Versa Nail Humeral Universal Surgical Technique

2016-04-01

: Pdf Versanail Humeral Universal Surgical Technique VersaNail_Humeral_Universal_Surgical_Technique 3 2016 pdf

Open the PDF directly: View PDF .
Page Count: 36

Download
Open PDF In Browser	View PDF

VersaNail ® Humeral Universal
Nailing System
Product Rationale & Surgical Technique

VersaNail ® Humeral Universal Nailing System
Contents
Design Summary........................................................................................................................................................... 3
Implant Overview.......................................................................................................................................................... 4
Precautions................................................................................................................................................................... 7
Antegrade Entry and Canal Preparation....................................................................................................................... 8
Antegrade Nail Insertion.............................................................................................................................................. 14
Antegrade Locking...................................................................................................................................................... 16
Retrograde Entry and Canal Preparation.................................................................................................................... 19
Retrograde Nail Insertion............................................................................................................................................ 21
Retrograde Locking..................................................................................................................................................... 23
End Cap Placement and Nail Removal....................................................................................................................... 26
Ordering Information................................................................................................................................................... 27
Flexible Reaming System............................................................................................................................................ 32

Note: This brochure presents a surgical technique available for use with the Biomet, Inc., VersaNail® Platform
instruments and implants. Surgeons may need to make modifications as appropriate in their own surgical technique with these devices depending on individual patient requirements.
1

VersaNail ® Humeral Universal Nailing System

One Implant Designed for the Efficient Treatment of
a Range of Humeral Fractures
• Anatomically designed for insertion in either the
antegrade or retrograde approach

The VersaNail® Humeral Universal Nail is part of a long
bone nailing system that offers a complete portfolio of
implants and instruments based on a single, standardized
technology platform. The Humeral Universal Nail System
from the VersaNail® Platform offers options to treat a range
of humeral fractures using either the antegrade or retrograde approach with one implant. The VersaNail® Platform
instrumentation system is designed for intuitive assembly
and ease-of-use by OR staff and surgeons, enabling a
simpler and more efficient procedure. The instrumentation is designed to provide intra-operative options including entry portals, reduction tools and color-coded screw
placement, while being standardized to maintain commonality across the platform.

• The intuitive, universal instrumentation system
enables efficiency in the OR
• Multiple locking options for management of
proximal to distal shaft fractures

VersaNail ® Humeral Universal Nailing System

The Humeral Universal Nail is designed
to treat:
•
•
•
•

Open and closed fracture patterns
Humeral shaft fractures
Fractures of the proximal and distal metaphysis
Comminuted fractures of the humerus with small
medullary canals
• Fracture nonunions and malunions
• Pathological fractures
• Floating elbow

3.0 mm cannulation facilitates nail insertion over guide wire.

Increased distal screw options:
•
•
•
•

3.5 mm for 7 and 8 mm nails
4.5 mm for 9 mm nail
2 transverse A-P screws
1 transverse L-M dynamization slot

4˚ Distal bend facilitates retrograde nail insertion.
Chamfer facilitates retrograde nail insertion.

End cap options to secure first proximal screw or second
proximal screw (in oblique) and prevents bone in-growth.

2.5º

Proximal End
9.2 mm

13.5 mm
25.5 mm
45º
51.5 mm

Versatile proximal screw options:
• 4.5 mm and 4.8 mm for 7, 8, and
9 mm nails
• 3 transverse screws
• 1 oblique screw
2.5˚ Proximal bend ensures nail is located away
from articular region when inserted in antegrade.

Drive End Locking Options
60 mm

39 mm
28 mm
17 mm
0 mm
4º

3 mm
cannulation

VersaNail ® Humeral Universal Nailing System
Multiple Locking Options for Optimum Implant Stability

Lateral-Medial (L-M) Locking Configurations
Proximal holes:
• 3 transverse holes
• 1 oblique hole

Distal holes:
• 1 transverse slot
Note: If using the oblique hole, do not use the first and
second transverse hole. If utilizing the oblique hole and
the most distal transverse hole, the screw tips may
interfere with one another, depending on how far past
the second cortex both screws are driven.

Anterior-Posterior (A-P) Locking Configurations
Distal holes:
• 2 transverse holes

Before embarking on humeral nailing, one should understand the obstacles that can be encountered. Adequate
planning will minimize these difficulties. Rotator cuff injury, proximal humerus articular cartilage destruction,
radial nerve injury and extension of comminution are
all possible complications of this procedure.

Axillary
Nerve

Radial
Nerve

Axillary Nerve

Figure 2

Figure 1

Precautions
Axillary Nerve

Radial Nerve

The axillary nerve is the nerve most often damaged during
the injury and iatrogenically—even by closed manipulation
and percutaneous fixation. During open reduction, the
damage occurs especially during soft tissue retraction and
percutaneous proximal screw drilling. To prevent axillary
nerve damage, it is advisable to make small skin incisions
and perform blunt dissection to bone, followed by drilling
and interlocking.

Another feared complication is radial nerve palsy. In cases
of secondary nerve palsy, exploration of the nerve is required (Figure 2). Clinical literature has well-documented
this. One noteworthy study describes the anatomical safe
zone.1
Note: While inserting the nail and before proximal or
distal locking is carried out, it is necessary to support
the distal fragment and prevent distraction of the fracture, which could lead to radial nerve palsy.

Note: The axillary nerve should be located about 10
mm below the oblique screw, about 30 degrees dorsally (Figure 1).

1. Tekdemir, I., U. Sayli, A. Elhan, K.M. Erbil and R. Basar. Relation
of the Radial Nerve with the Sulcus Nervi Radialis: a Morphometric
Study. Okajimas Folia Anat 76(4), 1999: 197–202.

VersaNail ® Humeral Universal Nailing System

Figure 3

Figure 5

Figure 4

Figure 6

Antegrade Entry and Canal Prep
Patient Positioning
A bolster can be utilized to elevate the shoulder from the
table and to allow shoulder extension (Figure 4).

Position the patient supine in the beach chair position on
a radiolucent table (Figure 3). To allow easy access to the
proximal humerus, it is helpful and recommended to place
the C-arm on the opposite side of the table of the injured
limb. The C-arm should also be positioned so it is parallel
with the head of the patient to allow an axial view of the
humeral head.

Note: It is not possible to achieve the correct entry
point and alignment of the humeral head with the shaft
when the shoulder is not extended (Figure 5).
Extend the shoulder to allow the correct entry point and
alignment of the humeral head and shaft. A K-wire inserted
into the head of the shoulder may be required to achieve
adequate extension of the head fragment (Figure 6).

Position the patient’s affected shoulder on the table to
allow visualization without interference of the table edge
with the fluoroscopic imaging. Extend the shoulder to expose the humeral head. This will prevent the acromion from
overlaying the center of the humeral head in the sagittal
plane, thus potentially obscuring the entry site or directing
an errant entry angle.

Figure 7

Figure 8

Humeral Head Reduction
Fracture reduction is accomplished by adducting and extending the proximal fragment with the aid of the joystick
while an assistant simultaneously maintains longitudinal
traction on the distal arm (Figure 8, right).

The humeral head is typically in a varus or valgus position
due to contraction of the rotator cuff muscles and the force
of impaction during injury (Figure 7, top). Manipulation of
the humeral head is accomplished by drilling one or two
K-wires lateral to medial in the anterior and posterior portions of the humeral head (Figure 7, bottom). Using the
K-wires, manipulate the humeral head lateral to medial out
of varus or valgus and in proper coronal plane alignment.
K-wires can also act as joysticks during fracture reduction
and to gain an orthogonal view of the humeral head.
Typically the K-wires should be drilled perpendicular to the
anatomic neck (Figure 8, left). These K-wires can then be
used in a joystick fashion to adduct and extend the head,
exposing the supraspinatus tendon and optimal entry site
in the head from beneath the anterior edge of the acromion.

VersaNail ® Humeral Universal Nail
Nailing System

Figure 9

Figure 10

Image intensification can be used to place a K-wire through
the humeral head in line with the intra-medullary axis of the
humerus (Figure 9).

manually to obtain two orthogonal views of the head in
reference to the shaft.
Finally, a guide pin centered axially and laterally through
the frontal plane between the two K-wires will offer ideal
nail entry site identification. The jig arm should go between
both K-wires (Figure 10).

There are some key considerations to this approach. The
first is to use the joysticks to extend and adduct the humeral proximal head, exposing the anterolateral portion of
the head from under the acromion while simultaneously
distracting the distal shaft, thereby aligning the longitudinal
intra-medullary axis of the proximal and distal fragments.
The second is to drive the K-wire into the head in a central
position with reference to the medullary canal in the sagittal
plane and lateral to central in reference to the canal in the
frontal plane. To achieve appropriate K-wire position, it is
necessary to use the first joystick in the proximal fragment
to rotate and stabilize the humeral head while simultaneously using the second joystick to rotate the distal shaft

Figure 12

Figure 11

Figure 13

Entry Site and Incision Placement

Soft Tissue Protection

Make an incision just anterior to the anterior edge of the
acromion. The anterior edge may be difficult to palpate
and differentiate from the humeral head due to edema and
hematoma from the fracture. Therefore, it is helpful to use
a K-wire under image intensification to locate the anterior
edge of the acromion angle where it intersects the longitudinal axis of the humerus (Figure 11).

In cases where the greater tuberosity is intact or nondisplaced, a 1 to 1.5 cm incision can be made in the supraspinatus tendon in line with its fibers, taking care not to
extend it too far laterally and interrupt the tendon insertion.
Care should be taken to avoid the tendon insertion site as
the rotator cuff does not have enough mobility at its insertion site to allow adequate retraction for instruments to be
used in subsequent steps. The medial entry site assures
minimal trauma to the cuff insertion during the procedure.

Make a sharp 3 cm oblique skin incision in line with the
deltoid fibers. Elevate the subcutaneous fat to expose the
fascial plane between the anterior and middle third of the
deltoid muscle fibers. Continue deep dissection in line with
muscle fibers, taking care to avoid incising the coracoacromial ligament until exposing the sub deltoid bursa. Elevate
the bursa to expose the supraspinatus tendon. (For type
C-3 injuries, a medial extension of the incision, necessary
for medial access, is recommended along the anterior acromion toward the AC joint) (Figure 12).

To preserve soft tissue during the reaming process, pass
a 2-0 braided non-absorbable suture on each side of the
incision (Figure 13). The sutures will aid in retracting the cuff
during reaming and in closing the cuff at the completion of
the procedure. The Antegrade Entry Portal (Cat. No. 281017-101), a tissue protector, is available to aid in the protection of soft tissues during the reaming process.

VersaNail ® Humeral Universal Nailing System

Figure 14

Figure 15

A starting point is made with a threaded 3.2 mm x 14 Inch
Guide Pin (Cat. No. 14012–14) and a Curved Cannulated
awl (Cat. No. 2810-01-005). Use A-P and lateral fluoroscope views to confirm accurate placement. The entry site
in the humeral head is made with the Cannulated Proximal
Nail Entry Reamer (Cat. No. 2810-18-002) over the 3.2 mm
x 14 inch guide pin about 1 to 1.5 mm above the bicipital groove, which is aligned with the intramedullary canal
(Figure 14).

After the head has been reamed to the desired size,
fluoroscopically verify the entry point and advance the awl
or entry reamer in line with the humeral canal. The entry
reamer is marked to identify the correct reaming depth.
Once access to the humeral canal has been gained, place
the 2.0 mm Ball Nose Guide Wire (Cat. No. 2810-17-006)
into the entry site utilizing the guide wire gripper. Two guide
wire gripper styles are available depending on surgeon
preference: the Pistol Grip (Cat. No. 2810-01-001) or the
T-handle Grip (Cat. No. 2810-01-002) (Figure 15).

Use the awl or cannulated entry reamer to open the humeral
head. Hand reaming is recommended, using a reamer with
a T-handle Hudson attachment (Cat. No. 2810-01-004).
Slow-power reaming can also be used for the head only.
Additionally, the reaming process can assist with gauging
the diameter of the canal at the isthmus.

Figure 16

Figure 17

Fracture Reduction

Canal Preparation; Flexible Reaming

Obtain appropriate anatomic reduction in order to restore
length, alignment and rotation of the injured limb. Reduction
can be achieved using the Reduction Tool (Cat. No. 281001-008) (Figure 16) that is passed through the medullary
canal and beyond the fracture site. Once the fracture is
in alignment, place a guide wire through the cannulation
of the reduction tool using the wire gripper. Remove the
reduction tool, and check reduction under image intensification. Final positioning of the ball nose guide wire is at the
distal end of the canal approximately 1 to 1.5 cm above the
olecranon fossa.

Achieve alignment of the injured limb prior to reaming
and maintain it throughout the reaming process to avoid
eccentric reaming. Commence reaming by placing an intramedullary flexible reamer over the ball nose guide wire.
Ream the medullary canal in half-millimeter increments until
cortical bone is reached. Monitor the reaming procedure
using image intensification to avoid eccentric or excessive
reaming (Figure 17).

VersaNail ® Humeral Universal Nailing System

Figure 18

Figure 19

Figure 20

Figure 21

Antegrade Nail Insertion
Nail Size Selection
Take a direct length measurement using radiographs of
the contralateral uninjured extremity with magnification
markers. Use the Radiographic Ruler (Cat. No. 1245) to
determine the length of the nail (Figure 19).

An X-ray template (Cat. No. 2810-17-023) is available to
determine nail size preoperatively (Figure 18).

Nail Diameter Selection
Choose a nail diameter 1 mm less than the final reamer
diameter. When treating distal humeral fractures with a
humeral nail, stresses are increased on the nail’s distal
portion. For distal humeral fractures, it is recommended
that the surgeon use the largest diameter that will fit in the
medullary canal, without excessive thinning of the cortex.
After selecting the appropriate nail diameter (7, 8 or 9 mm
option), secure the nail to the Jig Body (Cat. No. 2810-17009) using the Jig Locking Bolt (Cat. No. 2810-17-010).

Nail Length Gauge
Slide or snap the Nail Length Gauge (Cat. No. 2810-01009) onto the ball nose guide wire until it contacts the bone.
Read the measurement that lines up with the etch mark on
the guide wire to determine the nail length (Figure 20).
Insert the Guide Wire Exchange Tube (Cat. No. 1127)
(Figure 21) over the ball nose guide wire. Remove the ball
nose guide wire. Insert a 2.2 mm x 28 inch Guide Wire
(Cat. No. 8092-22-028) through the exchange tube. Once
the 2.2 mm x 28 inch guide wire is in place, remove the
exchange tube.

Nail Length Selection, Radiographic Ruler
There are two methods to determine nail length, the use of
a radiographic ruler or a nail length gauge.

Figure 22

Figure 23

Note: Cat. No. 1127 Guide Wire Exchange Tube is 8
mm in diameter and may not fit in all intramedullary
canals of the humerus.

Note: The complete jig should be assembled, and
targeting checked, to ensure accuracy prior to nail
insertion.

Jig Assembly and Nail to Jig Attachment

Insert the nail over the 2.2 mm x 28 inch guide wire into the
medullary canal. Care should be taken to avoid striking the
jig directly. Use the Hammer Pad (Cat. No. 2810-01-010)
instead. Avoid using excessive force when inserting the
nail. In instances when a nail jams in the medullary canal,
extract and choose the next smaller diameter size.

1. Insert the Sliding Jig Locking Bolt (Cat. No. 2810-17010) through the Jig Body (Cat. No. 2810-17-009).
2. M
ount the nail onto the nose and the protruding part of
the jig locking bolt, so that the two alignment tabs of the
nose engage fully with the keyways of the nail. The tabs
are of different widths to prevent incorrect indexing of the
nail onto the jig nose.

Nail length should allow room for fracture impaction. Guide
the nail into the medullary canal and confirm fracture reduction and distal placement using fluoroscopy. Assure nail
position is beneath the proximal cortex. The final nail depth
should be 5 mm below the articulating surface (Figure 23).

3. T
ighten the jig locking bolt onto the nail using the sliding
Jig Bolt Driver (Cat. No. 2810-17-028) that engages the
internal hex located inside the upper part of the jig locking bolt (Figure 22).
15

VersaNail ® Humeral Universal Nailing System

2
1
3

Figure 24

Figure 25

Figure 26

Antegrade Locking
Proximal and Distal Locking

Typical Locking Configurations

There are three L-M transverse and one L-M oblique locking holes (Figure 24).

Subcapital fractures:
• Screw 1 and 3 (optional) above fracture
• S crew 4 and distal (optional, as stem provides nail
stability) screws below fracture
• Do not use Screw 2 (in obllique) with Screw 1

Note: If using the oblique hole, do not use the first and
second transverse hole. If utilizing the oblique hole (2)
and the most distal transverse hole (4), the screw tips
may interfere with one another, depending on how far
past the second cortex both screws are driven.

Antegrade shaft fractures:
• Screw 1, 3 and 4 (optional) or 2 and 4 above fracture
• 2 A-P distal screws below fracture

Proximal Locking

Place the protective Static Screw-Sheath (Cat. No. 281017-011) and Trocar (Cat. No. 2810-17-013) through the
appropriate locking holes in the jig’s targeting arm. Make a
stab incision and bluntly dissect through the subcutaneous
tissues and deltoid muscle to the lateral cortex, taking care
to avoid injury to the axillary nerve and muscles during drilling and screw placement to the bone. A Sheath Locking
Nut (Cat. No. 2810-01-018) is available to help secure the
sheath to the jig (Figure 25).

4.8 mm Cancellous Fully-Threaded Screws (Cat. No. 181948-0XX) are recommended for proximal locking. 4.5 mm
Cortical Screws (Cat. No. 14022-XX) can also be used
for proximal locking of the nail. Both 4.8 mm and 4.5 mm
screws use the same instrumentation.

Figure 28

Figure 27

Figure 29

Remove the trocar and insert the Humeral Drill Sleeve
(Cat. No. 2810-17-014) into the sheath until the drill sleeve
touches the bone (Figure 26).

Verify fluoroscopically to assure the proper screw length
selection. Remove the drill guide. Using the Humeral
Screwdriver (Cat. No. 2810-17-017), insert the 4.8 mm fully
threaded cancellous screw or 4.5 mm cortical screw through
the sheath (Figure 28). The humeral screwdriver is etched
with two markings, oblique and transverse, to identify proper
screw seating for the proximal locking screw holes.

Using the 3.8 mm Drill Bit (color-coded green) (Cat. No.
2810-17-115), drill through the drill sleeve and sheath, across
the humeral canal until the far cortex is reached but not
penetrated. Read the calibration on the drill bit that lines up
with the drill sleeve. Should bicortical purchase be needed,
estimate in millimeters the far cortex and add to the calibrated
reading. Use fluoroscopy in multiple planes to monitor appropriate drill depth during the drilling procedure (Figure 27).

Appropriate seating of the screw should be verified when
the respective marking is flush to the drill sleeve. It is recommended to verify via fluoroscopy.

Distal Locking

Finish drilling through the far cortex. A Screw Depth Gauge
(Cat. No. 2810-17-020) is also provided for further screw
length verification. A 4.5 mm Screw Length Gauge (Cat.
No. 2810-01-032) is also available for 4.5 mm cancellous
screws. For an accurate reading, take care to ensure the
sleeve of the depth gauge is fully seated on the bone.

Prior to locking the distal screws, check humeral length and
rotation under fluoroscopy. Distal locking should be conducted using the standard image intensification freehand
technique. A Radiolucent Targeting Wand (Cat. No. 2810-17025) is available if desired (Figure 29). Accurate C-arm position
is confirmed when the nail hole appears to be a perfect circle.
17

VersaNail ® Humeral Universal Nailing System

Locking instrumentation is colour-coded by
screw size for simplicity.
Nail Diameter

Screw Size

Drill Bit

7 and 8 mm

3.5 mm Cortical

2.9 mm

9 mm

4.5 mm Cortical

3.8 mm

A compensation factor is built intothe measurement of the
screw depth gauge (for the screw head and cutting flutes),
and the calibrated drills (for the screw head only). Depending
on the surgeon preference for cutting tip extension, 3–5 mm
may be added to the reading when using the calibrated drill.

4.8 mm Cancellous
Figure 30

Figure 32

Figure 33

Figure 31

Antegrade Locking
Determining Screw Length
After fluoroscopically verifying correct placement, make a
stab wound in direct alignment with the nail hole. An open
approach is recommended to protect the neurovascular
structures during drilling and screw placement, particularly
to prevent injuring the radial nerve. Use the appropriate drill
bit for the locking screw (Figure 30).

The screw size indicates the total measurement from the
tip to the screw head. The calibrated drills and the screw
depth gauges have a compensation factor built into the
measurement such that the reading should indicate the
exact size screw to achieve bi-cortical purchase. To ensure
a proper reading, the screw depth gauge sheath and drill
sleeves must be touching bone. Fluoroscopy is recommended to verify the correct screw length (Figure 32).

The distal screw holes should be drilled with the drill bit.
Read the calibration marks on the drill bit to determine
screw length using the 4.5 mm Screw Length Gauge (Cat.
No. 2810-01-032). Alternatively, the Humeral Screw Depth
Gauge (Cat. No. 2810-17-020) can be used (Figure 31).

Countersinking Option
To decrease the risk of impingement of the proximal locking
screw(s) on the acromion, it is important to countersink the
head of the proximal screw. A Countersink (Cat. No. 281017-024) is provided in the set (Figure 33). After drilling, the
countersink is used on the lateral cortex. Care should be
taken to avoid complete reaming of the lateral cortex.

Remove the drill bit and advance the screw.

Figure 34

Figure 35

Figure 36

Retrograde Entry and Canal Prep
Patient Positioning

Entry Site and Incision Placement

Place the patient in prone on a radiolucent table with the
injured limb positioned such that the humerus is supported
and the forearm is hanging off of the table (Figure 34). The
C-arm should be positioned parallel with the head of the
patient, allowing anterior-posterior, medial-lateral and axillary views of the fracture site.

Incise the triceps tendon vertically at the midline (Figure
35). Continue dissection of soft tissues in line with muscle
fibers taking care to avoid critical neurovascular structures,
such as the radial nerve. Expose the distal humerus and
retract muscles.
The entry site into the bone is made immediately above the
olecranon fossa, at the end of the shaft and the end of the
fossa on the dorsal aspect (Figure 36).

VersaNail ® Humeral Universal Nailing System

Figure 39

Figure 37

Figure 38

Figure 40

Retrograde Entry and Canal Prep
Place the retrograde entry portal with the Inner Sleeve (Cat.
No. 2810-17-002) onto the bone at the entry site (Figure 37).
Connect the 3.2 mm x 14 inch Guide Pin (Cat. No. 1401214) to a power drill and drill into the entry site through the
entry portal sleeve. Perform this under fluoroscopy.

such as traction, and can also be achieved using the Short
Reduction Tool (Cat. No. 2810-01-008) (Figure 39, left) that
is passed through the medullary canal and beyond the fracture site (Figure 39, right). Once the fracture is in alignment,
place a ball nose guide wire through the cannulation of the
reduction tool using the wire gripper. Remove the reduction
tool, and check reduction under image intensification.

Once the guide pin is in the correct position to allow access
into the medullary canal, remove the inner sleeve of the
entry portal, while leaving the entry portal itself in place to
act as a soft tissue protector. The entry site is then enlarged
with the 9.4 mm Retrograde Entry Reamer (Cat. No. 281017-004) (Figure 38).

Canal Preparation; Flexible Reaming
Achieve alignment of the injured limb prior to reaming
and maintain it throughout the reaming process to avoid
eccentric reaming. Commence reaming by placing an intramedullary flexible reamer over the Ball Nose Guide Wire
(Cat. No. 2810-17-006). Ream the medullary canal in halfmillimeter increments until cortical bone is reached. Monitor
the reaming procedure using image intensification to avoid
eccentric or excessive reaming (Figure 40).

Fracture Reduction
Obtain appropriate anatomic reduction in order to restore
length, alignment and rotation of the injured limb. Reduction
can be achieved through the surgeon’s preferred method

Figure 41

Figure 42

Figure 43

Retrograde Nail Insertion
Nail Size Selection

Nail Length Selection

An X-ray Template (Cat. No. 2810-17-023) is available to
determine nail size preoperatively (Figure 41).

There are two methods to determine nail length, the use of
a radiographic ruler or a nail length gauge.

Nail Diameter Selection

Radiographic Ruler

Choose a nail diameter 1 mm less than the final reamer
diameter. When treating distal humeral fractures with a
humeral nail, stresses are increased on the nail’s distal
portion. For distal humeral fractures, it is recommended
that the surgeon use the largest diameter that will fit in the
medullary canal, without excessive thinning of the cortex.
After selecting the appropriate nail diameter (7, 8 or 9 mm
option), secure nail to the Jig Body (Cat. No. 2810-17-009)
using the Jig Locking Bolt (Cat. No. 2810-17-010).

Take a direct length measurement using radiographs of
the contralateral uninjured extremity with magnification
markers. Use the Radiographic Ruler (Cat. No. 1245) to
determine the length of the nail (Figure 42).

VersaNail ® Humeral Universal Nailing System

Figure 45

Figure 44

Figure 46

Retrograde Nail Insertion
of different widths to prevent incorrect indexing of the nail
onto the jig nose. Tighten the jig locking bolt onto the nail
using the sliding jig bolt driver that engages the internal hex
located inside the upper part of the jig locking bolt.

Insert the Guide Wire Exchange Tube (Cat. No. 1127) over
the ball nose guide wire. Remove the ball nose guide wire.
Insert a 2.2 mm x 28 inch Guide Wire (Cat. No. 809222-028) through the exchange tube. Once the 2.2 mm x
28 inch guide wire is in place, remove the exchange tube
(Figure 44).

Note: Cat. No. 1127 Guide Wire Exchange Tube is 8mm
in diameter and may not fit in all intramedullary canals
of the humerus.

Nail Insertion

Nail length should allow room for fracture impaction. Guide
the nail into the medullary canal and confirm fracture reduction and placement using fluoroscopy. Assure the distal nail
position is well below the proximal cortex (Figure 46).

Insert the sliding jig locking bolt through the jig body (Figure
45). Mount the nail onto the nose and the protruding part
of the jig locking bolt, so that the two alignment tabs of the
nose engage fully with the keyways of the nail. The tabs are

3
1

Figure 47

Figure 48

Figure 49

Retrograde Locking
Proximal and Distal Locking

• 2 A-P distal nail screws above fracture
• Do not use Screw 2 (in oblique) with Screw 1

Distal locking is targeted through the jig. There are 3 L-M
transverse and 1 L-M oblique locking holes (Figure 47).

Place the protective Static Screw-Sheath (Cat. No. 281017-011) and Trocar (Cat. No. 2810-17-013) through the appropriate locking holes in the jig’s targeting arm (Figure 48).

If using the oblique hole, do not use the first and second
transverse hole. If utilizing the oblique hole (2) and the most
distal transverse hole (4), the screw tips may interfere with
one another, depending on how far past the second cortex
both screws are driven.

Make a stab incision longitudinally and bluntly dissect the
subcutaneous tissues through the biceps and directly to
the humerus. Caution should be used during drilling to
avoid damage to neurovascular structures. An open approach is recommended using a finger to palpate the position of the screw sheath and trocar over the center of the
humerus. A sheath Locking Nut (Cat. No. 2810-01-018) is
available to help secure the sheath to the jig.

Distal Locking
4.8 mm Cancellous Fully Threaded Screws (Cat. No.
1819-48-0XX) are recommended for distal locking. 4.5 mm
Cortical Screws (Cat. No. 14022-XX) can also be used for
distal locking of the nail. Both 4.8 mm and 4.5 mm screws
use the same instrumentation.

Remove the trocar and insert the Humeral Drill Sleeve
(Cat. No. 2810-17-014) into the sheath until the drill sleeve
touches the bone (Figure 49).

Typical Locking Configurations
Retrograde shaft fractures:
• Screw 1, 3 and 4 or 2 and 4 or 1 and 4 below fracture
23

VersaNail ® Humeral Universal Nailing System

Figure 51

Figure 50

Figure 52

Screwdriver (Cat. No. 2810-17-017), insert the 4.8 mm
fully threaded cancellous screw or 4.5 mm cortical screw
through the sheath. The humeral screwdriver is etched
with two markings, oblique and transverse, to identify
proper screw seating for the proximal locking screw holes.
Appropriate seating at the screw should be verified when
the respective marking is flush to the drill sleeve. It is recommended to verify via fluoroscopy.

Finish drilling through the far cortex. A Screw Depth Gauge
(Cat. No. 2810-17-020) is also provided for further screw
length verification. A 4.5 mm Screw Length Gauge (Cat. No.
2810-01-032) is also available for 4.5 mm cancellous screws.
For anaccurate reading, take care to ensure the sleeve of the
depth gauge is fully seated on the bone (Figure 51).

Proximal Locking
Prior to locking proximal screws, check humeral length
and rotation under fluoroscopy. Proximal locking should be
conducted using the standard image intensification freehand technique. A Radiolucent Targeting Wand (Cat. No.
2810-17-025) is available if desired (Figure 52). Accurate
C-arm position is confirmed when the nail hole appears to
be a perfect circle.

Verify fluoroscopically to assure the proper screw length
selection. Remove the drill guide. Using the Humeral

Locking instrumentation is color-coded by
screw size for simplicity.
Nail Diameter
7 and 8 mm
9 mm

Screw Size

Drill Bit

3.5 mm Cortical

2.9 mm

4.5 mm Cortical

3.8 mm

4.8 mm Cancellous
Figure 53
A compensation factor is built into the measurement of
the screw depth gauge (for the screw head and cutting
flutes), and the calibrated drills (for the screw head only).
Depending on the surgeon preference for cutting tip
extension, 3–5 mm may be added to the reading when
using the calibrated drill.

Figure 54

Figure 55

Determining Screw Length
After fluoroscopically verifying correct placement, make a
stab wound in direct alignment with the nail hole. Dissect
bluntly through the subcutaneous tissues and deltoid
muscles to the lateral cortex. An open approach is recommended to protect the neurovascular structures and
muscles during drilling and screw placement. Use the appropriate drill bit for the locking screw (Figure 53).

The distal screw holes should be drilled with the drill bit.
Read the calibration marks on the drill bit to determine
screw length using the Screw Length Gauge (Cat. No.
2810-01-032). Alternatively, the Humeral Screw Depth
Gauge (Cat. No.2810-17-020) can be used (Figure 54).
Remove the drill bit and advance the screw.

VersaNail ® Humeral Universal Nailing System

Figure 56

Figure 58

Figure 57

Figure 59

End Cap Placement
Impinging and non-impinging end caps are provided in the
system to both prevent bony in-growth and add length
when needed.

ficiently tightened, and that it does not extend above the
articulating surface of the humeral head. Irrigate the joint to
make sure that no debris remains. Close the wound.

The available end caps are (Figure 56):
• Flush impinging on the 1st screw
• Flush impinging on the 2nd second screw in
oblique only
• 5 mm superior to nail end impinging on the
1st screw
• 5 mm superior to nail end impinging on the
2nd screw in oblique only
• 10 mm superior to nail end impinging on the
1st screw
Thread the end cap into place with the Humeral Screwdriver
(Cat. No. 2810-17-017) and Screwdriver Handle (Cat. No.
2141-49-000). A second screwdriver such as the SolidLok™
Screwdriver (Cat. Nos. 2810-01-021, Inner Shaft; 2810-01019, Tip; 2810-01-020, Handle) is also available to aid in
end cap placement (Figure 57). Ensure the end cap is suf-

Nail Removal
If the surgeon deems it appropriate to remove the nail,
an Extractor Bolt (Cat. No. 2810-17-022), used with the
3/4 Inch Hex Driver (Cat. No. 2810-01-027) and T-handle
Hudson (Cat. No. 2810-01-004), is provided to aid in nail
extraction (Figure 58). Additionally, a Sliding Hammer (Cat.
No. 1096) and Impactor Rod Assembly (Cat. No. 1095) can
also be used to aid in nail extraction.
Locate the top of the nail through an appropriate incision. If present, remove the end cap using the Humeral
Screwdriver (Cat. No. 2810-17-017) and Screwdriver
Handle (Cat. No. 2141-49-000). A second screwdriver
such as the SolidLok Screwdriver (Cat. Nos. 2810-01-021,
Inner Shaft; 2810-01-019, Tip; 2810-01-020, Handle) is
also available to aid in end cap removal (Figure 59).
26

VersaNail ® Humeral Universal Nailing System
Ordering Information

Universal Nail size offering:
Includes nail without end cap
Screw sizes (mm):
Diameter
7

Length
200–300 in 20 mm incr.

Cat. No.

Proximal

Distal

1817-07-201/301

4.5/4.8

3.5

200–300 in 20 mm incr.

1817-08-201/301

4.5/4.8

3.5

200–300 in 20 mm incr.

1817-09-201/301

4.5/4.8

4.5

Proximal screws:
Diameter (mm)

Length (mm)

Cat. No.

4.8 cancellous for
7-8-9 mm nails

30–60 in 2 mm increments

Sterile: 1818-48-030/076

60–76 in 4 mm increments

Non-sterile: 1819-48-030/076

3.8 mm drill bit to be used
Distal screws:
Diameter (mm)

Length (mm)

Cat. No.

4.5 cortical for
9 mm nail

20–60 in 2 mm increments

Sterile: 8050-45-020/070

65–70 in 5 mm increments

Non-sterile: 14022-20/070

3.8 mm drill bit
Diameter (mm)
3.5 cortical for
7–8 mm nail

Length (mm)

Cat. No.

20–40 in 2 mm increments

Sterile: 1818-35-020/040
Non-sterile: 1819-35-020/040

2.9 mm drill bit

Screw Dimensions

3.5 mm

4.5 mm

4.8 mm

Thread Major

3.5

4.7

4.9

Thread Minor

2.6

3.7

3.6

Thread Pitch

0.75

1.0

1.8

Head Diameter

7.0

7.7

7.8

Head Height

5.5

5.0

5.3

Hex Size

3.6

VersaNail ® Humeral Universal Nailing System
4.5 mm Cortical Screws: Non-Sterile

3.5 mm Cortical Screws: Non-Sterile

Cat. No.

Description

1819-35-020

Cortical Screw 20 mm

1402220

Cortical Bone Screw 20 mm

1819-35-022

Cortical Screw 22 mm

1402222

Cortical Bone Screw 22 mm

1819-35-024

Cortical Screw 24 mm

1402224

Cortical Bone Screw 24 mm

1819-35-026

Cortical Screw 26 mm

1402226

Cortical Bone Screw 26 mm

1819-35-028

Cortical Screw 28 mm

1402228

Cortical Bone Screw 28 mm

1819-35-030

Cortical Screw 30 mm

1402230

Cortical Bone Screw 30 mm

1819-35-032

Cortical Screw 32 mm

1402232

Cortical Bone Screw 32 mm

1819-35-034

Cortical Screw 34 mm

1402234

Cortical Bone Screw 34 mm

1819-35-036

Cortical Screw 36 mm

1402236

Cortical Bone Screw 36 mm

1819-35-038

Cortical Screw 38 mm

1402238

Cortical Bone Screw 38 mm

1819-35-040

Cortical Screw 40 mm

1402240

Cortical Bone Screw 40 mm

1402242

Cortical Bone Screw 42 mm

1402244

Cortical Bone Screw 44 mm

1817-07-201

Universal Humeral Nail 7 mm x 200 mm

1402246

Cortical Bone Screw 46 mm

1817-07-221

Universal Humeral Nail 7 mm x 220 mm

1402248

Cortical Bone Screw 48 mm

1817-07-241

Universal Humeral Nail 7 mm x 240 mm

1402250

Cortical Bone Screw 50 mm

1817-07-261

Universal Humeral Nail 7 mm x 260 mm

1402252

Cortical Bone Screw 52 mm

1817-07-281

Universal Humeral Nail 7 mm x 280 mm

1402254

Cortical Bone Screw 54 mm

1817-07-301

Universal Humeral Nail 7 mm x 300 mm

1402256

Cortical Bone Screw 56 mm

1402258

Cortical Bone Screw 58 mm

1402260

Cortical Bone Screw 60 mm

1817-08-201

Universal Humeral Nail 8 mm x 200 mm

1402265

Cortical Bone Screw 65 mm

1817-08-221

Universal Humeral Nail 8 mm x 220 mm

1402270

Cortical Bone Screw 70 mm

1817-08-241

Universal Humeral Nail 8 mm x 240 mm

1817-08-261

Universal Humeral Nail 8 mm x 260 mm

1817-08-281

Universal Humeral Nail 8 mm x 280 mm

1817-08-301

Universal Humeral Nail 8 mm x 300 mm

Universal Nail: 7 mm Diameter

Universal Nail: 8 mm Diameter

4.8 mm Cancellous Screws: Non-Sterile
1819-48-030

Cancellous Screw 30 mm

1819-48-032

Cancellous Screw 32 mm

1819-48-034

Cancellous Screw 34 mm

1819-48-036

Cancellous Screw 36 mm

1817-09-201

Universal Humeral Nail 9 mm x 200 mm

1819-48-038

Cancellous Screw 38 mm

1817-09-221

Universal Humeral Nail 9 mm x 220 mm

1819-48-040

Cancellous Screw 40 mm

1817-09-241

Universal Humeral Nail 9 mm x 240 mm

1819-48-042

Cancellous Screw 42 mm

1817-09-261

Universal Humeral Nail 9 mm x 260 mm

1819-48-044

Cancellous Screw 44 mm

1817-09-281

Universal Humeral Nail 9 mm x 280 mm

1819-48-046

Cancellous Screw 46 mm

1817-09-301

Universal Humeral Nail 9 mm x 300 mm

1819-48-048

Cancellous Screw 48 mm

1819-48-050

Cancellous Screw 50 mm

End Caps

1819-48-052

Cancellous Screw 52 mm

1817-01-001

End Cap, Flush 1st Hole Imping

1819-48-054

Cancellous Screw 54 mm

1817-01-002

1819-48-056

Cancellous Screw 56 mm

End Cap, Flush 2nd Hole Imping in
oblique only

1819-48-058

Cancellous Screw 58 mm

1817-01-051

End Cap, +5 mm 1st Hole Imping

1819-48-060

Cancellous Screw 60 mm

1817-01-052

End Cap, +5 mm 2nd Hole Imping in
oblique only

1819-48-064

Cancellous Screw 64 mm

1817-01-101

End Cap, +10 mm 1st Hole Imping

1819-48-068

Cancellous Screw 68 mm

1819-48-072

Cancellous Screw 72 mm

1819-48-076

Cancellous Screw 76 mm

Universal Nail: 9 mm Diameter

Indicates outlier size not included in standard set configuration.
28

General
2810-01-001

Pistol Guide Wire Gripper

2810-01-002

T-handle Guide Wire Gripper

2810-01-004

T-handle Hudson

1096

Hammer Sliding Impactor

Canal Preparation
2810-01-008

Short Reduction Tool

2810-01-005

Curved Cannulated Awl

2810-17-101

Antegrade Entry Portal

2810-17-002

Retrograde Entry Portal

2810-01-025

Awl Stylus

2810-01-026

Guide Wire Pusher

2810-17-003

9.4 mm Entry Reamer

2810-17-004

9.4 mm Retrograde Entry
Reamer

2810-18-002

11.5 mm Entry Reamer*

7
5

*The 11.5 mm Entry Reamer is used with the Humeral
Proximal Nail.

Nail Insertion
2810-17-009

Universal Jig Body

2810-01-010

Hammer Pad Tibial Humerus 15

2810-17-010

Universal Jig Locking Bolt

1095

Impactor Rod Assembly

17
29

VersaNail ® Humeral Universal Nailing System
Promixal Locking

18
19
22

20
21
23
24

2810-17-011

Static Screw Sheath

2810-17-007

3.2 mm Pin Sleeve Humeral

2810-17-013

Trocar

2810-17-014

Drill Sleeve

2810-01-018

Sheath Locking Nut

2810-01-032

4.5 mm Screw Length
Gauge

2810-17-017

Humeral Screwdriver

2810-17-024

Countersink

Distal Locking

28
29
30

2141-49-000

Lg Cann Screwdriver
Handle

2810-17-025

Humeral Nail Target Wand

2810-17-020

Humeral Screw Depth
Gauge

2810-17-021

Dynamic Screw Sheath

2810-01-032

4.5 mm Screw Length
Gauge

2810-01-020

SolidLok Screwdriver
Handle

2810-01-021

SolidLok Driver Inner Shaft

2810-17-017

Humeral Screwdriver

2810-17-022

Universal Nail Extractor Bolt

2810-01-027

3/4 inch Hex Driver

1401214

Guide Pin 3.2 mm x 14 inch

2810-01-019

SolidLok™ Hex Tip, 3.5 mm

2810-17-119

2.9 mm Drill Bit/Non-sterile

2810-17-115

3.8 mm Drill Bit/Non-sterile

2810-12-138

3.8 mm Drill Bit 6 inch NS

2810-17-129

2.9 mm Drill Bit Short NS

8092-22-028

Guide Wire 2.2 mm x 28
inch

2810-17-006

2.0 mm Ball Nose Guide
Wire

1127

Humeral Nail Exchange
Tube

Nail Removal

Disposables

36
37

38
39
40
41
42
43
44
30

Cases & Trays
2810-17-030

Humeral Nail Tray 45

2810-17-032

Humeral Nail Tray 2

2810-17-031

Humeral Nail Screw Caddie

–

8299-10-045

4.5 mm Cort Screw Module

8299-10-500

Mod Screw System Outer
Case

47
Module

Nail Measurement

1245

Radiographic Ruler

2810-01-009

Nail Length Gauge

2810-17-023

Universal Nail X-ray
Template

51
Endcap Placement
2810-17-017

Humeral Screwdriver

2141-49-000

Lg Cann Screwdriver Handle

2810-01-020

SolidLok Screwdriver Handle

2810-01-021

SolidLok Driver Inner Shaft

52
53
54
55
31

48
Outer Case

VersaNail ® Humeral Universal Nailing System
Flexible Reaming System

Monobloc Reamer Hudson

Coupling design is simple,long
established and easy to clean
(AO and/or HUDSON).

Excellent cleanability – Nitinol (NickelTitanium) alloy allows for a smooth cannulated shaft that provides the required
flexibility without the cleaning problems
associated with coil-cut or spring shaft
designs.

Small shaft diameters allow debris to be
removed and transported up to the open
proximal end of the medullary canal.

Deep cutting flutes allow debris to be
moved proximally away from the reamer
head, maintaining cutting edge efficiency.

Sharp side cutting edges are designed to
remove bone without generating a substantial increase in temperature.

Surface coating titanium nitride (TiNi) will
keep cutting edge sharper longer.

Ellipsoidal head shape allows the cutting edge to remove bone gradually and
transport debris away, while bone chipping design decreases the size of debris,
reducing canal pressure.

Reverse cutting feature minimizes the
potential for the reamer to catch in the
medullary canal.

Cat. No.

Diameter

2810-02-060
2810-02-065
2810-02-070
2810-02-075
2810-02-080
2810-02-085
2810-02-090
2810-02-095
2810-02-100
2810-02-105
2810-02-110
2810-02-115
2810-02-120
2810-02-125
2810-02-130

6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
10.5
11.0
11.5
12.0
12.5
13.0

mm
mm
mm
mm
mm
mm
mm
mm
mm
mm
mm
mm
mm
mm
mm

Modular Reamer Head
Cat. No.
Diameter
2810-04-090
9.0 mm
2810-04-095
9.5 mm
2810-04-100
10.0 mm
2810-04-105
10.5 mm
2810-04-110
11.0 mm
2810-04-115
11.5 mm
2810-04-120
12.0 mm
2810-04-125
12.5 mm
2810-04-130
13.0 mm
2810-04-135
13.5 mm
2810-04-140
14.0 mm
2810-04-145
14.5 mm
2810-04-150
15.0 mm
2810-04-155
15.5 mm
2810-04-160
16.0 mm
2810-04-165
16.5 mm
2810-04-170
17.0 mm
2810-04-175
17.5 mm
2810-04-180
18.0 mm
2810-04-185
18.5 mm
2810-04-190
19.0 mm
2810-04-195
19.5 mm
2810-04-200
20.0 mm
2810-04-205
20.5 mm
2810-04-210
21.0 mm
2810-04-215
21.5 mm
2810-04-220
22.0 mm

Nitinol Modular
Reamer Shaft Hudson
Cat. No.
Length
2810-02-400
400 mm
2810-02-470
470 mm

Reamer Extension
Cat. No.
2810-02-015

Length
150 mm

Ball Nose Guide Wires
Cat. No.
Length
3.0 mm

(use with 8.0–22.0 mm Reamers)

2810-01-080
2810-01-100
2.0 mm

800 mm
1000 mm

2810-17-006

700 mm

(use with 6.0–7.5 mm Reamers)

Flexible Reamer Case
2810-02-016

Proximal End
2.5º

Distal End
Proximal End 9.2 mm
60 mm

13.5 mm

39 mm

25.5 mm

28 mm
17 mm

45º
51.5 mm

0 mm
4º

3 mm Cannulation

Locking Options

Screws, Plates, Intramedullary Nails, Compression Hip Screws, Pins
and Wires
Important:
This Essential Product Information does not include all of the information necessary
for selection and use of a device. Please see full labeling for all necessary
information.
Indications:
The use of metallic surgical appliances (screws, plates, intramedullary nails,
compression hip screws, pins and wires) provides the orthopaedic surgeon a
means of bone fixation and helps generally in the management of fractures and
reconstructive surgeries. These implants are intended as a guide to normal healing,
and are NOT intended to replace normal body structure or bear the weight of the
body in the presence of incomplete bone healing. Delayed unions or nonunions in
the presence of load bearing or weight bearing might eventually cause the implant
to break due to metal fatigue. All metal surgical implants are subjected to repeated
stress in use, which can result in metal fatigue.
Contraindications:
Screws, plates, intramedullary nails, compression hip screws, pins and wires are
contraindicated in: active infection, conditions which tend to retard healing such
as blood supply limitations, previous infections, insufficient quantity or quality of
bone to permit stabilization of the fracture complex, conditions that restrict the
patient’s ability or willingness to follow postoperative instructions during the healing
process, foreign body sensitivity, and cases where the implant(s) would cross open
epiphyseal plates in skeletally immature patients.

Additional Contraindication for Retrograde Femoral Nailing:
A history of septic arthritis of the knee and knee extension contracture with inability
to attain at least 45º of flexion.
Additional Contraindications for Compression Hip Screws only:
Inadequate implant support due to the lack of medial buttress.
Warnings and Precautions:
Bone screws and pins are intended for partial weight bearing and non-weight
bearing applications. These components cannot be expected to withstand the
unsupported stresses of full weight bearing.
Adverse Events:
The following are the most frequent adverse events after fixation with orthopaedic
screws, plates, intramedullary nails, compression hip screws, pins and wires:
loosening, bending, cracking or fracture of the components or loss of fixation
in bone attributable to nonunion, osteoporosis, markedly unstable comminuted
fractures; loss of anatomic position with nonunion or malunion with rotation or
angulation; infection and allergies and adverse reactions to the device material.
Surgeons should take care when targeting and drilling for the proximal screws in
any tibial nail with oblique proximal screws. Care should be taken as the drill bit
is advanced to penetrate the far cortex. Advancing the drill bit too far in this area
may cause injury to the deep peroneal nerve. Fluoroscopy should be used to verify
correct positioning of the drill bit.
Additional Adverse Events for Compression Hip Screw only:
Screw cutout of the femoral head (usually associated with osteoporotic bone).

Additional Contraindication for Orthopaedic Screws and Plates only:
Cases with malignant primary or metastatic tumors which preclude adequate bone
support or screw fixations, unless supplemental fixation or stabilization methods
are utilized.

All trademarks herein are the property of Biomet, Inc. or its subsidiaries unless
otherwise indicated.
This material is intended for the sole use and benefit of the Biomet sales force and
physicians. It is not to be redistributed, duplicated or disclosed without the express
written consent of Biomet.
For product information, including indications, contraindications, warnings, precautions and potential adverse effects, see the package insert.

P.O. Box 587, Warsaw, IN 46581-0587 • 800.348.9500 x 1501
©2012 Biomet Orthopedics • biomet.com
Form No. BMET0083.0 • REV091512

Source Exif Data:

File Type                       : PDF
File Type Extension             : pdf
MIME Type                       : application/pdf
PDF Version                     : 1.5
Linearized                      : No
Create Date                     : 2012:08:31 14:51:25-04:00
Creator                         : Adobe InDesign CS4 (6.0.6)
Modify Date                     : 2015:02:02 11:38:48-05:00
XMP Toolkit                     : Adobe XMP Core 5.4-c005 78.147326, 2012/08/23-13:03:03
Instance ID                     : uuid:dce10801-17d0-884c-81c2-ca6559d84348
Document ID                     : xmp.did:37D2BFFD1E206811871F9F1D708A7A8F
Original Document ID            : adobe:docid:indd:c5fff251-ae56-11de-8871-a6c5c1863831
Rendition Class                 : proof:pdf
Derived From Instance ID        : xmp.iid:36D2BFFD1E206811871F9F1D708A7A8F
Derived From Document ID        : xmp.did:0256DAE71F206811871FA1F8B85CFD3E
Derived From Original Document ID: adobe:docid:indd:c5fff251-ae56-11de-8871-a6c5c1863831
Derived From Rendition Class    : default
History Action                  : saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved, saved
History Instance ID             : xmp.iid:0680117407206811A613A0FC8C39220D, xmp.iid:0780117407206811A613A0FC8C39220D, xmp.iid:0880117407206811A613A0FC8C39220D, xmp.iid:0980117407206811A613A0FC8C39220D, xmp.iid:0A80117407206811A613A0FC8C39220D, xmp.iid:D4456DBB1A206811A613A0FC8C39220D, xmp.iid:D5456DBB1A206811A613A0FC8C39220D, xmp.iid:D6456DBB1A206811A613A0FC8C39220D, xmp.iid:D7456DBB1A206811A613A0FC8C39220D, xmp.iid:0156DAE71F206811871FA1F8B85CFD3E, xmp.iid:0256DAE71F206811871FA1F8B85CFD3E, xmp.iid:84BCC2A432206811871FA1F8B85CFD3E, xmp.iid:85BCC2A432206811871FA1F8B85CFD3E, xmp.iid:86BCC2A432206811871FA1F8B85CFD3E, xmp.iid:87BCC2A432206811871FA1F8B85CFD3E, xmp.iid:88BCC2A432206811871FA1F8B85CFD3E, xmp.iid:89BCC2A432206811871FA1F8B85CFD3E, xmp.iid:8ABCC2A432206811871FA1F8B85CFD3E, xmp.iid:8DBCC2A432206811871FA1F8B85CFD3E, xmp.iid:8EBCC2A432206811871FA1F8B85CFD3E, xmp.iid:ADDEC3AE39206811871FA1F8B85CFD3E, xmp.iid:AEDEC3AE39206811871FA1F8B85CFD3E, xmp.iid:AFDEC3AE39206811871FA1F8B85CFD3E, xmp.iid:B0DEC3AE39206811871FA1F8B85CFD3E, xmp.iid:B1DEC3AE39206811871FA1F8B85CFD3E, xmp.iid:B2DEC3AE39206811871FA1F8B85CFD3E, xmp.iid:B3DEC3AE39206811871FA1F8B85CFD3E, xmp.iid:B4DEC3AE39206811871FA1F8B85CFD3E, xmp.iid:8471B18940206811871FA1F8B85CFD3E, xmp.iid:8571B18940206811871FA1F8B85CFD3E, xmp.iid:8671B18940206811871FA1F8B85CFD3E, xmp.iid:8771B18940206811871FA1F8B85CFD3E, xmp.iid:8871B18940206811871FA1F8B85CFD3E, xmp.iid:8971B18940206811871FA1F8B85CFD3E, xmp.iid:8A71B18940206811871FA1F8B85CFD3E, xmp.iid:8B71B18940206811871FA1F8B85CFD3E, xmp.iid:8C71B18940206811871FA1F8B85CFD3E, xmp.iid:8D71B18940206811871FA1F8B85CFD3E, xmp.iid:8E71B18940206811871FA1F8B85CFD3E, xmp.iid:2CE0B80646206811871FA1F8B85CFD3E, xmp.iid:2DE0B80646206811871FA1F8B85CFD3E, xmp.iid:2EE0B80646206811871FA1F8B85CFD3E, xmp.iid:2FE0B80646206811871FA1F8B85CFD3E, xmp.iid:30E0B80646206811871FA1F8B85CFD3E, xmp.iid:31E0B80646206811871FA1F8B85CFD3E, xmp.iid:32E0B80646206811871FA1F8B85CFD3E, xmp.iid:34E0B80646206811871FA1F8B85CFD3E, xmp.iid:35E0B80646206811871FA1F8B85CFD3E, xmp.iid:36E0B80646206811871FA1F8B85CFD3E, xmp.iid:1A053D144C206811871FA1F8B85CFD3E, xmp.iid:1E053D144C206811871FA1F8B85CFD3E, xmp.iid:1F053D144C206811871FA1F8B85CFD3E, xmp.iid:20053D144C206811871FA1F8B85CFD3E, xmp.iid:21053D144C206811871FA1F8B85CFD3E, xmp.iid:22053D144C206811871FA1F8B85CFD3E, xmp.iid:23053D144C206811871FA1F8B85CFD3E, xmp.iid:24053D144C206811871FA1F8B85CFD3E, xmp.iid:1A5A1FF06F206811871FA1F8B85CFD3E, xmp.iid:1C5A1FF06F206811871FA1F8B85CFD3E, xmp.iid:1D5A1FF06F206811871FA1F8B85CFD3E, xmp.iid:1E5A1FF06F206811871FA1F8B85CFD3E, xmp.iid:1F5A1FF06F206811871FA1F8B85CFD3E, xmp.iid:205A1FF06F206811871FA1F8B85CFD3E, xmp.iid:215A1FF06F206811871FA1F8B85CFD3E, xmp.iid:225A1FF06F206811871FA1F8B85CFD3E, xmp.iid:235A1FF06F206811871FA1F8B85CFD3E, xmp.iid:245A1FF06F206811871FA1F8B85CFD3E, xmp.iid:9813C32E7E206811871FA1F8B85CFD3E, xmp.iid:9913C32E7E206811871FA1F8B85CFD3E, xmp.iid:9A13C32E7E206811871FA1F8B85CFD3E, xmp.iid:9B13C32E7E206811871FA1F8B85CFD3E, xmp.iid:9C13C32E7E206811871FA1F8B85CFD3E, xmp.iid:9D13C32E7E206811871FA1F8B85CFD3E, xmp.iid:9E13C32E7E206811871FA1F8B85CFD3E, xmp.iid:0180117407206811871F9F1D708A7A8F, xmp.iid:0280117407206811871F9F1D708A7A8F, xmp.iid:0A80117407206811871F9F1D708A7A8F, xmp.iid:924CBE4A16206811871F9F1D708A7A8F, xmp.iid:934CBE4A16206811871F9F1D708A7A8F, xmp.iid:954CBE4A16206811871F9F1D708A7A8F, xmp.iid:964CBE4A16206811871F9F1D708A7A8F, xmp.iid:974CBE4A16206811871F9F1D708A7A8F, xmp.iid:984CBE4A16206811871F9F1D708A7A8F, xmp.iid:994CBE4A16206811871F9F1D708A7A8F, xmp.iid:9A4CBE4A16206811871F9F1D708A7A8F, xmp.iid:9B4CBE4A16206811871F9F1D708A7A8F, xmp.iid:9C4CBE4A16206811871F9F1D708A7A8F, xmp.iid:36D2BFFD1E206811871F9F1D708A7A8F, xmp.iid:37D2BFFD1E206811871F9F1D708A7A8F, xmp.iid:38D2BFFD1E206811871F9F1D708A7A8F, xmp.iid:39D2BFFD1E206811871F9F1D708A7A8F, xmp.iid:3AD2BFFD1E206811871F9F1D708A7A8F, xmp.iid:7392352534206811871F9F1D708A7A8F, xmp.iid:7492352534206811871F9F1D708A7A8F, xmp.iid:7592352534206811871F9F1D708A7A8F, xmp.iid:7692352534206811871F9F1D708A7A8F, xmp.iid:7792352534206811871F9F1D708A7A8F, xmp.iid:7892352534206811871F9F1D708A7A8F, xmp.iid:DAFE36FB3D206811871F9F1D708A7A8F, xmp.iid:DDFE36FB3D206811871F9F1D708A7A8F, xmp.iid:DEFE36FB3D206811871F9F1D708A7A8F, xmp.iid:DFFE36FB3D206811871F9F1D708A7A8F, xmp.iid:E0FE36FB3D206811871F9F1D708A7A8F, xmp.iid:E1FE36FB3D206811871F9F1D708A7A8F, xmp.iid:E2FE36FB3D206811871F9F1D708A7A8F, xmp.iid:38120887132068118BA3CF0CE7C0FB3C, xmp.iid:39120887132068118BA3CF0CE7C0FB3C, xmp.iid:0180117407206811871F926286C75BAA, xmp.iid:0480117407206811871F926286C75BAA, xmp.iid:0580117407206811871F926286C75BAA, xmp.iid:0680117407206811871F926286C75BAA, xmp.iid:0780117407206811871F926286C75BAA, xmp.iid:0880117407206811871F926286C75BAA, xmp.iid:0980117407206811871F926286C75BAA, xmp.iid:0A80117407206811871F926286C75BAA, xmp.iid:6AB44C5312206811871F926286C75BAA, xmp.iid:6BB44C5312206811871F926286C75BAA, xmp.iid:6CB44C5312206811871F926286C75BAA, xmp.iid:6DB44C5312206811871F926286C75BAA, xmp.iid:6EB44C5312206811871F926286C75BAA, xmp.iid:6FB44C5312206811871F926286C75BAA, xmp.iid:70B44C5312206811871F926286C75BAA, xmp.iid:71B44C5312206811871F926286C75BAA, xmp.iid:72B44C5312206811871F926286C75BAA, xmp.iid:96A258CD2B206811871F926286C75BAA, xmp.iid:9BA258CD2B206811871F926286C75BAA, xmp.iid:9CA258CD2B206811871F926286C75BAA, xmp.iid:9DA258CD2B206811871F926286C75BAA, xmp.iid:9EA258CD2B206811871F926286C75BAA, xmp.iid:9FA258CD2B206811871F926286C75BAA, xmp.iid:A0A258CD2B206811871F926286C75BAA
History When                    : 2009:10:26 10:32:58-04:00, 2009:10:26 10:32:58-04:00, 2009:10:26 10:35:56-04:00, 2009:10:26 10:38:27-04:00, 2009:10:26 10:39:55-04:00, 2009:10:26 10:41:40-04:00, 2009:10:26 10:51:46-04:00, 2009:10:26 10:52:54-04:00, 2009:10:26 13:06:01-04:00, 2012:08:29 14:59:52-04:00, 2012:08:29 14:59:53-04:00, 2012:08:29 15:15:34-04:00, 2012:08:29 15:16:52-04:00, 2012:08:29 15:22:33-04:00, 2012:08:29 15:29:57-04:00, 2012:08:29 15:40:12-04:00, 2012:08:29 15:42:29-04:00, 2012:08:29 15:44:41-04:00, 2012:08:29 16:00:45-04:00, 2012:08:29 16:02:38-04:00, 2012:08:29 16:12:52-04:00, 2012:08:29 16:14:25-04:00, 2012:08:29 16:16:08-04:00, 2012:08:29 16:16:25-04:00, 2012:08:29 16:32:08-04:00, 2012:08:29 16:37:13-04:00, 2012:08:29 16:40:49-04:00, 2012:08:29 16:51:07-04:00, 2012:08:29 16:55:01-04:00, 2012:08:29 17:00:52-04:00, 2012:08:29 17:02:33-04:00, 2012:08:29 17:07:20-04:00, 2012:08:29 17:13:03-04:00, 2012:08:29 17:18:02-04:00, 2012:08:29 17:20:23-04:00, 2012:08:29 17:20:49-04:00, 2012:08:29 17:25:39-04:00, 2012:08:29 17:26:17-04:00, 2012:08:29 17:32:35-04:00, 2012:08:29 17:34:19-04:00, 2012:08:29 17:36:57-04:00, 2012:08:29 17:40:29-04:00, 2012:08:29 17:40:49-04:00, 2012:08:29 17:44:34-04:00, 2012:08:29 17:48:30-04:00, 2012:08:29 17:48:41-04:00, 2012:08:29 17:59:07-04:00, 2012:08:29 18:06:34-04:00, 2012:08:29 18:08:02-04:00, 2012:08:29 18:17:38-04:00, 2012:08:29 21:51:34-04:00, 2012:08:29 21:52:17-04:00, 2012:08:29 21:54:49-04:00, 2012:08:29 22:03:11-04:00, 2012:08:29 22:11:19-04:00, 2012:08:29 22:13:51-04:00, 2012:08:29 22:26:06-04:00, 2012:08:29 22:34:20-04:00, 2012:08:29 22:44:23-04:00, 2012:08:29 22:54:28-04:00, 2012:08:29 23:08:19-04:00, 2012:08:29 23:14:24-04:00, 2012:08:29 23:15:54-04:00, 2012:08:29 23:25:53-04:00, 2012:08:29 23:28:27-04:00, 2012:08:30 00:03:30-04:00, 2012:08:30 00:12:17-04:00, 2012:08:30 00:16:18-04:00, 2012:08:30 00:29:58-04:00, 2012:08:30 00:33:36-04:00, 2012:08:30 00:54:40-04:00, 2012:08:30 00:55:56-04:00, 2012:08:30 01:09:13-04:00, 2012:08:30 01:13:58-04:00, 2012:08:30 09:26:39-04:00, 2012:08:30 09:44:21-04:00, 2012:08:30 11:12:23-04:00, 2012:08:30 11:12:52-04:00, 2012:08:30 11:31:58-04:00, 2012:08:30 11:44:49-04:00, 2012:08:30 11:46:53-04:00, 2012:08:30 11:51:17-04:00, 2012:08:30 11:54:31-04:00, 2012:08:30 12:07:27-04:00, 2012:08:30 12:10:42-04:00, 2012:08:30 12:12:19-04:00, 2012:08:30 12:14:25-04:00, 2012:08:30 12:15:09-04:00, 2012:08:30 12:15:09-04:00, 2012:08:30 12:26:27-04:00, 2012:08:30 12:28:12-04:00, 2012:08:30 12:34:22-04:00, 2012:08:30 15:15:16-04:00, 2012:08:30 15:16:18-04:00, 2012:08:30 15:19:47-04:00, 2012:08:30 15:25:30-04:00, 2012:08:30 15:35:56-04:00, 2012:08:30 15:52:08-04:00, 2012:08:30 15:56:59-04:00, 2012:08:30 16:04:23-04:00, 2012:08:30 16:18:14-04:00, 2012:08:30 16:21:23-04:00, 2012:08:30 16:23:48-04:00, 2012:08:30 16:24:19-04:00, 2012:08:30 17:04:06-04:00, 2012:08:30 21:39:36-04:00, 2012:08:30 21:43:20-04:00, 2012:08:31 09:36:42-04:00, 2012:08:31 10:20:31-04:00, 2012:08:31 10:25:30-04:00, 2012:08:31 10:26:24-04:00, 2012:08:31 10:27:13-04:00, 2012:08:31 10:28:19-04:00, 2012:08:31 10:47:49-04:00, 2012:08:31 10:47:56-04:00, 2012:08:31 10:54:32-04:00, 2012:08:31 10:59:07-04:00, 2012:08:31 11:05:42-04:00, 2012:08:31 11:10:07-04:00, 2012:08:31 11:10:58-04:00, 2012:08:31 11:12:16-04:00, 2012:08:31 11:14:27-04:00, 2012:08:31 11:22:38-04:00, 2012:08:31 11:23:50-04:00, 2012:08:31 13:56:54-04:00, 2012:08:31 14:28:35-04:00, 2012:08:31 14:32:07-04:00, 2012:08:31 14:44:48-04:00, 2012:08:31 14:47:07-04:00, 2012:08:31 14:48:51-04:00, 2012:08:31 14:50:58-04:00
History Software Agent          : Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0, Adobe InDesign 6.0
History Changed                 : /, /metadata, /, /, /, /, /, /, /, /metadata, /;/metadata, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /metadata, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /, /
Manifest Link Form              : ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream, ReferenceStream
Manifest Placed X Resolution    : 300.00, 72.00, 300.00, 300.00, 300.00, 300.00, 200.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 72.00, 300.00, 300.00, 532.00, 532.00, 300.00, 835.19, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 72.00, 300.00, 72.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 72.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 72.00, 300.00, 72.00, 300.00, 300.00, 300.00, 72.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 72.00, 300.00, 300.00, 72.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 240.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 250.00, 72.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 200.00, 200.00, 300.00, 300.00, 72.00
Manifest Placed Y Resolution    : 300.00, 72.00, 300.00, 300.00, 300.00, 300.00, 200.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 72.00, 300.00, 300.00, 532.00, 532.00, 300.00, 835.19, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 72.00, 300.00, 72.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 72.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 72.00, 300.00, 72.00, 300.00, 300.00, 300.00, 72.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 72.00, 300.00, 300.00, 72.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 240.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 250.00, 72.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 300.00, 200.00, 200.00, 300.00, 300.00, 72.00
Manifest Placed Resolution Unit : Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches, Inches
Manifest Reference Instance ID  : uuid:F50FB074840D11DE96C1C5279696055D, uuid:43c387b5-9096-ef46-8313-8386b3697a97, xmp.iid:08801174072068118F62896F56A20F5C, xmp.iid:0A801174072068118F62896F56A20F5C, xmp.iid:08801174072068118F62896F56A20F5C, xmp.iid:438F846F1C2068118F62896F56A20F5C, uuid:E263D9DC9DEA11DEB504FCBAADC66EE6, xmp.iid:418F846F1C2068118F62896F56A20F5C, xmp.iid:438F846F1C2068118F62896F56A20F5C, xmp.iid:DD0C91721D2068118F62896F56A20F5C, xmp.iid:DB0C91721D2068118F62896F56A20F5C, xmp.iid:90D12D811D2068118F62896F56A20F5C, xmp.iid:DF0C91721D2068118F62896F56A20F5C, xmp.iid:F893F2FD1C2068118F62896F56A20F5C, xmp.iid:EB045E111D2068118F62896F56A20F5C, xmp.iid:F1045E111D2068118F62896F56A20F5C, xmp.iid:F3045E111D2068118F62896F56A20F5C, xmp.iid:ED045E111D2068118F62896F56A20F5C, xmp.iid:EF045E111D2068118F62896F56A20F5C, xmp.iid:88D12D811D2068118F62896F56A20F5C, xmp.iid:E30C91721D2068118F62896F56A20F5C, xmp.iid:F493F2FD1C2068118F62896F56A20F5C, xmp.iid:F693F2FD1C2068118F62896F56A20F5C, xmp.iid:8ED12D811D2068118F62896F56A20F5C, xmp.iid:F293F2FD1C2068118F62896F56A20F5C, xmp.iid:F093F2FD1C2068118F62896F56A20F5C, xmp.iid:8CD12D811D2068118F62896F56A20F5C, xmp.iid:EE93F2FD1C2068118F62896F56A20F5C, xmp.iid:498F846F1C2068118F62896F56A20F5C, xmp.iid:8AD12D811D2068118F62896F56A20F5C, xmp.iid:478F846F1C2068118F62896F56A20F5C, xmp.iid:458F846F1C2068118F62896F56A20F5C, xmp.iid:E10C91721D2068118F62896F56A20F5C, uuid:67e3a172-964f-11da-9cb5-e7218130b47d, uuid:720C5D7EE75EDD11887E87916F4FAEDB, uuid:3f6da352-1cc8-11db-ade4-ad404a0fe056, xmp.iid:94523A52200C1168AD3DC87F591DAA72, xmp.iid:94523A55200C1168AD3DC87F591DAA72, uuid:C0D1F634C224DD1187BCFC3381547BDF, uuid:52972A33A37711DE8879F0921681CF20, xmp.iid:EA2B30631D2068118F62896F56A20F5C, xmp.iid:E82B30631D2068118F62896F56A20F5C, xmp.iid:E42B30631D2068118F62896F56A20F5C, uuid:544e6418-0696-11db-9d7f-f9eca141e40f, xmp.iid:E62B30631D2068118F62896F56A20F5C, xmp.iid:E22B30631D2068118F62896F56A20F5C, uuid:c3ca18f7-6db8-11da-8348-8b14e4597935, xmp.iid:F9B8E8911D2068118F62896F56A20F5C, xmp.iid:B4932F221D2068118F62896F56A20F5C, uuid:67ac0396-1cc8-11db-ade4-ad404a0fe056, uuid:00963B1B9E22DD1182B8BC2A071899D9, xmp.iid:FBB8E8911D2068118F62896F56A20F5C, xmp.iid:E02B30631D2068118F62896F56A20F5C, xmp.iid:2FF032511D2068118F62896F56A20F5C, xmp.iid:2DF032511D2068118F62896F56A20F5C, xmp.iid:2BF032511D2068118F62896F56A20F5C, xmp.iid:E10C91721D2068118F62896F56A20F5C, uuid:67e3a172-964f-11da-9cb5-e7218130b47d, uuid:7d0a6b68-1cc8-11db-ade4-ad404a0fe056, uuid:720C5D7EE75EDD11887E87916F4FAEDB, xmp.iid:94523A55200C1168AD3DC87F591DAA72, uuid:C0D1F634C224DD1187BCFC3381547BDF, uuid:52972A33A37711DE8879F0921681CF20, xmp.iid:94523A52200C1168AD3DC87F591DAA72, uuid:a3ce31c4-1cc8-11db-ade4-ad404a0fe056, uuid:a3ce31cb-1cc8-11db-ade4-ad404a0fe056, uuid:3f6da352-1cc8-11db-ade4-ad404a0fe056, uuid:b2b5b895-1cc8-11db-ade4-ad404a0fe056, xmp.iid:29F032511D2068118F62896F56A20F5C, xmp.iid:27F032511D2068118F62896F56A20F5C, uuid:544e6418-0696-11db-9d7f-f9eca141e40f, xmp.iid:30D3AA411D2068118F62896F56A20F5C, xmp.iid:2ED3AA411D2068118F62896F56A20F5C, uuid:c7d2e7d5-1cc8-11db-ade4-ad404a0fe056, uuid:c3ca18f7-6db8-11da-8348-8b14e4597935, xmp.iid:B4932F221D2068118F62896F56A20F5C, uuid:00963B1B9E22DD1182B8BC2A071899D9, uuid:67ac0396-1cc8-11db-ade4-ad404a0fe056, uuid:d614502a-1cc8-11db-ade4-ad404a0fe056, uuid:789ec65e-11a9-11db-bd43-beb6b97077f7, uuid:c7d2e7dc-1cc8-11db-ade4-ad404a0fe056, xmp.iid:92D12D811D2068118F62896F56A20F5C, uuid:e8de7c03-1cc8-11db-ade4-ad404a0fe056, uuid:e8de7bfa-1cc8-11db-ade4-ad404a0fe056, uuid:e8de7bfa-1cc8-11db-ade4-ad404a0fe056, xmp.iid:2CD3AA411D2068118F62896F56A20F5C, xmp.iid:2AD3AA411D2068118F62896F56A20F5C, xmp.iid:28D3AA411D2068118F62896F56A20F5C, xmp.iid:673DE5321D2068118F62896F56A20F5C, xmp.iid:613DE5321D2068118F62896F56A20F5C, uuid:6d02fca8-1cc9-11db-ade4-ad404a0fe056, uuid:7f3307c2-1cc9-11db-ade4-ad404a0fe056, uuid:66528d55-1d56-11db-b980-ea2c7b66c1ea, uuid:7f08868c-1d56-11db-b980-ea2c7b66c1ea, uuid:7d0a6b68-1cc8-11db-ade4-ad404a0fe056, uuid:738d2c5b-1d56-11db-b980-ea2c7b66c1ea, xmp.iid:26D3AA411D2068118F62896F56A20F5C, xmp.iid:653DE5321D2068118F62896F56A20F5C, uuid:b4ac9c00-1d55-11db-b980-ea2c7b66c1ea, uuid:ebdd179a-46e2-11d9-bcd9-977e8f9f87f2, uuid:738d2c62-1d56-11db-b980-ea2c7b66c1ea, xmp.iid:5F3DE5321D2068118F62896F56A20F5C, uuid:5c189cc1-1cc9-11db-ade4-ad404a0fe056, uuid:b4ac9c07-1d55-11db-b980-ea2c7b66c1ea, uuid:a3ce31cb-1cc8-11db-ade4-ad404a0fe056, uuid:a3ce31c4-1cc8-11db-ade4-ad404a0fe056, uuid:14606a4f-1d56-11db-b980-ea2c7b66c1ea, uuid:2fce9cfc-1cc9-11db-ade4-ad404a0fe056, uuid:2fce9d03-1cc9-11db-ade4-ad404a0fe056, xmp.iid:B8932F221D2068118F62896F56A20F5C, uuid:fa93c373-1cc8-11db-ade4-ad404a0fe056, uuid:09f81603-1cc9-11db-ade4-ad404a0fe056, uuid:9e97867c-1d55-11db-b980-ea2c7b66c1ea, uuid:17b79f82-1cc9-11db-ade4-ad404a0fe056, uuid:09f8160a-1cc9-11db-ade4-ad404a0fe056, xmp.iid:BA932F221D2068118F62896F56A20F5C, uuid:3e2b2c74-1d56-11db-b980-ea2c7b66c1ea, uuid:351d90dd-1d56-11db-b980-ea2c7b66c1ea, uuid:50e93d4e-1cc9-11db-ade4-ad404a0fe056, uuid:3d528927-1cc9-11db-ade4-ad404a0fe056, uuid:595a5986-1d56-11db-b980-ea2c7b66c1ea, uuid:03d591ef-1d56-11db-b980-ea2c7b66c1ea, uuid:718233d4-0a15-11d9-8c9e-c79931b53088, uuid:50e93d4e-1cc9-11db-ade4-ad404a0fe056, xmp.iid:B2932F221D2068118F62896F56A20F5C, uuid:5c189cba-1cc9-11db-ade4-ad404a0fe056, uuid:4d044394-1d56-11db-b980-ea2c7b66c1ea, uuid:595a598d-1d56-11db-b980-ea2c7b66c1ea, uuid:3e2b2c74-1d56-11db-b980-ea2c7b66c1ea, xmp.iid:74117F4220071168AD3DC87F591DAA72, xmp.iid:94523A52200C1168AD3DC87F591DAA72, uuid:718233d4-0a15-11d9-8c9e-c79931b53088, uuid:50e93d4e-1cc9-11db-ade4-ad404a0fe056, xmp.iid:B2932F221D2068118F62896F56A20F5C, xmp.iid:74117F3C20071168AD3DC87F591DAA72, xmp.iid:74117F3F20071168AD3DC87F591DAA72, xmp.iid:74117F9E200711688F0EAAEB8ACF4977, xmp.iid:633DE5321D2068118F62896F56A20F5C, xmp.iid:BA932F221D2068118F62896F56A20F5C, uuid:720C5D7EE75EDD11887E87916F4FAEDB, uuid:76A1B9BE43D411DBABB3B9BC48F7474A, uuid:0F95EC6F43D611DBABB3B9BC48F7474A, uuid:0F95EC6F43D611DBABB3B9BC48F7474A, uuid:E263D9DC9DEA11DEB504FCBAADC66EE6, uuid:E263D9DC9DEA11DEB504FCBAADC66EE6, uuid:F50FB07E840D11DE96C1C5279696055D, xmp.iid:418F846F1C2068118F62896F56A20F5C, uuid:43c387b5-9096-ef46-8313-8386b3697a97
Manifest Reference Document ID  : uuid:6F51C092840A11DE96C1C5279696055D, xmp.did:02801174072068118083D922FDDA8E69, uuid:DC16F1EC45F911DEA1A3CE2956A96706, uuid:BFCFAF1345F911DEA1A3CE2956A96706, uuid:DC16F1EC45F911DEA1A3CE2956A96706, uuid:600E3BD3B517DE11B6E0BA14D394DF89, uuid:E263D9DB9DEA11DEB504FCBAADC66EE6, uuid:4F023BADB617DE11B6E0BA14D394DF89, uuid:600E3BD3B517DE11B6E0BA14D394DF89, adobe:docid:photoshop:c18007c2-f741-11da-a6bb-9d3ee2b5fc8a, adobe:docid:photoshop:4d64c87e-f646-11da-a6bb-9d3ee2b5fc8a, uuid:B8A4DD82BD24DD1187BCFC3381547BDF, uuid:7A5F3593BE24DD1187BCFC3381547BDF, adobe:docid:photoshop:fe741acb-ef0d-11da-94f6-816d1225e5ee, adobe:docid:photoshop:df16afe7-ef02-11da-94f6-816d1225e5ee, adobe:docid:photoshop:5e393459-f0e3-11da-94f6-816d1225e5ee, adobe:docid:photoshop:ba125291-ee0c-11da-94f6-816d1225e5ee, adobe:docid:photoshop:fe741acb-ef0d-11da-94f6-816d1225e5ee, adobe:docid:photoshop:5e39345f-f0e3-11da-94f6-816d1225e5ee, adobe:docid:photoshop:cb947663-e368-11da-9e81-92991e022ed5, adobe:docid:photoshop:cb947663-e368-11da-9e81-92991e022ed5, adobe:docid:photoshop:2614e277-ef04-11da-94f6-816d1225e5ee, adobe:docid:photoshop:0da03016-ef18-11da-94f6-816d1225e5ee, adobe:docid:photoshop:1f0905dd-02ab-11db-aad3-9b15b5b23437, adobe:docid:photoshop:5e39345d-f0e3-11da-94f6-816d1225e5ee, adobe:docid:photoshop:79f74e75-ef19-11da-94f6-816d1225e5ee, adobe:docid:photoshop:a0ea766e-02b3-11db-aad3-9b15b5b23437, adobe:docid:photoshop:45cf1f45-ef21-11da-94f6-816d1225e5ee, adobe:docid:photoshop:45cf1f45-ef21-11da-94f6-816d1225e5ee, adobe:docid:photoshop:15be5d18-02b5-11db-aad3-9b15b5b23437, uuid:BC6C89DA9AF111DEB80F9A326FA8D05D, uuid:849655819AEF11DEB80F9A326FA8D05D, adobe:docid:photoshop:1e3a9da7-5bf1-11da-a9fa-fea050889bc6, adobe:docid:photoshop:6df9b106-785f-11da-9687-b3ea3b917243, uuid:710C5D7EE75EDD11887E87916F4FAEDB, adobe:docid:photoshop:574304be-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:540b2c1e-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:57c495b9-076f-11db-80bc-9791065ff634, uuid:BFD1F634C224DD1187BCFC3381547BDF, uuid:52972A32A37711DE8879F0921681CF20, adobe:docid:photoshop:827a861e-e6be-11da-9e81-92991e022ed5, adobe:docid:photoshop:e9b1b821-f741-11da-a6bb-9d3ee2b5fc8a, adobe:docid:photoshop:e9b1b820-f741-11da-a6bb-9d3ee2b5fc8a, adobe:docid:photoshop:544e6417-0696-11db-9d7f-f9eca141e40f, uuid:6FA4E304C624DD1187BCFC3381547BDF, adobe:docid:photoshop:c18007c1-f741-11da-a6bb-9d3ee2b5fc8a, adobe:docid:photoshop:c3ca18f4-6db8-11da-8348-8b14e4597935, uuid:703A4287C824DD1187BCFC3381547BDF, adobe:docid:photoshop:7712d27e-7f73-11da-88f8-e34b6f187596, adobe:docid:photoshop:5d4cb1ec-076f-11db-80bc-9791065ff634, uuid:8FCB8A689922DD1182B8BC2A071899D9, xmp.did:FAB8E8911D2068118F62896F56A20F5C, adobe:docid:photoshop:e9b1b81e-f741-11da-a6bb-9d3ee2b5fc8a, adobe:docid:photoshop:0521d107-f6bf-11da-a6bb-9d3ee2b5fc8a, adobe:docid:photoshop:693a869e-f6bc-11da-a6bb-9d3ee2b5fc8a, uuid:208D2FF7CC24DD1193C8DC8DE8E3490B, adobe:docid:photoshop:1e3a9da7-5bf1-11da-a9fa-fea050889bc6, adobe:docid:photoshop:6df9b106-785f-11da-9687-b3ea3b917243, adobe:docid:photoshop:5691bbbf-076f-11db-80bc-9791065ff634, uuid:710C5D7EE75EDD11887E87916F4FAEDB, adobe:docid:photoshop:57c495b9-076f-11db-80bc-9791065ff634, uuid:BFD1F634C224DD1187BCFC3381547BDF, uuid:52972A32A37711DE8879F0921681CF20, adobe:docid:photoshop:540b2c1e-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:551114a0-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:558a9e2d-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:574304be-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:5d9ba643-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:cc131d8e-f70f-11da-a6bb-9d3ee2b5fc8a, uuid:87F77061CF24DD1193C8DC8DE8E3490B, adobe:docid:photoshop:544e6417-0696-11db-9d7f-f9eca141e40f, adobe:docid:photoshop:cc131d8e-f70f-11da-a6bb-9d3ee2b5fc8a, adobe:docid:photoshop:cc131d8e-f70f-11da-a6bb-9d3ee2b5fc8a, adobe:docid:photoshop:58505a9e-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:c3ca18f4-6db8-11da-8348-8b14e4597935, adobe:docid:photoshop:7712d27e-7f73-11da-88f8-e34b6f187596, uuid:8FCB8A689922DD1182B8BC2A071899D9, adobe:docid:photoshop:5d4cb1ec-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:55fb1eea-076f-11db-80bc-9791065ff634, uuid:932412F409B711DBBDDEE36EF4BC9335, adobe:docid:photoshop:58d7ffa7-076f-11db-80bc-9791065ff634, uuid:7E19919ABE24DD1187BCFC3381547BDF, uuid:4C8CFDCAFED911DA86E290732197997B, uuid:3612B231FED911DA86E290732197997B, uuid:3612B231FED911DA86E290732197997B, adobe:docid:photoshop:6389dc0f-0a13-11d9-8c9e-c79931b53088, uuid:06CCC11AA37811DE8879F0921681CF20, adobe:docid:photoshop:954bd8bd-0a12-11d9-8c9e-c79931b53088, adobe:docid:photoshop:47311010-0a13-11d9-8c9e-c79931b53088, adobe:docid:photoshop:f03f083c-0a12-11d9-8c9e-c79931b53088, adobe:docid:photoshop:e7faa9b5-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:547e300f-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:55111496-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:e9fc4253-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:5691bbbf-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:44bb2f51-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:16be5bdc-0a13-11d9-8c9e-c79931b53088, adobe:docid:photoshop:8e2a2628-0a12-11d9-8c9e-c79931b53088, adobe:docid:photoshop:4624dcce-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:24cc13f1-0a13-11d9-8c9e-c79931b53088, adobe:docid:photoshop:4624dcc4-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:8e2a2620-0a12-11d9-8c9e-c79931b53088, adobe:docid:photoshop:d906e440-0368-11db-aacb-a5438f953bf3, uuid:C559DABAFEB111DA86E290732197997B, adobe:docid:photoshop:558a9e2d-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:551114a0-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:e5de81fe-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:51aaee68-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:522edbeb-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:7baa76ca-0a14-11d9-8c9e-c79931b53088, adobe:docid:photoshop:e371b2a0-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:e4067579-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:e371b296-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:e4a2e390-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:e541f73b-0368-11db-aacb-a5438f953bf3, uuid:CFEC3B93A37711DE8879F0921681CF20, adobe:docid:photoshop:4ded8fde-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:4ff47f65-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:dbd9277f-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:dd573757-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:db0213d0-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:4f5ea3ce-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:5dc07c34-0a15-11d9-8c9e-c79931b53088, adobe:docid:photoshop:dbd9277f-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:35c7b83e-7f77-11da-88f8-e34b6f187596, adobe:docid:photoshop:da13754b-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:db0213c6-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:488183ee-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:4ded8fde-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:0e64d24e-85b0-11da-8503-87b283010a49, adobe:docid:photoshop:540b2c1e-076f-11db-80bc-9791065ff634, adobe:docid:photoshop:5dc07c34-0a15-11d9-8c9e-c79931b53088, adobe:docid:photoshop:dbd9277f-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:35c7b83e-7f77-11da-88f8-e34b6f187596, adobe:docid:photoshop:80d5ec2c-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:d0090891-0368-11db-aacb-a5438f953bf3, adobe:docid:photoshop:4cfb24bd-0a13-11d9-8c9e-c79931b53088, adobe:docid:photoshop:7536d51f-7f7e-11da-88f8-e34b6f187596, uuid:CFEC3B93A37711DE8879F0921681CF20, uuid:710C5D7EE75EDD11887E87916F4FAEDB, uuid:76A1B9BD43D411DBABB3B9BC48F7474A, uuid:0F95EC6E43D611DBABB3B9BC48F7474A, uuid:0F95EC6E43D611DBABB3B9BC48F7474A, uuid:E263D9DB9DEA11DEB504FCBAADC66EE6, uuid:E263D9DB9DEA11DEB504FCBAADC66EE6, uuid:F50FB07D840D11DE96C1C5279696055D, uuid:4F023BADB617DE11B6E0BA14D394DF89, xmp.did:02801174072068118083D922FDDA8E69
Metadata Date                   : 2015:02:02 11:38:48-05:00
Creator Tool                    : Adobe InDesign CS4 (6.0.6)
Thumbnail Format                : JPEG
Thumbnail Width                 : 256
Thumbnail Height                : 256
Thumbnail Image                 : (Binary data 7956 bytes, use -b option to extract)
Doc Change Count                : 2043
Format                          : application/pdf
Producer                        : Adobe PDF Library 9.0
Trapped                         : False
Page Count                      : 36

EXIF Metadata provided by EXIF.tools

Versa Nail Humeral Universal Surgical Technique

Navigation menu

Versions of this User Manual:

Views

Navigation