Large Fragment Locking

Compression Plate (LCP ) ®

TECHNIQUE GUIDE

Original Instruments and Implants of the Association

for the Study of Internal Fixation — AO ASIF
Introduction
The aim of any surgical fracture treatment is to stability, but function similarly to multiple small
reconstruct the anatomy and restore its function. angled blade plates.
According to the AO ASIF, internal fixation
is distinguished by anatomic reduction, stable The following points distinguish treatment using
fixation, preservation of blood supply and Locking Compression Plate technology:
early, functional mobilization. Plate and screw • Allows fracture treatment using conventional
osteosynthesis has been established and clinically plating with conventional cortex or cancellous
beneficial for quite some time. Clinical results bone screws.
have improved by using internal fixation with • Allows fracture treatment using locked plating
angular stability (internal fixators) in complicated with bicortical or unicortical locking screws.
fractures and in osteopenic bone.
• Permits the combination of conventional and
The Synthes Locking Compression Plate (LCP) locking screw techniques.
is part of a stainless steel and titanium plate and
screw system that merges locking screw technology
with conventional plating techniques.* The
Locking Compression Plate System has many Important notes:
similarities to conventional plate fixation methods, The LCP system applies to many different plate
but with a few important improvements. Locking types and is therefore suitable for a large number
of fracture types. For that reason, the Large
screws provide the ability to create a fixed-angle
Fragment Locking Compression Plate Technique
construct while utilizing familiar AO plating Guide does not deal with any specific fracture
techniques. A fixed-angle construct provides type. For more information please refer to
improved fixation in osteopenic bone or AO Principles of Fracture Management,1 to
multifragment fractures where traditional screw AO ASIF courses (www.ao-asif.ch), and to the
purchase is compromised. LCP constructs do not corresponding special literature.
rely on plate-to-bone compression to maintain

Indications
The Synthes Locking Compression Plates — Narrow and Broad, are intended for fixation of
various long bones, such as the humerus, femur and tibia. They are also for use in fixation
of periprosthetic fractures, osteopenic bone, and nonunions or malunions.
The Synthes Locking Compression Plates — T-Plates are intended to buttress metaphyseal
fractures of the proximal humerus, medial tibial plateau and distal tibia. They are also for
use in fixation of osteopenic bone and fixation of nonunions and malunions.
The Synthes LCP Proximal Tibia Plate is intended for treatment of non-unions, malunions,
and fractures of the proximal tibia, including simple, comminuted, lateral wedge, depression,
medial wedge, bicondylar, combinations of lateral wedge and depression, periprosthetic,
and fractures with associated shaft fractures.

1. Thomas P. Rüedi, et al, ed., AO Principals of Fracture Management, New York: Thieme, 2000.
AO Principles

Anatomic
Reduction
Exact screw placement
utilizing wire sleeves
facilitates restoration
of the articular surface. Early
Mobilization
Plate features combined
with AO technique create
an environment for bone
healing, expediting a
return to optimal function.
Stable Fixation
Locking screws create
a fixed-angle construct,
providing angular
stability.

Preservation of
Blood Supply
Tapered end for
submuscular plate
insertion, improving
tissue viability.
Limited–contact plate
design reduces plate-
to-bone contact,
minimizing vascular
trauma.

1
 Features
Locking Compression Plates
The Locking Compression Plates (LCP) have
these LC-DCP features:
• 50° of longitudinal screw angulation
• 14° of transverse screw angulation 224.591
• Uniform hole spacing
• Load (compression) and neutral screw positions

The Locking Compression Plates have combination

locking and compression (Combi™) holes.

The Combi holes allow placement of conventional

cortex and cancellous bone screws on one side or D
C
threaded conical locking screws on the opposite
side of each hole.
A. Threaded hole section for locking screws A
B
B. DCU hole section for conventional screws
C. Locking screw in threaded side of Combi hole
D. Cortex screw in compression side of Combi hole

Note: Combi holes in straight plates are

oriented with the conventional portion of
each hole further from the middle of the
plate. This facilitates utilization of LCP
plates for dynamic compression using
traditional AO techniques.

2
4.0 mm and 5.0 mm Locking Screws, self-tapping,
with StarDrive recess
The locking screws mate with the threaded portion of the
Combi holes to form a fixed-angle construct.

Self-tapping
flutes
Locking
threads
mate with
the plates

Cortical thread
profile
StarDrive
recess

Locking Screw Design

The screw design has been modified, from standard 4.5 mm cortex screw
design, to enhance fixation and facilitate the surgical procedure.

New features include:

Conical screw head Thread profile

The conical head facilitates alignment of The shallow thread profile of the locking screws
the locking screw in the threaded plate hole results from the larger core diameter, but is accept-
to provide a fixed connection between the able because locking screws do not rely solely on
screw and the plate. screw purchase in the bone to maintain stability.

Large core diameter Drive mechanism

The large core diameter improves bending and The StarDrive recess provides improved torque
shear strength of the screw, and distributes the transmission to the screw, while retaining the
load over a larger area in the bone. screw without the use of a holding sleeve.

3
 Features (continued)
Unicortical Screw Fixation
Bicortical screw fixation has long been the traditional method of compressing a plate to the bone
where friction between the plate and the bone maintains stability. Screw stability and load transfer
are accomplished at two points along the screw: the near and far cortices.
Unicortical locking screws provide stability and load transfer only at the near cortex due to
the threaded connection between the plate and the screw. Screw stability and load transfer are
accomplished at two points along the screw: the screw head and near cortex. Because the screw
is locked to the plate, fixation does not rely solely on the pullout strength of the screw or on
maintaining friction between the plate and the bone.
A. Bicortical screws require two (2) cortices to achieve stability
B. Unicortical screws utilize the locked screw head and the near cortex to achieve stability

A B

4
Implants for the Large Fragment LCP System

224.591 226.591

4.5 mm Narrow LCP Plates 4.5 mm Broad LCP Plates

• Available with 2–22 holes • Available with 6 –22 holes
• Available in stainless steel or titanium • Available in stainless steel or titanium

226.622

240.039 4.5 mm Curved Broad LCP Plates*

4.5 mm LCP Proximal Tibia Plate* • Available with 12–18 holes

• Available with 4 , 6, 8, 10, 12 and • Available in stainless steel or titanium

14 shaft holes
• Available in left and right configurations
• Available in stainless steel or titanium

240.161

4.5 mm LCP T-Plates

• Available with 4, 6 and 8 shaft holes
4.0 mm Locking Screws, self-tapping
• Available in stainless steel or titanium
• Available in 14 mm – 18 mm lengths
(2 mm increments)
• Available in 22 mm – 62 mm lengths
(4 mm increments)
• Available in stainless steel or titanium alloy**
5.0 mm Locking Screws, self-tapping
• Available in 14 mm – 50 mm lengths
(2 mm increments)
• Available in 55 mm – 90 mm lengths
(5 mm increments)
• Available in stainless steel or titanium alloy**
**Also Available
**Ti-6Al-7Nb

5
 Featured Instruments for the
Large Fragment LCP System

3.2 mm Drill Bit [310.31] 4.3 mm Drill Bit [310.431]

Use a 3.2 mm Drill Bit to drill the pilot hole Use a 4.3 mm Drill Bit to drill the pilot hole
for self-tapping 4.0 mm locking screws. for self-tapping 5.0 mm locking screws.

3.2 mm Threaded Drill Guide [312.445] 4.3 mm Threaded Drill Guide [312.449]
Centers and permits perpendicular drilling Centers and permits perpendicular drilling
with the 3.2 mm Drill Bit and protects the with the 4.3 mm Drill Bit and protects the
soft tissue. The use of the drill guide is critical soft tissue. The use of the drill guide is critical
to ensure proper mating of the locking screw to ensure proper mating of the locking screw
in the threaded portion of the Combi hole. in the threaded portion of the Combi hole.
The drill guide also has internal threads so The drill guide also has internal threads so
guides can be assembled in series to increase guides can be assembled in series to increase
length for percutaneous use. length for percutaneous use.

StarDrive Screwdriver [314.118]

For manual insertion and removal of locking screws.

StarDrive Screwdriver Shaft [314.119]

Mates with the Torque Limiting Attachment (TLA) for insertion of locking screws.

Threaded Plate Holder [324.075]

Used as an aid to position the plate on the bone. In less invasive
surgical procedures, the plate holder is also useful for plate insertion.

6
 2.0 mm Wire Sleeve [323.046] Direct Measuring Device [323.021]
Mates with either threaded drill guide and Used over the 2.0 mm guide wire (with
is used to direct the insertion of a 2.0 mm either threaded drill guide and the wire
guide wire. sleeve) to measure for screw length.

Torque Limiting Attachment (TLA), 4.0 Nm [511.774]

for AO Reaming Coupler
When inserting locking screws under power, the Torque Limiting Attachment
controls the tightening torque to 4.0 Nm.
• Ensures that enough torque is used to minimize the risk of the locking
screw backing out of the plate
• Avoids locking the screw to the plate at full speed and minimizes the risk
of cold-welding the screw to the plate
• DO NOT fully insert the locking screws by power without using the TLA

Handle for AO Reaming Coupler connection [397.706]

For manual insertion of locking screws while using the TLA [511.774].

Also Available
Torque Limiting Attachment (TLA), 4.0 Nm [511.771]
for use with the ComPact Air Drive/Power Drive
Handle, quick coupling, for
ComPact Air Drive connection [397.705]

Important: The TLA is a calibrated instrument. Annual service

and recalibration of the TLA by Synthes is recommended.

7
 Fixation Principles
The following examples show the biomechanical features of conventional plating techniques,
locked or bridge plating techniques, and a combination of both.
Important note:
Please refer also to the AO Principles of Fracture Management,2 to AO ASIF courses
(www.ao-asif.ch), and to the corresponding special literature.

Conventional Plating
F3 F2
Construct stability
F1 F2 The tensile force (F1) originating from tightening the screws
F4 F4
compresses the plate onto the bone (F2). The developing
frictional force (F3) between the plate and the bone leads to
stable plate fixation. To ensure construct stability, the frictional
force must be greater than the patient load (F4).

Anatomic contouring of the plate

The aim of internal fixation is anatomic reduction, particularly
in articular fractures. Therefore, the plate must be contoured
exactly to match the shape of the bone.

Lag screw
Interfragmentary compression is accomplished with a lag screw.
This is particularly important in intra-articular fractures which
require a precise reduction of the joint surfaces. Lag screws can
be angled in the plate hole, allowing placement of the screw
perpendicular to the fracture line.

Primary loss of reduction

In conventional plating, even though the bone fragments are
correctly reduced prior to plate application, fracture dislocation
will result if the plate does not precisely fit the bone. In
addition, if the lag screw is not placed perpendicular to the
fracture line, shear forces will be introduced. These forces
may also cause loss of reduction.

Secondary loss of reduction

Under axial load, postoperative secondary loss of reduction may
occur by toggling of the screws in the plate. Since cortex screws do
not lock to the plate, the screws cannot oppose the acting force
and may loosen, or be pushed axially through the plate holes.
2. Ibid.

8
 Blood supply to the bone
Construct stability depends upon compressing
the plate to the bone. Therefore, the periosteum
is compressed under the plate, reducing or even
interrupting blood supply to the bone. The result
is delayed bone healing due to temporary
osteoporosis underneath the plate.

Osteoporosis
Due to a compromised cortical structure, screws cannot be tightened sufficiently
to obtain the compression needed for a stable construct. This may cause loosening
of the screws and loss of stability, and may cause loss of reduction.

Conventional plating achieves good results in:

1. Good quality bone;
2. Fractures which are traditionally fixed with lag screws to achieve direct
bone healing.
Special attention must be paid to:
1. Osteoporotic bone—during rehabilitation, the load should be kept to a minimum
to prevent postoperative loss of reduction;
2. Multifragment fractures—the anatomic reduction may be accomplished at the
expense of extensive soft tissue trauma and denudation.

9
 Fixation Principles (continued)

Locked Plating
Screws lock to the plate, forming a fixed-angle construct.

Maintenance of primary reduction

Once the locking screws engage the plate, no further tightening
is possible. Therefore, the implant locks the bone segments in
their relative positions regardless of degree of reduction.
Precontouring the plate minimizes the gap between the plate
and the bone, but an exact fit is not necessary for implant
stability. This feature is especially advantageous in minimally
or less invasive plating techniques because these techniques
do not allow exact contouring of the plate to the bone surface.

Stability under load

F
By locking the screws to the plate, the axial force is transmitted
over the length of the plate. The risk of a secondary loss of
reduction is reduced.

Blood supply to the bone

Locking the screw into the plate does not generate plate-to-bone
compression. Therefore, the periosteum will be protected and
the blood supply to the bone preserved.

10
The Locking Compression Plate (LCP)

Combining Conventional and Locked Plating Techniques

The combination of conventional compression plating and locked plating techniques enhances
plate osteosynthesis. The result is a Combi hole that, depending on the indication, allows
conventional compression plating, locked plating, or a combination of both.

Internal fixation using a combination of locking screws and standard screws

Note: If a combination of cortex and locking screws is used, a

cortex screw should be inserted first to pull the plate to the bone.

If locking screws (1) have been used to fix a plate to a

fragment, subsequent insertion of a conventional screw
1 1
(2) in the same fragment without loosening and retight-
ening the locking screw is NOT RECOMMENDED.
Note: If a locking screw is used first, care should be taken
2
to ensure that the plate is held securely to the bone to avoid
spinning of the plate about the bone.

Dynamic compression
In this example, once the metaphyseal fragment has been
fixed with locking screws, the fracture can be dynamically
compressed using a conventional screw in the DCU portion
of the Combi hole.

Locked and conventional plating techniques

• Lag screws can be used to anatomically reduce the fracture and promote absolute stability.
• The behavior of a locking screw is not the same as that of a lag screw. With the locked
plating technique, the implant locks the bone segments in their relative positions regardless of
how they are reduced. Therefore, anatomical reduction must be achieved prior to implanting
any locking screws.
• A plate used as a locked plate does not produce any additional compression between the plate
and the bone.
• The unicortical insertion of locking screws creates a construct that is at least as strong as a
construct made with bicortical insertion of conventional screws.

11
 Screw Selection Information
The 4.0 mm and 5.0 mm Locking Screws are both Chart 1*
suitable for diaphyseal and metaphyseal indications. Comparative Bending and Shear Strength of Locking Screws
Relative to 4.5 mm Cortex Screws
The 5.0 mm Locking Screw was designed as the 300%

principle screw for use with LCP. It provides greater 250%

Bending
bending and shear strength than 4.0 mm Locking Screws 200%
Shear
(Chart 1). The 4.0 mm Locking Screw, with a 3.4 mm

Percent
150%
core diameter versus the 4.4 mm core diameter of the
5.0 mm Locking Screw, was developed to provide the 100%

option of placing a smaller diameter screw in small 50%

statured patients or in cases where it is desirable to 0%
4.5 mm Cortex 4.0 mm Locking 5.0 mm Locking
leave a smaller hole on explantation. 3.2 mm Core Diameter 3.4 mm Core Diameter 4.4 mm Core Diameter

Screw Type

Locking screw fixation provides the greatest advantage over conventional

screw fixation in poor quality bone. Even though 5.0 mm Locking Screws are
significantly stronger in bending and shear than 4.0 mm Locking Screws, the
behavior of both locking screw constructs provides relatively similar results in
mechanical tests using 15 lb/ft 3 foam, which simulates osteopenic bone, under
axial load (Chart 2). Both bicortical locking screw constructs outperform a
construct with conventional 4.5 mm Cortex Screws. When all constructs are
tested in 40 lb/ft 3 foam simulating good quality cortical bone, both locking
and conventional constructs yield similar results when loaded axially (Chart 3).

Test Setup

Chart 2* Chart 3*
3
Locked Plate and Screw Testing (15 lb/ft foam) Locked Plate and Screw Testing (40 lb/ft3 foam)

600 800
● ■ ●
● ●
● ■ 700 ● ▲
■
500 ■ ■
● ●
■ ■ ▲
◆
◆
◆
600 ● ■ ▲
●
400 ■ ◆ ▲
■
500
Load (N)

▲
Load (N)

◆
300 400
● 5.0 mm locking bicortical, 3 ea. ● 5.0 mm locking bicortical, 3 ea.
■ 4.0 mm locking bicortical, 3 ea. 300 ■ 4.0 mm locking bicortical, 3 ea.
200 ◆ 4.5 mm cortex, 2 ea. and ▲ 4.5 mm cortex, 2 ea. and
4.0 mm locking bicortical, 1 ea. 5.0 mm locking bicortical, 1 ea.
200
4.5 mm cortex, 3 ea. 4.5 mm cortex, 3 ea.
100 4.5 mm cortex, 2 ea. and 4.5 mm cortex, 2 ea. and
5.0 mm locking unicortical, 1 ea. 100 5.0 mm locking unicortical, 1 ea.
4.0 mm locking unicortical, 3 ea. 4.0 mm locking unicortical, 3 ea.
0 ● 0 ●

0 1 2 3 4 5 6 7 8 0 1 2 3 4 5 6 7 8
Displacement (mm) Displacement (mm)

*Note: Data represents test results from stainless steel implants only.

12
Surgical Technique

1 Plate selection
The plates are available in various lengths and configurations
similar to the Synthes Basic Plate Set. If necessary, use a bending
template to determine plate length and configuration.

2 Contouring
Use the current bending instruments to contour the
Locking Compression Plate to the anatomy.
Note: The plate holes have been designed to accept some degree of deformation.
When bending the plate, place the bending irons on two consecutive holes.
This ensures that the threaded holes will not be distorted. Significant distortion
of the locking holes will reduce locking effectiveness.
Important: Please refer also to the AO Principles of Fracture Management,
(pgs. 181,182) 3

3 Reduction and temporary plate placement

The plate may be temporarily held in place with standard plate holding
forceps or the Push-Pull Reduction Device [311.449].
Note: The middle of the plate should be positioned over the fracture
site if compression of the fracture fragments is desired.

The Push-Pull Reduction Device is designed to temporarily hold

the plate to the bone through a plate hole. The device is self-drilling
311.449 and connects with the Synthes quick coupling for power insertion.
Insert into the near cortex only. After power insertion, turn the
collet clockwise until it pulls the plate securely to the bone.
Note: Care should be taken to avoid inserting this device in a Combi hole
that will be needed immediately for plate fixation. Also, if the chosen Combi
hole is needed for placement of a locking screw, it is desirable to place the
Push-Pull Reduction Device in the conventional portion of the Combi hole
so that it does not interfere with the correct placement of the locking screw.

Alternatively, the Threaded Plate Holder [324.075] can be used as an aid

to position the plate on the bone. The plate holder may also function as
an insertion handle for use with minimally invasive plating techniques.

3. Ibid.

13
 Surgical Technique (continued)

4 Screw insertion
Determine whether conventional cortex screws, cancellous bone screws or
locking screws will be used for fixation. A combination of all may be used.
Note: If a combination of cortex, cancellous and locking screws is used,
a conventional screw should be used first to pull the plate to the bone.
Warning: If a locking screw is used first, care should be taken to ensure that
the plate is held securely to the bone to avoid spinning of the plate about the bone
as the locking screw is tightened to the plate.

Insertion of a cortex or cancellous bone screw

Use the 4.5 mm Universal Drill Guide [323.46] for an eccentric (compression)
or neutral (buttress) insertion of cortex screws.
Note: The 4.5 mm LC-DCP Drill Guide [323.45] and the
4.5 mm DCP Drill Guide [322.44 ] are NOT suitable for use with LCP plates.

Neutral insertion of a conventional screw

When pressing the universal drill guide into the DCU
portion of the Combi hole, it will center itself and allow
neutral predrilling.

Neutral position

Dynamic compression, eccentric insertion of a cortex screw

To drill a hole for dynamic compression, place the universal
drill guide eccentrically at the edge of the DCU portion of the
Combi hole, without applying pressure. Tightening of the cortex
screws will result in dynamic compression corresponding to that
of LC-DCP plates.

Dynamic compression

14
 4 Screw insertion (continued)

Insertion of 4.0 mm and 5.0 mm Locking Screws

Reminder: The locking screw is not a lag screw. Use nonlocking screws when requiring a precise anatomical
reduction (e.g., joint surfaces) or interfragmentary compression. Before inserting the first locking screw, perform
anatomical reduction and fix the fracture with lag screws, if necessary. After the insertion of locking screws,
an anatomical reduction will no longer be possible without loosening the locking screw.

A A Screw the appropriate Warning: Do not try to bend the

Threaded Drill Guide plate using the Threaded Drill
(312.445 for 4.0 mm Guide because damage may
screws and 312.449 for occur to the threads.
5.0 mm screws) into an
LCP plate hole until fully Note 1: Since the direction of
seated. a locking screw is determined
(see Note 1) by plate design, final screw
position may be verified with
a guide wire prior to insertion.
B B Use the appropriate Drill
This becomes especially
Bit (3.2 mm for 4.0 mm
important when the plate has
screws and 4.3 mm for been contoured or applied in
5.0 mm screws) to drill metaphyseal regions around
to the desired depth. joint surfaces. (Refer to “Screw
placement verification” on p.17)

Note 2: 5.0 mm cannulated

locking screws and 5.0 mm
cannulated conical screws
C Remove the drill guide. for the Locking Periarticular
D Plating System are compatible
with the Large Fragment LCP
D Use the Depth Gauge
plates.
[319.10] to determine
screw length.

15
 Surgical Technique (continued)
Insertion of 4.0 mm and 5.0 mm Locking Screws (continued)

E E Insert the locking screw under power using the

Torque Limiting Attachment [511.771 or 511.774]
and StarDrive Screwdriver Shaft [314.119].
Note: The screw is securely locked to the plate when
a “click” is heard.
Warning: Locking Screws may be partially inserted
using power equipment alone. However, never use
power equipment to seat the locking screws into the
plate without a Torque Limiting Attachment (TLA).

Alternative Method of Locking Screw Insertion

Use the StarDrive Screwdriver [314.118] to manually
insert the appropriate locking screw. Carefully
tighten the locking screw, as excessive force is not
necessary to produce effective screw-to-plate locking.

16
Screw placement verification A
Since the direction of a locking screw is determined by plate design, final
screw position may be verified with a guide wire prior to insertion. This
becomes especially important when the plate has been contoured or applied
in metaphyseal regions around joint surfaces.

A With the threaded drill guide in place, thread the 2.0 mm Wire
Sleeve [323.046] into the threaded drill guide until fully seated.

B Insert a 2.0 mm Non-Threaded Guide Wire [292.656] through the

B
wire sleeve to the desired depth.

C Verify guide wire placement under image intensification to

determine if final screw placement is acceptable.

Important: The guide wire position represents the final position of

the locking screw. Confirm that the guide wire does not enter the joint.

D Measurement may be taken by sliding the tapered end of the C

Direct Measuring Device [323.021] over the guide wire down to
the wire sleeve.

Remove the Direct Measuring Device, guide wire and wire sleeve,
leaving the threaded drill guide intact.
Use the appropriate size drill bit to drill the near cortex. Remove
the threaded drill guide. Insert the appropriate length locking screw.
D
Postoperative treatment
Postoperative treatment with locking compression plates does not differ
from conventional internal fixation procedures.

Implant removal
To remove locking screws, unlock all screws from the plate; then remove
the screws completely from the bone. This prevents simultaneous rotation
of the plate when removing the last locking screw.

17
 Large Fragment LCP Instrument and Implant Sets,
with 4.0 mm and 5.0 mm Locking Screws
Stainless Steel [115.400]
Titanium [146.400]

Large Fragment LCP

Instrument Set Graphic Case
[690.363]

Instruments
292.656 2.0 mm Non-Threaded Guide Wire, 230 mm, 314.27 Large Hexagonal Screwdriver
spade point, 10 ea. 319.10 Depth Gauge, for 4.5 mm and 6.5 mm screws
310.19 2.0 mm Drill Bit, 100 mm, quick coupling, 2 ea. 319.39 Sharp Hook
310.31 3.2 mm Drill Bit, 145 mm, quick coupling, 2 ea. 321.12 Articulated Tensioning Device
310.431* 4.3 mm Drill Bit, 180 mm, quick coupling, 321.15 Socket Wrench with universal joint,
for 5.0 mm Locking Screws, 2 ea. 11.0 mm width across flats
310.44 4.5 mm Drill Bit, 145 mm, quick coupling, 2 ea. 323.021* Direct Measuring Device
310.99 Countersink, for 4.5 mm and 6.5 mm screws 323.046* 2.0 mm Wire Sleeve, 2 ea.
311.44 T-Handle with quick coupling 323.46 4.5 mm Universal Drill Guide
311.449* Push-Pull Reduction Device, for use with 324.075* Threaded Plate Holder
4.5 mm LCP plates, 2 ea.
397.706* Handle, for AO Reaming Coupler connection
311.46 Tap, for 4.5 mm screws, 2 ea.
511.774* Torque Limiting Attachment, 4 Nm,
311.66 Tap, for 6.5 mm Cancellous Bone Screws, 2 ea. for AO Reaming Coupler
312.445* 3.2 mm Threaded Drill Guide, 2 ea.
312.449* 4.3 mm Threaded Drill Guide, 4 ea.
Also Available
312.46 4.5 mm/3.2 mm Double Drill Sleeve
312.48 4.5 mm/3.2 mm Insert Drill Sleeve 115.401 Large Fragment LCP Instrument Set
312.67 6.5 mm/3.2 mm Double Drill Sleeve 115.402 Large Fragment LCP Plate Set
314.11 Holding Sleeve 146.402 Large Fragment Titanium LCP Plate Set
314.118* StarDrive Screwdriver, T25, self-retaining, 115.403 Large Fragment LCP Screw Set
245 mm
146.403 Large Fragment Titanium LCP Screw Set
314.119* StarDrive Screwdriver Shaft, T25, self-retaining,
292.652 2.0 mm Threaded Guide Wire
165 mm, for use with Torque Limiting
Attachment (511.771 or 511.774) 397.705* Handle, quick coupling, for ComPact Air
Drive connection
314.15 Large Hexagonal Screwdriver Shaft
511.771* Torque Limiting Attachment, 4 Nm

* LCP-specific instruments

18
 Large Fragment LCP
Implant Set Graphic Case
Stainless Steel [690.360]
Titanium [690.420]

Implants Implants (continued)

4.5 mm Narrow LCP Plates 4.5 mm Broad LCP Plates
STAINLESS STAINLESS
STEEL TITANIUM STEEL TITANIUM

224.541 424.541 4 holes, 80 mm 226.561 426.561 6 holes, 116 mm

224.551 424.551 5 holes, 98 mm 226.571 426.571 7 holes, 134 mm
224.561 424.561 6 holes, 116 mm, 2 ea. 226.581 426.581 8 holes, 152 mm
224.571 424.571 7 holes, 134 mm 226.591 426.591 9 holes, 170 mm
224.581 424.581 8 holes, 152 mm, 2 ea. 226.601 426.601 10 holes, 188 mm
224.591 424.591 9 holes, 170 mm 226.611 426.611 11 holes, 206 mm
224.601 424.601 10 holes, 188 mm, 2 ea. 226.621 426.621 12 holes, 224 mm
224.611 424.611 11 holes, 206 mm 226.641 426.641 14 holes, 260 mm
224.621 424.621 12 holes, 224 mm, 2 ea. 226.661 426.661 16 holes, 296 mm
224.641 424.641 14 holes, 260 mm Also Available
224.661 424.661 16 holes, 296 mm 226.681 426.681 18 holes, 332 mm
Also Available 226.701 426.701 20 holes, 368 mm
224.521 424.521 2 holes, 44 mm 226.721 426.721 22 holes, 404 mm
224.531 424.531 3 holes, 62 mm
224.631 424.631 13 holes, 242 mm
224.651 424.651 15 holes, 278 mm Also Available
224.681 424.681 18 holes, 332 mm
4.5 mm LCP Proximal Tibia Plates
224.701 424.701 20 holes, 368 mm
240.036 440.036 4 holes, 82 mm, right
224.721 424.721 22 holes, 404 mm
240.037 440.037 4 holes, 82 mm, left
240.038 440.038 6 holes, 118 mm, right
4.5 mm LCP T-Plates 240.039 440.039 6 holes, 118 mm, left
240.141 440.141 4 holes, 83 mm
240.161 440.161 6 holes, 115 mm
4.5 mm Curved Broad LCP Plates
240.181 440.181 8 holes, 147 mm
226.622 426.622 12 holes, 229 mm
226.632 426.632 13 holes, 247 mm
Templates 226.642 426.642 14 holes, 256 mm
Bending Templates 226.652 426.652 15 holes, 282 mm
226.662 426.662 16 holes, 300 mm
329.92 12 holes
226.672 426.672 17 holes, 318 mm
329.97 7 holes
226.682 426.682 18 holes, 336 mm
329.99 9 holes

19
 Large Fragment LCP Instrument and Implant Sets,
with 4.0 mm and 5.0 mm Locking Screws
Stainless Steel [115.400]
Titanium [146.400] (continued)

Large Fragment LCP

Screw Set Graphic Case
Stainless Steel [690.362]
Titanium [690.425]

Instruments
319.97 Screw Forceps

Screws Locking Screws

STAINLESS 4.0 mm Locking Screws, self-tapping,
STEEL TITANIUM
with T25 StarDrive recess
214.228 – 414.228 – 4.5 mm Shaft Screws, STAINLESS
214.250 414.250 28 mm – 50 mm,* 2 ea. STEEL TITANIUM

222.670 – 422.670 – 14 mm – 18 mm,* 3 ea.

4.5 mm Cortex Screws, self-tapping 222.672 422.672
214.814 – 414.814 – 14 mm – 18 mm,* 4 ea. 222.673 – 422.673 – 22 mm – 62 mm,** 3 ea.
214.818 414.818 222.683 422.683
214.820 – 414.820– 20 mm – 24 mm,* 6 ea.
214.824 414.824 5.0 mm Locking Screws, self-tapping,
214.826– 414.826– 26 mm – 42 mm,* 12 ea. with T25 StarDrive recess
214.842 414.842 212.201 – 412.201 – 14 mm – 42 mm,* 5 ea.
214.844– 414.844– 44 mm – 70 mm,* 4 ea. 212.215 412.215
214.870 414.870 212.216 – 412.216 – 44 mm – 50 mm,* 3 ea.
212.219 412.219
4.5 mm Malleolar Screws 212.220 – 412.220 – 55 mm – 90 mm,*** 3 ea.
212.227 412.227
215.025 – n/a 25 mm – 70 mm,*** 2 ea.
215.070

6.5 mm Cancellous Bone Screws Other Implants

216.030 – 416.030 – 16 mm thread,
216.110 416.110 30 mm –110 mm,*** 3 ea. 219.99 419.99 Washer, 13 mm, 6 ea.
217.045 – 417.045 – 32 mm thread,
217.110 417.110 45 mm – 110 mm,*** 3 ea. * 2 mm increments
218.025 – 418.025 – fully threaded, ** 4 mm increments
218.060 418.060 25 mm – 60 mm,*** 3 ea. *** 5 mm increments

20
SYNTHES (USA)
1302 Wrights Lane East
West Chester, PA 19380
Telephone: (610) 719-5000
To order: (800) 523-0322
Fax: (610) 251-9056

SYNTHES (CANADA) LTD.

2566 Meadowpine Boulevard
Mississauga, Ontario L5N 6P9
Telephone: (905) 567-0440
To order: (800) 668-1119
Fax: (905) 567-3185

Original Instruments and Implants of the Association

for the Study of Internal Fixation — AO ASIF

© 2003 SYNTHES (USA) Combi, LCP, DCP, LC-DCP, SYNTHES and ASIF are trademarks of SYNTHES (USA) and SYNTHES AG Chur. Printed in U.S.A. GP2304-C 11/ 05 J4331-D