AAP LOQTEQ Proximal Medial Tibia Plate 3.5 User manual

Proximal Medial Tibia Plate 3.5
Surgical Technique
Locking Compression Technology by aap

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Proximal Medial Tibia Plate 3.5
Surgical Technique

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Disclaimer
This surgical technique is exclusively intended for medical professionals, especially physicians, and therefore
may not be regarded as a source of information for non-medical persons. The description of this surgical
technique does not constitute medical advice or medical recommendations nor does it convey any diagnostic or
therapeutic information on individual cases. Therefore, the attending physician is fully responsible for providing
medical advice to the patient and obtaining the informed consent of the patient which this surgical technique
does not supersede.
The description of this surgical technique has been compiled by medical experts and trained staff of aap
Implantate AG with utmost diligence and to the best of their knowledge. However, aap Implantate AG excludes
any liability for the completeness, accuracy, currentness, and quality of the information as well as for material
or immaterial damages arising from the use of this information.

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Contents •
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
Surgical Technique
Proximal Medial Tibia Plate 3.5
•Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
LOQTEQ® Proximal Medial Tibia Plate 3.5 long . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
•Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
LOQTEQ® Proximal Medial Tibia Plate 3.5 short . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
•Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
•Material . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
•Indications/Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
•Processing (Sterilization & Cleaning) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
•Surgical Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
•Preoperative Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
•Positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
•Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
•Preparing the plate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
•Repositioning and primary fixation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
•Securing the proximal plate holes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
•Fixating the plate shaft . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
•Inserting screws . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
•Inserting standard screws . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
•Inserting locking screws . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
•Interfragmentary compression using a LOQTEQ® locking screw . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
•Explantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
•Aside on double plating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
•Assembly instructions, load drill guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
•Trays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
•LOQTEQ® Proximal Tibia Plate, Set of Plates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
•LOQTEQ® Screw rack for extension screw set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
•LOQTEQ® Small Fragment Set, Set of Instruments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
•LOQTEQ® Small Fragment Set, Screw Rack . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

Surgical Technique
Proximal Medial Tibia Plate 3.5
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
4
•Introduction
LOQTEQ® Proximal Medial Tibia Plate 3.5, long
The Proximal Medial Tibia Plate 3.5 long is part of the LOQTEQ® plate system and unifies angular stability with modern
plate design. Special features include the gliding-locking holes in the plate shaft of the long plate version. They enable
compression and angle stable locking in one single step.
Description
•The anatomic plate design is adapted to the proximal medial tibia
•The flattened end of the plate shaft enables the tissue-conserving, submuscular
insertion of the plate
•Minor contact undercuts are designed to minimize the reduction in blood supply to
the periosteum
•Gliding-locking holes in the shaft area allow compression and angular stability with
LOQTEQ® technology
•Round locking holes in the plate head are suitable for 3.5 mm locking screws (blue) as
well as standard screws with small head
•3 proximal screws in the T-head slightly diverge, parallel to the joint
•Locking screw oriented in a diagonal cranial direction supports the stabilization of
the tibial head
•Fitted targeting devices guarantee a safe placement of drill guides at the preset angle
•Holes for K-wires and an oblong hole facilitate the primary fixation of the plate
•Additional recesses at the underside of the proximal holes for K-wires allow the
attachment of suture material
•Available as right and left version
•6 and 10 holes in the plate shaft

aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
5
Introduction •
Surgical Technique
Proximal Medial Tibia Plate 3.5
LOQTEQ® Proximal Medial Tibia Plate 3.5, short
The Proximal Medial Tibia Plate 3.5 short is part of the LOQTEQ® plate system and unifies angular stability with modern
plate design. Its minimal thickness and short anatomic design make the plate suitable for double plating proximal tibial
fractures.
Description
•The anatomic plate design is adapted to the proximal medial tibia
•The plate is only 2.5 mm thick and is suitable for double plating the proximal tibia
•The 58 mm long plate allows minimally invasive access
•The flattened end of the plate shaft enables the tissue-conserving, submuscular
insertion of the plate
•Minor contact undercuts are designed to minimize the reduction in blood supply to
the periosteum
•Round locking holes in the plate head are suitable for 3.5 mm locking screws (blue) as
well as standard screws with small head
•Fitted targeting devices guarantee a safe placement of drill guides at the preset angle
•Holes for K-wires facilitate the primary fixation of the plate
•Additional recesses at the underside of the proximal holes for K-wires allow
the attachment of suture material
•Available as right and left version with 3 holes in the plate shaft

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•Introduction
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
Material
For the manufacture of angle stable plate systems materials are used which have been proven to be successful in medical
technology for decades. The anatomical plates and bone screws are made of titanium alloy.
All materials employed comply with national and international standards. They are characterized by good biocompatibility,
a high degree of safety against allergic reactions and good mechanical properties.
Indications/Contraindications
Indications
The aap LOQTEQ® Proximal Medial Tibia Plate 3.5 is indicated for:
•Metaphyseal fractures of the medial tibial plateau
•Split fractures of the medial tibial plateau
•Medial split fractures with depression
•Split or depression fracture of the medial tibial plateau
In addition, the plates may be used for fixation of the proximal quarter (lateral and medial) of the tibia as well as multi-
fragment fractures of the proximal tibia.
Contraindications
•Infection or inflammation (localized or systemic)
•Allergies against the implant material
•High risk patients for anesthesia
•Severe soft tissue swelling impacting normal wound healing
•Insufficient soft tissue coverage
•Fractures in children and adolescents with epiphyseal plates not yet ossified
Processing (Sterilization & Cleaning)
The implants are supplied sterile and non-sterile.
Implants and instruments that are supplied in non-sterile condition must be sterilized before use.
For this purpose, please refer to the Instructions for Use that are enclosed with the plates, instruments, and trays.
Do not use (sterile) implants from damaged or open inner packaging.
Implant components that have come or might have come into contact with infectious fluids (e.g. blood) must not be
resterilized and reused in another surgery. They must be returned to the manufacturer. Resterilization is prohibited
under any circumstances (see Instructions for Use).
Surgical Technique
Proximal Medial Tibia Plate 3.5

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Surgical Technique •
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
INSTRUMENTS ART.-NO.
LOQTEQ® Proximal Tibia Plates 3.5, Set of Plates IC 6936-00
LOQTEQ® Small Fragment Set, Set of Instruments IC 6931-10
LOQTEQ® Small Fragment Set, Screw Rack, complete IC 6931-35
Preoperative Planning
•Preoperatively assess the fracture situa-
tion using the X-ray images. Select the
suitable plate and screw lengths.
•Prepare the necessary instruments for
insertion.
Positioning
•The patient is positioned supine on a
radiolucent operating table.
The proximal tibia must be clearly visible
during intraoperative fluoroscopy in
both planes, AP and ML.
Access
•Medial, according to the fracture
situation.
Surgical Technique
Proximal Medial Tibia Plate 3.5

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•Surgical Technique
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
•Mount the targeting device on the plate using the fixing screw.
NNOTE:
A thread holds the fixing screw in the targeting device. For
cleaning purposes, the screw must be screwed out of the tar-
geting device. For this purpose, apply slight pressure onto the
screw from the underside of the targeting device, and remove
the screw.
INSTRUMENTS ART.-NO.
Torque limiting screwdriver 2.0 Nm, quick coupling IU 7825-55
Aiming device LOQTEQ® PMT Plate 3.5, R/L IU 8186-0x
Preparing the plate
Surgical Technique
Proximal Medial Tibia Plate 3.5

Surgical Technique •
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
9
INSTRUMENTS ART.-NO.
K-wire with trocar point, ø1.6, L 150 NK 0016-15
Double drill guide, ø2.5 / 3.5, with spring aided centering IU 8116-50
Twist drill ø2.5, L 180, coil 50, quick coupling IU 7425-18
Repositioning and
primary fixation
Surgical Technique
Proximal Medial Tibia Plate 3.5
•Reposition fracture fragments and joint surface and temporarily
fixate with K-wires. Depending on the fracture situation, it is re-
commended to use an external fixator or large distractor before-
hand. Check the result of repositioning using fluoroscopy.
NNOTE:
If the fracture gap should be closed via interfragmentary com-
pression by a lag screw, ensure that the desired compression is
created with standard screws. For the lag screw technique use
the methods descripted by AO.
•Alternatively: Position the plate and secure using the oblong hole
•As an alternative to the K-wires, a standard cortical screw 3.5 mm
may be placed in the oblong hole. For this purpose use a double
drill guide ø2.5/3.5 and a drill bit ø2.5 and drill to the desired
depth. Then determine the screw length using the depth gauge
and insert a standard cortical screw 3.5 mm of appropriate length.
The plate can be simultaneously pulled against the shaft using
this standard cortical screw.
•If necessary, readjust the plate position.

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•Surgical Technique
Securing the proximal plate holes
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
INSTRUMENTS ART.-NO.
K-wire with trocar point, ø1.6, L 150 NK 0016-15
Drill guide for round hole LOQTEQ® 3.5, I-ø 2.8, blue IU 8166-20
Reduction sleeve for K-wire ø1.6 IU 8166-16
Torque limiting screwdriver 2.0 Nm, quick coupling IU 7825-55
Twist drill ø2.7, L 220, coil 50, quick coupling IU 7427-22
Surgical Technique
Proximal Medial Tibia Plate 3.5
•Using a K-wire, the later position of the screw can be checked.
For this purpose, insert a threaded drill guide (blue) for round
holes into a proximal plate hole, insert the reduction sleeve and
place the K-wire through the reduction sleeve. Use fluoroscopy to
check whether
•the wire is positioned parallel to the joint surface,
•the joint was repositioned correctly and
•the plate position at the shaft is optimal.
•The round locking holes in the proximal portion of the plate
should be secured with locking screws (blue). For this purpose,
screw the threaded drill guide (blue) for round holes into the
desired hole. The use of the screwdriver duo may facilitate the
screwing or later unscrewing of the threaded drill guide.
NNOTE:
We recommend drilling under fluoroscopic guidance to ensure
optimal plate positioning and screw orientation in AP and
lateral view.

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Surgical Technique •
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
INSTRUMENTS ART.-NO.
Depth gauge for locking screws, small IS 7904-00
Handle with quick coupling, with torque limiter, 2.0 Nm IU 7707-20
Torque limiting screwdriver 2.0 Nm, quick coupling IU 7825-55
Surgical Technique
Proximal Medial Tibia Plate 3.5
•Then remove the drill guide and determine the length of the screw
with the depth gauge. Choose a locking screw (blue) of the appro-
priate length and loosely insert using screwdriver T15. Finally,
tighten the screw using the torque limiter. Optimal fixation is
reached once an audible click is heard. Secure all three proximal
plate holes in this way.
NN
OTE
:
As soon as the head of the screw reaches the plate hole it is
compulsory to switch to the torque limiter. In cases of very
hard bone in the diaphysis it is necessary to make sure that the
screw head is flush to the plate. Therefore it is permissible in
exceptionally hard bone of the diaphysis to finish the screw
without the torque limiter.
NC
AUTION
:
When using lag screws, they must be inserted before using
locking screws!

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•Surgical Technique
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
Fixating the plate shaft
Inserting screws
Surgical Technique
Proximal Medial Tibia Plate 3.5
•First reposition the shaft relative to the tibial plateau, using indirect
repositioning techniques if possible. Then check axis as well as
rotation of the tibia.
•For the primary fixation of the plate shaft, a standard screw can
be inserted into the oblong hole. For this purpose use a double
drill guide and a drill bit ø2.5 and drill to the desired depth.
•Then determine the length of the screw using the depth gauge
and insert a screw of appropriate length using the hexagonal
screwdriver. The plate can be simultaneously pulled against the
shaft using this screw.
NNOTE:
Securing the oblong hole before securing other plate holes can
facilitate the positioning of the plate on the bone.
NNOTE:
If compression of the fracture is necessary, an anatomically
correct and secure fixation of the plate in the periarticular
fragment must first be achieved.
•The gliding holes in the plate shaft can now be used in the
following ways:
•Locking screw (red) with/ without compression
•Standard screw with/ without compression
•For inserting a standard screw use the double drill guide in neutral
position, i.e. center in the plate hole by applying pressure on the
variable end. Drill using a drill bit ø2.5, determine the length of
the screw using the depth gauge and insert a screw of appro-
priate length using the hexagonal screwdriver.
NCAUTION:
The standard cortical screws with small head as well as the
blue locking screws are not suitable for use in a gliding hole!
•After insertion of the first shaft screw or a compression screw, a
clinical examination or check using fluoroscopy is recommended
to assess the alignment of the tibial plateau relative to the tibial
shaft.
Inserting standard
screws

Surgical Technique •
13
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
Inserting locking screws
INSTRUMENTS ART.-NO.
Drill guide for gliding hole LOQTEQ® 3.5, I-ø 2.8, red IU 8166-10
Twist drill ø2.7, L 220, coil 50, quick coupling IU 7427-22
Depth gauge for locking screws, small IS 7904-00
Torque limiting screwdriver 2.0 Nm, quick coupling IU 7825-55
Handle with quick coupling, with torque limiter, 2.0 Nm IU 7707-20
Surgical Technique
Proximal Medial Tibia Plate 3.5
•Screw the threaded drill guide (red) into the desired plate hole,
and drill to the desired depth using the drill bit ø2.7 (blue-red).
•Remove the drill guide and determine the length of the required
screw using the depth gauge. Loosely insert a locking screw (red)
of the appropriate length using the screwdriver T15 and tighten
the screw with the torque limiter. Optimal fixation is reached
once an audible click is heard.
NNOTE:
As soon as the head of the screw reaches the plate hole it is
compulsory to switch to the torque limiter. In cases of very
hard bone in the diaphysis it is necessary to make sure that
the screw head is flush to the plate. Therefore it is permissible
in exceptionally hard bone of the diaphysis to finish the screw
without the torque limiter.

14
•Surgical Technique
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
Interfragmentary compression
using a LOQTEQ® locking screw
Surgical Technique
Proximal Medial Tibia Plate 3.5
INSTRUMENTS ART.-NO.
Basic Insert for load drill guide LOQTEQ® 3.5 IU 8166-05
Load drill guide LOQTEQ® 3.5, compression 1 mm IU 8166-01
Load drill guide LOQTEQ® 3.5, compression 2 mm IU 8166-02
Twist drill ø2.7, L 220, coil 50, quick coupling IU 7427-22
OPTIONAL
Load drill guide LOQTEQ® 3.5, adjustable up to 2 mm IU 8166-03
•Screw the basic insert for load drill guide (IU 8166-05) into a
distal shaft hole or, if necessary, above the fracture line.
Choose a load drill guide in accordance with the compression
distance (1 mm or 2 mm) and position on the basic insert, away
from the fracture gap.
•Alternatively, the adjustable load drill guide (IU 8166-03) can be
used. The fracture gap serves as orientation in the setting of the
compression distance (max. 2 mm). For this purpose, turn the
wheel of the load drill guide until an appropriate gap forms in
the upper part of the instrument and position the drill guide on
the basic insert, away from the fracture gap.
•Drill to the desired depth using a drill bit ø2.7 (blue-red) and
determine the depth with the depth gauge.
NNOTE:
Please refer to the LOQTEQ® Application Notes, pp. 12 and 13.

Surgical Technique •
15
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
Surgical Technique
Proximal Medial Tibia Plate 3.5
•Choose a locking screw (red) of the appropriate length and loosely
insert using screwdriver T15. Finally, tighten the screw using the
torque limiter. Optimal fixation is reached once an audible click is
heard.
NNOTE:
As soon as the head of the screw reaches the plate hole it is
compulsory to switch to the torque limiter. In cases of very
hard bone in the diaphysis it is necessary to make sure that
the screw head is flush to the plate. Therefore it is permissible
in exceptionally hard bone of the diaphysis to finish the screw
without the torque limiter.
•Alternatively, a standard screw can be placed as a compression
screw. For this purpose, use the double drill guide in compression
position (no pressure applied at the opening of the hole away
from the thread) and drill using a drill bit ø2.5.
•When all required screws have been inserted, perform the final
check using fluoroscopic monitoring, AP and lateral views, and
close the wound.

•Surgical Technique
16 aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
Explantation
INSTRUMENTS ART.-NO.
Screwdriver, hexagonal, ø2.5, blue handle IU 7841-00
Screwdriver, T15, Round Handle IU 7811-15
Surgical Technique
Proximal Medial Tibia Plate 3.5
NNOTE:
The screwdrivers (T15) in the set are self-retaining. To achieve
maximum torque during screw removal, we recommend using
the appropriate explantation screwdriver (IU 7811-15). It allows
deeper penetration into the screw head and hence safe screw
removal. It can be ordered separately.
•Place an incision on the old scar. Manually undo all screws and
sequentially remove them.
NNOTE:
After manually undoing all screws, the removal can be perfor-
med in automated mode in the second step.

C1 C2 C3
17
aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
Aside on double plating
Surgical Technique •
Surgical Technique
Proximal Medial Tibia Plate 3.5
•Double plating is most commonly performed for Type C fractures
of the proximal tibia (AO 41-C1/C2/C3).
•Type C3 fractures are among the most difficult proximal tibia
fractures to surgically treat. They require extensive surgical training
and experience. The ultimate goal is anatomic reconstruction with
attention to the necessary vascularization and the soft tissue
situation. In the acute phase, an external fixator is often used for
maintaining and stabilizing leg length while the swelling subsides.
•In the subsequent double plating, the positioning of the plates and
screws depends on the fracture situation. Typically, the fragment is
supported from the medial side using the proximal medial tibia plate
(buttress plating). The plate is positioned antero-medially if possible,
but often also postero-medially. Depending on the situation, the
proximal lateral tibia plate is then used to stabilize the lateral side.
NNOTE:
If possible, the screws are applied bicortically from the medial
side as well. However, they must not interfere with the screws
of the lateral plate.
NNOTE:
When combining lag or standard screws with locking screws,
the lag screws must be placed first.

aap Implantate AG
Lorenzweg 5 •12099 Berlin •Germany
18
• Assembly instructions, load drill guide
•The load drill guide facilitates setting a variable compression path.
It can be disassembled and reassembled in only a few steps.
Disassembly
Assembly
4.2
4.1
3
1
2
5
4.1
4.2 3
1
2
Surgical Technique
Proximal Medial Tibia Plate 3.5
•Remove screws (item 4) using a hexagonal screwdriver SW 2.5
•Unscrew the set screw (item 3)
•Pull the compression block apart (items 1 and 2)
•Fit together the compression block (items 1 and 2)
•Insert the set screw (item 3) into the compression block,
middle hole
•Insert the retaining screws (items 4.1 and 4.2)
using a hexagonal screwdriver SW 2.5