TK News 1|03

.EWS .EW 0RODUCTS FROM !/ $EVELOPMENT

.EWS .UMBER \

$EAR 2EADER

7ORKING WITH SURGEONS FROM ALL OVER THE WORLD AND DIFFERENT SPE CIALTIES ON NEW DEVELOPMENTS AND PRODUCTS IS TRULY ONE OF THE MOST EXCITING TASKS ) EVER HAVE EXPERIENCED )T IS THRILLING TO WATCH HOW AN IDEA FROM A MOTIVATED SURGEON DEVELOPS AS A TEAM EFFORT TOGETHER WITH RESEARCHERS AND ENGINEERS INTO A NEW TECHNOLOGY )T IS ALSO VERY REWARDING TO MEET NEW INTERESTING PEOPLE WHO ARE DEDICATED TO FIND ING SOLUTIONS FOR CLINICAL PROBLEMS ,ET ME ENCOURAGE YOU TO BECOME PART OF THIS GREAT ORGANIZATION AND THE VERY SPECIAL !/ SPIRIT 7E ARE ALWAYS VERY INTERESTED IN YOUR IDEAS AND OR COMMENTS TO EXISTING !/ TECHNIQUES )N THIS ISSUE OF .EW 0RODUCTS FROM !/ $EVELOPMENT WE HAVE ASKED 2AINER 3CHMELZEISEN -$ CHAIRMAN OF THE !/ #RANIOMAXILLOFACIAL %XPERT 'ROUP TO PROVIDE US WITH AN OUTLOOK ON HIS SPECIALTY %VEN IF YOU ARE NOT OPERATING IN THIS AREA ) AM CONVINCED THAT YOU WILL FIND HIS IDEAS IN TISSUE ENGINEERING AND ENDOSCOPY FASCINATING !ND HOPEFULLY IT MAY ALSO MAKE YOU LOOK AT THE NEW CRANIOMAXILLOFACIAL PRODUCTS WITH A DIFFERENT PERSPECTIVE 7ITHIN !/ $EVELOPMENT THE EXCHANGE OF EXPERIENCES AND TECHNOLOGIES BETWEEN SPINE CRANIOMAX ILLOFACIAL GENERAL TRAUMA AND EVEN VETERINARY SURGERY HAS PROVEN TO BE VERY FRUITFUL ) WOULD LIKE TO STRESS THAT NONE OF THE ARTICLES IN THIS BROCHURE ARE A SUBSTITUTE FOR THE RELEVANT /0 4ECHNIQUE AND THE !/ TEACHING TOOLS 0LEASE GET MORE DETAILED INFORMATION ON THE PRODUCTS FROM YOUR LOCAL 3YNTHES REPRESENTATIVE ,AST BUT NOT LEAST A WHOLEHEARTED THANK YOU TO OUR 3YNTHES PARTNERS

WHO HAVE SUPPORTED US IN DIFFERENT WAYS AND TO ALL THE CONTRIBUTORS OF THIS THIRD ISSUE ESPECIALLY TO THE MEDICAL DOCTORS WHO HAVE ALSO PAR TICIPATED IN THE DEVELOPMENT OF THE DESCRIBED PRODUCTS 9OURS FAITHFULLY

.ORBERT 0 (AAS

.EW 0RODUCTS FROM !/ $EVELOPMENT

#ONTENTS

.EWS IN CRANIOMAXILLOFACIAL SURGERY

.EW CRANIOMAXILLOFACIAL PRODUCTS

.EW HAND PRODUCTS

,OCKING $ISTAL 2ADIUS 3YSTEM

.EW ANKLE AND FOOT PRODUCTS

-AXILLARY $ISTRACTOR MM #RANIAL 4UBE #LAMP #RANIAL &LAP 4UBE #LAMP WITH TEXTURED SURFACE 0OINT "ENDING 0LIERS ,OW 0ROFILE .EURO 3YSTEM :YGOMATIC $#0 HOLES WITH CENTER SPACE 3CREW 2EPLENISHMENT $EVICE (EX #OUPLING 3CREWDRIVER -ANDIBLE ,OCKING 0LATE ˆ"ENDING 4EMPLATES 2ATCHETING 3CREWDRIVERˆ.EW (ANDLE 2ESORBABLE 4ACK 3YSTEM )N 3ITU "ENDER #UTTER !UTOMATED 4ACK $RIVER !DJUSTABLE 2ESORBABLE 4AP 2ESORBABLE 3CREWS 2ESORBABLE #ONTOURABLE -ESH 0LATE

.EW KNEE PRODUCTS

.EW PEDIATRIC PRODUCTS

,#0 -ETAPHYSEAL 0LATE

AND 4I $ISTAL &EMORAL .AIL $&.

4ROCHANTERIC &IXATION .AIL 4&.

0ROXIMAL &EMORAL .AIL 0&. ˆ.EW !IMING !RM #OUPLING 3CREW AND 'UIDE 3HAFT !DAPTOR FOR $(3 /RTHOLINEˆ(ARRIS AND +à NTSCHER !DAPTORS 1UICK #OUPLING FOR $(3 $#3 TRIPLE REAMERS !TTACHMENT FOR !CETABULAR AND -EDULLARY 2EAMING !DAPTOR FOR 2ADIOLUCENT $RIVE MM 3TEINMANN 0INS WITH CENTRAL THREAD !DJUSTABLE ,ARGE %XTERNAL &IXATOR MM #ANNULATED 3CREW MM 'UIDE 7IRE MM LONG MM #ANCELLOUS "ONE 3CREW WITH MM THREAD MM ,OCKING 3CREW ,# $#0 AND

 4ODDLER /STEOTOMY 0LATE

.EW SPINE PRODUCTS

4OMO&IXˆ/STEOTOMY 'AP -EASURING $EVICE

.EW LONG BONE PRODUCTS

-ODULAR &OOT 3ETˆ!DDITIONS

#ERVIOS #ERVIOS CHRON/3 AND INSTRUMENTS 3YN#AGE ,2 6ERTEBRAL 3PACER 02 0,)6)/3 6ERTEBRAL 3PACER 42 42!6)/3 6)3)/3 3YN-ESHˆ!DDITIONS !DDITIONAL !#& 3PACER INSTRUMENTS !DDITIONAL 0,)& INSTRUMENTS $UAL /PENING 533 .EW INSTRUMENTS FOR 0EDIATRIC 533 0EDICLE 0REPARATION INSTRUMENTS %XTRACTION INSTRUMENTS FOR DAMAGED #LICK 8 ,OCKING #APS 3YN&RAME 2ETRACTOR (OLDER

%ARLY CLINICAL EXPERIENCE WITH THE ,#0 SYSTEM

"IORESORBABLE POLYLACTIDE MESH IMPLANTS

4+ 2ECOGNITION 0RIZE

0ORTRAIT OF #HRISTOPH 3OMMER

.EW PRODUCTS FROM !/ )NTERNATIONAL

2AINER 3CHMELZEISEN

.EWS IN CRANIOMAXILLOFACIAL SURGERY

&IG #ONTROL VIEW FOLLOWING ENDOSCOPIC ASSISTED REDUCTION AND FIXATION OF A RIGHT CONDYLAR FRACTURE

&IG 0RE AND POSTOPERATIVE X RAYS OF A SEVERE DISLOCATED FRACTURE OF THE LEFT MANDIBULAR BODY IN A YEAR OLD MAN &IXATION WITH TWO ,OCKED -ANDIBLE 0LATES SMALL AND MEDIUM

4HE #RANIOMAXILLOFACIAL %XPERT 'ROUP -&%' IS WORKING TOWARDS INNOVATIVE AP PROACHES AND WIDENING THE SCOPE OF PRODUCTS FOLLOWING CLINICAL TESTINGS IN CRANIOMAXILLO FACIAL SURGERY 0RIORITIES OF THE GROUP ARE EXPANDING APP LICATIONS OF IMPLANTS IN NEUROSURGERY AND SKULL BASE SURGERY BIOTECHNOLOGY AND NEW ENDOSCOPIC TECHNIQUES )N CRANIOMAXILLO FACIAL TRAUMA NEW TECHNIQUES OF ENDOSCOPIC FRACTURE REDUCTION AND PLATE FIXATION HAVE BEEN INITIALIZED AND CONTINUOUSLY IMPROVED &OLLOWING THE PRESENTATION OF A PROTOTYPE FOR ENDOSCOPIC FIXATION OF CONDYLAR FRACTURES AT THE %XPERT 'ROUP -EETING IN THE CONSTANT ACTIVITY OF THE GROUP IN CLOSE CO OPERATION ESPECIALLY WITH 3YNTHES 53! AND !/ $EVELOPMENT IN $AVOS LED TO A COM PLETELY NEW SET FOR THE INTRAORAL TREATMENT OF CONDYLAR FRACTURES -EANWHILE THERE IS A WORLDWIDE NEED FOR CONTINUING EDUCATION OF THIS NEW TYPE OF SURGERY &IRST STEPS ARE BEING UNDERTAKEN FOR ENDOSCOPIC TREATMENT OF ORBITAL AND FRONTAL SINUS INJURIES &IG 4HE DEVELOPMENT OF ENDOSCOPIC TECHNIQUES IS PARALLELED BY A WIDESPREAD CLINICAL APPLICA TION OF LOCKING SYSTEMS IN CRANIOMAXILLOFACIAL SURGERY )T IS EXPECTED USING THESE SYSTEMS

THAT ACT AS AN INTERNAL FIXATOR MAY SIGNIFI

.EWS IN CRANIOMAXILLOFACIAL SURGERY

CANTLY DROP THE COMPLICATION RATE &IG 4HESE SYSTEMS MAY HAVE IMPLICATIONS ON THE WORK OF OTHER %XPERT 'ROUPS AS FOR EXAMPLE

IN HAND SURGERY %STABLISHING SYSTEMS FOR COMPUTER AIDED SUR GERY AND NAVIGATION IN CRANIOMAXILLOFACIAL SURGERY HAS BEEN DISAPPOINTING 5P TO NOW

IT HAS NOT BEEN POSSIBLE TO ESTABLISH TOOLS THAT MATCH THE POSSIBILITIES OF COMPARABLE SYSTEMS #OMPUTER AIDED SURGERY AND NAVIGA TION IS REGARDED AS A hDOOR OPENERv FOR CLINICAL RESEARCH IN MANY CLINICS AND FURTHER ATTEMPTS SHOULD BE MADE TO DEVELOP CRANIOMAXILLO FACIAL NAVIGATION UP TO A STATE OF THE ART LEVEL IN THE !/ ! STEADY DEVELOPMENT HAS BEEN ACHIEVED IN BIOTECHNOLOGY !N IMPORTANT EVENT WAS THE "IOTECHNOLOGY -EETING IN &REIBURG HELD ON -ARCH

WITH THE #HAIRMAN .ORBERT (AAS AND THE #HAIRMEN OF THE -& AND THE 3HOULDER %XPERT 'ROUPS -ORE THAN PARTICIPANTSˆINTERNATIONALLY KNOWN SCIEN TISTS PRODUCERS AND SURGEONSˆCONTRIBUTED TO THIS MEETING 4OPICS INCLUDED CELL PROLIFERA TION BONE SUBSTITUTE MATERIALS GENE THERAPY

AND GROWTH FACTORS 4HIS ACTIVITY IS EXPECTED TO INCREASE WITHIN THE !/ IN THE FUTURE AN OTHER SYMPOSIUM ON BIOTECHNOLOGY AND ITS FUTURE ASPECTS IN THE !/ WILL BE HELD NEXT YEAR 7ITH INCREASING DEMAND FOR SPECIALIZED KNOWLEDGE IN AREAS OTHER THAN IMPLANTS THE -&%' WILL STEADILY INVOLVE EXPERTS OF OTHER FIELDS IN ITS MEETINGS $URING THE LAST MEETING OF THE 'ROUP IN 4UCSON !RIZONA AN INTER NATIONALLY WELL KNOWN SCIENTIST $R #ESAR 'UERRERO FROM 6ENEZUELA PRESENTED HIS OUT STANDING EXPERIENCE WITH THE APPLICATION OF DISTRACTORS IN CRANIOMAXILLOFACIAL SURGERY "UILDING UP NETWORKS AND INVOLVING SPECIAL ISTS OF NON !/ SPECIFIC FIELDS WILL NOT ONLY BE THE FUTURE CHALLENGE FOR THE CRANIOMAXILLO FACIAL GROUP WITHIN THE !/ 7E WOULD REGARD THE ABBREVIATION !/ IN THAT ENVIRONMENT TO READ AS hALWAYS OPENv AS AN ESSENTIAL PRECON DITION TO MAINTAINING LEADERSHIP IN INNOVA TION AND QUALITY ASSURANCE IN TRAUMATOLOGY AND RECONSTRUCTIVE SURGERY

2AINER 3CHMELZEISEN

.EW CRANIOMAXILLOFACIAL PRODUCTS -AXILLARY $ISTRACTOR 4HE -AXILLARY $ISTRACTOR IS A COMPLETELY INTRAORAL DISTRAC TOR DESIGNED TO MEET THE CLINICAL NEEDS FOR A DISTRACTION DEVICE THAT CAN CORRECT SEVERE MAXILLARY BONE DEFICIENCES IN BOTH !0 AND VERTICAL DIRECTIONS )T IS ADVANTAGEOUS FOR PATIENTS WITH MAXILLARY HYPOPLASIA PARTICULARLY CLEFT LIP AND PALATE PATIENTS DUE TO ITS ABILITY TO OVERCOME THE SUBSTANTIAL SOFT TISSUE FORCES AROUND THE MAXILLA 4HE -AXILLARY $ISTRACTOR INCLUDES A POSTERIOR FOOT PLATE AND AN ANTERIOR FOOT PLATE WHICH ARE COMPLETELY INTERCHANGE ABLE AND PINNED TO THE BODY OF THE DISTRACTOR /VERALL THE -AXILLARY $ISTRACTOR OFFERS FOUR DISTRACTOR LENGTHS AND THE ABILITY TO CREATE CUSTOM SIZES WITH THE AVAILABLE FOOT PLATE OPTIONS

MM #RANIAL 4UBE #LAMP LINE EXTENSION 4HE #RANIAL 4UBE #LAMPS RAPIDLY REATTACH A CRANIAL BONE FLAP BACK TO THE SKULL AFTER A CRANIOTOMY 4HEY PROVIDE RIGID FIXATION TO PROTECT THE BRAIN AND TO ENCOURAGE HEALING OF HARD AND SOFT TISSUES 7HEN USED OVER A BURR HOLE THE #RANIAL 4UBE #LAMP ALSO HELPS PREVENT TISSUE FROM ENTERING OR EXITING THE CRANIUM FURTHER PROTECTING THE BRAIN AND IMPROVING COSMESIS 4HE MM #LAMP UTILIZES TWO MM DIAMETER DISCS IN CONJUNCTION WITH A STANDARD LENGTH TUBE SHAFT #RANIAL &LAP 4UBE #LAMP WITH TEXTURED SURFACE LINE EXTENSION 4HE #RANIAL &LAP 4UBE #LAMPS WITH TEXTURED SURFACE RAPIDLY REATTACH A CRANIAL BONE FLAP BACK TO THE SKULL AFTER A CRANIOTOMY 7HEN CREATING CRANIOTOMIES IN THE POSTERIOR REGIONS OF THE CRANIUM THERE ARE AREAS OF GREATER CONCAVITY ON THE INTERIOR SURFACE OF THE CRANIUM $UE TO ITS HIGHER SURFACE ROUGHNESS THE #RANIAL &LAP 4UBE #LAMP WITH TEXTURED SURFACE ENABLES THE CLAMP TO GRIP THE BONE MORE AGGRESSIVELY WHICH INCREASES THE RIGIDITY OF THE FIXATION 0OINT "ENDING 0LIERS 4HE 0OINT "ENDING 0LIERS ALLOW BENDING OF THE -IDFACIAL 0LATES AND WITH CENTER SPACE USING ONE PAIR OF BENDING PLIERS ONLY 4HE PLIERS ALLOW BENDING IN PLANE BY MEANS OF THE THREE PRONGS ON THE TIP OF THE BENDER IN PLANE BY MEANS OF THE GROOVE IN THE TIP OF THE BENDER

AND OUT OF AND BY THE hSCISSORv LIKE TIP OF THE BENDER 4HE PLIERS CANNOT BE USED FOR BENDING PLATES WITHOUT CENTER SPACE SINCE THE SCREW HOLES WOULD BE DEFORMED

.EW CRANIOMAXILLOFACIAL PRODUCTS

,OW 0ROFILE .EURO 3YSTEM 4HE ,OW 0ROFILE .EURO 3YSTEM OFFERS A COMPLETE LINE OF PLATES SCREWS

MESHES AND INSTRUMENTS DESIGNED TO CLOSE BONE FLAPS QUICKLY ENA BLING STABLE INTERNAL FIXATION AND ADDRESSING ESPECIALLY NEUROSURGICAL PROBLEMS WITH THE LOWEST PLATE SCREW PROFILE OF ANY SELF DRILLING PROD UCT AVAILABLE ON THE MARKET 4HE ,OW 0ROFILE .EURO 3YSTEM INCLUDES ALL PLATES AND MESHES CURRENTLY AVAILABLE IN THE #RANIAL 3YSTEM AND AS WELL AS THE NEW 4I ,OW 0ROFILE .EURO 3TRUT 0LATES AND THE NEW 4I ,OW 0ROFILE .EURO !DAPTION 0LATES 4HE ,OW 0ROFILE .EURO 3YSTEM OFFERS NEW 4I ,OW 0ROFILE .EURO 3ELF $RILLING #RANIAL 3CREWS WITH GREATER STRENGTH AND AN IMPROVED CRUCIFORM DRIVE SYSTEM THAT DELIVERS SUPERIOR BLADE SCREW RETENTION AND OFF AXIS STABILITY

3CREW 2EPLENISHMENT $EVICE 2ESTOCKING OF MODULES WITH SCREWS ESPECIALLY WITH VERY SMALL AND SHORT SCREWS IS A VERY FIDDLY AND TIME CONSUMING WORK 4HIS SCREW LOADER IS DESIGNED FOR EASIER AND FASTER RESTOCKING OF SMALL SCREWS INTO MODULES )T WORKS FOR

AND MM SCREWS

(EX #OUPLING 3CREWDRIVER (ANDLES AND "LADES LINE EXTENSION 4HREE NEW (EX #OUPLING (ANDLES IN THE DIMENSIONS SMALL MEDIUM

AND LARGE ARE AVAILABLE 4HE (ANDLES HAVE A TEXTURED DISTAL END WHICH DISTINGUISHES THEM FROM THE MINI QUICK HANDLES 4HE NEW

AND MM #RUCIFORM "LADES WITH HOLDING SLEEVE AND (EX #OUPLING COME IN A LONG AS WELL AS A SHORT VERSION AND ARE ALSO USABLE FOR BIORESORBABLES 4HE NEW (OLDING 3LEEVE FEATURES A DEFINITIVE SNAP WHEN THE SLEEVE ENGAGES THE SCREW AND IS EASIER TO ASSEMBLE AND DISASSEMBLE

-ANDIBLE ,OCKING 0LATE ˆ"ENDING 4EMPLATES 4HE "ENDING 4EMPLATE FOR THE -ANDIBLE ,OCKING 0LATE HELPS CONTOURING OF THE PLATE 4HE TEMPLATES ARE MANUFACTURED OUT OF !, &. WHICH IS AN ALUMINIUM ALLOY WELL SUITED FOR THIS APPLICA TION DUE TO ITS STRENGTH AND DUCTILITY

:YGOMATIC $#0 HOLES WITH SPACE 4HE :YGOMATIC $#0 WITH HOLES AND CENTER SPACE IS A LINE EXTEN SION OF THE EXISTING HOLE :YGOMATIC $#0 WITH THE SAME DIMEN SIONS 4HE NEW PLATE IS MORE STABLE AND OFFERS A LARGER DISTANCE TO BRIDGE THE FRACTURE .EW CRANIOMAXILLOFACIAL PRODUCTS

2ATCHETING 3CREWDRIVERˆ.EW (ANDLE 4HE NEW 2ATCHETING 3CREWDRIVER FOR MANUAL INSERTION AND PLACE MENT OF 3YNTHES MM MM AND MM MAXILLOFACIAL SCREWS FEATURES A MORE ERGONOMIC HANDLE MADE OF STANDARD MEDICAL GRADE PHENOLIC AND STAINLESS STEEL 4HE SCREWDRIVER HAS THREE OPERATION POSI TIONSˆFORWARD RATCHET REVERSE RATCHET AND LOCKED )T TAKES 3YNTHES MAXILLOFACIAL HEX COUPLING BLADES TAPES

)N 3ITU "ENDER #UTTER 4HE )N 3ITU "ENDER #UTTER PROVIDES SURGEONS WITH A SIMPLE DEVICE FOR HEATING AND CUTTING RESORBABLE IMPLANTS IN SITU OR AWAY FROM THE SUR GICAL SITE 4HE )N 3ITU "ENDER #UTTER CONSISTS OF A PLASTIC HAND PIECE

WHICH HOUSES TWO !! BATTERIES AND A CHOICE OF THREE HEATING CUTTING ATTACHMENTS WIDE PLATE HEATING NARROW PLATE HEATING AND CUTTING ATTACHMENT 4HE DEVICE IS STERILE PACKAGED

!UTOMATED 4ACK $RIVER 4HE !UTOMATED 4ACK $RIVER SIMPLIFIES THE INSERTION OF THE 3YNTHES X MM RESORBABLE TACKS )T ALSO REDUCES THE GROSS FORCES APPLIED TO THE SURROUNDING BONE DURING INSERTION WITH THE CURRENT INSTRUMEN TATION 4HE !UTOMATED 4ACK $RIVER INSERTS THE TACKS INTO PREDRILLED HOLES VIA AN INTERNAL SPRING POWERED SHAFT 0RIOR TO EACH INSERTION

THE SPRING IS COMPRESSED MANUALLY BY DEPRESSING THE INSTRUMENT TIP ON A STERILE SURFACE OR DIRECTLY ON A TACK ITSELF 4HE INSERTION FORCE CAN BE MODIFIED INTRAOPERATIVELY DEPENDING ON THE PATIENT S BONE QUALITY AND THE SURGEON S PREFERENCE 4HE !UTOMATED 4ACK $RIVER CAN BE DIS ASSEMBLED WITHOUT TOOLS FOR POSTOPERATIVE CLEANING

X MM 4ACK AND %MERGENCY 4ACKS FOR THE 2ESORBABLE 4ACK 3YSTEMS AND LINE EXTENSION 4HE 3YNTHES 2ESORBABLE 4ACK 3YSTEM PROVIDES SURGEONS WITH A MEANS FOR FAST AND SIMPLE FIXATION OF RESORBABLE PLATES TO BONE IN CRANIOFACIAL RECONSTRUC TION AND FRACTURE REPAIR 4HE TACKS ARE ALSO INDICATED FOR USE IN MANDIBULAR AUGMENTATION PROCEDURES BY CONTAINING BONE GRAFTS USING RESORBABLE MESHES OR SHEETS 4HIS LINE EXTENSION INCLUDES X MM 4ACKS FOR THINNER PEDIATRIC BONE AND %MERGENCY 4ACKS FOR THE 3YSTEMS AND AS WELL AS A NEW MM 4ACK $RIVER WITH (OLDING 3LEEVE A MM SELF RETAINING (OLDING 3LEEVE AND THREE NEW MM $RILL "ITS

.EW CRANIOMAXILLOFACIAL PRODUCTS

!DJUSTABLE 2ESORBABLE 4AP 4HE IMPLANTATION OF RESORBABLE SCREWS REQUIRES PREDRILLED SCREW HOLES AND TAPPING WITH THE EXISTING 3ELF $RILLING 4APS FOR THE 2ESORBABLE &IXATION 3YSTEM 4HESE TAPS ARE SPECIFIC TO DIAMETER AND LENGTH OF EACH SCREW 4HE NEW !DJUSTABLE 2ESORBABLE 4APS FOR THE EXISTING ELEV EN MM MM AND MM 2ESORBABLE #ORTEX 3CREWS ARE MORE VERSATILE REDUCING THE NUMBER OF NECESSARY TAPS TO SIX

2ESORBABLE 3CREWS LINE EXTENSION 4HE MM 2ESORBABLE #ORTEX 3CREW LINE IS NOW ALSO AVAILABLE IN MM MM AND MM LENGTH FOR VARYING BONE THICKNESS 4HE SCREWS ARE MADE OF POLY , $, LACTIDE AND ARE COMPATIBLE WITH THE EXISTING 2ESORBABLE 0LATES -ESHES AND 3CREWDRIVER LADES 4HE X MM 2ESORBABLE #ORTEX 3CREWS COME WITH NEW TAPS IN MINI QUICK AND HEX COUPLINGS 4HE X MM AND X MM SCREWS USE THE NEW !DJUSTABLE 2ESORBABLE 4AP

2ESORBABLE #ONTOURABLE -ESH 0LATE 4HE 2ESORBABLE #ONTOURABLE -ESH 0LATES CONFORM TO THE IRREGULAR SHAPE OF THE SKULL WITHOUT FOLDING OR WRINKLING DURING CONTOUR ING AND PROVIDE TEMPORARY FIXATION OF BONE FRAGMENTS OR BONE GRAFT CONTAINMENT #ONTOURING IS EASY AND POSSIBLE IN THREE DIMENSIONS )NDICATIONS ARE MAINTAINING POSITION AND OR CONTAINING BONY FRAG MENTS BONE GRAFTS ALLOGRAFT OR AUTOGRAFT OR BONE GRAFT SUBSTITUTES OR MANDIBULAR RECONSTRUCTIONS 4HE MESH PLATES ARE ALSO INDICATED TO PREVENT SOFT TISSUE PROLAPSE AT BONE GRAFT DONOR SITES 4HE MESH PLATES ARE COMPATIBLE WITH THE EXISTING 2ESORBABLE &IXATION 3YSTEM TACKS AND SCREWS THEY ARE -2) #4 COMPATIBLE 4HE SURGEON CAN CHOOSE BETWEEN A ROUND OR SQUARE SHAPE MM OR MM DIAMETER AND A THICKNESS OF MM MM OR MM

!NDRÏ 'ËCHTER

.EW KNEE PRODUCTS 4OMO&IX /STEOTOMY 'AP -EASURING $EVICE 4HE 4OMO&IX 'AP -EASURING $EVICE ENABLES SIMPLE MEASURING OF THE DEPTH OF THE OSTEOTOMY GAP AND DETERMINATION OF THE SUITABLE CHRON/3 BLOCK IF USED

.EW CRANIOMAXILLOFACIAL KNEE PRODUCTS

#HRISTIAAN VAN DER 7ERKEN

.EW LONG BONE PRODUCTS ,#0 -ETAPHYSEAL 0LATE

AND 4HE ,#0 -ETAPHYSEAL 0LATE IS INDICATED FOR FRACTURES IN THE META PHYSEAL AREAS WHICH REACH INTO THE PROXIMAL AND DISTAL SHAFT OF THE HUMERUS PROXIMAL AND DISTAL TIBIA AS WELL AS FIBULA AND PROXIMAL

AND DISTAL RADIUS AS WELL AS ULNA 4HE ,#0 COMBINATION HOLES PROVIDE A CHOICE OF DYNAMIC COMPRESSION AND OR ANGULAR STABILITY IN ONE IMPLANT 4HE DENSE NET OF ,#0 COM BINATION HOLES IN THE THINNED PLATE AREA ALLOWS A CLOSER INSERTION OF THE SCREWS AND THEREFORE PROVIDES A HIGHER PURCHASE WITH BETTER STABILITY 4HE LONG HOLE HELPS TO OPTIMIZE FINE TUNING OF THE REDUCTION IN THE LONGITUDINAL AXIS ! BULLET TIP ENABLES EASIER APPLICATION OF A MINI MALLY INVASIVE SURGICAL TECHNIQUE 4HE SMALL HOLE IS INTENDED FOR TEM PORARY FIXATION WITH A + WIRE 4HE THINNED PLATE PROFILE ESPECIALLY DESIGNED FOR THE DISTAL ENDS PROVIDES EASY CONTOURING OF THE PLATE AND TAKES THE PECULIARITIES OF THE METAPHYSEAL AREA INTO ACCOUNT 4HE ANGULATION OF THE TWO OUTERMOST HOLE UNITS TOWARDS THE CENTER OF THE THINNED PLATE AREA ALLOWS A CLOSER JUXTA ARTICULAR PLATE PLACEMENT 4HE PLATE S UNDERCUTS MAINTAIN GOOD VASCULARIZATION OF THE PERIOST 4HE ,#0 -ETAPHYSEAL 0LATE IS AVAILABLE IN STAINLESS STEEL AND TITANIUM AND IS FULLY COMPATIBLE WITH THE INSTRUMENTS AND IMPLANTS OF THE ,#0 3YSTEM

YEAR OLD WOMAN CLOSED FRACTURE TYPE # WITH MINIMAL SOFT TISSUE INJURY AFTER SKIING ACCIDENT -INIMALLY INVASIVE PLATE OSTEOSYNTHESIS OF THE TIBIA !0 AND LATERAL X RAYS POSTOPERATIVE VIEWS AND WEEKS FOLLOW UP 7EIGHT BEARING OF INTIALLY KG WAS INCREASED TO KG AT WEEKS PATIENT IS PAIN FREE

4I $ISTAL &EMORAL .AIL $&. !DDITIONAL .AIL ,ENGTHS AND MM 4I ,OCKING 3CREWS 4HE 4ITANIUM $ISTAL &EMORAL .AIL $&. IS NOW AVAILABLE IN ADDITIONAL SIZES OF MM MM AND MM IN ALL DIAMETERS TO BETTER ACCOMMODATE PATIENTS ANATOMY 4HE EXISTING MM 4I ,OCKING 3CREW LINE HAS BEEN EXTENDED WITH SIZES MM MM AND MM FOR SMALLER PATIENTS .EW LONG BONE PRODUCTS

4ROCHANTERIC &IXATION .AIL 4&.

4HE 4&. IS A NEW CANNULATED INTRAMEDULLARY NAIL SYSTEM )T IS INDI CATED IN STABLE AND UNSTABLE FRACTURES OF THE PROXIMAL FEMUR INCLUD ING PERTROCHANTERIC INTERTROCHANTERIC BASAL NECK FRACTURES AS WELL AS A COMBINATION THEREOF !DDITIONALLY THE LONG 4&. IS INDICATED IN HIGH AND LONG SUBTROCHANTERIC FRACTURES PERTROCHANTERIC FRACTURES ASSOCIATED WITH AN INJURED SHAFT PATHOLOGICAL FRACTURES OF OSTEO POROTIC BONE IN BOTH TROCHANTERIC AND DIAPHYSEAL AREAS PROXIMAL OR DISTAL NONUNIONS MALUNIONS AND REVISIONS 4HE HELICAL BLADE PROVIDES IMPROVED RESISTANCE TO VARUS COLLAPSE AND ROTATIONAL CONTROL OF THE HEAD NECK FRACTURE SEGMENT 4HE RESULT IS SUPERIOR LIFE TO CUT OUT VERSUS SINGLE SCREW FIXATION AND REDUCED BONE REMOVAL VERSUS A TRADITIONAL HIP SCREW 4HE 4&. IS MADE OF TITANIUM ALLOY 4I !) .B AND AVAILABLE IN LENGTHS FROM MM TO MM 4HE 4&. IS AT THE MOMENT ONLY AVAILABLE IN 353! AND 3TRATEC TER RITORIES

0ROXIMAL &EMORAL .AIL 0&. .EW !IMING !RM 4HE NEW !IMING !RM FOR THE 0ROXIMAL &EMORAL .AIL 0&.

IS MANUFACTURED IN CARBON FIBRE REINFORCED 0%%+ 0OLY %THER %THER +ETONE MATERIAL WHICH INCREASES MECHANICAL AND THERMAL STABILITY 4HE GUIDING DISTANCE WAS INCREASED TO REDUCE THE EFFECT OF MATERIAL WEAR 4HE HEIGHT HAS BEEN INCREASED FOR LONGER GUIDANCE OF THE DRILL SLEEVES AND BIGGER LABELING

#OUPLING 3CREW AND 'UIDE 3HAFT !DAPTOR FOR $(3 /NE 3TEP ,AG 3CREW 4HIS NEW DEVICE ALLOWS THE USE OF STANDARD $(3 INSTRUMENTATION TO IMPLANT A /NE 3TEP ,AG 3CREW 4HE 'UIDE 3HAFT !DAPTOR FOR $(3 /NE 3TEP ,AG 3CREW FITS INTO THE TRUNCATED HEX RECESS OF A /NE 3TEP ,AG 3CREW 4HE #OUPLING 3CREW !DAPTOR SECURES THE 'UIDE 3HAFT !DAPTOR TO THE /NE 3TEP ,AG 3CREW 4HE STANDARD $(3 WRENCH THEN FITS OVER THE ASSEMBLY FOR INSERTION 4HE PLATE IS PLACED OVER THE INSERTED ,AG 3CREW AS IN STANDARD $(3 TECHNIQUE 4HE #OUPLING 3CREW AND 'UIDE 3HAFT !DAPTOR ENABLE CLINICS TO UP GRADE THEIR $(3 SYSTEMS TO THE 3YNTHES $(3 /NE 3TEP ,AG 3CREW WITHOUT NEEDING TO PURCHASE NEW INSTRUMENT SETS

.EW LONG BONE PRODUCTS

/RTHOLINE (ARRIS !DAPTOR AND +àNTSCHER !DAPTOR 4HE (ARRIS !DAPTOR AND +àNTSCHER !DAPTOR HAVE THE SAME FUNCTION AS THE (UDSON OR 4RINKLE !DAPTOR BUT A DIFFERENT COUPLING MECHANISM FOR THE DIFFERENT REAMER SHAFTS 4HE NEW ADAPTORS PERMIT USE OF 3YNTHES 0OWER 4OOLS WITH REAMERS FROM COMPETITORS

1UICK #OUPLING FOR $(3 $#3 TRIPLE REAMERS FOR #OMPACT !IR $RIVE 0OWER $RIVE 4HE NEW 1UICK #OUPLING FOR $(3 $#3 TRIPLE REAMERS PROVIDES EASIER INSERTION COUPLING AND EXTRACTION OF THE TRIPLE REAMER SHAFTS THAN THE EXISTING DEVICE !TTACHMENT FOR !CETABULAR AND -EDULLARY 2EAMING WITH REVERSE 4HE NEW ATTACHMENT FOR ACETABULAR AND MEDULLARY REAMING HAS THE ADDITIONAL FEATURE OF A REVERSE GEAR !DAPTOR FOR 2ADIOLUCENT $RIVE FOR "ATTERY 0OWER ,INE 4HE ADAPTOR PERMITS TO USE THE "ATTERY 2EAMER WITH THE 2ADIOLUCENT $RIVE AND TRANSFORMS THE SPEED OF THE HANDPIECE TO THE OPTIMAL SPEED FOR THE 2ADIOLUCENT $RIVE 4HE ADAPTOR IS DIRECTLY CONNECTED TO THE "ATTERY 2EAMER HENCE NO EXTRA COUPLING DEVICE IS NEEDED MM 3TEINMANN 0INS WITH CENTRAL THREAD 4HE ADDITIONAL MM 3TEINMANN 0INS WITH CENTRAL THREAD IN MM

MM MM AND MM LENGTH ARE INDICATED FOR KNEE OR ANKLE FUSIONS IN OBESE PATIENTS OR INJURIES WITH SEVERE SWELLING 4HE PINS ARE PART OF THE ,ARGE %XTERNAL &IXATOR 3ET $ANKWARD (ÚNTZSCH

YEAR OLD MAN !0 AND LATERAL X RAYS

PRE AND POSTOPERATIVE

!DJUSTABLE ,ARGE %XTERNAL &IXATOR 4HE !DJUSTABLE ,ARGE %XTERNAL &IXATOR IS INDICATED FOR FRACTURES OF THE TIBIA AND FEMUR JOINT BRIDGES AND OSTEOTOMIES )TS PIVOTING 4 CLAMP AND CONVERGENT PIN SLOTS ALLOW FOR FIXATION OF SHAFT FRACTURES AS WELL AS OF TIBIAL PILON AND PLATEAU FRACTURES 4HE RADIOLUCENT PRE ASSEMBLED FIXATOR IS APPLIED TO THE BONE USING A MINIMUM OF FOUR 3CHANZ SCREWS THROUGH TWO PIN CLAMPS 4HE BODY OF THE !DJUSTABLE ,ARGE %XTER NAL &IXATOR IS OF RADIOLUCENT FIBRE REINFORCED 0%%+ 4HE OVERALL LENGTH RANGES FROM MM TO MM DEPEND ING ON CLAMPS AND DISTRACTOR TRAVEL 4HE PIN PLACEMENT FOR THE INNERMOST PINS RANGES FROM MM TO MM )T FEATURES TWO SPRING LOADED POSITION PIN CLAMPS -, !0 ANGULATION TORSION OF IN EACH DIRECTION AND GROSS MM AND FINE MM DISTRACTION COMPRESSION 4HE !DJUSTABLE ,ARGE %XTERNAL &IXATOR IS EQUIPPED WITH NEW 2EDUCTION (ANDLES A MM #OMBINATION 4 7RENCH AND A MM #OMBINATION 7RENCH .EW LONG BONE PRODUCTS

MM #ANNULATED 3CREWS 4HE MM #ANNULATED 3CREW IS A LINE EXTENSION OF THE EXISTING MM #ANNULATED 3CREW FOR USE IN PATIENTS WITH SMALLER BONES SUCH AS SMALLER ELDERLY FEMALES AND ADOLESCENTS )T MAKES IT EASIER TO FIT THREE SCREWS IN THE FEMORAL NECK AND FURTHERMORE IT FITS BETTER THROUGH THE METAPHYSEAL HOLES IN SOME PLATES 4HE MM #ANNULATED 3CREW IS USED WITH A MM 'UIDE 7IRE 4HE MM #ANNULATED 3CREW IS AVAILABLE IN LENGTHS OF MM AND MM AS WELL AS WITH DIFFERENT THREAD LENGTHS 4HE CUTTING FLUTE HAS BEEN SHORTENED )T IS MADE OF , AND 4!.

MM 'UIDE 7IRE FOR MM #ANNULATED 3CREWS 4HE LONGER MM THREADED 'UIDE 7IRE FOR THE MM #ANNULATED 3CREW SET IS ADVANTAGEOUS FOR PROCEDURES IN OBESE PATIENTS WITH MORE THAN THE USUAL AMOUNT OF SOFT TISSUESˆESPECIALLY IN PELVIC INJURIES

MM #ANCELLOUS "ONE 3CREWS WITH MM THREAD LENGTH 4HE MM #ANCELLOUS "ONE 3CREW WITH A MM THREAD PROVIDES SURGEONS WITH AN ADDITIONAL OPTION FOR STABLE FIXATION OF METAPHYSEAL FRACTURES AND JOINT FUSIONS 4HESE SCREWS IMPROVE SCREW HOLD IN THE FAR FRAGMENT IN CASE OF A FRACTURE OR FAR BONE IN CASE OF A JOINT FUSION WHEN A MM THREAD IS TOO SHORT AND A MM #ANCELLOUS 3CREW WITH MM THREAD WOULD CROSS THE FRACTURE LINE OR JOINT IN CASES OF ARTHRODESIS

MM ,OCKING 3CREWS LINE EXTENSION 4HE MM ,OCKING 3CREW LINE EXTENSION IS AN ADDITION TO THE 3MALL &RAGMENT ,#0 SET )T PROVIDES LONGER LENGTH RANGING FROM MM TO MM FOR USE IN METADIAPHYSEAL AREAS 4HE SCREWS FEATURE A 4 3TARDRIVE˜ HEAD LOCKING THREADS AND ARE SELF TAPPING &OR MORE INFORMATION ABOUT THE CHANGE TO 3TARDRIVEˆAS THE NEW !/ STAND ARDˆSEE PAGE IN .EWS

,# $#0 AND ,# $#0 LINE EXTENSION 4HE ,# $#0 0LATES AND ARE INTENDED FOR TREATING FRACTURES

OSTEOTOMIES AND REPLANTATION OF SMALL BONES INCLUDING HAND ANKLE

AND FOOT AS WELL AS LONG BONE FRACTURES IN THE VETERINARY PATIENTSˆ CANINES AND FELINES 4HE ,# $#0 LINE IS EXTENDED BY THE HOLE AND HOLE ,# $#0 AS WELL AS THE HOLE AND HOLE THROUGH HOLE ,# $#0 !DDITIONALLY THE ,# $#0 INCORPORATES ROUNDED

CHAMFERED EDGES TO AID IN PERCUTANEOUS PLACEMENT AND TO DECREASE THE RISK OF SOFT TISSUE IRRITATION

.EW LONG BONE PRODUCTS

*ESSE " *UPITER

.EW HAND PRODUCTS ,OCKING $ISTAL 2ADIUS 3YSTEM 4HE ,OCKING $ISTAL 2ADIUS 3YSTEM CONSISTS OF THE NEW PLATES ,#0 4 0LATE ,#0 2ADIAL #OLUMN 0LATE ,#0 , 0LATE ,#0 $ISTAL 2ADIUS 0LATE DORSAL P 0LATE ,#0 6OLAR 0LATE AND ,#0 6OLAR "UTTRESS 0LATE 4HE MM ,OCKING (EAD 3CREW SELF TAPPING THE MM #ORTEX 3CREW SELF TAPPINGˆBOTH WITH 3TARDRIVE RECESSˆAND SPECIAL INSTRUMENTS COMPLETE THE NEW SYSTEM 4HIS VARIETY OF PLATES ALLOWS FRAGMENT SPECIFIC TREATMENT OF ALL PATTERNS OF DISTAL RADIAL FRACTURES )NDICATIONS ARE SIMPLE AND DISPLACED EXTRAARTICULAR AND INTRAARTICULAR DISTAL RADIAL FRACTURES AND CORRECTIVE OSTEOTOMIES OF THE DISTAL RADIUS !LL IMPLANTS ARE MANUFACTURED IN 4I -O RESULTING IN EXCELLENT BENDING PROPERTIES AND RESISTANCE TO FATIGUE FAILURE ALLOW ING REVERSE BENDING 4HE EDGES OF ALL PLATES ARE CHAMFERED TO REDUCE SHARP EDGES THAT COULD CONTRIBUTE TO IRRITATION OF TENDONS 3URFACES ARE POLISHED TO MINIMIZE TISSUE ADHESION 4HE DISTAL ARMS PROVIDE A SMOOTH GLIDING SURFACE FOR THE TENDONS $IFFERENT PLATE LENGTHS ARE OFFERED TO AVOID CUTTING 4HE ANGULAR STABILITY OF THE CONSTRUCT ALLOWS TREATMENT OF OSTEOPOROTIC BONE

!0 AND LATERAL X RAYS OF A REVERSED "ARTON FRACTURE " IN A YEAR OLD WOMAN AFTER FALL ON OUTSTRETCHED HAND MONTHS FOLLOW UP

(ANS :WIPP

.EW ANKLE AND FOOT PRODUCTS -ODULAR &OOT 3ET !DDITIONAL PLATES SCREWS AND INSTRUMENTS 4HE -ODULAR &OOT 3ET IS INDICATED FOR OSTEOTOMIES FUSIONS REPLAN TATIONS AND FRACTURE REPAIR OF THE FOOT 4HE FOLLOWING DEVICES ARE ADDITIONS TO THE EXISTING IMPLANTS AND INSTRUMENTS OF THE -ODULAR &OOT 3ET .EW HAND FOOT PRODUCTS

.EWLY DESIGNED HOLE AND HOLE ,# $#0 TO ADDRESS LARGER FOOT MIDFOOT FRACTURES OSTEOTOMIES FUSIONS AND REPLANTATIONS 4HE STANDARD $#5 PART OF THE HOLE ALLOWS FOR n OF ANGULATION WITH A LIMITED CONTACT UNDERSURFACE TO PRESERVE THE PERIOSTIUM 4HE ROUNDED EDGES AID IN PERCUTANEOUS PLACEMENT AND REDUCE SOFT TISSUE IRRITATION 4HE (IND -IDFOOT 0LATES ARE INDICATED FOR CALCANEAL CUBOID FUSIONS AND LATERAL COLUMN LENGTHENING ! THIN MM PROFILE THICK NESS IS UTILIZED TO MINIMIZE SOFT TISSUE IRRITATION 4HE MM #ANCELLOUS "ONE 3CREW WITH LARGE CORE DIAMETER IS INDI CATED FOR TRIPLE ARTHRODESIS FUSION OF THE CALCANEUS TALUS NAVICULAR AND CUBOID AND HIND MIDFOOT FUSIONS OF THE INJURED FOOT IN DIABETIC PATIENTS )T IS A FULLY THREADED BONE SCREW WITH A CANCELLOUS THREAD PITCH 4HE CORE DIAMETER IS MM THE RANGE IS n MM IN MM INCREMENTS ! 3HARP (OOK WITH SMALL 4APER FEATURES A STRONGER AND MORE ROBUST TIP

*ONES FRACTURE WITH PSEUDARTHROSIS IN A YEAR OLD MAN &IXATION WITH A HOLE ,# $#0 WHEREBY DYNAMIC COMPRESSION WAS ACHIEVED USING MM SCREWS

*AMES " (UNTER

.EW PEDIATRIC PRODUCTS 4ODDLER /STEOTOMY 0LATE 4HE 4ODDLER /STEOTOMY 0LATE MM DISPLACEMENT WITH MM BLADE LENGTH OFFERS PEDIATRIC SURGEONS GREATER FLEXIBILITY WHEN PER FORMING INTERTROCHANTERIC FEMORAL OSTEOTOMIES 4HE DESIGN OF THIS !NGLED "LADE 0LATE IS IDENTICAL TO THE EXISTING MM DISPLACEMENT WITH MM BLADE LENGTH 4HE YEAR OLD BOY WITH TECHNIQUE FOR INSERTION IS ,EGG #ALVÏ 0ERTHES THE SAME DISEASE PRE AND POSTOPERATIVE X RAYS

.EW PEDIATRIC PRODUCTS

0AUL 7 0AVLOV

.EW SPINE PRODUCTS #ERVIOS 6ERTEBRAL 3PACER #2 4HE 6ERTEBRAL 3PACER #2 IS A RADIOLUCENT CAGE SYSTEM MADE OUT OF 0%%+ /PTIMA DESIGNED FOR USE IN INTERBODY PROCEDURES FROM # THROUGH # 4HE SPACER HAS A TRAPEZOIDAL FOOTPRINT WHICH IS MM !0 X MM -, THE HEIGHTS VARY FROM MM THROUGH MM 4HE 6ERTE BRAL 3PACER #2 IS AVAILABLE IN THREE DIFFERENT SAGITTAL PROFILES CONVEX

LORDOTIC AND PARALLEL ! CENTRAL CANAL FOR AUTOGRAFT OR OSTEOCONDUCTIVE

AND MAYBE IN FUTURE OSTEOINDUCTIVE MATERIALS ALLOWS FUSION TO OCCUR THROUGH THE IMPLANT 4HE TEETH ON THE SURFACE MINIMIZE MIGRATION

#ERVIOS CHRON/3 6ERTEBRAL 3PACER #2 CHRON/3 )NTERBODY FUSION PROCEDURES INVOLVE THE USE OF BONE GRAFTS AND BONE REPLACEMENT MATERIALS TO ENCOURAGE BONY FUSION 3TUDIES HAVE SHOWN THAT THE SUCCESS RATE OF FUSION DEPENDS ON THE INTRAOPERATIVE PACKING OF THE INTERBODY FUSION IMPLANT WITH THE BONE SUBSTITUTE 4HEREFORE

THE !/ OFFERS THE #ERVIOS 6ERTEBRAL 3PACER #2 AS PREFILLED CAGES WITH CHRON/3 TO COMPLEMENT OR EVEN REPLACE PAINFUL BONE GRAFT HARVESTING FROM THE ILIAC CREST #HRON/3 IS A RESORBABLE CERAMIC ” 4#0 BONE SUBSTITUTE WHICH IS FULLY SYNTHETIC AND HAS AN INTERCONNECTIVE OPEN POROSITY )N VIVO STUDIES HAVE DEMONSTRATED ITS OSTEOCONDUCTIVE BEHAVIOR AND LATER RE SORPTION WITHIN WEEKS )NCLUDED IN THE #ERVIOS INSTRUMENT SET ARE

0ACKING "LOCK )S USED FOR FILLING THE EMPTY #ERVIOS CAGE WITH BONE GRAFT

#ANCELLOUS "ONE )MPACTOR 5SED WITH 0ACKING "LOCK TO IMPACT BONE GRAFT TIGHTLY INTO THE EMPTY #ERVIOS CAGE

(OLDER FOR )MPLANTS AND 4RIAL )MPLANTS 0ERMITS SIMPLE ATTACH MENT OF TRIAL IMPLANTS AND CAGES

)NSTRUMENT 3ET FOR #ERVICAL $ISTRACTOR !N EFFICIENT DISTRACTOR SYSTEM TO FURTHER SIMPLIFY THE ANTERIOR CERVICAL APPROACH

.EW SPINE PRODUCTS

3YN#AGE ,2 3YN#AGE ,2 IS INTENDED FOR USE IN THE LUMBAR SPINE TO FACILITATE FUSION OF TWO ADJACENT VERTEBRAE )NDICATIONS ARE LUMBAR AND LUMBOSACRAL PATHOL OGIES WHICH MAY REQUIRE ANTERIOR SEGMENTAL ARTHRODESIS INCLUDING DE GENERATIVE DISC DISEASE AND INSTABILITY REVISION SURGERY FOR FAILED DECOM PRESSION SYNDROME OR PSEUDARTHROSIS AND REDUCED SPONDYLOLISTHESIS 4HE DESIGN OF THE 3YN#AGE ,2 FEATURES CONVEX SUPERIOR AND INFERIOR SURFACES WHICH MIMIC THE NATURAL ENDPLATE CURVATURE )TS WEDGE SHAPED BODY DESIGN HELPS TO RESTORE THE NATURAL LORDOTIC CURVATURE OF THE SPINE AND TO RESTORE THE DISC HEIGHT 4HE SURFACES FEATURE LARGE HOLES FOR BONY IN GROWTH OR CHRON/3 PREFILLING MASS 4HE PATTERN OF THE HOLES AND THE LARGE CONTACT SURFACE OF THE IMPLANT WITH THE ANA TOMICAL CONTOUR OF THE ENDPLATE INTERFACE SERVE TO REDUCE THE RISK OF SUBSIDENCE AND TO TRANSFER LOAD TO THE STRONG PERIPHERAL BONE OF THE VERTEBRAL BODY 4HE 3YN#AGE ,2 IS RADIOLUCENT AND MADE OUT OF 0%%+ /PTIMA )T IS AVAILABLE IN FIVE HEIGHTS AND TWO FOOTPRINTS &OR THE , n3 SEGMENT A SPECIAL WEDGE ANGLE THE 3YN#AGE ,32 IS AVAILABLE !N ADDITIONAL POSTERIOR FIXATION INCREASES THE BIOMECHANICAL SITUATION SIGNIFICANTLY 4RIAL )MPLANT (OLDER 0ROVIDES A SECURE GRASP OF THE TRIAL IMPLANTS IN ORDER TO ALLOW A SAFE IN SITU MANIPULATION

$ISTRACTORS 5SABLE FOR STRAIGHT APPROACH AND TO EASE THE ACCESS TO THE LUMBOSACRAL INTERVERTEBRAL SPACE

#ANCELLOUS "ONE )MPACTORS AND 0ACKING "LOCKS %NABLE EASY FILLING AND PACK AGING OF THE IMPLANT WITH BONE GRAFT MATERIAL

4RIAL )MPLANTS 0ERMIT PRECISE SELECTION OF THE IM PLANT SIZE AND CAN ALSO SERVE TO OPEN THE DISC SPACE 6ERTEBRAL 3PACER 02 0,)6)/3

YEAR OLD WOMAN LATERAL

PRE AND POSTOPERATIVE X RAYS

.EW SPINE PRODUCTS

4HE 6ERTEBRAL 3PACER 02 IS A RADIOLUCENT SPACER SYSTEM DESIGNED FOR USE IN INTERBODY PROCEDURES FOR , THROUGH , 4HE FOOTPRINT IS X MM AND COMES IN

AND MM HEIGHTS 4HIS NARROW WIDTH ALLOWS FOR A SMALLER WINDOW TO BE CREATED

BY A PARTIAL LAMINECTOMY

LATERAL TO THE SPINAL CORD WITHOUT COMPROMISING THE FACET JOINTS AND STRUCTURAL STABILITY OF THAT VERTEBRAL LEVEL 4HE SPACER IS MADE OUT OF 0%%+ /PTIMA A RADIOLUCENT BIOCOMPAT IBLE INERT POLYMER MATERIAL )T HAS A RECTANGULAR FOOTPRINT AND CONVEX CRANIAL CAUDAL SURFACES TO MATCH THE VERTEBRAL ENDPLATE GEOMETRY 4HE IMPLANT HAS A SCAFFOLD LIKE STRUCTURE WHICH REDUCES THE OVERALL AMOUNT OF SYNTHETIC MATERIAL NEEDED ! CENTRAL HOLE ALLOWS THE USE OF ALLOGRAFT 4HE 6ERTEBRAL 3PACER 02 CONTAINS TWO RADIO OPAQUE PINS FOR PROPER PLACEMENT UNDER FLUOROSCOPY AND RECOGNITION IN FOLLOW UP EVALUATIONS

6ERTEBRAL 3PACER 42 42!6)/3 4HE 6ERTEBRAL 3PACER 42 IS A RADIOLUCENT CAGE SYSTEM DESIGNED FOR USE IN TRANSFORAMINAL LUMBAR INTERBODY FUSION PROCEDURES FROM , THROUGH , 4HE MATERIAL IS 0%%+ /PTIMA A BIOCOMPATIBLE INERT POLY MER )T ENABLES ADEQUATE COMPRESSION OF AUTOGRAFT IN AND AROUND THE IMPLANT THUS ASSURING BETTER STRESS DISTRIBUTION AND LOAD SHARING PRO VIDING AN OPTIMAL ENVIRONMENT FOR BIOLOGICAL FUSION 4HE 6ERTEBRAL 3PACER 42 HAS A KID NEY SHAPED FOOTPRINT 4HE CRANIAL CAUDAL SURFACE IS CONVEX IN THE MEDI AL LATERAL DIRECTION TO PROVIDE OPTIMAL INTERFACE WITH THE LUMBAR VERTEBRAL ENDPLATE GEOMETRY 4HE IMPLANT HAS TWO CENTRAL HOLES TO RECEIVE AUTOGRAFT OR OTHER OSTEO INDUCTIVE MATERIAL AND TO ALLOW FUSION TO OCCUR THROUGH THE IMPLANT

0RE AND POSTOPERATIVE X RAYS LATERAL VIEW

6)3)/3ˆ6ERTEBRAL 3PACER !2 6)3)/3 IS A RADIOLUCENT ANTERIOR LUMBAR INTERVERTEBRAL SPACER INDI CATED FOR PROCEDURES , THROUGH 3 4HE 6)3)/3 CAGE CAN BE INSERTED THROUGH AN ANTERIOR ANTEROLATERAL OR LATERAL APPROACH 4HE POSTERIOR CURVATURE ENABLES OPTIMAL ANATOMICAL ADAPTATION ! LARGE CENTRAL APERTURE ALLOWS GOOD BONE INGROWTH 4HE WEDGE SHAPED CONVEX DE SIGN PERMITS RESTORATION OF LORDOSIS AND CONFORMITY WITH THE ENDPLATE GEOMETRY 6)3)/3 IS AVAILABLE IN FIVE DIFFERENT HEIGHTS FOR ADAPTATION TO THE NATURAL DISC HEIGHT !N ADDITIONAL POSTERIOR FIXATION IS RECOMMENDED &OR 6)3)/3 SPECIFIC INSTRUMENTS HAVE BEEN DESIGNED s (OLDER FOR 6)3)/3 s $ISTRACTOR FOR 6)3)/3 s 0ACKING "LOCK FOR 6)3)/3 s #ANCELLOUS "ONE )MPACTOR FOR 6)3)/3

YEAR OLD MAN LATERAL

PRE AND POSTOPERATIVE X RAYS

3YN-ESHˆ!DDITIONAL SIZES AND INSTRUMENTS 4HE 3YN-ESH SYSTEM IS INDICATED FOR USE AS A VERTEBRAL BODY REPLACEMENT DEVICE IN THORACOLUMBAR SPINE 4 THROUGH , TO REPLACE A COLLAPSED DAMAGED OR UNSTABLE VERTEBRAL BODY DUE TO TUMOR OR TRAUMA 4HIS MODULAR SYSTEM ALLOWS BUILDING OF THE MOST APPROPRIATE CONSTRUCT TO ADDRESS THE DEFECT AND PATIENT S ANATOMY 4HE 3YN-ESH SYSTEM IS TO BE USED WITH 3YNTHES SUPPLEMENTAL INTERNAL FIXATION SYSTEMS EG 6ENTRO&IX OR 533 4HIS UPDATE FEATURES ADDITIONAL MESH HEIGHTS AND ADDITIONAL INSTRU MENTS .EW SPINE PRODUCTS

#ONVEX %ND 2INGS 4HE #ONVEX %ND 2INGS ENABLE LOCKING THE END RING TO THE MESH WITH THE NEW LOW PROFILE MM OR MM ,OCKING 3CREW

MM AND MM ,OCKING 3CREW LOW PROFILE TITANIUM 4HE LOW PROFILE MM AND MM ,OCKING 3CREW ARE USED TO SECURE THE NEW #ONVEX %ND 2INGS TO THE MESH FOOTPRINTS

)MPLANT (OLDER LARGE AND SMALL WITH TIPS 4HE )MPLANT (OLDER IMPROVES SECURE HANDLING OF THE MESH AND DIST RIBUTES THE IMPACTION FORCES OVER A LARGER AREA REDUCING IMPLANT DEFORMATION DURING INSERTION

&ORKED )MPACTORS 4HE &ORKED )MPACTORS ENABLE BETTER MANEUVERING OF THE 3YN-ESH CONSTRUCT INTO ITS FINAL POSITION 4HREE DESIGNS ARE AVAILABLE ANGLE LAT ERAL ANGLE SUPERIOR AND STRAIGHT

#ORPECTOMY #ALIPER 4HE #ORPECTOMY #ALIPER MEASURES THE SIZE OF THE DEFECT TO DETERMINE THE SIZE OF THE IMPLANT NEEDED )T HAS LONG ARMS TO MEASURE THE DEFECT THROUGH DEEP SURGICAL INCISIONS 3YN#ORE )NSERT 4RIMMER 4HE )NSERT 4RIMMER IS TO BE USED WITH 3YN#ORE WHICH ARE CANCELLOUS BONE INSERTS TO FILL THE INTERIOR OF THE 3YN-ESH 3PACER 4HE INSERTS CAN BE STACKED AND OR TRIMMED TO THE DESIRED LENGTHS

YEAR OLD WOMAN PATHOLOGICAL FRACTURE IN , DUE TO METASTASIS OF BREAST CANCER -2LS AND X RAYS 3YNMESH COMBINED WITH 6ENTROFIX

.EW SPINE PRODUCTS

!DDITIONAL !#& 3PACER INSTRUMENTSˆ &2! INSTRUMENTS ARE INCORPORATED IN THE #ERVIOS SYSTEM 4HE !NTERIOR #ERVICAL &USION !#& INSTRUMENTS ARE DESIGNED TO FACIL ITATE !#& PROCEDURES UTILIZING A MODIFIED 3MITH 2OBINSON 4ECHNIQUE 4HE EXISTING 3YNTHES˜ !#& 3PACER INSTRUMENT SET HAS BEEN ENLARGED TO IMPROVE DISCETOMY AND ENDPLATE PREPARATION WHICH ARE KEY ELE MENTS FOR SUCCESSFUL BIOLOGICAL FUSION !#& #ERVICAL $ISC 3HAVER &ACILITATES THE REMOVAL OF THE LARGER FRAGMENTS OF THE NUCLEUS PULPOSUS AND CARTILAGINOUS ENDPLATE )T WILL LESSEN THE /2 TIME REQUIRED FOR PER FORMING CERVICAL DISCETOMY AND BLOOD LOSS OF THE PATIENT !#& 2ASP 0ERMITS REMOVAL OF CARTILAGINOUS TISSUE FROM THE CERVICAL ENDPLATES TO EXPOSE BLEEDING BONE AND ASSISTS PREPARATION OF THE CERVICAL VERTEBRAL ENDPLATES WITHOUT DAMAGING THE SUBCHONDRAL BONE !#& $ETACHABLE 4RIAL 3PACER 4HE NEW TRIAL SPACERS ARE DETACHABLE AND AVAILABLE IN PARALLEL LORDOTIC

AND CONVEX GEOMETRIES TO PERMIT THE SELECTION OF THE MOST APPROPRIATE IMPLANT AND HEIGHT SO THAT RESTORATION OF DISC HEIGHT CAN BE MAIN TAINED !#& 3PACER )MPLANT (OLDER 3ECURELY GRIPS THE !#& IMPLANT FOR CONTROLLED INSERTION BY EMPLOYING A NEW SPEEDNUT LOCKING MECHANISM 4HE HANDLE ENABLES IMPACTION OF THE IMPLANT WITH A HAMMER !#& 'RAFT 0ACKING "LOCK 5SED IN CONJUNCTION WITH THE EXISTING GRAFT PACKER TO FACILITATE PACKING OSTEOINDUCTIVE MATERIAL INTO THE CENTRAL CANAL IN CERVICAL SPACERS

!DDITIONAL 0,)& INSTRUMENTSˆ &2! INSTRUMENTS ARE INCORPORATED IN 0,)6)/3 SET 4HE 0OSTERIOR ,UMBAR )NTERBODY &USION 0,)& INSTRUMENTS ALLOW FOR A POSTERIOR APPROACH A COMPLETE DISCECTOMY AND IMPLANT INSER TION UNDER DISTRACTION 4RIAL 3PACERS PERMIT THE SELECTION OF THE MOST APPROPRIATE HEIGHT SO THAT RESTORATION OF DISC HEIGHT CAN BE MAINTAINED 'RAFT &UNNEL 4HE 'RAFT &UNNEL ENABLES BETTER PLACEMENT OF AUTOGRAFT OR ALLOGRAFT IN THE ANTERIOR AND MEDIAL ASPECT OF THE VERTEBRAL DISC SPACE 'RAFT 0USHER 4HE 'RAFT 0USHER FACILITATES IN THE DELIVERY OF AUTOGRAFT OR ALLOGRAFT WITH THE USE OF THE 'RAFT &UNNEL 0,)& 3PREADER MM 4HE 0,)& 3PREADER HAS THE SAME OVERALL HEIGHT AS THE IMPLANT AND ENSURES ACCURATE SIZING AND DISTRACTION .EW SPINE PRODUCTS

0,)& 4RIAL 3PACER 4HE 0,)& 4RIAL 3PACER HAS THE SAME OVERALL HEIGHT AS THE IMPLANT AND ENSURES ACCURATE SIZING AND APPROPRIATE IMPLANT SELECTION 0,)& $ETACHABLE 4RIAL 3PACERS 4HE $ETACHABLE 4RIAL 3PACERS HAVE THE SAME GEOMETRY AND HEIGHT AS THE 0,)& IMPLANTS 4HEY ENSURE ACCURATE SIZING AND APPROPRIATE IMPLANT SELECTION $ISTRACTION CAN BE ACHIEVED WITHOUT WORRYING ABOUT COMPRESSING THE DURAL SAC /NCE THE $ETACHABLE 4RIAL 3PACER HAS BEEN POSITIONED THE DURAL SAC CAN THEN SLIDE OVER THE TOP OF THE SPACER

WHILE IMPLANT INSERTION OCCURS ON THE CONTRALATERAL SIDE )NTERVERTEBRAL $ISC 3HAVERS 4HE )NTERVERTEBRAL $ISC 3HAVER ALLOWS THE SURGEON TO BREAK UP THE NUCLEUS PULPOSUS IN A FAST AND EFFICIENT MANNER WHILE ALSO BEGINNING TO SCRAPE OFF THE CARTILAGINOUS LAYER OF THE VERTEBRAL ENDPLATE )NTERVERTEBRAL $ISC %XCISORS &ACILITATES REMOVAL OF NUCLEUS PULPOSUS FROM THE INTERVERTEBRAL DISC SPACE "ONE 2ASP 3TRAIGHT MM WIDTH "ONE #URETTE STRAIGHT MM WIDTH MM LENGTH "ONE #URETTE REVERSE ANGLE MM WIDTH MM LENGTH !LL THREE INSTRUMENTS FACILITATE REMOVAL OF NUCLEUS PULPOSUS AND THE CARTILAGINOUS LAYER OF THE ENDPLATES TO EXPOSE BLEEDING BONE %ND PLATE PREPARATION CAN BE ACHIEVED WITHOUT DAMAGING THE SUBCHONDRAL BONE

$UAL /PENING 5NIVERSAL 3PINE 3YSTEM 533 4HE $UAL /PENING 533 IS A STAND ALONE SYSTEM DESIGNED TO TREAT DEFORMITIES IN THE THORACIC LUMBAR AND SACRAL SPINE USING THE TECHNIQUE OF SEGMENTAL TRANSLATION )T INCORPORATES THE DUAL OPENING FEATURES OF THE 3MALL 3TATURE 533 SYSTEM WITH SCREWS AND HOOKS APPLIED TO A MM ROD 4HE NEW HOOK DESIGNS FOR PEDI CLE LAMINA SMALL MEDIUM AND LARGE THORACIC LAMINA ANGLED LAMINA TALL BODY LAMINA SMALL

MEDIUM AND LARGE AND TRANS VERSE PROCESS LEFT AND RIGHT ARE AVAILABLE FOR STANDARD SIDE LOAD ING AND FOR FRONT LOADING WHEN USING A TRANSVERSE BAR 4HE SCREWS FEATURE THE DUAL OPENING DESIGN AND A DUAL CORE THREAD DESIGN WHICH INCLUDES TWO CORE DIAMETERS WITHIN EACH SCREW TO IMPROVE BONY PURCHASE A CORTICAL THREAD AT THE SCREW BEND AND A CANCELLOUS THREAD AT .EW SPINE PRODUCTS

THE SCREW TIP 4HE AVAILABLE SCREW DIAMETERS ARE

AND MM WITH LENGTHS FROM MM TO MM /THER NEW IMPLANTS ARE COLLARS STANDARD AND GROOVED TO MATCH TRANS VERSE BARS A POINT NUT AND NEW TRANSVERSE BARS IN LENGTHS OF

AND MM !LL IMPLANTS ARE OFFERED IN BOTH 4ITANIUM AND 3TAIN LESS 3TEEL 4HE $UAL /PENING 533 FEATURES SEVERAL NEW INSTRUMENTS (OOK (OLDING &ORCEPS 2OD )NTRODUCTION 0LIERS 0ERSUADER $ISTRACT ION #LIP 3OCKET 7RENCH (OLDING 3LEEVE FOR 3OCKET 7RENCH AND #OLLAR 0OSITIONER

YEAR OLD WOMAN WITH PROGRESSIVE KYPHOSCOLIOSIS SCOLIOTIC DOUBLE CURVE PREOPERATIVE THORACIC ² AND LUMBAR ² POSTOPERATIVE ² AND ² POSTE RIOR INSTRUMENTATION WITH PEDICLE SCREWS IN , TO , AND PEDICLE LAMINA AND TRANSVERSE PROCESS HOOKS IN 4 TO 4 AFTER ANTERIOR RELEASE

.EW INSTRUMENTS FOR 0EDIATRIC SMALL STATURE 5NIVERSAL 3PINE 3YSTEM 533

3CREWDRIVER MM WITH 4 (ANDLE

3UPPORT FOR 2OD )NTRODUCTION 0LIERS

3LEEVE 0OSITIONER FOR 533 0EDIATRIC 3LEEVES

3OCKET 7RENCH FOR POINT NUT WITH , (ANDLE

$EPTH 'AUGE FOR 0EDICLE 3CREWS TO MM

533 0EDIATRIC 2OD )NTRODUCTION 0LIERS

3OCKET 7RENCH MM WITH 4 (ANDLE

(OLDING 3LEEVE FOR &ILLISTER (EAD 3CREWS

3LEEVE 0USHER

.EW SPINE PRODUCTS

0EDICLE 0REPARATION INSTRUMENTS 4HE 0EDICLE 0REPARATION INSTRUMENTS ARE USED IN THE PREPARATION OF THE VERTEBRAL BODY FOR SCREW INSERTION !LL INSTRUMENTS ARE COMPATIBLE WITH DUAL CORE SCREWS IN THE 5NIVERSAL 3PINE 3YSTEM 6ARIABLE !XIS 3CREW AND #LICK |8 3YSTEMS 0ALM (ANDLED 2ATCHET 4HE 0ALM (ANDLED 2ATCHET HAS A MM HEX QUICK DISCONNECT ATTACH MENT FOR INSERTION OF TAPS AND PEDICLE MARKERS ,ARGE (ANDLED !WL 4HE ,ARGE (ANDLED !WL IS USED TO PUNCTURE THE PROXIMAL CORTICAL LAYER OF THE VERTEBRAL BODY AND HAS A LARGE OVAL SHAPED HANDLE 4HE !WL ENABLES EASY INSERTION OF MM AND MM DUAL CORE SCREWS DUE TO ITS LARGE TIP ,ARGE (ANDLE #URVED 0ROBE 4HE ,ARGE (ANDLE #URVED 0ROBE IS USED TO CREATE A HOLE FOR SCREW INSERTION )T HAS A LARGE HANDLE BENT DISTAL END AND A GOLD COATED TITANIUM NITRATE TIP FOR EASY VISIBILITY IN THE SURGICAL FIELD 1UICK 2ELEASE 0ROBE 3HAFT 4HE 1UICK 2ELEASE 0ROBE 3HAFT IS USED WITH A QUICK RELEASE HANDLE TO PROBE THE PEDICLE FOR SCREW INSERTION 4HE 0ROBE 3HAFT HAS A RIB ON IT THAT ALLOWS IDENTIFICATION OF !0 AND LATERAL VIEWS !FTER PROBING THE SHAFT IS UNCOUPLED FROM THE HANDLE AND LEFT IN THE HOLE FOR IDENTIFICA TION ON X RAY OR FLUOROSCOPY 0EDICLE -ARKER BEADED 4HE BEADED 0EDICLE -ARKER IDENTIFIES THE DIMENSION AND DIRECTION OF THE PEDICLE HOLE AFTER PROBING 4HE BEADS CORRESPOND WITH SPECIFIC LENGTHS ALONG THE SHAFT SO THAT DEPTHS CAN BE DETERMINED IN LATERAL VIEWS 4APS FOR $UAL #ORE 3CREWS 4HE 4APS FOR $UAL #ORE 3CREWS ENABLE TAPPING A PEDICLE SCREW HOLE PRIOR TO SCREW INSERTION USING A HANDLE WITH MM HEX QUICK DISCON NECT 4HE 4APS ARE AVAILABLE SOLID OR CANNULATED

%XTRACTION INSTRUMENTS FOR DAMAGED #LICK |8 ,OCKING #APS 4HE %XTRACTION INSTRUMENTS FOR DAMAGED #LICK |8 ,OCKING #APS ENABLE REMOVAL OF A DAMAGED HEX DRIVE #LICK |8 LOCKING CAP 7ITH THE CLAMP ING MECHANISM OF THE EXTRACTOR THE LOCKING CAP IS FIRMLY HELD AND CAN EASILY BE REMOVED

3YN&RAME 2ETRACTOR (OLDER 4HE 3YN&RAME 2ETRACTOR (OLDER IS FREE ADJUSTABLE AND FEATURES A CATCH MECHANISM

.EW SPINE PRODUCTS

-ATHIAS -Ã LLER

%ARLY CLINICAL EXPERIENCE WITH THE ,#0 SYSTEMS 4HE AIM OF THIS PROSPECTIVE STUDY WAS TO SYSTEMATICALLY DOCUMENT THE RESULTS OF THE FIRST APPLICATIONS OF THE ,#0 SYSTEM IN ROUTINE CLINICAL PRACTICE FOR A BROAD SPECTRUM OF INDI CATIONS &ROM -ARCH TO &EBRUARY PATIENTS WITH FRACTURES WERE TREATED WITH THE ,#0 SYSTEM AT SIX %UROPEAN TRAUMA CENTERS AND AT ONE !MERICAN CENTER 0ATIENT RECRUITMENT WAS DISTRIBUTED ACROSS THE INDI VIDUAL CENTERS AS FOLLOWS +ANTONSSPITAL #HUR +ANTONSSPITAL &RIBOURG 7ILHELMINENSPITAL 7IEN (OSPITAL FOR 3PECIAL 3URGERY .EW 9ORK +ANTONSSPITAL !ARAU 3PITAL $AVOS +ANTONSSPITAL ,UZERN

PATIENTS PATIENTS PATIENTS PATIENTS PATIENTS PATIENTS PATIENTS

4HE PATIENT SAMPLE WAS COMPRISED OF WOMEN AND MEN AGED BETWEEN AND YEARS 4HE PERIOD FROM ACCIDENT TO OPERATION WAS DAYS ON AVERAGE MINIMUM AND MAXIMUM DAYS 'RAPHˆ3PECTRUM OF INDICATIONS

&RACTURED BONE

3CAPULA

)LIUM

2ADIUS 5LNA COMBINED

3YMPHYSIS

#ALCANEUS

&IBULA

#LAVICULA

5LNA

&EMUR

4IBIA &IBULA COMBINED

!CETABULUM

2ADIUS

(UMERUS

4IBIA

.O OF CASES

&OR THIS STUDY A FOLLOW UP RATE OF WAS ACHIEVED &IVE PATIENTS DIED BEFORE FRACTURE HEALING WAS CONCLUDED WITHOUT THERE BEING ANY RECOGNIZABLE LINK BETWEEN THE CAUSE OF

DEATH AND THE IMPLANT /NE YEAR AFTER THE OPERATION FRACTURES HAD GONE ON TO COM PLETE AND UNEVENTFUL HEALING &OR PATIENTS A TOTAL OF UNEXPECTED hADVERSE EVENTSv WERE DOCUMENTED 4ABLEˆ$OCUMENTED vADVERSE EVENTSh !DVERSE EVENTS

.O OF CASES

$ELAYED OR NONUNION

,OSS OF REDUCTION

,OOSENING OF IMPLANT

,OOSENING OF IMPLANT LOSS OF REDUCTION

"REAKAGE OF IMPLANT

)NFECTION

0OSTOPERATIVE NERVE PALSY

2EFRACTURE ND FRACTURE CLOSE TO IMPLANT

)MPLANT RELATED PAIN

/STEONECROSIS

4HE COMPLICATIONS DOCUMENTED WERE OF VARI OUS DEGREES OF SEVERITY AND CORRESPONDED TO A COMPLICATION RATE OF .ONE OF THESE COMPLICATIONS WAS DETERMINED TO BE hPURELY IMPLANT RELATEDh )NSTEAD EIGHT OF THE REVISION OPERATIONS WERE THE CONSEQUENCE OF TECHNICAL INADEQUACIES DURING THE OPERATION

OR THE STABILITY OF THE OSTEOSYNTHESIS WAS OVER ESTIMATED BY THE SURGEON 4HE INFECTION RATE OF THE FRACTURES FOLLOWED UP IS LOW FOR THIS HETEROGENEOUS PATIENT SAMPLE THAT INCLUDED NUMEROUS OPEN FRACTURES AND MANY REVISION OPERATIONS ON PATIENTS WHO HAD ALREADY BEEN OPERATED ON REPEATEDLY THIS IS ESPECIALLY TRUE FOR THE RATE OF SECONDARY CANCELLOUS BONE GRAFTS 4HE ,#0 SYSTEM WITH ITS DIFFERENT TYPES OF SCREWS AND A VERY BROAD RANGE OF APPLICATIONS IS OF NECESSITY ASSOCIATED WITH THE HIDDEN RISKS OF ERROR DURING OPERATIVE PLANNING AND DURING OPERATIVE INTERVENTION 4HE SURGEONS EMPHASIZED THAT THANKS TO THE POSSIBILITY OF FRACTURE BRIDGING FIXATION THE ADVANTAGES OF THE ,#0 SYSTEM LIE ESPECIALLY IN s ITS GOOD PURCHASE IN OSTEOPOROTIC BONE s THE STABLE ANGLE FIXATION OF SMALL UNSTABLE FRAGMENTS s THE REDUCTION OF PRIMARY CANCELLOUS BONE GRAFTING %ARLY CLINICAL EXPERIENCE

3YLWESTER 'OGOLEWSKI

"IORESORBABLE POLYLACTIDE MESH IMPLANTS IN THE TREATMENT OF CRITICAL SIZE BONE DEFECTS "ONE DEFECTS ABOVE A hCRITICAL SIZEv DO NOT HEAL SPONTANEOUSLY !UTOGENOUS CANCELLOUS BONE GRAFTS ARE USED TO PROMOTE HEALING OF SUCH DEFECTS 3URROUNDING BONE GRAFT PACKED IN THE DEFECT WITH BIORESORBABLE MICROPOROUS MEMBRANES CAN ADDITIONALLY FACILITATE HEAL ING )N THE MAXILLOFACIAL SKELETON MICROPOROUS MEMBRANES ARE USED TO REGENERATE THE LARGE ORBITAL AND FACIAL DEFECTS AND CRITICAL SIZE DE FECTS OF THE MANDIBLE 7HILE THE MICROPOROUS POLYLACTIDE MEMBRANES OFTEN IN COMBINATION WITH BONE GRAFT FUNCTION EFFECTIVELY IN THE MAXILLOFACIAL SKELETON IT IS PREREQUISITE TO USE PERFORATED MEMBRANESˆMESHES IN COMBINA TION WITH BONE GRAFTˆFOR THE TREATMENT OF CRITICAL SIZE SEGMENTAL DEFECTS OF LONG BONES )N THE SHEEP MODEL THE CRITICAL SIZE AND CM LONG SEGMENTAL DEFECTS IN THE TIBIA WERE PACKED WITH AUTOGENOUS CANCELLOUS BONE GRAFT AND SURROUNDED WITH NONPERFORATED AND OR PERFORATED POLYLACTIDE MESHES 4HE IMPLANTS HAD A SINGLE TUBE AND OR A TUBE IN TUBE CONFIGURATION )N ALL CASES WHERE NONPERFORATED MEMBRANES WERE USED TO TREAT BONE DEFECTS THERE WAS A NONUNION AT WEEKS "ONE HEALING WAS ONLY OBSERVED IN THE DEFECTS FILLED WITH BONE GRAFT AND COVERED

WITH PERFORATED MEMBRANES SUGGESTING THAT THE PRESENCE OF PERFORATIONS IMPROVES BONE GRAFT RECONSTITUTION $ESPITE A HIGHER GRAFT VOLUME CONTAINED IN DEFECTS COVERED WITH THE SINGLE TUBE PERFORATED MEMBRANES THAN THOSE IMPLANTED WITH THE PERFORATED TUBE IN TUBE MEMBRANES THE HEALING WAS MORE EFFICACIOUS IN THE LATTER CASE 4HE IMPLANT CONSISTING OF THE TUBE IN TUBE MEMBRANES ALLOWS FOR A SIGNIFICANT REDUCTION OF THE AMOUNT OF BONE GRAFT TO BE USED AND FOR THE FORMATION OF THE hNEO CORTEXv WITH WELL DEFINED THICKNESS 4HE PRIMARY FUNCTIONS OF POLYMERIC MESHES IN THE HEALING OF BONE DEFECTS ABOVE THE hCRITICAL SIZEv ARE OPTIMIZING THE CONTACT BETWEEN THE SOFT TISSUES AND BONE GRAFT TO AVOID ITS EXCESSIVE RESORPTION ALLOWING AD EQUATE GRAFT VASCULARIZATIONˆNUTRITION FROM THE SURROUNDING SOFT TISSUE MAINTAINING THE GRAFT IN THE REQUIRED LOCATION AND PROVIDING A SUBSTRATE FOR OSTEOGENIC CELLS 4HE INTERFACE BETWEEN THE SOFT TISSUES AND BONE GRAFT SEEMS TO BE A PREDOMINANT FACTOR THAT DETERMINES GRAFT SURVIVAL AND FUNCTIONALITY 4HE PER FORATED POLYMERIC MEMBRANES MAY PROVIDE SUCH AN INTERFACE )T IS WORTH MENTIONING THAT IN EXPERIMENTAL ANIMALS AND IN A LIMITED NUMBER OF CLINICAL

"ONE HEALING IN A CM LONG CRITICAL SIZE SEGMENTAL DEFECT IN THE SHEEP TIBIA IMPLANTED WITH POROUS $ SCAFFOLD FROM POLY , $, LACTIDE IMPREGNATED WITH BONE MARROW AT MONTHS POST IMPLANTATION !RROWS INDICATE THE ENDS OF THE SCAFFOLD

"IORESORBABLE POLYLACTIDE MESH IMPLANTS

CASES IT IS POSSIBLE TO USE $ POROUS POLYLAC TIDE SCAFFOLD IMPREGNATED WITH MARROW BLOOD INSTEAD OF AUTOGENOUS CANCELLOUS BONE GRAFT

)N BOTH CASES THE HEALING OF THE DEFECTS IS COMPARABLE

2EFERENCES -EINIG 20 2AHN " 0ERREN 3- ET AL "ONE REGENERATION WITH RESORBABLE POLYMERIC MEMBRANES 4REATMENT OF DIAPHYSEAL DEFECTS IN THE RABBIT RADIUS WITH POLY , LACTIDE MEMBRANE ! PILOT STUDY * /RTHOP 4RAUMA n 0INEDA ,- "Ã SING -# -EINIG 20 ET AL "ONE REGENERATION WITH RESORBABLE POLY MERIC MEMBRANES ))) %FFECT OF POLY , LACTIDE MEMBRANE PORE SIZE ON THE BONE HEALING PROCESS IN LARGE DEFECTS * "IOMED -ATER 2ES n -EINIG 20 "Ã SING #- (ELM * ET AL 2EGENERATION OF DIAPHYSEAL BONE DEFECTS USING RESORBABLE POLY , $, LACTIDE AND POLY $ LACTIDE MEMBRANES IN THE 9UCATAN PIG MODEL * /RTHOP 4RAUMA n

'UGALA : 'OGOLEWSKI 3 2EGENERATION OF SEGMENTAL DIAPHYSEAL DEFECTS IN THE SHEEP TIBIAE USING RESORBABLE POLYMERIC MEMBRANES ! PRELIM INARY STUDY * /RTHOP 4RAUMA n 'OGOLEWSKI 3 0INEDA , "Ã SING #- "ONE REGENERATION WITH RESORBABLE POLYMERIC MEM BRANES )6 $OES THE CHEMICAL COMPOSITION OF THE MEMBRANE AFFECT HEALING PROCESS "IOMATERIALS n 'ERBER !

'OGOLEWSKI 3 2ECONSTRUCTION OF LARGE SEGMENTAL DEFECTS IN THE SHEEP TIBIAE USING POLYLACTIDE MEMBRANES ! CLINICAL AND RADIOGRAPHIC REPORT )NJURY )NT * #ARE )NJURED 3UPPL n 'UGALA : 'OGOLEWSKI 3 (EALING OF CRITI CAL SIZE SEGMENTAL BONE DEFECTS IN THE SHEEP TIBIAE USING BIORESORBABLE POLYLACTIDE MEMBRANES )NJURY

)NT * #ARE )NJURED 3UPPL n

4+ 2ECOGNITION 0RIZE 4HE !/ HONORED 0HIL +REGOR -$ .ASHVILLE

4ENN WITH THE 4+ 2ECOGNITION 0RIZE FOR HIS OUTSTANDING CONTRIBUTIONS IN THE CLINICAL APPLICATION TEACHING AND DISSEMINATION OF THE ,ESS )NVASIVE 3TABILIZATION 3YSTEM ,)33 ,)33 IS AN ANATOMICAL PRESHAPED INTERNAL FIXATOR WHICH CAN BE APPLIED IN A MINIMALLY INVASIVE TECHNIQUE INDICATED FOR FRACTURES OF THE DISTAL FEMUR AND THE PROXIMAL TIBIA

0HIL +REGOR RECEIVES CERTIFICATE FROM .ORBERT (AAS

4+ RECOGNITION PRIZE

4HOMAS 2Ã EDI

0ORTRAIT OF $R MED #HRISTOPH 3OMMER #HRISTOPH 3OMMER IS A HIGHLY DEVOTED AND SKILLED GENERAL SUR GEON WITH A SPECIAL INTEREST IN THE MANAGEMENT OF THE INJURED PATIENT AS A WHOLE (E HAS BEEN INVOLVED IN THE CLINICAL TESTING OF THE NEW ,OCKING #OMPRES SION 0LATE ,#0 FROM THE VERY BEGINNING AS ONE OF THE PRINCI PAL INVESTIGATORS 7ITHIN A SHORT TIME HE HAS ACCUMULATED A LARGE NUMBER OF CHALLENGING CASESˆ EVERY ONE OF WHICH WAS CAREFULLY PLANNED METICULOUSLY PERFORMED AND DOCU MENTED WITH INTRA AND POSTOPERATIVE PHOTO GRAPHS AND AN OVER FOLLOW UP 4HANKS TO HIS EXTREMELY CONSCIENTIOUS WORK #HRISTOPH HAS PRESENTED NOT ONLY HIGHLY SUCCESSFUL RESULTS BUT HAS ALSO CRITICALLY AND HONESTLY DISCUSSED COMPLICATIONS TO ILLUSTRATE POTEN TIAL PITFALLS OF THE NEW PRINCIPLES #HRISTOPH 3OMMER HAS THEREFORE BEEN A REGULAR PAR TICIPANT AND SPEAKER AT THE ,#0 5SER -EETINGS IN "ERLIN WHERE PERSONAL EXPERIENCES WERE REGULARLY EXCHANGED (IS VAST EXPERIENCE AND MANY OF HIS PERSONAL CASES HAVE BEEN INTEGRATED IN THE NEW INTER ACTIVE #$ 2/- h!/ 4EACHING 3ERIESˆ,#0v OF WHICH HE IS A CO AUTHOR

#HRISTOPH 3OMMER WAS BORN IN $ECEMBER AND GREW UP IN THE MOUNTAINOUS EASTERN PART OF 3WITZERLAND (E HAS A BROAD MEDICAL POSTGRADUATE EDUCATION INCLUDING PATHOLOGY

INTERNAL MEDICINE AND GENERAL SURGERY (E SPENT ONE YEAR IN THE 5+ AS A VISCERAL SURGEON AND ONE YEAR AT THE 4RAUMA 5NIT OF 0ROF /TMAR 4RENTZ AT THE 5NIVERSITY OF :URICH &OR THREE YEARS HE HAS BEEN A CONSULTANT AT THE $EPT OF 3URGERY +ANTONSSPITAL #HUR WHERE HE ALSO DID MOST OF HIS SURGICAL TRAINING (AV ING ATTENDED NUMEROUS NATIONAL AND INTERNA TIONAL !/ COURSES HE IS PRESENTLY A CHAIRMAN OF THE $AVOS 0RINCIPLES #OURSES (E IS AN IN STRUCTOR FOR THE 3WISS !4,3 COURSES AND HOLDS THE %UROPEAN TITLE FOR 4RAUMATOLOGY %"13 4RAUMA "ESIDES HIS DEDICATION TO SURGERY #HRISTOPH IS AN AVID SKIER MOUNTAINEER COMPETITION ROCK CLIMBER AND HAS SUCCESSFULLY TAKEN PART IN CLIMBING THE $AULAGHIRI IN THE (IMALAYA 4HIS PASSION FOR THE MOUNTAINS IS SHARED BY HIS TWO SONS AND DAUGHTERˆALL THREE RANK ING AMONGST THE BEST CLIMBERS IN 3WITZERLAND AND EVEN IN %UROPE /N TOP OF HIS CLINICAL AND OUTDOOR ENGAGEMENTS #HRISTOPH HAS ALSO PUBLISHED A NUMBER OF KEY ARTICLES AND BOOK CHAPTERS

.EW PRODUCTS FROM !/ )NTERNATIONAL !/ 4EACHING 3ERIESˆ,#0 ,OCKING #OMPRESSION 0LATE !/ˆYOUR PARTNER IN EDUCATION /UR MISSION IS TO ADVANCE KNOWLEDGE TRANSFER AND PROFESSIONAL PRACTICE FOR THE IMPROVEMENT OF LEARNING WITHIN THE INTERNATIONAL !/ COMMUNITY 4HIS INTERACTIVE #$ 2/- EDITED BY -ICHAEL 7AGNER

-$ IS THE FIRST OF THE NEW !/ 4EACHING 3ERIES #ONTENT LAYOUT IS SIMILAR TO THE MOST COMMONLY USED SOFTWARE PROGRAMS 3IMPLY CHOOSE YOUR TOPIC OF INTEREST FROM HIERARCHICAL MENUS $OWNLOAD IL LUSTRATIONS AND ANIMATIONS FOR TEACHING COURSES 2EGULAR UPDATES ARE PLANNED FOR !/ FACULTY VIA DOWNLOADS FROM A RESTRICTED 7EB SITE 4HE !/ 4EACHING 3ERIES IS THERE TO MAKE YOUR LIFE EASIER 0ORTRAIT

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%DITORS

!/4+ /FFICE

5NIV 0ROF .ORBERT 0 (AAS

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!/4+ #HAIRMAN

#( $AVOS 0LATZ

NORBERT HAAS

0HONE

0HILIP 3CHREITERER

&AX

!/4+ !SSISTANT

AOTK

AO ASIF CH

AO ASIF CH

PHILIP SCHREITERER

AO ASIF CH

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