that can lead
to failure of the fixation of the device or to failure of the device itself.
Patients having inadequate tissue coverage over the operative site.
Implant utilization that would interfere with anatomical structures or physiological performance.
Any mental or neuromuscular disorder which would create an unacceptable risk of fixation
failure or complications in postoperative care.
Other medical or surgical conditions which would preclude the potential benefit of surgery.
PREOPERATIVE PLANNING
Review the frontal and lateral X-Rays of the pelvis and
injured femur prior to surgery to assess fracture stability,
bone quality, as well as neck-shaft angle and to estimate
plate length required.
Use templates preoperatively to plan plate angle, plate length,
barrel length, and Hansson Twin Hook / Lag Screw length.
The Hansson Twin Hook / Lag Screw should be centered
in the head within 10 millimeters of subchondral bone,
and the plate should allow for fixation of four bone screws
below the fracture line. Application of the template to an
X-Ray of the uninvolved hip may help simulate reduction
of the fractured hip.
PATIENT POSITIONING
The patient is placed supine on the fracture table.
Satisfactory access to the hip with the C-arm in the frontal and lateral planes are verified.
The fracture is reduced by flexion, longitudinal traction, abduction and internal rotation on a fracture table.
In unstable fractures, guide pins can be placed, in order to stabilize the reduced fragments.
SKIN INCISION
The corresponding landmark is established by placing
a guide pin on the skin under frontal view of the image
intensifier, centrally in relation to the femoral neck and
head. A 5cm longitudinal incision is made distal from
this point through the skin. After closure at the end of
the procedure, the line should be over the holes in the
side plate.
Optimal
skin
incision
point
10
With the guide pin placed at 135 angle, the pin crosses
the lateral cortex at the level of the lesser trochanter;
at the insertion of the gluteus maximus at the
posterolateral edge of the femur; or two fingerbreadths
(2.5 to 3.5cm) below the crest of the greater trochanter
at the origin of the vastus lateralis.
Correct positioning of the guide pin is achieved
referencing anatomical and visual landmarks,
as shown in the figure below.
Lesser Trochanter
135
Insertion of gluteus
maximus
11
FRONTAL VIEW
LATERAL VIEW
(1)
12
(2)
(3)
Slide the Variable Angle Guide over the guide pin and
adjust it down to the lateral aspect of the femur (make sure
that all the spikes are in contact with the bone shaft).
The arrow on the cylinder will indicate at which angle
the guide pin has been inserted (3), and therefore the angle
of the barrel plate to be selected.
EXAMPLE:
Direct reading depth gauge measurement: 110mm
Reamer depth setting: 100mm
Hansson Twin Hook length selected: 100mm
13
14
15
16
(1)
(2)
When the Hansson Twin Hook is seen to be in position,
the Introducer assembly is inserted through the channel of
the Inner Introducer (1) and rotated clockwise (2) until it
meets resistance, that is, the tip of the Introducer touches
the tip of the inner Twin Hook.
17
PLATE ATTACHMENT
Using standard screw insertion technique, fix the Omega 2 Hip Plate to the femoral shaft
beginning at the proximal end of the plate.
NOTE: When using the reduced skin incision technique, supplementary stab incisions can be
performed for distal screws placements.
Use the 3.2mm Drill bit through the
3.2 drill sleeve with the green ring
(Neutral) assembled to the Drill Guide
Handle, to drill the bone screw holes.
NOTE: If necessary it is possible to obtain
compression of a shaft fracture
or osteotomy site when using
the 3.2mm drill sleeve with the
yellow ring (1mm compression).
Option
18
19
20
NOTE: Check under image intensifier that the hooks are fully
retracted to prior pulling back the implant. This can
be done without removing the plate.
The Hansson Twin Hook can then be extracted by pulling
the extractor assembly laterally (5).
NOTE: Once the Hansson Twin Hook is removed the hooks
cannot be spread again for repositioning and must be
discarded.
(2)
(1)
(3)
(4)
(5)
21
SKIN INCISION
A 10 to 15 centimetre incision is made,
starting at the tip of the greater trochanter
and continuing straight distally.
23
With the guide pin placed at 135 angle, the pin crosses
the lateral cortex at the level of the lesser trochanter;
at the insertion of the gluteus maximus at the
posterolateral edge of the femur; or two fingerbreadths
(2.5 to 3.5cm) below the crest of the greater trochanter
at the origin of the vastus lateralis.
Correct positioning of the guide pin is achieved
referencing anatomical and visual landmarks,
as shown in the figure below.
Lesser Trochanter
135
Insertion of gluteus
maximus
24
LATERAL VIEW
(1)
25
(2)
(3)
Slide the Variable Angle Guide over the guide pin and
adjust it down to the lateral aspect of the femur (make sure
that all the spikes are in contact with the bone shaft).
The arrow on the cylinder will indicate at which angle the
guide pin has been inserted (3), and therefore the angle
of the barrel plate to be selected.
EXAMPLE:
Direct reading depth gauge measurement: 110mm
Reamer depth Setting: 100mm
Tapping depth (if required): 100mm
Lag Screw Length selected: 100mm
26
27
28
29
NO COMPRESSION
5mm COMPRESSION
10mm COMPRESSION
30
PLATE INSERTION
Upon completion of Lag Screw
insertion, the Lag Screw Inserter
assembly is removed from the
Lag Screw, leaving the Lag Screw
Adapter in place.
31
ONE-STEP INSERTION
As an option to the standard technique, the One-Step Insertion Instrument may be used to insert
the plate and the Lag Screw in a one-step procedure.
For Valgus anatomy (150 head/neck angle), advance the
One-Step Insertion Wrench until the ring marked 150
reaches the One-Step Insertion Sleeve.
Other angled plates should be inserted proportionally
between the marks.
32
PLATE ATTACHMENT
Using standard screw insertion technique, fix the Omega 2 Hip Plate
to the femoral shaft beginning at the proximal end of the plate.
Option
A 4.5mm Tap is available, to pre-tap in
extremely hard cortical bone.
33
FRACTURE COMPRESSION
When all screws are inserted and tightened, and all traction is released,
fracture compression can be accomplished by means of the Compression Screw,
or with the Compression Instrument connected to the Large Elastosil T-Handle.
34
35
REMOVAL
Should the need arise for hardware removal, the Lag Screw is extracted
after removal of the Hip Plate through use of the Large T-Handle
connected to the Lag Screw Inserter and the Connecting Bolt.
(See assembling instructions page 40).
36
Flat sides
Step 3 Slide the Barrel reamer until the stop has been adjusted to the right
measurement. Lock the Barrel Reamer by turning the Stop Sleeve firmly.
37
Outer Introducer
38
Inner Introducer
Lag Screw
Connecting Bolt
39
Lag Screw
Connecting Bolt
40
Description
Reference
CASES
901721
901723
901725
704014
704020
Description
702823
702824
702822
702402
700358
700359
702808
Tap 4.5mm
702809
Tap 6.5mm
702878
702430
704010
704004
Connecting Bolt
704005
702844
Screwdriver Hex3.5mm
704009
704006-20
704021
702863
704007
704008
704019
901713
Screw Rack
704022
Inserter Sleeve
704026
Cleaning Stylet
704001
Impactor Assembly
704601
Outer Introducer
704602
Inner Introducer
704606
Introducer
704607
Extractor Handle
704608
Outer Extractor
704609
Inner Extractor
41
Description
Reference
CASES
901724
901725
901728
704014
704020
Description
702823
702824
702822
702402
700358
700359
702808
Tap 4.5mm
702809
Tap 6.5mm
704010
702878
704004
Connecting Bolt
702430
704005
702844
704009
704006-20
702863
704021
704007
704022
Inserter Sleeve
704008
704026
Cleaning Stylet
704019
704001
Impactor Assembly
901713
Screw Rack
42
Optional instruments
Description
Reference
CASES
901722
901726
Description
CASES
Omega 2 Hansson Twin Hook Sterilisation Tray Lid
Omega 2 Hansson Twin Hook Instruments
Sterilisation Tray
901727
901729
TRAY CONFIGURATION
TRAY CONFIGURATION
704020
704601
704602
Outer Introducer
Inner Introducer
704606
Introducer
704607
Extractor Handle
704608
704609
Outer Extractor
704020
704030
704031
704032
704033
704034
704023
704002
704003
704024
Compression Instrument
702634
AO/Hall Coupling
704027
702939
702946
981010
X-Ray Template
Inner Extractor
REPLACEMENT PARTS
704001-1
43
Impactor Head
LAG SCREW
Stainless Steel
REF
Length
mm
Stainless Steel
REF
Length
mm
394550S
394555S
394560S
394565S
394570S
394575S
394580S
394585S
394590S
394595S
394600S
394605S
394610S
394615S
394620S
394625S
394630S
394635S
394640S
50
55
60
65
70
75
80
85
90
95
100
105
110
115
120
125
130
135
140
3362-5-050
3362-5-055
3362-5-060
3362-5-065
3362-5-070
3362-5-075
3362-5-080
3362-5-085
3362-5-090
3362-5-095
3362-5-100
3362-5-105
3362-5-110
3362-5-115
3362-5-120
3362-5-125
3362-5-130
50
55
60
65
70
75
80
85
90
95
100
105
110
115
120
125
130
Stainless Steel
REF
Length
mm
Stainless Steel
REF
Length
mm
394500S
25
3362-8-050
3362-8-055
3362-8-060
3362-8-065
3362-8-070
3362-8-075
3362-8-080
3362-8-085
3362-8-090
3362-8-095
3362-8-100
3362-8-105
3362-8-110
3362-8-115
3362-8-120
3362-8-125
3362-8-130
50
55
60
65
70
75
80
85
90
95
100
105
110
115
120
125
130
Length
mm
596001S
32.3
44
Length Diameter
mm
mm
230
230
2.8
2.8
Fitting
Jacobs chuck
Quick coupling
chuck
Stainless Steel
REF
Holes
Angle
Length
mm
596302S
596303S
596304S
596305S
596306S
596308S
596310S
596312S
596322S
596323S
596324S
596325S
596326S
596328S
596330S
596332S
596342S
596343S
596344S
596345S
596346S
596348S
596350S
596352S
596362S
596363S
596364S
596365S
596366S
596368S
596370S
596372S
596382S
596383S
596384S
596385S
596386S
596388S
596390S
596392S
2
3
4
5
6
8
10
12
2
3
4
5
6
8
10
12
2
3
4
5
6
8
10
12
2
3
4
5
6
8
10
12
2
3
4
5
6
8
10
12
130
130
130
130
130
130
130
130
135
135
135
135
135
135
135
135
140
140
140
140
140
140
140
140
145
145
145
145
145
145
145
145
150
150
150
150
150
150
150
150
46
62
78
94
110
142
174
206
46
62
78
94
110
142
174
206
46
62
78
94
110
142
174
206
46
62
78
94
110
142
174
206
46
62
78
94
110
142
174
206
45
Stainless Steel
REF
Holes
Angle
Length
mm
596504S
596505S
596514S
596515S
596524S
596525S
596534S
596535S
596544S
596545S
4
5
4
5
4
5
4
5
4
5
130
130
135
135
140
140
145
145
150
150
78
94
78
94
78
94
78
94
78
94
Stainless Steel
REF
Diameter
mm
Length
mm
Stainless Steel
REF
Diameter
mm
Length
mm
Stainless Steel
REF
Diameter
mm
Length
mm
340614
340616
340618
340620
340622
340624
340626
340628
340630
340632
340634
340636
340638
340640
340642
340644
340646
340648
340650
340652
340654
340655
340656
340658
340660
340662
340664
340665
340666
340668
340670
340672
340674
340675
340676
340678
340680
340685
340690
340695
340700
340705
340710
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
4.5
14
16
18
20
22
24
26
28
30
32
34
36
38
40
42
44
46
48
50
52
54
55
56
58
60
62
64
65
66
68
70
72
74
75
76
78
80
85
90
95
100
105
110
341030
341035
341040
341045
341050
341055
341060
341065
341070
341075
341080
341085
341090
341095
341100
341105
341110
341115
341120
341125
341130
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
30
35
40
45
50
55
60
65
70
75
80
85
90
95
100
105
110
115
120
125
130
343020
343025
343030
343035
343040
343045
343050
343055
343060
343065
343070
343075
343080
343085
343090
343095
343100
343105
343110
343115
343120
343125
343130
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
20
25
30
35
40
45
50
55
60
65
70
75
80
85
90
95
100
105
110
115
120
125
130
Stainless Steel
REF
Diameter
mm
Length
mm
Stainless Steel
REF
Total
Length mm
Thread
Length mm
342045
342050
342055
342060
342065
342070
342075
342080
342085
342090
342095
342100
342105
342110
342115
342120
342125
342130
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
6.5
45
50
55
60
65
70
75
80
85
90
95
100
105
110
115
120
125
130
326255S
326260S
326265S
326270S
326275S
326280S
326285S
326290S
326295S
326300S
326305S
326310S
326315S
326320S
55
60
65
70
75
80
85
90
95
100
105
110
115
120
40
40
40
40
40
40
40
40
40
40
40
40
40
40
46
The TGN is the latest development in the continuing evolution of the Gamma
Locking Nail family designed for rapid and secure fixation of intertrochanteric
and pertrochanteric fractures. Combining strength and biomechanical advantages of
the existing Gamma family it is the Golden standard for proximal femoral fractures.
Based on the long Hansson Pin experience, the Hansson Twin Hook is a unique
alternative to the traditional lag screw, and is used together with the Omega 2
or the Omega Plus Hip plate. The operative procedure includes a minimally
invasive surgical approach. If necessary, cephalic implant revision can be
accomplished without removing the sideplate.
This new generation of Cannulated Screws has been designed to optimise surgical
outcomes while simplifying procedures. The ASNIS III System offers the surgeon
a complete choice of implants, material and packaging combined with a new
user-friendly instrumentation.
This innovative device has been developed for Femoral Neck Fracture and Slipped
Capital Femoral Epiphysis treatments. The Hansson Pin System is a simple and
precise instrumentation combined with a unique implant. This unthreaded pin
with a spreading hook allows a strong and stable fixation through a simple and
short procedure, thus preserving the blood supply and the bone integrity.
www.strykertrauma.com
MANFACTURER:
Stryker Trauma AG
Bohnackerweg 1
2545 Selzach
Switzerland
REF NO: 982270
2003 Stryker Corporation. All rights reserved.