0X6.000.995_AB 01.10.

12 12:10 Seite Cvr1

Small Fragment System. Instruments

and implants for 2.7 and 3.5 plate
fixation.

Technique Guide

Veterinary
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0X6.000.995_AB 01.10.12 12:10 Seite 1

Table of Contents

Introduction Small Fragment System 2

Plates 4

Screws 6

Fixation Principles 8

Surgical Technique Preparation 11

Reduction and Temporary Plate Placement 13

Screw Insertion 14

Postoperative Treatment and Implant Removal 18

Product Information Featured Instruments 19

Set Lists 21

Quick Reference Guide – Instruments 28

Quick Reference Guide – Implants 29

Image intensifier control

Warning
This description alone does not provide sufficient background for direct use of
the instrument set. Instruction by a surgeon experienced in handling these
instruments is highly recommended.

Reprocessing, Care and Maintenance of

Synthes Instruments
For general guidelines, function control and dismantling of multi-part instruments,
please contact your local sales representative or refer to:
www.synthes.com/reprocessing

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Small Fragment System.

Instruments and implants for 2.7
and 3.5 plate fixation.

The Small Fragment Standard System

The Small Fragment Standard System contains the
2.7, 3.5 and 4.0 implants and related instruments required
for standard compression plating.

Features
– Equipment for LC-DCP and DCP plating systems
– Can be upgraded to LCP system
– Cases are organized in general order of use
– Compact case sizes fit most tabletop autoclaves
– Plate case stores a full range of 2.7, 3.5, and 3.5 Broad
DCP, LC-DCP or LCP plates
– Includes auxiliary bins for storing additional equipment

The standard system consists of:

– Small Fragment Standard Instrument Set (103.501)
– Small Fragment Standard Screw Set (103.518)
– Small Fragment DCP Plate Set (103.513)
or
Small Fragment LC-DCP Plate Set (103.514)

The Small Fragment Locking System

The Small Fragment Locking System contains the 2.7 and
3.5 LCP implants and related instruments required for locked
plating.

Features
– Dedicated equipment designed for LCP plating
– Locking instruments fit in the Graphic Case for Small
Fragment Instrument Set (690.591)
– All cases are organized in general order of use
– Compact case sizes fit most tabletop autoclaves

The locking system consists of:

– Small Fragment Locking Instrument Set (103.502)
– Small Fragment Locking Screw Set (103.517)
– Small Fragment LCP Plate Set (103.516)

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Plates

DCP (Dynamic Compression Plate)

DCP plate hole
– Incorporates an incline in the hole that converts screw
compression into plate translation and compression of
the bone fracture
– Accepts conventional screws that may be placed in either
load or neutral positions, depending on whether inter-
fragment compression is desired (see using the universal
drill guide on pages 14 and 15 for more detail)
– Allows 25° of longitudinal screw angulation and 7° of
transverse screw angulation

LC-DCP (Limited-Contact Dynamic Compression Plate)

Grooved undersurface
– Provides limited contact between the plate and bone,
minimizing the chance for temporary porosis under the
plate
– Allows periosteal callus formation at the fracture site

LC-DCP plate hole

– The Dynamic Compression Unit (DCU) hole is symmetrical Bone loss observed beneath a Reduced bone loss beneath a
full-contact plate limited-contact plate
and provides bidirectional compression
– Allows 40° of longitudinal screw angulation and 7° of
transverse screw angulation
– Accepts conventional screws that may be placed in either
load or neutral positions, depending on whether inter-
fragment compression is desired (see using the universal
drill guide on pages 14 and 15 for more detail)
– Centrally located hole at one end for metaphyseal
fracture repair
– Tapered end for submuscular plate insertion, minimizing
tissue trauma
LC-DCP

Uniform stiffness
– Allows smooth contouring of the plate to the bone
– Protects the plate from localized high bending stress,
because of the even distribution of stresses over a long
distance along the plate DCP

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LCP (Locking Compression Plate)

– Locking screws create a fixed-angle construct, resulting B
in angular stability
A
– Tapered end for submuscular plate insertion, minimizing
tissue trauma (1)
– Limited-contact plate design reduces plate-to-bone
contact, protecting vascularity
– Centrally located hole at one end for metaphyseal fracture C
repair D

LCP plate holes

– Dynamic Compression Unit (DCU) hole allows 40° of
longitudinal screw angulation and 7° of transverse
screw angulation
– Combi-holes allow placement of conventional screws
on one side or locking screws on the opposite side of
each hole
A. Threaded hole section for locking screws
B. Dynamic Compression Unit (DCU) hole section for
conventional screws
C. Locking screw in threaded side of plate hole
D. Cortex screw in compression side of plate hole
E. Stacked combi-holes at plate end accepts either cortex,
cancellous or locking screws 1

Bibliography
1. Gasser, R., and S.M. Perren, "Parametric Numerical Design Optimization of
Internal Fixation Plates", 7th Meeting of the European Society of Biomechanics,
Aarhus (Denmark), 1990.
2. Klaue, K. and S.M. Perren. Unconventional Shapes of the Plate Cross-Section in
Internal Fixation: The Trapezoid Plate. Long Term Study of Bone Reaction in Sheep
Tibiae. Davos, Switzerland: Laboratory for Experimental Surgery, AO/ASIF, 1990.

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Screws

Cortex Screws
– For bicortical fixation in diaphyseal bone
– Self-tapping screws are standard in all sets
– Non-self-tapping screws are also available

Cancellous Bone Screws

– For fixation in poor quality or metaphyseal bone
– Deeper threads and coarser pitch maximizes the surface
area of the threads in contact with the bone, thereby
increasing the screw’s holding power in softer bone

Locking Screws
– Use with the Locking Compression Plate (LCP)
– Conical, double-lead machine thread on the head locks
into the threaded combi-hole or stacked combi-hole in the
plate
– Create a fixed-angle construct
– Large core diameter provides improved bending and
shear strength
– Stardrive recess provides improved torque transmission
to the screw, while retaining the screw without the use of
a holding sleeve

Screw Reference Chart

Thread Diameter 2.7 mm 2.7 mm 2.7 mm 3.5 mm 3.5 mm 3.5 mm 4.0 mm
Screw Type Cortex Cortex Locking Cortex Cortex Locking Cancellous
Drill Bit for 2.0 mm 2.0 mm 2.0 mm 2.5 mm 2.5 mm 2.8 mm 2.5 mm
Threaded Hole
Tap self-tapping self-tapping self-tapping self-tapping self-tapping self-tapping 4.0 mm
Drive Type 2.5 mm T8 T8 2.5 mm T15 T15 2.5 mm
Hexagonal Stardrive Stardrive Hexagonal Stardrive Stardrive Hexagonal

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Screw fixation
Bicortical cortex screw fixation is the traditional method of 1
compressing a plate to the bone. Friction between the plate
and bone maintains stability. Therefore, bicortical screws
require two cortices of fixation to achieve stability (1).

Locking screws provide stability and load transfer due to the

threaded connection between the plate and screw. There is
no compression of the plate to the bone (2).

Note: If a combination of a cortex screw and locking screws

is used, a cortex screw should be inserted first to pull the
plate to the bone. 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.

Warning:
– Synthes implants and instruments are manufactured with
proprietary processes that produce superior products to
those created by conventional manufacturing processes.
Though other companies may be able to estimate the Syn-
thes general product design, Synthes product dimensions
are proprietary. The precision design of Synthes products
is very important for long-term product function and opti-
mal fit between implants.
– Only the finest quality materials are used to manufacture
Synthes implants. The metals Synthes uses have been sci-
entifically proven to be of the best biocompatibility and
quality available today.
– With these features and qualities, the mixing of Synthes
implants with the implants from other companies is not
recommended. The overall performance may be compro-
mised due to differences in design, chemical composition,
mechanical properties, and quality.
– Given these qualities are trade-secret, no competitor of
Synthes can make a genuine claim “the same as Synthes.”
Combining implants from other companies with Synthes
implants could reduce product performance. Conse-
quently, it is strongly recommended to not mix parts from
different manufacturers.

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Fixation Principles

Conventional plating using standard screws

1
Primary loss of reduction
In conventional plating, even though the bone fragments are
correctly reduced prior to plate application, fracture disloca-
tion will result if the plate contour does not fit the bone (1).
In addition, if the lag screw is not seated perpendicular to
the fracture line (e.g., spiral fracture of the distal tibia), shear
forces will be introduced. These forces may cause loss of
reduction.

Secondary loss of reduction

Under axial load, postoperative, secondary loss of reduction
may occur by toggling of the screws. 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).
2
Blood supply to the bone
The periosteum is compressed under the plate area, reducing
or even interrupting blood supply to the bone (3).
This can delay bone healing due to temporary devasculariza-
tion underneath the plate.

Poor-quality bone
In poor-quality bone, screws cannot be tightened sufficiently
to obtain the compression and friction needed to withstand
the loading. This can result in loosening of the screws and
loss of stability and reduction.

Standard plating achieves good results in:

– Good-quality bone
– Fractures which are traditionally fixed with lag screws
3
to achieve direct bone healing

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Bridge/locked plating using locking screws

– Screws lock to the plate, forming a fixed-angle construct 4
– Bone healing is achieved indirectly by callus formation
when using locking screws exclusively

Maintenance of primary reduction

Once the locking screws engage the plate, no further tight-
ening 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 im-
plant stability (4). 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.
5
Stability under load
By locking the screws to the plate, the axial force is trans-
mitted over the length of the plate. The risk of a secondary
loss of the intraoperative reduction is reduced (5).

Blood supply to the bone

Locking the screw into the plate does not generate addi-
tional compression. Therefore, the periosteum will be pro-
tected and the blood supply to the bone preserved (6).

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Fixation Principles

Combined internal fixation

The combination of conventional compression plating and 7
locked plating techniques enhances plate osteosynthesis. The
result is a combination hole or combi-hole that, depending
on the indication, allows standard compression plating,
locked/bridge plating or a combination of both.

Internal fixation using a combination of locking screws

and standard screws

Note: If a combination of standard and locking screws is

used, the standard screws should be inserted first to pull the
plate to the bone (7).

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

ment, subsequent insertion of a standard screw (2) in the
same fragment without loosening and retightening the lock- 8 1 1
2
ing screws is NOT RECOMMENDED (8).

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.

Dynamic compression
Once the metaphyseal fragment has been fixed with locking
screws, the fracture can be dynamically compressed using
standard screws in the DCU portion of the combi-hole (9).

Locked and standard plating techniques

– First, use lag screws to anatomically reconstruct the
bone surfaces
– The behavior of a locking screw is not the same as that 9
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
– A plate used as a locked/bridge plate does not produce
any additional compression between the plate and the
bone

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Preparation

The following techniques apply to any of the Synthes plate

systems: LCP, LC-DCP and DCP. For this example, a 3.5 LCP
plate was selected since it can accommodate both standard
and locking screws.

The surgeon should select the appropriate plate system

based on indication and experience.

1
Plate selection

Required sets

103.503 Small Fragment Instrument Set

103.515 Small Fragment Screw Set

103.514 Small Fragment LC-DCP Plate Set

or
103.516 Small Fragment LCP Plate Set

The plates are available in various lengths. Complete the

preoperative radiographic assessment and plan to determine
plate length.

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Preparation

2
Contouring
329.890

Instruments

329.040 / Bending Iron for Plates 2.4 to 3.5,

329.050 length 145 mm

329.240 Bending Pliers for Plates 4.5,

length 250 mm, complete, with Anvils
Nos. 329.250 and 329.260

329.870 Bending Template for LC-DCP 3.5 and

DCP 3.5, length 87 mm
or
329.890 Bending Template for LC-DCP 3.5 and
DCP 3.5, length 114 mm
or
329.820 Bending Template for LC-DCP 3.5 and
DCP 3.5, length 153 mm

Use the bending templates to determine plate contour. Use

the bending irons or bending pliers to contour the LCP or the
LC-DCP plate to the anatomy.

Note: The LCP 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. Please
refer to the AO Principles of Fracture Management in the
Dog and Cat,1 AO Principles of Fracture Management,2 and
AO Manual of Fracture Management – Internal Fixators.3

1
Johnson.
2
Rüedi.
3
Wagner.

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Reduction and Temporary Plate Placement

3 1
Reduction and temporary plate placement

Instruments

324.023 Bending Pin for LCP Plates 3.5,

with thread, length 100 mm

324.024 Instrument for temporary reduction

398.811 Plate Holding Forceps, with Swivel Foot,

size 0
or
398.812 Holding Forceps with Swivel Foot,
for Plates 3.5, speed lock

The plate may be temporarily held in place with standard

plate holding forceps or the instrument for temporary
reduction.

Note: The middle of the plate should be positioned over

the fracture site if compression of the fracture fragments
is desired. 2

The instrument for temporary reduction (1) is designed to

temporarily hold the plate to the bone through a plate hole.
The device is self-drilling and connects with the Synthes
quick connection for power insertion. Insert into 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 hole that will be needed immediately for plate fixation.
However, the device may be removed and a screw inserted
through the same plate hole.

A bending pin (2) can also be used as an aid to position the

plate, and is particularly useful with minimally invasive plat-
ing technique.

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Screw Insertion

4
Screw insertion

Determine whether standard 3.5 mm cortex screws, 4.0 mm 323.360

cancellous screws or 3.5 mm locking screws will be used for
fixation. A combination of all may be used.
1

Note: If a combination of cortex, cancellous and locking

screws is used, a standard 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.

Insertion of a cortex or cancellous bone screw

Instruments

310.250 Drill Bit ⭋ 2.5 mm, length 110/85 mm,

2-flute, for Quick Coupling
Compression (load)
314.020 Screwdriver, hexagonal, small,
with Holding Sleeve

319.010 Depth Gauge for Screws ⭋ 2.7 to 4.0 mm,

measuring range up to 60 mm

323.360 Universal Drill Guide 3.5

Use the 2.5 mm drill bit through the 3.5 mm universal drill
guide to predrill the bone.

Measure for screw length using the depth gauge.

Select and insert the appropriate 3.5 mm cortex screw using

the small hexagonal screwdriver.

Use the 3.5 mm universal drill guide for an eccentric

(compression) or neutral (buttress) insertion of cortex screws.

Note: The 3.5 mm LC-DCP drill guide and the 3.5 mm

DCP drill guide are not suitable for use with LCP plates.

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The universal drill guides are the only drill guides which
function in all Synthes plate holes. When a cortex or cancel-
lous bone screw is used, a universal drill guide should be
used to guide the drill bit. If the screw is intended to achieve
interfragment compression, the universal drill guide should
be placed in the load position, as shown. If the screw is
intended to hold the plate, the universal drill guide should
2
be placed in the neutral position.

Compression (load) position

Compression is achieved by placing the universal drill guide
in the eccentric position, and maintaining the drill guide
body above the plate as shown (1, previous page).

Neutral position
Neutral position is achieved by placing the universal drill
guide in the eccentric position, then compressing the drill
guide body into the hole, which will shift the drill guide
into the neutral position as shown (2).

Note: For illustrative purposes, a combi-hole has been

depicted. The same methodology applies to LC-DCP and Neutral
DCP holes.

gap

Small Fragment System Technique Guide Synthes 15

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Screw Insertion

Insertion of 3.5 mm locking screws

3
Instruments

310.288 Drill Bit ⭋ 2.8 mm, length 165 mm,

for AO/ASIF Quick Coupling

312.648 LCP Drill Sleeve 3.5, for Drill Bits ⭋ 2.8 mm

314.115 Screwdriver Stardrive 3.5, T15

314.116 Screwdriver Shaft Stardrive 3.5, T15,

self-holding, for AO/ASIF Quick Coupling

319.010 Depth Gauge for Screws ⭋ 2.7 to 4.0 mm,

measuring range up to 60 mm

511.773 Torque Limiter, 1.5 Nm, for AO/ASIF 4

Quick Coupling

Note: A locking screw cannot be used as a lag screw. Use

standard 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, further anatomical reduction will
no longer be possible.

Screw the LCP drill sleeve into an LCP plate hole until fully
seated (3).

Note: Since the direction of a locking screw is determined 5

by plate design, final screw position may be verified with a
Kirschner wire prior to insertion. This becomes especially im-
portant when the plate has been contoured or applied in
metaphyseal regions around joint surfaces.

Warning: Do not try to bend the plate using the LCP drill
sleeve because damage may occur to the plate hole threads.

Use the 2.8 mm drill bit to drill to the desired depth (4).

Remove the LCP drill sleeve and use the depth gauge to
determine screw length (5).

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Insert the locking screw under power using the torque limiter
and Stardrive screwdriver shaft (6). 6

Note: Recheck each locking screw before closing to verify

that the screws are securely locked to the plate. Screwheads
must be flush with the plate in the locked position before
they can be considered fully seated.

Warning: Always use a torque limiter when using power to

insert locking screws.

Alternative method of locking screw insertion

Use the Stardrive screwdriver to manually insert the appropri-
ate length locking screw (7). Carefully tighten the locking
screw, as excessive force is not necessary to produce effective
screw-to-plate locking.

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Postoperative Treatment and Implant Removal

Postoperative treatment
Postoperative treatment with locking compression plates
does not differ from conventional internal fixation proce-
dures.

Implant removal

319.390 Sharp Hook, length 155 mm

When removing a screw, first clear the screw drive mecha-

nism (hexagonal or Stardrive) of all tissue ingrowth using a
sharp hook and irrigation. This allows complete engagement
of the screwdriver and minimizes the chance of stripping the
screw drive mechanism. See the Universal Screw Removal Set
brochure (036.000.773) for additional instrumentation and
technique.

When removing 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.

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Featured Instruments

313.353 Drill Sleeve 2.7, for Aiming Arm

No. 313.354, for DHP

The drill sleeve threads into locking plates for correct align-
ment of locking screws with plate holes. The drill sleeve cen-
ters a drill bit to ensure perpendicular drilling, and permits
proper mating of locking screws to the threaded portion of
the combi-hole.

312.648 LCP Drill Sleeve 3.5, for Drill Bits ⭋ 2.8 mm

Notes:
– To prevent cross-threading, turn the LCP drill sleeve coun-
terclockwise until a slight click is noticed, and then turn it
clockwise. If properly aligned, threads should engage
within a quarter-turn.
– The LCP drill sleeve can also be used intraoperatively as a
reference for visualizing the angle at which the locking
screws engage in the bone.

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Featured Instruments

324.023 Bending Pin for LCP Plates 3.5,

with thread, length 100 mm
– Facilitates positioning the plate on the
bone

324.024 Instrument for temporary reduction

– For use with LCP 3.5 plates
– Temporarily compresses the plate to the
bone
– Can assist bone fragment reduction to
the plate
– Self-drilling, self-tapping 2.5 mm thread
– Synthes quick coupling connection
Insert into near cortex only. After power insertion, turn the
collet clockwise until it compresses the plate securely to the
bone. Take care when inserting this device in a hole that will
be needed for plate fixation. After the device is removed, a
conventional screw can be placed in the same hole.

Also available
511.773 Torque Limiter, 1.5 Nm, for AO/ASIF
Quick Coupling
– For use with 3.5 mm locking screws

511.776 Torque Limiter, 0.8 Nm, with AO/ASIF

Quick Coupling
– For use with 2.7 mm locking screws

A torque limiter is used to ensure the appropriate amount of

torque is applied to minimize the risks of a locking screw
backing out of the plate.

Note: With titanium implants, this also minimizes the risk

of cold welding the screw to the plate. Where steel implants
are used, more torque can be applied by hand tightening the
screw to ensure it is fully seated in the plate.

398.811 Plate Holding Forceps, with Swivel Foot,

size 0
or
398.812 Holding Forceps with Swivel Foot,
for Plates 3.5, speed lock

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Small Fragment Standard Instrument Set (103.501)

Graphic Case
690.591 Graphic Case for Instrument Set Small
Fragments, without Contents

Instruments
310.210 Drill Bit ⭋ 2.0 mm, length 125/100 mm,
2-flute, for Quick Coupling
310.250 Drill Bit ⭋ 2.5 mm, length 110/85 mm,
2-flute, for Quick Coupling
310.260 Drill Bit ⭋ 2.7 mm, length 100/75 mm,
2-flute, for Quick Coupling
310.350 Drill Bit ⭋ 3.5 mm, length 110/85 mm,
2-flute, for Quick Coupling
310.890 Countersink 3.5
311.260 Tap for Cortex Screws ⭋ 2.7 mm,
length 100/33 mm Shown with both 103.501 and 103.502 set combined
311.320 Tap for Cortex Screws ⭋ 3.5 mm,
length 110/50 mm
311.430 Handle with Quick Coupling,
length 110 mm
311.440 T-Handle with Quick Coupling
312.200 Triple Drill Guide 2.0, with 3 holes
312.240 Double Drill Guide 2.7/2.0
312.280 Double Drill Guide 3.5/2.5
312.300 Drill Sleeve Insert 3.5/2.5, length 42 mm
314.020 Screwdriver, hexagonal, small,
with Holding Sleeve
314.030 Screwdriver Shaft, hexagonal, small, VW1203.15.10 Kirschner Wire ⭋ 1.25 mm with trocar tip,
⭋ 2.5 mm length 150 mm, Stainless Steel,
319.010 Depth Gauge for Screws ⭋ 2.7 to 4.0 mm, pack of 10 units
measuring range up to 60 mm VW2003.15.10 Kirschner Wire ⭋ 2.0 mm with trocar tip,
319.970 Screw Forceps, self-holding, length 85 mm length 150 mm, Stainless Steel,
323.260 Universal Drill Guide 2.7 pack of 10 units
323.360 Universal Drill Guide 3.5
329.040 / Bending Irons for Plates 2.4 to 3.5,
Note: Small Fragment Instrument Set (103.503) consists of
329.050 length 145
Small Fragment Standard Instrument Set (103.501), with
graphic case, and Small Fragment Locking Instrument Set
(103.502).

For additional information, please refer to package insert.

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Small Fragment Standard Screw Set (103.518)

Screw Rack
690.593 Small Fragment Standard Screw Rack

Standard Screws
Cortex Screws ⭋ 2.7 mm, self-tapping, 6 each
Length (mm) Length (mm)
VS205.008 8 VS205.016 16
VS205.010 10 VS205.018 18
VS205.012 12 VS205.020 20
VS205.014 14 Lid not shown

Cortex Screws ⭋ 3.5 mm, self-tapping, 6 each

Length (mm) Length (mm)
VS302.012 12 VS302.022 22
VS302.014 14 VS302.024 24
VS302.016 16 VS302.026 26
VS302.018 18 VS302.028 28
VS302.020 20 VS302.030 30

Cancellous Bone Screws ⭋ 4.0 mm, fully-threaded, 4 each

Length (mm) Length (mm)
VS403.016 16 VS403.024 24
VS403.018 18 VS403.026 26
VS403.020 20 VS403.028 28
VS403.022 22 VS403.030 30

Note: Small Fragment Screw Set (103.515) consists of

Small Fragment Standard Screw Set (103.518) and Small
Fragment Locking Screw Set (103.517) stored in the optional
Graphic Case for Small Fragment Screw Set (690.515).

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Also Available Optional

Cortex Screws ⭋ 2.7 mm, self-tapping Cortex Screws Stardrive ⭋ 2.7 mm, self-tapping
(rack will hold 6 each) (rack will hold 6 each)
Length (mm) Length (mm) Length (mm)
VS205.006 6 VS205.038 38* VS211.006 – 6 – 30
VS205.022 22 VS205.040 40* VS211.030
VS205.024 24 VS205.042 42* VS211.032 – 32 – 60*
VS205.026 26 VS205.044 44* VS211.060
VS205.028 28 VS205.045 45*
VS205.030 30 VS205.046 46*
VS205.032 32* VS205.048 48*
VS205.034 34* VS205.050 50*
VS205.036 36* VS205.055 55*
Cortex Screws Stardrive ⭋ 3.5 mm, self-tapping
Cortex Screws ⭋ 3.5 mm, self-tapping (rack will hold 6 each) (rack will hold 6 each)
Length (mm) Length (mm) Length (mm)
VS302.010 10 VS302.055 55 VS304.010 – 10 – 60
VS302.032 32 VS302.060 60 VS304.060
VS302.034 34 VS302.065 65* VS304.065 65 – 90*
VS302.036 36 VS302.070 70* VS304.090
VS302.038 38 VS302.075 75*
VS302.040 40 VS302.080 80*
VS302.045 45 VS302.085 85*
VS302.050 50 VS302.090 90*

Cancellous Bone Screws ⭋ 4.0 mm, fully threaded (rack will Cancellous Bone Screws ⭋ 4.0 mm, partially threaded,
hold four each 10 – 40 mm screws, two each 45 mm and (rack will hold four each 10 – 40 mm screws, two each
50 mm screws) 45 mm and 50 mm screws)
Length (mm) Length (mm) Length (mm)
VS403.010 10 VS403.040 40 VS404.010 – 10 – 50
VS403.012 12 VS403.045 45 VS404.050
VS403.014 14 VS403.050 50 VS404.055 – 55 – 60*
VS403.032 32 VS403.055 55* VS404.060
VS403.036 36 VS403.060 60*

* Do not fit in screw rack

Small Fragment System Technique Guide Synthes 23

0X6.000.995_AB 01.10.12 12:10 Seite 24

Small Fragment LC-DCP Plate Set (103.514)

Graphic Case
690.511 Graphic Case for Small Fragment Plate Set,
without Contents

Implants
LC-DCP Plates 2.7
Length Length
Holes (mm) Holes (mm)
VP3031.06 6 55 VP3031.10 10 91
VP3031.08 8 73 VP3031.12 12 109

LC-DCP Plates 3.5

Length Length
Holes (mm) Holes (mm) Lid not shown

VP3041.06 6 80 VP3041.10 10 132

VP3041.08 8 106 VP3041.12 12 158

Broad LC-DCP Plates 3.5

Length Length
Holes (mm) Holes (mm)
VP3051.08 8 107 VP3051.12 12 159
VP3051.10 10 133 VP3051.14 14 185

Also Available
LC-DCP Plates 2.7
Length Length
Holes (mm) Holes (mm)
VP3031.04 4 37 VP3031.11 11 100
VP3031.05 5 46 VP3031.14 14 127
VP3031.07 7 64 VP3031.16 16 145
VP3031.09 9 82

LC-DCP Plates 3.5 Broad LC-DCP Plates 3.5

Length Length Length Length
Holes (mm) Holes (mm) Holes (mm) Holes (mm)
VP3041.02 2 28 VP3041.14 14 184 VP3051.07 7 94 VP3051.16 16 211
VP3041.03 3 41 VP3041.15 15 197 VP3051.09 9 120 VP3051.17 17 224
VP3041.04 4 54 VP3041.16 16 210 VP3051.11 11 146 VP3051.18 18 237
VP3041.05 5 67 VP3041.18 18 236 VP3051.13 13 172 VP3051.20 20 263
VP3041.07 7 93 VP3041.20 20 262 VP3051.15 15 198 VP3051.22* 22 289
VP3041.09 9 119 VP3041.22* 22 288
VP3041.11 11 145

* Do not fit in case

24 Synthes Small Fragment System Technique Guide

0X6.000.995_AB 01.10.12 12:10 Seite 25

Small Fragment Locking Instrument Set (103.502)

Instruments
310.288 Drill Bit ⭋ 2.8 mm, length 165 mm, 310.288
for AO/ASIF Quick Coupling
312.648 LCP Drill Sleeve 3.5, for Drill Bits ⭋ 2.8 mm
313.353 Drill Sleeve 2.7, for Aiming Arm
312.648
No. 313.354, for DHP
314.116 Screwdriver Shaft Stardrive 3.5, T15,
self-holding, for AO/ASIF Quick Coupling
313.353
314.467 Screwdriver Shaft, Stardrive, T8,
self-holding
324.023 Bending Pin for LCP Plates 3.5,
314.116
with thread, length 100 mm
324.024 Instrument for temporary reduction
314.467

Also Available
314.115 Screwdriver Stardrive 3.5, T15
324.023
314.468 Holding Sleeve for Screws Stardrive
⭋ 2.4 mm, T8, for Screwdriver Shafts
⭋ 3.5 mm, for No. 314.467
511.773 Torque Limiter, 1.5 Nm, 324.024
for AO/ASIF Quick Coupling
511.776 Torque Limiter, 0.8 Nm,
with AO/ASIF Quick Coupling
314.115
VW1605.15.10 Kirschner Wire ⭋ 1.6 mm with threaded
tip, length 150 mm, Stainless Steel,
pack of 10 units

314.468

Note: Small Fragment Instrument Set (103.503) consists of

Small Fragment Standard Instrument Set (103.501), with VW1605.15
graphic case, and Small Fragment Locking Instrument Set
(103.502).

Small Fragment System Technique Guide Synthes 25

0X6.000.995_AB 01.10.12 12:10 Seite 26

Small Fragment Locking Screw Set (103.517)

Screw Rack
690.592 Small Fragment Locking Screw Rack

Implants
Locking Screws ⭋ 2.7 mm, self-tapping, 2 each
(rack will hold 6 each)
Length (mm) Length (mm)
VS206.012 12 VS206.022 22
VS206.014 14 VS206.024 24
VS206.016 16 VS206.026 26 Lid not shown

VS206.018 18 VS206.028 28
VS206.020 20

Locking Screws ⭋ 3.5 mm, self-tapping (rack will hold 6 each)

Length Length
(mm) Qty. (mm) Qty.
VS303.014 14 2 VS303.030 30 2
VS303.016 16 2 VS303.032 32 2
VS303.018 18 2 VS303.034 34 2
VS303.020 20 2 VS303.036 36 2
VS303.022 22 2 VS303.038 38 2
VS303.024 24 2 VS303.040 40 2
VS303.026 26 2 VS303.045 45 2
VS303.028 28 2 VS303.050 50 1

Also Available
Locking Screws ⭋ 2.7 mm, self-tapping (rack will hold 6 each)
Length (mm) Length (mm)
VS206.010 10 VS206.034 34
VS206.030 30 VS206.036 – 36
VS206.032 32 VS206.050 50*

Locking Screws ⭋ 3.5 mm, self-tapping (rack will hold 6 each)

Length (mm) Length (mm)
VS303.010 10 VS303.055 55
VS303.012 12 VS303.060 60
VS303.042 42 VS303.065* 65
VS303.048 48 VS303.070* 70 Note: Small Fragment Screw Set (103.515) consists of Small
VS303.052 52 Fragment Standard Screw Set (103.518) and Small Fragment
Locking Screw Set (103.517) stored in the optional Graphic
Case for Small Fragment Screw Set (690.515).

* Do not fit in screw rack

26 Synthes Small Fragment System Technique Guide

0X6.000.995_AB 01.10.12 12:11 Seite 27

Small Fragment LCP Plate Set (103.516)

Graphic Case
690.511 Graphic Case for Small Fragment Plate Set,
without Contents

Implants
LCP Plates 2.7
Length Length
Holes (mm) Holes (mm)
VP4031.06 6 54 VP4031.10 10 90
VP4031.08 8 72 VP4031.12 12 108

LCP Plates 3.5

Length Length
Holes (mm) Holes (mm) LCP Plates 2.7 and lid
VP4041.06 6 79 VP4041.10 10 131 not shown

VP4041.08 8 105 VP4041.12 12 157

Broad LCP Plates 3.5

Length Length
Holes (mm) Holes (mm)
VP4045.08 8 107 VP4045.12 12 159
VP4045.10 10 133 VP4045.14 14 185

Also Available
LCP Plates 2.7
Length Length
Holes (mm) Holes (mm)
VP4031.04 4 36 VP4031.09 9 81
VP4031.05 5 45 VP4031.14 14 126
VP4031.07 7 63 VP4031.16 16 144

LCP Plates 3.5 Broad LCP Plates 3.5

Length Length Length Length
Holes (mm) Holes (mm) Holes (mm) Holes (mm)
VP4041.02 2 27 VP4041.13 13 170 VP4045.07 7 94 VP4045.16 16 211
VP4041.03 3 40 VP4041.14 14 183 VP4045.09 9 120 VP4045.17 17 224
VP4041.04 4 53 VP4041.15 15 196 VP4045.11 11 146 VP4045.18 18 237
VP4041.05 5 66 VP4041.16 16 209 VP4045.13 13 172 VP4045.20 20 263
VP4041.07 7 92 VP4041.18 18 235 VP4045.15 15 198 VP4045.22* 22 289
VP4041.09 9 118 VP4041.20 20 261
VP4041.11 11 144 VP4041.22* 22 287

* Do not fit in case

Small Fragment System Technique Guide Synthes 27

0X6.000.995_AB 01.10.12 12:11 Seite 28

Quick Reference Guide – Implants

Small Small Small Small Small

Fragment Fragment Fragment Fragment Fragment
Standard Locking Screw LC-DCP LCP
Screw Set Screw Set Set Plate Set Plate Set
Part Number Description (103.518) (103.517) (103.515) (103.514) (103.516)

VS205.008 – Cortex Screw ⭋ 2.7 mm,

• •
VS205.020 self-tapping, lengths 8 – 20 mm
VS206.012 – Locking Screw Stardrive ⭋ 2.7 mm
• •
VS206.028 (head LCP 2.4), self-tapping, lengths 12–28 mm
VS302.012 – Cortex Screw ⭋ 3.5 mm,
• •
VS302.030 self-tapping, lengths 12 – 30 mm
VS303.014 – Locking Screw Stardrive ⭋ 3.5 mm,
• •
VS303.050 self-tapping, lengths 14 – 50 mm
VS403.016 – Cancellous Bone Screw ⭋ 4.0 mm,
• •
VS403.030 fully threaded, lengths 16 – 30 mm
VP3031.06 LC-DCP 2.7, 6 holes, length 55 mm •
VP3031.08 LC-DCP 2.7, 8 holes, length 73 mm •
VP3031.10 LC-DCP 2.7, 10 holes, length 91 mm •
VP3031.12 LC-DCP 2.7, 12 holes, length 109 mm •
VP3041.06 LC-DCP 3.5, 6 holes, length 80 mm •
VP3041.08 LC-DCP 3.5, 8 holes, length 106 mm •
VP3041.10 LC-DCP 3.5, 10 holes, length 132 mm •
VP3041.12 LC-DCP 3.5, 12 holes, length 158 mm •
VP3051.08 LC-DCP 3.5, broad, 8 holes, length 107 mm •
VP3051.10 LC-DCP 3.5, broad, 10 holes, length 133 mm •
VP3051.12 LC-DCP 3.5, broad, 12 holes, length 159 mm •
VP3051.14 LC-DCP 3.5, broad, 14 holes, length 185 mm •
VP4031.06 LCP 2.7, 6 holes, length 54 mm •
VP4031.08 LCP 2.7, 8 holes, length 72 mm •
VP4031.10 LCP 2.7, 10 holes, length 90 mm •
VP4031.12 LCP 2.7, 12 holes, length 108 mm •
VP4041.06 LCP 3.5, 6 holes, length 79 mm •
VP4041.08 LCP 3.5, 8 holes, length 105 mm •
VP4041.10 LCP 3.5, 10 holes, length 131 mm •
VP4041.12 LCP 3.5, 12 holes, length 157 mm •
VP4045.08 LCP 3.5, broad, 8 holes, length 107 mm •
VP4045.10 LCP 3.5, broad, 10 holes, length 133 mm •
VP4045.12 LCP 3.5, broad, 12 holes, length 159 mm •
VP4045.14 LCP 3.5, broad, 14 holes, length 185 mm •

28 Synthes Small Fragment System Technique Guide

0X6.000.995_AB 01.10.12 12:11 Seite 29

Small Small Small Small Small

Fragment Fragment Fragment Fragment Fragment
Standard Locking Screw LC-DCP LCP
Screw Set Screw Set Set Plate Set Plate Set
Part Number Description (103.518) (103.517) (103.515) (103.514) (103.516)

690.511 Graphic Case for Small Fragment Plate Set, • •

without Contents
690.592 Rack for Locking Screws ⭋ 2.7 and 3.5 mm, • •
self-tapping, without Contents, with Lid
690.593 Rack for Cortex Screws ⭋ 2.7 and 3.5 mm and • •
Cancellous Bone Screws ⭋ 4.0 mm,
without Contents, with Lid
690.515 Graphic Case for Screw Set Small Fragments, •
without Contents

Small Fragment System Technique Guide Synthes 29

0X6.000.995_AB 01.10.12 12:11 Seite 30

Quick Reference Guide – Instruments

Small Small Small

Fragment Fragment Fragment
Standard Locking Instrument
Instrument Instrument Set
Set Set
Part Number Description (103.501) (103.502) (103.503)
310.210 Drill Bit ⭋ 2.0 mm, length 125/100 mm, 2-flute, • •
for Quick Coupling
310.250 Drill Bit ⭋ 2.5 mm, length 110/85 mm, 2-flute, • •
for Quick Coupling
310.260 Drill Bit ⭋ 2.7 mm, length 100/75 mm, 2-flute, • •
for Quick Coupling
310.350 Drill Bit ⭋ 3.5 mm, length 110/85 mm, 2-flute, • •
for Quick Coupling
310.890 Countersink 3.5 • •
311.260 Tap for Cortex Screws ⭋ 2.7 mm, length 100/33 mm • •
311.320 Tap for Cortex Screws ⭋ 3.5 mm, length 110/50 mm • •
311.430 Handle with Quick Coupling, length 110 mm • •
311.440 T-Handle with Quick Coupling • •
312.200 Triple Drill Guide 2.0, with 3 holes • •
312.240 Double Drill Guide 2.7/2.0 • •
312.280 Double Drill Guide 3.5/2.5 • •
312.300 Drill Sleeve Insert 3.5/2.5, length 42 mm • •
314.020 Screwdriver, hexagonal, small, with Holding Sleeve • •
314.030 Screwdriver Shaft, hexagonal, small, ⭋ 2.5 mm • •
319.010 Depth Gauge for Screws ⭋ 2.7 to 4.0 mm, • •
measuring range up to 60 mm
319.970 Screw Forceps, self-holding, length 85 mm • •
323.260 Universal Drill Guide 2.7 • •
323.360 Universal Drill Guide 3.5 • •
329.040 / Bending Iron for Plates 2.4 to 3.5, length 145 mm • •
329.050
VW1203.15.10 Kirschner Wire ⭋ 1.25 mm with trocar tip, length 150 mm, • •
Stainless Steel, pack of 10 units
VW2003.15.10 Kirschner Wire ⭋ 2.0 mm with trocar tip, length 150 mm, • •
Stainless Steel, pack of 10 units
310.288 Drill Bit ⭋ 2.8 mm, length 165 mm, • •
for AO/ASIF Quick Coupling
312.648 LCP Drill Sleeve 3.5, for Drill Bits ⭋ 2.8 mm • •
313.353 Drill Sleeve 2.7, for Aiming Arm No. 313.354, for DHP • •
314.116 Screwdriver Shaft Stardrive 3.5, T15, self-holding, • •
for AO/ASIF Quick Coupling
314.467 Screwdriver Shaft, Stardrive, T8, self-holding • •
324.023 Bending Pin for LCP Plates 3.5, with thread, length 100 mm • •
324.024 Instrument for temporary reduction • •
690.591 Graphic Case for Instrument Set Small Fragments, without Contents • •

30 Synthes Small Fragment System Technique Guide

0X6.000.995_AB 01.10.12 12:11 Seite 31

Small Fragment System Technique Guide Synthes 31

0X6.000.995_AB 01.10.12 12:11 Seite 32

32 Synthes Small Fragment System Technique Guide

0X6.000.995_AB 01.10.12 12:11 Seite Cvr3
 0X6.000.995_AB 01.10.12 12:11 Seite Cvr4

www.synthes.com/lit
All technique guides are available as PDF files at
Ö036.000.995öAB9ä
036.000.995 version AB rev. 1 10/2012 35100072 © Synthes, Inc. or its affiliates Subject to modifications Synthes, LCP and Stardrive are trademarks of Synthes, Inc. or its affiliates