lag screw & dcp

Lecture by Dr Robert Yap

1. Basic Lag Screw Principles

2. Lag Screw vs Lag Technique

3. | 30.05.19 | APTUS Hand | Page 4 | Anatomy Overview 1.2 2.0 2.3 1.5 Hand

4. | 30.05.19 | APTUS Hand | Page 5 | Medartis instruments & storage - Instruments Instruments and drills Twist drill Ø1.0 mm, 1.2 mm, 1.6 mm 1.9 mm Dental, Stryker or AO drill shaft end Please note: The twist drill MUST ALWAYS be guided over the drill guide to: prevent damage of the plate hole protect surrounding tissue from direct contact with the drill limit the drilling angle of +/- 15° Allow concentric ( fixation andTriLock ) and eccentric ( compression ) drill position repectively in the plate hole Gliding hole drill Ø1.2 mm, 1.6 mm, 2.1 mm 2.35 mm Dental, Stryker or AO drill shaft end A-2020: 2.0/2.3 Drill guide A-2025: 1.2/1.5 Drill guide

5. | 30.05.19 | APTUS Hand | Page 6 | Surgical technique – Steb by Step Lag screws Drilling of the core hole: Use the twist drill for core holes (one colored ring) of the appropriate system size and drill up to the opposite cortex . Drilling of gliding hole: Use the gliding hole drill (two colored rings) of the appropriate system size to drill up to the fracture line. Fracture compression : Insert a cortical screw of the appropriate system size to compress the fracture. Optional steps prior to compression : Use countersink to sink the screw heads or for better stress distribution apply biconcave washer .

6. Countersinking

7. Metacarpal head #

8. Metacarpal Shaft spiral #

9. Dynamic Compression Plate

10. Dynamic Compression Plate

11. | 30.05.19 | APTUS Hand | Page 20 | Medartis instruments & storage - Instruments Instruments and drills Twist drill Ø1.0 mm, 1.2 mm, 1.6 mm 1.9 mm Dental, Stryker or AO drill shaft end Please note: The twist drill MUST ALWAYS be guided over the drill guide to: prevent damage of the plate hole protect surrounding tissue from direct contact with the drill limit the drilling angle of +/- 15° Allow concentric ( fixation andTriLock ) and eccentric ( compression ) drill position repectively in the plate hole Gliding hole drill Ø1.2 mm, 1.6 mm, 2.1 mm 2.35 mm Dental, Stryker or AO drill shaft end A-2020: 2.0/2.3 Drill guide A-2025: 1.2/1.5 Drill guide

12. | 30.05.19 | APTUS Hand | Page 21 | Surgical technique – Steb by Step Instrument application Hand Drilling: For compression plates use excentric side of the drill guide ( arrow pointing towards fracture ), for all other plates use the centrical side Measuring depth : catch the far cortex of the bone with the caliper of the depth gauge , push measuring sleeve onto the plate , determine correct screw length .