T2 Alpha

Femur Retrograde
Nailing System
Operative technique
T2 Alpha
Femur Retrograde Nailing System

Contents
1. Indications and contraindications...........3 Follow the instructions provided in our cleaning
and sterilization guide (OT-RG-1). All non-strile
2. MRI Safety information..............................4 devices must be cleaned and sterilized before use.
2. Additional information...............................5
3. Operative technique..................................10 Consult Instructions for Use (www.ifu.stryker.com)
for a complete list of potential adverse effects and
Patient positioning........................................ 10 adverse events, contraindications, warnings and
Entry point.....................................................11 precautions.
Reaming........................................................ 14
Nail selection................................................. 15
Multi-component instruments must
Nail insertion................................................ 16 be disassembled for cleaning.
Guided distal locking.................................... 18 Please refer to the corresponding assembly /
disassembly instructions.
Compression.................................................. 24
Guided proximal locking.............................. 26
The surgeon must discuss all relevant risks including
Freehand proximal locking.......................... 32 the finite lifetime of the device with the patient when
necessary.
Advanced locking screws............................. 33
Condyle screw insertion............................... 36
End cap insertion.......................................... 40 The surgeon must advise patients of surgical
risks, and make them aware of adverse effects
Nail removal.................................................. 41
and alternative treatments.
This publication sets forth detailed recommended
procedures for using Stryker devices and instruments.
It offers guidance that you should heed, but, as The patient should be advised that the device
with any such technical guide, each surgeon must cannot and does not replicate a normal healthy
consider the particular needs of each patient and bone, that the device can break or become
make appropriate adjustments when and as required. damaged as a result of strenuous activity or
A workshop training is recommended prior to trauma and that the device has a finite expected
performing your first surgery. service life.
Please remember that the compatibility* of different Removal or revision of the device may be
product systems has not been tested unless specified required sometime in the future due to
otherwise in the product labeling. medical reasons.

•
*The terms "all Stryker IM Systems" / "all titanium-made Use instruments / implants as described in
Stryker IM Nailing Systems" are defined as T2 Alpha this operative technique to avoid damage to
Femur Retrograde Nailing Systems.
instruments / implants or bone and soft tissue.
2
Indications and
contraindications

Intended use • Obesity. An overweight or obese patient can

produce loads on the implant that can lead to
The T2 Alpha Femur Retrograde Nailing System
failure of the fixation of the device or to failure
is intended for temporary stabilization of bone
of the device itself.
segments or fragments until bone consolidation
has been achieved. • Patients having inadequate tissue
Indications for use (US and Canada) coverage over the operative site.

The indications for use of these internal • Implant utilization that would interfere
fixation devices include: with anatomical structures or physiological
performance.
• Open and closed femoral fractures.
• Pseudoarthrosis and correction osteotomy. • Any mental or neuromuscular disorder which
would create an unacceptable risk of fixation
• Pathologic fractures, impending pathologic
failure or complications in postoperative care.
fractures and tumor resections.
• Supracondylar fractures, including • Other medical or surgical conditions which
those with intra-articular extension. would preclude the potential benefit of surgery.
• Fractures involving osteopenic
IMN Screws System Intended Use
and osteoporotic bone.
• Fractures distal to a total hip prosthesis. The IMN screws system is intended to stabilize the
intramedullary nail-bone construct for temporary
• Periprosthetic fractures.
stabilization.
• Nonunions and malunions.
IMN Instruments System Intended Use
Contraindications The IMN instruments system is intended to enable
The physician’s education, training and the implantation and extraction of intramedullary
professional judgement must be relied upon to nail and screw.
choose the most appropriate device and treatment.

Conditions presenting an increased risk of failure The T2 Alpha Femoral Nail Retrograde is not
include: intended for full weight bearing in patients
with complex unstable fractures until bone
• Any active or suspected latent infection or
consolidation is confirmed in the follow-up
marked local inflammation in or about the
X-rays.
affected area.

• Compromised vascularity that would inhibit

adequate blood supply to the fracture or the The T2 Alpha Femoral Nail Retrograde is
operative site. designed for temporary implantation until bone
• Bone stock compromised by disease, infection or consolidation occurs. If bone consolidation does
prior implantation that cannot provide adequate not occur or if the consolidation is insufficient,
support and /or fixation of the devices. the implant may break. The aim of post-
operative care must be to ensure the promotion
• Material sensitivity documented or suspected. of bone consolidation.
3
MRI safety information

Non-clinical testing has demonstrated that the T2

Alpha Retrograde Femur Nailing System and IMN
screws system are MR conditional. A patient with
this device can be safely scanned in an MR system MR Conditional

meeting the following conditions:

•S
 tatic magnetic field of 1.5 T or 3.0 T.
•M
 aximum spatial field gradient of 3,000 gauss /
cm (30 T / m).
•M
 aximum MR system reported, whole body
averaged specific absorption rate (SAR) of 2W / kg
(Normal Operating Mode).
Under the scan conditions defined above, the T2
Alpha Retrograde Nailing System and IMN screws
system are expected to produce a maximum
temperature rise of less than 2.1°C* after
15 minutes of continuous scanning.
In non-clinical testing, the image artifact caused
by the device extends approximately 27mm from
the T2 Alpha Retrograde Nailing System and IMN
screws system when imaged with a spin echo or
gradient echo pulse sequence and a 3.0 T
MRI system.

•
The MRI safety information provided is based
on testing which did not include supplementary
devices. If there are supplementary devices (i.e.
plates, screws, wires, etc.) present in proximity
to the T2 Alpha Femur Retrograde Nailing
System and IMN Screws System, this could
result in additional MRI effects and the
information provided above may not apply.

*∆1°C = 1.8° F
∆2.1° C = 3.78° F

4
Additional Information
T2 Alpha Femur
Retrograde Nailing System
Nail diameter
Ø9mm–Ø14mm1
Driving end diameter
Driving end diameter of the 9–11mm nails is Ø11.5mm;
nail sizes 12–14mm have a constant diameter
Nail length
Femoral Nail Retrograde, Short: 170mm and 200mm
Femoral Nail Retrograde: 220mm– 480mm in 20mm increments

Locking Screw2,3
Ø5mm, 25mm–120mm length
25mm–60mm in 2.5mm increments
60mm–120mm in 5mm increments

Advanced Locking Screws4

Ø5mm, 30mm–100mm length
30mm–60mm in 2.5mm increments
60mm–100mm in 5mm increments

Condyle Screws and Condyle Nut4

Ø5mm, 40mm –120mm length
in 5mm increments

Compression Screw Femur5

End Cap SCN4

Drills6
4.2mm – green
5.5mm – green (counterbore drill)
1. Check with local representative regarding
availability of implant sizes
2. Screw length measures from top of head to tip
3. Product from IMN Screws System
4. Product from T2 SCN
5. Product from T2 Alpha Femur Antegrade Femoral Nail Femoral Nail
GT/PF Nailing System Retrograde, short Retrograde
6. Product from IMN Instruments System

5
Additional Information
T2 Alpha Femur Retrograde
Nailing Length

0mm 0mm
10mm
15mm
25mm
35mm
45mm

0mm
RoC:
10mm 700mm-1350mm

30mm

Distal posterior
bend 1-5°

70mm

Distal posterior 55mm

bend 4° 45mm
32mm 32mm
21mm 21mm
14mm 14mm
6mm 6mm
0mm 0mm

6
Additional Information
T2 Alpha Femur Retrograde
Nailing System Locking Options

Static locking Static locking Dynamic mode

(proximal dynamization)

Internal compression External compression Short nail, static

Note: Distal locking option is patient and fracture dependent. Surgeon my choose to utilize any combination of the distal locking options.

7
Additional information
Packaging

The implants in the T2 Alpha

Femur Retrograde Nailing and
IMN Screws systems include
packaging that minimizes user
contact with the implant prior to
implantation. After the pouch is
opened, all implants include a
sheath that is introduced into
the sterile field.
Example 1: Nail is removed
from pouch, sheath is opened
and attached to the Nail Adapter
Femur Retrograde (fig. 1, 2, 3). Fig. 1

Fig. 2

Fig. 3

8
Additional Information
Packaging

Example 2: After removal from

pouch, screw (fig. 4, 5) or other
implant (fig. 6, 7) is attached to
the corresponding screwdriver.

Do not touch sharp edges of

drill bits, reamer heads and
cutting tools with surgical
gloves. Take care when
Fig. 4
handling sharp edges of
packaging and instruments.

Fig. 5

Fig. 6

Fig. 7

9
Operative technique
Pre-operative planning
Patient positioning
and reduction
Retrograde nail insertion is
performed with the patient supine
on a radiolucent table. The affected
lower extremity and hip region
are freely draped, and the knee
is placed over a sterile bolster
to allow for knee flexion (fig.8).
Manual traction through a flexed
knee or a distraction device may
be used to facilitate reduction for
most femoral fractures. Fig. 8

Incision
Make a longitudinal 5cm, or an
appropriate sized incision, just
distal to the inferior pole, over
the midline of the patellar tendon
(fig. 9). Spread the tissues medial
to the patellar tendon and retract
the patellar tendon gently to
allow for guide-wire insertion.
Alternatively, a patellar tendon
split may be performed. In some
instances (e.g. fractures with
intra-articular extensions
requiring fixation of the condyles) Fig. 9
larger incision may be necessary.
Distal femoral fractures are often
complicated by intra-articular
fracture line extension. These
fractures should be anatomically
reduced and secured. Titanium
Asnis III cannulated screws may
be used with a combination of
bone holding clamps to secure An alternative is to reduce
the intracondylar region for nail and maintain reduction of the
insertion. Consider placement of femoral condyles with pointed
the cannulated screws to avoid reduction forceps and only
interference with the nail during utilize the cross locking
nail insertion. screws for definitive fixation.

10
Operative technique
Entry point

The medullary canal is opened

through the intercondylar notch
anterior to Blumensaat’s line
on the ML radiograph (fig. 10).
Find the entry point by palpating
a distinct ridge slightly anterior
and lateral respectively at the
posterior cruciate ligament.
Radiographic confirmation of
this area is essential to prevent
damage to the intraarticular
surface during opening and
nail insertion.
Fig. 10
If a total knee replacement is
present, ensure that the femoral
box is open and will accommodate
the nail; the entry point may
Opening Trocar
have to be adjusted to allow
for entry through the box.
The opening should be directed
with a central orientation in
relation to the medullary canal. Opening Opening Reamer Handle
Insert the 3 x 285mm K-wire at Reamer Sleeve
the identified entry point and into
the medullary canal. Assemble
the Opening Reamer Handle and
Opening Reamer Sleeve Ø11.5mm,
Fig. 11a
and together with the Opening
Trocar Ø11.5mm (fig. 11a), guide
the assembly over the K-wire Do not use a bent K-wire
until the Opening Reamer Trocar for entry point definition.
is fully seated on the bone.
The scallop of the Opening •
Reamer Sleeve is designed to
Verify correct entry point
sit in the intercondylar notch.
prior to opening the cortex.

11
Operative technique
Entry point

If the initial K-wire is not

optimally positioned, the
off-center trocar holes can be
used to correct the entry point
by inserting a second K-wire.
To utilize, rotate the trocar into
the desired position and place
a second K-wire 3 x 285mm
through one of the off-center
holes. The distance from the
center hole is 4mm (fig. 11b). 4mm
Once the second K-wire is 4mm
positioned as desired, remove
Fig. 11b
the initial K-wire and the trocar.
If more than 4mm of correction
is required, 8mm of correction
can be achieved by removing the
sleeve and trocar assembly from
the initial K-wire and reinserting
the assembly over the K-wire
through one of the off-center
holes of the trocar (fig. 11c).
Then, insert a second K-wire
through the remaining off-center
hole. Once the second K-wire is
positioned as desired, remove
the initial K-wire and trocar. Fig. 11c

The drill sleeve can be engaged If the initial K-wire is not

on the modular handle every optimally positioned, the off-
90 degrees to suit surgeon center holes of the Opening
preference. Trocar can be used to correct
the entry point by inserting a
second K-wire.
•
Proceed with caution to
not cause harm to patella, •
intercondular notch and Use of the Opening Reamer
surrounding tissue. Sleeve is recommended.
The Opening Reamer Sleeve
may reduce the risk of
hetreotrophic ossification.

12
Operative technique

After verifying that the Opening

Reamer Sleeve is fully seated on
the bone (fig. 12), advance the
Opening Reamer over the K-wire
to open the medullary canal.
To avoid damage to the cartilage,
advance on power only after
the Opening Reamer fully passes
through the sleeve. If hand
reaming is preferred, attach
the Opening Reamer to the
Quick-Lock Delta Handle and
rotate the reamer assembly
Fig. 12
to open the medullary canal.
Remove the K-wire. As an
alternative, the cortex can be
opened with the Curved Awl. Fixation lever

The driving end diameter of the

Release lever
9–11mm nails is Ø11.5mm; nail
sizes 12–14mm have a constant
diameter. Ream far enough to
accommodate the distal section
of the nail. Use X-ray to confirm
Adjustment
depth.
wheel
Guide wire insertion
Insert the Ball Tip Guide Wire
3 x 1000mm through the Guide
Wire Handle (fig. 13). Adjust the Fig. 13
handle as desired and lock the
assembly by closing the fixation •
lever. The Guide Wire Handle
Do not use bent guide wires. The Opening Reamer is
can accommodate guide wires
a front and side cutting
and K-wires with diameters
instrument and should be
from 1.8mm–4mm. If necessary, •
used with care to ensure that
loosen or tighten the adjustment Confirm correct position of the sharp edges of the reamer
wheel to increase or decrease Ball Tip Guide Wire prior to do not inadvertently damage
the diameter of the insertion reaming. bone or soft tissue. Use of
hole. Advance the Ball Tip Guide
the Opening Reamer Sleeve
Wire through the fracture site
is recommended.
and to the desired insertion
depth. The guide wire should lie
in the center of the metaphysis
and the diaphysis in both the AP
and lateral views to avoid offset
13
positioning of nail.
Operative technique

The reduction rod and Quick-Lock

Delta Handle assembly may be
used as a fracture reduction tool
to facilitate guide wire insertion
through the fracture site (fig. 14).
Reaming
Commence reaming in 0.5mm
increments until the desired diameter
has been achieved. To help maintain
the position of the guide wire during Fig. 14
reamer shaft extraction, press the
funnel tip end of the guide wire
pusher at the end of the wire while
extracting the reamer from the
medullary canal (fig.15).

The diameter of the selected T2

Alpha Femoral Nail Retrograde
must be 1–1.5mm smaller than
Fig. 15
that of the last reamer used.

The diameter of the selected Femoral

Nail Retrograde should be 1–1.5mm To ensure proper positioning of the guide wire tip during reaming,
smaller than that of the last reamer the Guide Wire Pusher may be replaced with any other Stryker
used. Additionally, the diameter of the 3mm guide wire.
nail may be determined by using the
X-ray ruler fluoroscopy before or after
guide wire insertion. To determine
diameter, use the ruler at the smallest The smallest diameter
diameter of the medullary canal (fig. 16). nail available is 9mm. The
diaphyseal bone must be
• large enough to allow for
Excessive heat generation during reaming of the medullary
reaming/drilling can cause soft canal up to at least 10mm.
tissue or bone damage.
•
Fig. 16
 The connection diameter
Care must be taken to ensure of the 9mm–11mm
that the entry portal is not diameter nails is 11.5mm. The ball tip at the end of the
extended during reaming. This Additional metaphyseal guide wire will stop the reamer
could lead to an offset position reaming may be required head.
for the nail and a risk of shaft to facilitate nail insertion.
fracture. Nail size 12–14mm have a
constant diameter.
14
Operative technique
Nail selection

Length
Determine appropriate nail length
by measuring the remaining length
of the Ball Tip Guide Wire (fig. 17).
Place the Guide Wire Ruler on the
Ball Tip Guide Wire and read the
correct nail length at the end of the
Ball Tip Guide Wire on the Guide
Wire Ruler (fig 18). Ensure that
the tip of the Guide Wire Ruler
is fully seated on the bone prior
to determining measurement. Fig. 17

If the measurement is between

markings, use of the shorter nail is
recommended. If using a short nail
(170mm or 200mm), always consider
the shortest nail first (170mm) and
move to a longer nail if applicable
Fig. 18
for fracture.
If apposition / compression is
planned, the selected nail should
be at least 10mm shorter than the
measured length.

•
Use fluoroscopy to ensure that The end of the Guide Wire Ruler
the Ball Tip Guide Wire and should align with the distal end
Guide Wire Ruler are correctly of the nail once inserted.
positioned and verify nail
length measurement prior
to nail insertion. •
The Guide Wire Ruler is
calibrated for 800mm and
• 1000mm guide wires.
If the fracture is suitable
for apposition / compression
the implant selected should
be at least 10mm shorter
than measured to help avoid
migration of the nail beyond
the insertion site.

15
Operative technique
Nail insertion

The selected nail is assembled onto the

Nail Adapter Femur Retrograde with the
Nail Holding Screw Femur Retrograde.
Pre-tighten the screw to the nail by
hand and then use the Ball Tip
Screwdriver to tighten the assembly
(fig.19). Preoperative assembly of the
distal targeting device is recommended
prior to nail insertion. Attach the distal
targeting device to the Nail Adapter
Femur Retrograde, ensure that the knob
on the Nail Adapter Femur Retrograde is
in the open position and slide the arm up
the shaft of the Nail Adapter Femur
Retrograde until it hits the stop. Turn Fig. 19
knob to lock (fig. 19). Insert the Tissue
Protection Sleeve, long, together with
the Drill Sleeve, long, into one of the
holes of the Distal Targeting Arm Femur
Retrograde and confirm that the device
has been assembled properly. If guided
proximal locking is to be performed,
follow the pre-operative assembly
instructions as described in this
operative technique. Remove Targeting
Arm Femur Retrograde from the nail
adapter prior to inserting the nail. Insert
the nail by hand over the Ball Tip Guide
Wire and into the entry site of the distal
femur. Advance the nail past the Fig. 20
fracture site. Using Blumensaat’s line as
a reference, insert the nail so that it is
countersunk below the subchondral •
bone. Do not leave the nail proud as
Ensure by fluoroscopy that curvature, length and diameter
this could damage the patella cartilage.
Remove the guide wire once the nail is of selected nail fit the patient’s anatomy.
appropriately positioned. If dense bone
is encountered, first confirm that •
sufficient reaming has been achieved.
Prior to nail insertion, ensure that the following measures are taken:
If hammering is desired, thread the
Strike Plate into the Nail Adapter Femur 1.V
 erify that the nail is tightly secured to the Nail Adapter Femur
Retrograde and deliver light blows with Retrograde.
the Slotted Hammer to advance the nail 2.E
 nsure that both the head of the Nail Holding Screw Femur
further (fig. 20).
Retrograde and the driving end of the nail completely align
with the appropriate nail adapter.
3.V
 erify correct alignment by inserting a drill through the sleeve
Do not hit the Nail Adapter
and targeting arm assembly. The drill must pass through the
Femur Retrograde with the
holes of the nail.
Slotted Hammer; only hit
the Strike Plate. 4.I f guided proximal locking is to be performed, follow the
pre-operative assembly instructions as described in this
16 operative technique.
Operative technique
Nail insertion

If the nail has been inserted

too far, reposition as needed.
Repositioning of the nail should
be carried out either by hand or
by using the universal rod.

Backslapping may be performed

using the Slotted Hammer to
extract the assembly.

A chamfer is located on the

distal end of the nail to help
identify the junction of the
nail and insertion post under Fig. 21
fluoroscopy. Three circumferential
1mm 15mm
grooves are located on the
insertion post of the target
device assembly at 1mm, 10mm
and 15mm from the driving end
of the nail (fig. 21, 22). Depth of
insertion may be visualized with Fig. 22
10mm
the aid of fluoroscopy. When
apposition/compression is desired,
the recommended depth of
insertion is at least 10mm to
avoid protrusion of the nail.

To attach the Targeting Arm

Femur Retrograde to the Nail
Adapter Femur Retrograde,
ensure that the knob on the
Targeting Arm Femur Retrograde
is in the unlocked position and
slide the arm up the shaft of the
Nail Adapter Femur Retrograde
Fig. 23
until it hits the stop. Turn knob
to lock (fig. 23). Do not insert •
nail with the Targeting Arm Do not impact or backslap Do not apply excessive force
Femur Retrograde attached the nail with the Targeting during reaming and nail
to the Nail Adapter Femur Arm, Femur Retrograde insertion. If severe resistance
Retrograde. Attached to the Nail is encountered, removal
Adapter Femur Retrograde. of the nail and additional
•
reaming or selection of a nail
Final implant position must with a smaller diameter is
be confirmed by X-ray. recommended.

17
Operative technique
Guided distal locking

Prior to locking the nail distally,

verify that the Nail Holding
Screw Femur Retrograde is
securely tightened and that the
Targeting Arm Femur Retrograde 2 3
is properly attached to the Nail
Adapter Femur Retrograde.

The T2 Alpha Femoral Nail 7 7

Retrograde, long, have 7 options 4 6 4 6
for distal locking. 5 1 1 5

1. Static locking (Femoral

Nail Retrograde). Fig. 24

Any combination of the static

locking holes may be used 6
(fig. 24,25,26). 5
7
2 3
4
1. ML static
1
2. Oblique static
3. Oblique static
4. ML static
5. ML static
6. ML static
7. Dynamic/Compression
Fig. 25

Numeric markings are for

illustration only. The targeting
device is not marked with
numbers. All circles marked
on targeting device indicate 1
potential locking options. 2
3
Dynamic / compression 4
locking options are marked 7
accordingly. 5
6

Fig. 26
5.0mm Locking Screws and
Advanced Locking Screws
require the 4.2mm drill
(green color-coded drill).

18
Operative technique
Guided distal locking

The T2 Alpha Femoral Nail

Retrograde, short, includes 4
options for distal locking (fig. 27).
2 3
4
2. Distal static locking.
1. ML static 1
2. Oblique static
3. Oblique static
4. ML static

3. Distal locking (Femoral

Nail Retrograde, short).
Any combination of the static
Fig. 27
locking holes may be used (fig. 27).
1. ML static
2. Oblique static
3. Oblique static
4. ML static
The Femoral Nail Retrograde
allows for active compression
using a compression screw
(internal compression) or an 7
external compression device
(external compression). 6
4. Internal apposition
/ compression (Femoral Nail
Retrograde (fig. 28)).
Fig. 28
In the internal apposition
/ compression mode, use of the
dynamic hole is required. The
use of the second distal screw
is recommended.
7. Dynamic/compression
6. ML static (recommended)
5. External apposition
/ compression (Femoral
Nail Retrograde (fig. 29)).
In the external apposition
/ compression mode, use of the
dynamic hole is required. Use of the
most proximal of the distal screws
(#6) is required.
Fig. 29
7. Dynamic/compression
6. ML static (required) 19
Operative technique
Guided distal locking

After the nail has been inserted

and positioning has been verified
under X-ray, the bone must be
prepared for screw insertion.
The T2 Alpha Femur Retrograde Fig. 30
System includes 3 options for
screw insertion: the IMN
Locking Screws, Advanced
Locking Screws and Condyle
Screws.

Distal screw insertion of

the IMN Locking Screws

Assemble the Locking Trocar,

Long, Locking Drill Sleeve, Long,
and Locking Tissue Protection
Sleeve, Long (fig. 30). Insert the
assembly through the appropriate
hole of the Targeting Arm Femur
Retrograde (fig. 31). Fig. 31

Make a small skin incision

at the sleeve entry point.

Ensure that the paddle tip of

the Tissue Protection Sleeve,
long, is positioned along the
muscle fibers. Advance the sleeve
assembly through the incision
until it is in contact with the
cortex. Fully seat the Tissue
Protection Sleeve, Long, on the
cortex. This will drive the head
of the Locking Trocar, Long,
from the sleeve assembly (fig. 32).
Fully seat the Tissue Protection Fig. 32
Sleeve on the bone and remove
the Locking Trocar, Long.
•
Remove Ball Tip Guide Wire
prior to drilling.

20
Operative technique
Guided distal locking

Advance the locking drill,

4.2 x 360mm, through the
Locking Drill Sleeve, Long,
and onto the cortex. Drill both
cortices (fig. 33). Position the
drill tip at the desired final
position of the screw tip.
Determine screw measurement
by rotating the grip of the
Locking Drill Sleeve, Long,
pulling the sleeve towards the
drill attachment until the sleeve
hits the stop (fig. 34). Read the
Fig. 33
measurement on the Locking
Drill Sleeve, long, at the junction
of the Tissue Protection Sleeve,
Long. Alternatively, the Guided
Depth Gauge can be used
through the Tissue Protection
Sleeve, Long, to read off the
length at the end of the sleeve
(fig. 35). Advance the screw
through both cortices until
the screw is fully seated.

Drilling past the far cortex

may damage soft tissue. Fig. 34

Damage of the nail during

drilling may reduce the
fatigue strength of the implant
which could cause the nail to
fail.

•
Applying excessive force
may result in breakage
of the drill which could
require recovery. Recovery
could result in an iatrogenic Fig. 35
fracture and/or bone damage
may occur.
21
Operative technique
Guided distal locking

Remove the Locking Drill and

Locking Drill Sleeve, Long,
and insert the selected Locking
Screw through the Tissue
Protection Sleeve, Long, using the
Screwdriver Bit, Long, and Quick-
Lock Delta Handle (fig. 36).
•
Ensure sleeve assembly
is seated on bone prior to
drilling and screw length
measuring. Verify correct
Fig. 36
position of sleeve under
imaging prior to drilling.
The gray friction lock
mechanism is designed to
maintain the position of
the drill sleeves.
To remove the sleeve assembly
from the Targeting Arm, press
the gray mechanism while
pulling the sleeves and trocar.

When the marking on the

screwdriver nears the head of
the Tissue Protection Sleeve,
Long, the screw is close to its final
position (fig. 37). Use imaging to Fig. 37
confirm placement of the screw.
The paddle tip of the Tissue
Protection Sleeve, Long, allows
the user to visually verify that the
screw head is seated on the bone
under X-ray without retracting
the sleeve from the bone.
Alternatively, the sleeve can
be pulled away from the bone
to verify that the screw is fully
seated. Repeat the locking
procedure for the second oblique
screw and / or the static or
dynamic ML screws as
appropriate.
22
Operative technique
Guided distal locking

Dynamic locking mode See the guided proximal locking •

or freehand locking sections of
When the fracture profile Dynamic locking might
this operative technique for
permits, controlled dynamic be associated with bone
proximal screw insertion
locking may be utilized for shortening during the
techniques. Retrograde
transverse or axially stable healing period. Simultaneous
dynamization is performed
fractures. While dynamic utilization of distal and
by statically locking the nail
locking can be performed at proximal dynamization
distally via the Targeting Arm
either end of the nail, routine option could lead to
Femur Retrograde.
retrograde dynamic locking unintended bone shortening.
should utilize the oblong hole at A screw is then placed in
the proximal end of the nail as the dynamic position of the
this reduces the potential for proximal oblong hole.
nail migration into the joint.
This allows the nail to move
and the fracture to settle while
torsional stability is maintained.
Either a freehand or guided
technique may be used.

23
Operative technique
Compression

Internal apposition
/ compression mode
(long nail only)
In transverse, axially stable
fracture patterns, active
mechanical apposition /
compression may be desired.

The Compression Screw Femur

can be used to apply apposition /
compression. When compressing
the nail, the implant must be Fig. 38
inserted at a safe distance from
the entry point to accommodate
for the 10mm of active compression.

The three grooves on the insertion

post help attain accurate insertion
depth of the implant. After inserting
two proximal Locking Screws,
insert a Locking Screw distally
in the dynamic position of the
oblong hole.

To apply compression, attach Fig. 39

the Compression Screw Femur to
the Compression Screwdriver and
Quick-lock Delta Handle assembly.
Insert the Compression Screwdriver
through the Nail Holding Screw
Femur Retrograde and apply
apposition / compression (fig. 38, 39).

Once apposition / compression has

been applied, the compression
screw driver may be removed.
Insertion of the subsequent distal
ML screw is recommended (fig. 40).
Fig. 40

• •
Apposition / compression must The Compression Screw Femur
Once initial signs of bending
be carried out under X-ray must be screwed in correctly
of the Locking Screw is
control. Over-compression and with reasonable forces to
observed, further compression
may cause the nail or screw provide desired function and
should be limited to one
to fail. to avoid damage of implants
additional turn of the
/ instruments. Excessive
Compression Screw Femur.
deformation of the Locking
Screw may indicate unreasonable
24 force.
Operative technique
Compression

External apposition
/ compression mode
(long nail only)
As an alternative to internal
compression, the External
Compression Device Femur
(fig. 41) can be used to apply
apposition / compression. Fig. 41
When compressing the nail,
the implant must be inserted
at a safe distance from the entry
point to accommodate for the
10mm of active compression.
The three grooves on the
insertion post help attain
accurate insertion depth of the
implant. After insertion of two
proximal Locking Screws, insert
a Locking Screw in the dynamic
position of the distal oblong hole.
To apply compression, attach the
External Compression Device to
the Quick-Lock Delta Handle and
insert the External Compression
Device through the Nail Holding
Screw Femur Retrograde to
engage the internal threads
of the nail. Rotate to apply Fig. 42
compression (fig. 42,43).
Once apposition / compression
has been applied, insert the most
proximal of the distal ML
screws. Once the second screw
has been inserted, the External
Compression Device Femur can
be detached.

Once initial signs of bending of

the locking screw is observed,
further compression should be
limited to one additional turn of
the Compression Screw Femur. Fig. 43

25
Operative technique
Guided proximal locking

Guided proximal locking

– long nail

Use of the Proximal Targeting

Device Femur Retrograde is
recommended when performing
proximal locking of the AP
screws. The proximal ML
screws require freehand distal
locking. Preoperative assembly
is recommended prior to nail
insertion. Preoperative assembly
steps are as follows:
Fig. 44
1. A
 ttach the Adapter Tibia /
Femur Retrograde to the
Proximal Targeting Device
Femur Retrograde. The length
of the selected nail determines
the attachment point. Insert
the center pin of the Adapter
Tibia /Femur Retrograde into
the hole of the Proximal
Targeting Arm Femur
Retrograde that corresponds
with the selected nail. Turn
knob to secure (fig. 44, 45).

Fig. 45

26
Operative technique
Guided proximal locking

2. Attach the proximal targeting

arm assembly to the Nail
Adapter Femur Retrograde.
Turn knob to secure
(fig. 46, 47).
3. I nsert the Tissue Protection
Sleeve, Long, into one of the
holes of the Proximal Targeting
Arm Femur Retrograde and
confirm that the device has
been assembled to accommodate
the selected nail length (using
a drill) (fig 48). Fig. 46
If the sleeve is properly positioned,
remove the sleeve and disassemble
the proximal targeting assembly
from the Nail Adapter Femur
Retrograde and place on the back
table. Do not disassemble construct.
Proceed with nail and distal screw
insertion as described in this
operative technique. Depending on
the preferred locking configuration,
proximal screw insertion may be
performed prior to distal locking.
Attach the proximal targeting arm
assembly to the Nail Adapter Femur
Retrograde as previously described. Fig. 47
Insert the sleeve assembly through
the appropriate hole of the proximal
targeting arm. The sleeves should
not contact the skin of the patient.
Do not make an incision until the
C-arm and sleeves are correctly
positioned as described in the steps
below.
The following three steps must
be taken prior to drilling.
1. Oblique positioning
of C-arm
2. Orbital rotation and second
plane of rotation adjustment Fig. 48
of the C-arm
3. Sleeve adjustment to
the nail position 27
Operative technique
Guided proximal locking

Oblique positioning of C-arm

30°
To perform guided proximal
locking, it is essential to place
the X-ray beam of a C-arm
approximately 30° oblique to the
axis of the drill sleeve assembly
(fig. 49). As an option, the 3 x
285mm K-wire or alignment
wire can be inserted from the
K-wire hole of the adjusting Fig. 49
device. The wire indicates a 30°
axis to the drill sleeve assembly to
aid in correct C-arm positioning.

Orbital rotation and the

second rotation of the C-arm
In this step, it is important to
position the C-arm so that the
nail tip and the sleeve axis are
seen parallel in the fluoroscopic
image.
After oblique C-arm positioning,
adjust the height and orbital
rotation of the X-ray beam at the
same plane as the drill sleeve
assembly. Take an X-ray.
If the sleeve and nail tip are
parallel (fig. 50) or colinear in
the X-ray image, the C-arm is
correctly positioned and no Fig. 50
adjustments to the C-arm
position are necessary. If the
sleeve and nail tip are not
parallel, the C-arm is
incorrectly positioned (fig 51).

28 Fig. 51
Operative technique
Guided proximal locking

Adjust the rotation of the C-arm

(fig. 52) until the tip of the nail
and sleeve are parallel or
colinear in the X-ray.

This step requires appropriate

C-arm positioning only. Do not
turn the knob of the proximal
targeting arm before the nail
and sleeve are parallel.

Sleeve adjustment
to the nail position
Once the C-arm has been Fig. 52
adjusted so that nail and sleeve
are shown in parallel (fig. 50),
the deviated image will show
the sleeve either medial or
lateral to the nail. If the sleeve
and the nail are shown parallel
and collinear (fig. 54), no further
adjustment of the sleeve is
needed.

If the sleeve and nail tip are not

seen on the same axis, sleeve
adjustment is required by
turning the knob of the
Proximal Targeting Arm, Femur
Retrograde. By turning the Fig. 53
adjusting knob, the sleeves move
medially or laterally (fig. 53).

Fig. 54

29
Operative technique
Guided proximal locking

Proximal drilling
and locking
Once the correct nail and sleeve
adjustment has been obtained,
make a small skin incision at the
sleeve entry point. Ensure that
the incision is straight to avoid
forces on the sleeve.
Advance the Locking Tissue
Protection Sleeve, Long, Locking
Drill Sleeve, long, and Locking
Trocar, Long, assembly through
the incision until the sleeve tip Fig. 55
is close to the cortex. Do not
force the chamfers of the sleeve •
into the bone as this could cause To prevent skiving of the Patient anatomy, entry point
deviations. Take an X-ray to sleeve while ensuring bone or other factors may result in
confirm correct position of the contact for correct screw excessive nail bending that
sleeve as sleeve alignment could measurement, gently seat cannot be compensated by
be compromised by soft tissue the sleeve on the bone. Do design or with the adjustment
or slippage on the bone. Adjust not apply excessive forces function. In these instances,
sleeve position if needed. to the sleeve. freehand proximal locking
Once sleeve position has been must be performed.
confirmed, commence distal
drilling (fig. 55) and screw •
insertion as outlined in the Avoid applying soft tissue
distal locking section. Repeat pressure to the sleeve
these steps for the insertion assembly. Do not make
of a second AP screw. skin incision until correct
alignment of screw trajectory
is confirmed.

30
Operative technique
Guided proximal locking

Guided proximal locking

– short nail only
The Proximal Targeting Device
Short Femur Retrograde is
designed to provide guided
proximal locking for the short
version of the T2 Alpha Femoral
Nail Retrograde (170 and
200mm).
To use, attach the device to the
Targeting Arm Femur Retrograde
by inserting the pins of the
Proximal Targeting Device
Short Femur Retrograde into Fig. 56
the Targeting Arm Femur
Retrograde (fig. 56).
Attach the Proximal Targeting
Device Short Femur Retrograde
knob to the proximal targeting
device. Rotating this knob will
lock the sleeve assembly into
position (fig. 57).
Employ drilling and routine
screw insertion as previously
described while ensuring that
forces are not applied to the
targeting arm or drill sleeve
assembly (fig. 58).
Fig. 57

Patient anatomy, entry point

or other factors may result in
excessive nail bending that
cannot be compensated by
design or with the adjustment
function. In these instances,
freehand proximal locking
must be performed.

Fig. 58

31
Operative technique
Freehand proximal locking

The freehand technique may be

used to insert the proximal AP
screws. The critical step with any
freehand locking technique is to
adjust the C-arm until a perfectly
circle locking hole is visualized
with the C-arm (fig. 59b).
Once the C-arm is correctly
positioned, make a skin incision
that is in line with the distal hole
of the nail (fig. 60a). Place the 4.2
x 130mm or 4.2 x 185mm
Freehand Drill at an oblique
angle in the frontal plane with Fig. 59a: Locking hole is not perfectly Fig. 59b: Locking hole is perfectly
circular. The C-arm is not correctly curcular. The C-arm is correctly
the tip on the center hole (fig. 60b).
positioned. positioned.
Move the drill into the same axis
as the holes in the nail and drill
through the first cortex of the
nail until resistance of the second
cortex is felt. Confirm in both
the AP and ML planes that the
Freehand Drill passes through
the hole in the nail. Use the
screw scale with the drill to read
off the screw length directly at
the color coded marking (fig. 61a).
Alternatively, the Freehand Depth
Gauge, Long, or Freehand Depth
Gauge, Short, may be used after
Fig. 60a Fig. 60b
drilling to determine the required
screw length (fig. 61b).
Repeat steps as needed to insert
additional screws.

•
Take care to avoid capturing
soft tissue during freehand
drilling.

Fig. 61a Fig. 61b

32
Operative technique
Advanced locking screws

The self-retaining screwdriver

assembly may be used to facilitate
freehand locking. To use,
assemble the Self-retaining
Screwdriver Sleeve to the Self-
Retaining Screwdriver Bit /
quick-lock delta handle assembly
(fig. 62) and attach the screwdriver
to the screw and secure the
connection by turning the
screwdriver sleeve counter-
clockwise.
Routine screw insertion is Fig. 62
employed to insert the screw.

Advanced Locking Screws

Ø5.7mm
Advanced Locking Screws (fig. 63)
can be used as an alternative to
the Locking Screws. The Ø5.3mm
Advanced Locking Screws are
designed with oversized threads
that engage with the internal
threads of the T2 Alpha
Retrograde Femoral Nail while Ø4.5mm
maintaining bicortical purchase.
Overdrilling of the near cortex
must be performed to create a
Fig. 63
path for the screw. Advanced
Locking Screws may be preferred
in instances of osteopenic bone
and in other instances when
axial stability is desired.
Advanced Locking Screws may be
inserted in any circular hole of the
nail (fig. 64). They cannot be used
in the dynamic / oblong holes.
The Advanced Locking Screws
are inserted in a guided locking
technique via the Targeting Arm
Femur Retrograde and / or the
Proximal Targeting Arm Femur Fig. 64
Retrograde or using a proximal
freehand technique. Gold screws indicate holes which accept advanced locking screws.
33
Operative technique
Advanced locking screws

When using a guided technique,

drilling and insertion of the
Advanced Locking Screws is
performed through the sleeve(s)
of the Proximal Targeting Arm
Femur Retrograde or distal
targeting arm. Drill both cortices
(fig. 65) and determine screw
length in a guided or freehand
manner as previously described
in this operative technique. Fig. 65
Once screw length has been
determined, open the near cortex
using the counterbore drill (fig. 66,
67). Freehand locking requires use
of the Counterbore Drill, Short,
and guided locking requires use
of the Counterbore Drill, Long.
Ensure that the drill is centered
with the hole of the nail prior to
insertion, and then drill until the
stop is felt. Verify under imaging.
In some instances, thick cortex or Fig. 66

strong trabecular bone stock may

prevent the counterbore drill from
fully clearing the insertion path to
the nail.
When this occurs, use the
Ø5.5mm Ø4.2mm
Counterbore Drill, Manual,
in combination with the quick
Quick-Lock Handle to ensure
that the passage to the nail is
sufficiently widened.
Fig. 67
•
Overdrilling with the
counterbore drill must be Do not use the Counterbore
performed prior to Advanced Drill, Manual with the power
Locking Screw Insertion. tool.

34
Operative technique
Advanced locking screws

To use, insert the Counterbore Drill,

Manual, through the path created
by the first counterbore drill and
turn the drill in a gentle clockwise
motion with moderate axial
pressure until the pathway to the
nail has been opened (fig. 68). Once
drilling has been completed, insert
the Advanced Locking Screw with
gentle axial force using the
appropriate screwdriver through
the near cortex without turning
the screw, while ensuring that the
Fig. 68
axis of the screw is aligned with
the corresponding locking hole.
Push the screw until the leading
tip is engaged with the nail hole.
X-ray verification can be used to
confirm position. To confirm
correct starting point and axial
alignment of the screw, gently
rotate the screw counter-clockwise
while applying gentle axial force
(fig. 69). A click sound or snapping
of the thread indicates that the
screw is in the correct position.
Once position has been confirmed,
insert the screw by rotating Fig. 69
clockwise until the screw is fully
seated (fig. 70). Use X-ray to confirm.

•
The Advanced Locking Screw
must be inserted using
reasonable force to provide
desired function and to
avoid damaging the screw. If
unreasonable insertion torque
is noticed, stop insertion, turn
the screw counterclockwise
and then attempt to insert
the screw. If unreasonable Fig. 70
insertion torque is still noticed,
remove the screw and proceed
with a Locking Screw. 35
Operative technique
Condyle screw insertion

Optionally, Condyle Screws can

be used as an alternative to the
Advanced Locking or Locking
Screws in the distal transverse
static holes. If a Condyle Screw
is to be inserted, drill both
cortices with the 4.2 x 360mm
drill through the triple sleeve
assembly (fig. 71). Screw length
measurement should be
determined as previously
described in this operative
technique.
Fig. 71
Note: The measurement equals
Condyle Screw fixation length
(from top of the Condyle Screw
head to the top of Condyle Nut
head). The Condyle Screw length
is defined with the Condyle
Screw tip flush to the Condyle
Nut head. The possible fixation
length ranges from 2mm longer
than the Condyle Screw length
to 5mm shorter. Ensure that
the Condyle Nut is tightened
a minimum of 5 turns on the
Condyle Screw.

36
Operative technique
Condyle screw insertion

Use of the countersink (fig. 72)

is necessary to widen the path
to the nail and to prepare the
cortex to properly seat the Condyle
Screw and nut. To use, attach the
countersink to the Quick Lock
Delta Handle and insert the
countersink through the Tissue
Protection Sleeve into the path
created by the 4.2mm drill. Turn
the Countersink Bit for Condyles
in a gentle clockwise motion while
applying gentle axial pressure
until the stop at the Tissue Fig. 72
Protection Sleeve (fig. 73). This step
must be performed from the lateral
and then from the medial side.

• In cases where the chosen

Condyle Screw is too long
it may be easier to extract
the screw with the Revision
Condyle Screwdriver Bit
(1806-0257) placed on top
of the Condyle Screwdriver.
• Do not use the revision
Condyle Screwdriver Bit
for screw insertion and/or
compression.
Fig. 73
•
The measurement equals
Condyle Screw fixation length
(from top of the condyle screw
head to the top of Condyle
Nut head). The Condyle Screw
length is defined with the
Condyle Screw tip flush to the
Condyle Nut head. The possible
fixation length ranges from
2mm longer than the condyle
screw length to 5mm shorter.
Ensure that the condyle nut
is tightened a minimum of 5
37
turns on the Condyle Screw!
Operative technique
Condyle screw insertion

Once both the medial and lateral

side have been opened, using
the countersink, insert the 1.8
× 310mm K-Wire through the
path created by the countersink
so it passes all the way through
the leg. (The K-wire may have
to be bent under the targeter).
Then remove the targeting arm
from the nail adapter (fig 74, 75,
76). From the medial side, the
Condyle Screw is now brought
forward over the K-wire and
inserted using the condyle Fig. 74
screwdriver bit/delta handle
assembly.

Fig. 75

Fig. 76

38
Operative technique
Condyle screw insertion

Using both Condyle Screwdriver

Bits, tighten the Condyle Nut
and the Condyle Screw. Once
tightened, remove the K-wire
(fig. 77, 78).
Alternatively, the Condyle Screw
may be introduced from lateral
to medial in a similar manner
as described above.

Fig. 77

Fig. 78

39
Operative technique

End cap insertion

Remove the targeting arm and nail
holding screw. Be sure to maintain
the position of nail adapter and
nail while removing the nail
holding screw (fig. 79). Insert the
End Cap through the nail adaptor
using the Screwdriver, Long, and
delta handle assembly (fig. 80).
Fully seat the end cap to minimize
the potential for loosening. The
End Cap will lock the Locking
Screw at the distal end of the
Fig. 79
nail. This will create a fixed angle
between nail and Locking Screw
and prevent lateral sliding of the
nail. Remove the nail adapter
(fig. 81). Thoroughly irrigate
the wound to prevent debris
from remaining within the knee
joint and close using a standard
technique.

Fig. 80

Fig. 81

40
Operative technique
Nail removal

The End Cap SCN and the most • •

Distal Locking Screw is removed
Special care must be taken Stryker offers a universal
with the Screwdriver Bit, Long
to check if the nail moves implant extraction set that
and Quick-Lock Delta Handle
off-center of the entry point is not compatible with the
assembly. To remove the nail,
when screws are removed. T2 Alpha Femur Retrograde
thread the Universal Rod into
Any attempt to remove a nail Nailing System. Use of the
the driving end of the nail and
that is off-center may result T2 Alpha Extraction Shaft is
use the Slotted Hammer to
in fractures of the distal Required for removal. The
extract the nail in a controlled
condylar region. universal implant extraction
manner. Alternatively, the
When extracting a Condyle set may be used for removal
Universal Rod used in
Screw, it may be easier of IMN Screws or other
conjunction with the Extraction
to extract with the T2 internal fixation systems.
Shaft may be threaded into the
nail and used for extraction. All Emergency Screwdriver Bit
screws must be removed prior to placed on top of the Condyle
nail removal. Screwdrivers.

All IMN Screws are removed

with the Screwdriver Bit. If the
Compression Screw Femur was
used, it must be removed prior
to assembly of the Extraction
Shaft. Unlock and loosen the
Compression Screw Femur with
the Compression Screwdriver.
The Condyle Screws must be
removed with the Condyle
Revision Screwdriver.
When extracting a Condyle
Screw, it may be easier to
extract with the Revision
Condyle Screwdriver Bit placed
on top of the Condyle
Screwdrivers.

41
System components

Femoral Nail Retrograde

9.0mm 10.0mm
Ref # Diameter Length Ref # Diameter Length
(mm) (mm) (mm) (mm)
2339-0922S Ø9.0 220 2339-1022S Ø10.0 220
2339-0924S Ø9.0 240 2339-1024S Ø10.0 240
2339-0926S Ø9.0 260 2339-1026S Ø10.0 260
2339-0928S Ø9.0 280 2339-1028S Ø10.0 280
2339-0930S Ø9.0 300 2339-1030S Ø10.0 300
2339-0932S Ø9.0 320 2339-1032S Ø10.0 320
2339-0934S Ø9.0 340 2339-1034S Ø10.0 340
2339-0936S Ø9.0 360 2339-1036S Ø10.0 360
2339-0938S Ø9.0 380 2339-1038S Ø10.0 380
2339-0940S Ø9.0 400 2339-1040S Ø10.0 400
2339-0942S Ø9.0 420 2339-1042S Ø10.0 420
2339-0944S Ø9.0 440 2339-1044S Ø10.0 440
2339-0946S Ø9.0 460 2339-1046S Ø10.0 460
2339-0948S Ø9.0 480 2339-1048S Ø10.0 480
11.0mm 12.0mm
Ref # Diameter Length Ref # Diameter Length
(mm) (mm) (mm) (mm)
2339-1122S Ø11.0 220 2339-1222S Ø12.0 220
2339-1124S Ø11.0 240 2339-1224S Ø12.0 240
2339-1126S Ø11.0 260 2339-1226S Ø12.0 260
2339-1128S Ø11.0 280 2339-1228S Ø12.0 280
2339-1130S Ø11.0 300 2339-1230S Ø12.0 300
2339-1132S Ø11.0 320 2339-1232S Ø12.0 320
2339-1134S Ø11.0 340 2339-1234S Ø12.0 340
2339-1136S Ø11.0 360 2339-1236S Ø12.0 360
2339-1138S Ø11.0 380 2339-1238S Ø12.0 380
2339-1140S Ø11.0 400 2339-1240S Ø12.0 400
2339-1142S Ø11.0 420 2339-1242S Ø12.0 420
2339-1144S Ø11.0 440 2339-1244S Ø12.0 440
2339-1146S Ø11.0 460 2339-1246S Ø12.0 460
2339-1148S Ø11.0 480 2339-1248S Ø12.0 480
13.0mm 14.0mm
Ref # Diameter Length Ref # Diameter Length
(mm) (mm) (mm) (mm)
2339-1322S Ø13.0 220 2339-1422S Ø14.0 220
2339-1324S Ø13.0 240 2339-1424S Ø14.0 240
2339-1326S Ø13.0 260 2339-1426S Ø14.0 260
2339-1328S Ø13.0 280 2339-1428S Ø14.0 280
2339-1330S Ø13.0 300 2339-1430S Ø14.0 300
2339-1332S Ø13.0 320 2339-1432S Ø14.0 320
2339-1334S Ø13.0 340 2339-1434S Ø14.0 340
2339-1336S Ø13.0 360 2339-1436S Ø14.0 360
2339-1338S Ø13.0 380 2339-1438S Ø14.0 380
2339-1340S Ø13.0 400 2339-1440S Ø14.0 400
2339-1342S Ø13.0 420 2339-1442S Ø14.0 420
2339-1344S Ø13.0 440 2339-1444S Ø14.0 440
2339-1346S Ø13.0 460 2339-1446S Ø14.0 460
2339-1348S Ø13.0 480 2339-1448S Ø14.0 480

42
System components

Femoral Nail Retrograde, Short

Ref # Diameter (mm) Length (mm)

2339-0917S Ø9.0 170

2339-0920S Ø9.0 200

2339-1017S Ø10.0 170

2339-1020S Ø10.0 200

2339-1117S Ø11.0 170

2339-1120S Ø11.0 200

2339-1217S Ø12.0 170

2339-1220S Ø12.0 200

2339-1317S Ø13.0 170

2339-1320S Ø13.0 200

2339-1417S Ø14.0 170

2339-1420S Ø14.0 200

43
System components

End Cap
Ref # Diameter (mm)
1826-0003S Ø8.0

Compression Screw, Femur

Ref # Diameter (mm)
2330-0001S Ø5.5

Condyle Screws
Ref# Diameter (mm) Length (mm)
1895-5040S Ø5.0 40
1895-5045S Ø5.0 45
1895-5050S Ø5.0 50
1895-5055S Ø5.0 55
1895-5060S Ø5.0 60
1895-5065S Ø5.0 65
1895-5070S Ø5.0 70
1895-5075S Ø5.0 75
1895-5080S Ø5.0 80
1895-5085S Ø5.0 85
1895-5090S Ø5.0 90
1895-5095S Ø5.0 95
1895-5100S Ø5.0 100
1895-5105S Ø5.0 105
1895-5110S Ø5.0 110
1895-5115S Ø5.0 115
1895-5120S Ø5.0 120

Condyle Screw Nut

Ref# Diameter (mm)

1895-5001S Ø5.0

44
System components

Locking Screws
Ref # Diameter (mm) Length (mm)
2360-5025S Ø5.0 25.0
2360-5027S Ø5.0 27.5
2360-5030S Ø5.0 30.0
2360-5032S Ø5.0 32.5
2360-5035S Ø5.0 35.0
2360-5037S Ø5.0 37.5
2360-5040S Ø5.0 40.0
2360-5042S Ø5.0 42.5
2360-5045S Ø5.0 45.0
2360-5047S Ø5.0 47.5
2360-5050S Ø5.0 50.0
2360-5052S Ø5.0 52.5
2360-5055S Ø5.0 55.0
2360-5057S Ø5.0 57.5
2360-5060S Ø5.0 60.0
2360-5065S Ø5.0 65.0
2360-5070S Ø5.0 70.0
2360-5075S Ø5.0 75.0
2360-5080S Ø5.0 80.0
2360-5085S Ø5.0 85.0
2360-5090S Ø5.0 90.0
2360-5095S Ø5.0 95.0
2360-5100S Ø5.0 100.0
2360-5105S Ø5.0 105.0
2360-5110S Ø5.0 110.0
2360-5115S Ø5.0 115.0
2360-5120S Ø5.0 120.0

45
System components

Advanced Locking Screws

Ref # Diameter (mm) Length (mm)

2361-5030S Ø5.0 30.0

2361-5032S Ø5.0 32.5
2361-5035S Ø5.0 35.0
2361-5037S Ø5.0 37.5
2361-5040S Ø5.0 40.0
2361-5042S Ø5.0 42.5
2361-5045S Ø5.0 45.0
2361-5047S Ø5.0 47.5
2361-5050S Ø5.0 50.0
2361-5052S Ø5.0 52.5
2361-5055S Ø5.0 55.0
2361-5057S Ø5.0 57.5

2361-5060S Ø5.0 60.0
2361-5065S Ø5.0 65.0

2361-5070S Ø5.0 70.0
2361-5075S Ø5.0 75.0
2361-5080S Ø5.0 80.0
2361-5085S Ø5.0 85.0
2361-5090S Ø5.0 90.0
2361-5095S Ø5.0 95.0
2361-5100S Ø5.0 100.0

46
 System components

Basic Instruments Basic Long*

Ref # Description

2351-0010 Curved Awl

2351-0011 Awl Plug

2351-0020 Reduction Rod

2351-0030 Guide Wire Handle

2351-0040 Ball Tip Screwdriver

1806-0150 Strike Plate

2351-0060 Slotted Hammer

2351-0070 Tissue Protection Sleeve, Long

2351-0100 Screwdriver Bit, Short

2351-0101 Self-Retaining Screwdriver Sleeve, Short

2351-0105 Screwdriver Bit, Medium

2351-0106 Self-Retaining Screwdriver Sleeve, Medium

2351-0110 Screwdriver Bit, Long

2351-0140 Quick-Lock Delta Handle, Modified Trinkle

2351-0150 Guided Depth Gauge

2351-0160 Freehand Depth Gauge, Short

2351-0170 Freehand Depth Gauge, Long

2351-0180 Extraction Shaft

2351-0340 Screw Scale

2351-0380 Guide Wire Pusher

2351-0400 Compression Screwdriver

2351-0420 X-ray Ruler

2351-4280 Locking Drill Sleeve, Long

2351-4290 Locking Trocar, Long

2355-5000 Basic Tray IMN Instruments

2355-5005 Basic Tray Base IMN Instruments

2355-5010 Basic Tray Insert IMN Instruments
2355-5020 Upgrade Tray Insert IMN Instruments
* IMN Instrument System
47
System components

Optional Instruments*
Ref # Description

2351-0145 Quick-Lock T-Handle, Modified Trinkle

2351-0370 Reamer Head Tray Insert

2355-5030 Drills and Pins Tray Insert

2351-0111 Self-Retaining Screwdriver Sleeve, Long

1806-0022 Guide Wire Ruler

1806-0110 Universal Rod, Ø9.0

Retrograde Indication Set

Ref # Description

1806-0257 T2 Emergency Screwdriver Bit 6.3mm

2351-0070 Tissue Protection Sleeve, Long
2351-0140 Quick-Lock Delta Handle, Modified Trinkle
2351-0250 External Compression Device Femur
2351-0330 Screwdriver Bit For Condyles
2351-0335 Countersink Bit For Condyles
2351-6000 Opening Reamer Handle
2351-6112 Opening Reamer, Ø11.5
2351-6212 Opening Reamer, Sleeve Ø11.5
2351-6312 Opening Reamer, Trocar Ø11.5

2353-3903 Nail Adapter Femur Retrograde

2353-3904 Nail Holding Screw Femur Retrograde

2353-3907 Distal Targeting Device (DTD) Femur Retrograde

2355-3910 Femur Retrograde Indication Tray

2355-3920 Femur Retrograde Indication Tray Insert

* IMN Instrument System

48
System components

Proximal Targeting Device instruments

Ref # Description
2353-3906 Proximal Targeting Device (PTD) Femur Retrograde

2355-3915 Femur Retrograde Proximal Targeting Tray

2353-4109 Adapter Tibia / Femur Retrograde

1320-5395 Oblique Alignment Wire

Proximal Targeting Device Short Instruments (optional)

Ref # Description
2353-3908 Proximal Targeting Device (PTD) Short Femur Retrograde
2353-3909 Knob for Proximal Targeting Device (PTD) Short

Disposables*
Ref # Description
2351-3028S K-Wire, Ø3.0 × 285mm
0152-0218S K-Wire, Ø1.8 × 310mm
2351-4236S Locking Drill, Ø4.2 × 360mm
2351-4213S Freehand Drill, Ø4.2 × 130mm
2351-4218S Freehand Drill, Ø4.2 × 185mm
1806-0085S Guide-Wire, Ball Tip, Ø3.0 × 1000mm
2351-5500 Counterbore Drill, Short, Ø5.5 × 185mm
2351-5500S Counterbore Drill, Short, Ø5.5 × 185mm, Sterile
2351-5510 Counterbore Drill, Long, Ø5.5 × 255mm
2351-5510S Counterbore Drill, Long, Ø5.5 × 255mm, Sterile
2351-5515 Counterbore Drill, Manual, Ø5.5 × 280mm
2351-5515S Counterbore Drill, Manual, Ø5.5 × 280mm, Sterile
2351-0335S Countersink Bit For Condyles, Sterile

* IMN Instrument System

The information in the section is not intended to be used for sales and/or promotional purposes. This information is solely intended to be used
as a reference for clinical usage.

49
Notes

50
Notes

51
This document is intended solely for the use of healthcare professionals. A surgeon must always rely on his or her own professional Manufacturer:
clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense
Stryker GmbH
medical advice and recommends that surgeons be trained in the use of any particular product before using it in surgery.
Bohnackerweg 1
The information presented is intended to demonstrate a Stryker product. A surgeon must always refer to the product label and/or 2545 Selzach, Switzerland
Instructions for Use, including the instructions for Cleaning and Sterilization (if applicable), before using any Stryker product. Products
stryker.com
may not be available in all markets because product availability is subject to the regulatory and/or medical practices in individual
markets. Please contact your Stryker representative if you have questions about the availability of Stryker products in your area.

The Instructions for Use, Operative Techniques, Cleaning instructions, patient information leaflets and other associated labeling may
be requested online at www.ifu.stryker.com or www.stryker.com. If saving the Instructions for Use, Operative Techniques, Cleaning
instructions from the above mentioned websites, please make sure you always have the most up to date version prior to use.

Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or
service marks: Stryker, T2, T2 Alpha. All other trademarks are trademarks of their respective owners or holders.

This document is is only applicable to US and Canada.

Content ID: 'T2-ST-37_Rev-1, 09-2022

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