AAP LOQTEQ Proximal Medial Tibia Plate 3.5 User manual

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

1
Proximal Medial Tibia Plate 3.5
Surgical Technique

2
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.

3
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

6
•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

7
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

8
•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