Zimmer Periarticular Proximal Humeral Locking Plate Surgical Technique

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Zimmer

®

Periarticular

Proximal Humeral

Locking Plate

Surgical Technique

The Science of the Landscape

1

Zimmer Periarticular Proximal Humeral Locking Plate

Surgical Technique Table of Contents

Introduction 2

Locking Plate Technology 2

Proximal Humeral Plate Indications 2

Fracture Classification 3

Plate Features 3

Surgical Technique 4

Required Instrumentation 4

Preoperative Preparation 4

Fracture Reduction 4

Surgical Approach 5

Reduction of Intra-articular Fragments 6

Plate Positioning 6

Screw Trajectory 9

Fracture Fixation 10

Wound Closure 14

Postoperative Treatment 14

Implant Removal 14

Surgical Pearls 14

Instruments and Implants 15

Order Information 18

2Zimmer Periarticular Proximal Humeral Locking Plate

Introduction

The Zimmer Periarticular Locking

Plate System combines locking screw

technology with periarticular plates to

create fixed-angle constructs for use in

comminuted fractures or where deficient

bone stock or poor bone quality is

encountered. The fixed-angle plate/

screw device can be used in osteopenic

bone and other areas where traditional

screw fixation may be compromised.

The Periarticular Locking Plates will

accommodate standard screws, as well

as locking screws with threaded heads

that allow the screw to be locked into the

plate. When necessary, interfragmentary

compression can be achieved using

standard screws in the dual

compression slots.

Cannulated screws and instruments

allow provisional fixation with guide pins

in the metaphysis. This helps ensure that

the threaded locking screw heads align

properly with the threaded plate holes.

All plate configurations contain locking

screw holes in the plate head, and

alternating locking and compression

screw slots in the shaft.

Locking Screw Technology

The heads of the locking screws contain

male threads while the holes in the

plates contain female threads. This

allows the screw head to be threaded

into the plate hole, locking the screw

into the plate. This technical innovation

provides the ability to create a fixed-

angle construct while using familiar

plating techniques.

Locking Plate Technology

By using locking screws in a bone plate,

a fixed-angle construct is created.

In osteopenic bone or fractures with

multiple fragments, secure bone

purchase with conventional screws may

be compromised. The locking screws do

not rely on bone/plate compression to

resist patient load, but function similarly

to multiple small angled blade plates.

In osteopenic bone or comminuted

fractures, the ability to lock screws into

a fixed-angle construct is imperative.

By combining locking screw holes with

compression screw slots in the shaft,

the plate can be used as both a locking

device and a fracture compression

device. If compression is desired, it

must be achieved first by inserting the

standard screws in the compression

screw slots before inserting any

locking screws.

The locking plate design does not

require compression between the plate

and bone to accommodate loading.

Therefore, purchase of the screws in

the bone can be achieved with a thread

profile that is shallower than that of

traditional screws. The shallow thread

profile, in turn, allows for screws with

a large core diameter to accommodate

loading with improved bending and

shear strength.

Indications

The Periarticular Locking Plate System is

indicated for temporary internal fixation

and stabilization of osteotomies and

fractures, including:

• Comminuted fractures

• Supracondylar fractures

• Intra-articular and extra-articular

condylar fractures

• Fractures in osteopenic bone

• Nonunions

• Malunions

3

Zimmer Periarticular Proximal Humeral Locking Plate

Fracture Classification

Refer to the OTA Fracture and Dislocation

Compendium, for more specific

information.

Plate Features

• Anatomically contoured plates are

precontoured to create a fit that

requires little or no additional

bending and helps with metaphyseal/

diaphyseal reduction

• Low plate profile facilitates fixation

without impinging soft tissue

• Dual compression slots will

accommodate periarticular screws

or conventional stainless screws and

allow bi-directional compression

The locking plate design does not

require compression between the plate

and bone to accommodate loading.

Therefore, purchase of screws in the

bone can be achieved with a thread

profile that is shallower than that of

traditional screws. The shallow thread

profile, in turn, allows for screws with

a large core diameter to accommodate

loading with improved bending and

shear strength (Fig. 1).

Fig. 1

The anatomical shape of

the plate head matches

the shape of the proximal

humerus

Multiple locking holes in the

plate head allow placement

of the screws to capture

fragments while avoiding

lag screws that have been

placed outside the plate

Tapered Shaft design

allows for a minimally

invasive technique

4Zimmer Periarticular Proximal Humeral Locking Plate

Surgical Technique

Required Instrumentation

The following sets may be required for

application of the 3.5mm Periarticular

Locking Proximal Humeral Plate:

• Small Fragment Screw and

Instrument Set

• Basic Forceps Set

• 3.5mm/2.7mm Locking Screw and

Instrument Set

• 3.5mm Locking Proximal Humeral

Plate and Standard Jig Set

NOTE: The 2.7mm Locking Screws

should not be used with the 3.5mm

Locking Proximal Tibial Plate.

Preoperative Preparation

After assessing the fracture

radiographically and preparing a

preoperative plan, place the patient in

the beach chair position with the injured

shoulder resting on a translucent part of

the operating table (Fig. 2). Be sure that

the fluoroscope can be positioned to

visualize the proximal humerus in both

the lateral and A/P views.

X-rays and Classification

At least two x-rays of the glenohumeral

joint taken at right angles to each other

are mandatory to identify the fracture

type. X-rays in internal and external

rotation can be important if tuberosity

fractures are suspected. Traction views

can frequently help to clarify complex

fracture patterns. If standard x-rays do

not allow clear evaluation of the fracture

features, articular damage, displacement

and soft tissue damage, CT may be

helpful. You must be able to determine

whether the fracture runs through the

anatomical or surgical neck

of the humerus.

Recommended X-rays

AP View

The patient must be placed with the

posterior aspect of the injured side

against the x-ray plate, and the opposite

side must be elevated at least

30 degrees.

Lateral Anterior View

The lateral/anterior aspect of the injured

shoulder is placed against the x-ray

plate. The x-ray beam is then directed

posteriorly along the spine of the

scapula at 90 degrees to the direction

of the AP.

Axillary View

The patient is supine with the x-ray plate

placed above the injured shoulder.

Abduction of about 30 degrees

is needed.

Fracture Reduction

It is imperative that accurate reduction

of the fracture be obtained prior to and

maintained during application of the

proximal humeral plate. Intraoperative

x-ray visualization is critical in all planes.

Closed reduction should be tried under

image intensification. In acute fractures

and fracture dislocations, reduction is

often successful.

If closed reduction cannot be achieved,

assisted percutaneous reduction by

means of a joystick or hook, or open

reduction will be necessary in order to

obtain good alignment and

fracture fixation.

Exposing the Humerus

After radiographic verification of

preliminary reduction of the fracture, use

the preferred approach and technique to

expose the proximal humerus.

Fig. 2

5

Zimmer Periarticular Proximal Humeral Locking Plate

Fig. 3

On the distal shaft, especially in

comminuted fractures, the insertions

of the deltoid and pectoralis major may

have to be partially released, especially

for reduction and plate fixation on the

lateral aspect of the humerus. The plate

should lie dorsal to the long biceps

tendon and the lateral branch of the

anterior circumflex humeral artery.

The position of this artery and the axillary

nerve should be noted, and damage

should be avoided (Fig. 4).

Retract the deltoid muscle to the

lateral side to look for the humeral

head (Fig. 5).

Fig. 5

Surgical Approach

Deltopectoral Approach

The standard approach for fixation of

fractures of the proximal humerus is

between the deltoid and the pectoral

muscles. Start the skin incision at the

coronoid process and continue it in a

slightly convex way toward the medial

side as far as the insertion of the deltoid

muscle on the lateral humeral shaft

(Fig. 3). The cephalic vein can usually

be identified proximally with its main

connections on the lateral side. Incise

the fascia medial to the vein and with the

arm slightly abducted. The fracture and

the humeral head can be palpated after

blunt separation of the deltoid muscle

from around the bursa, soft tissues and

fracture hematoma. After removal of the

hematoma, the long biceps tendon can

be identified under internal and external

rotation and will lead to identification

of the greater and lesser tuberosities.

Even if the tuberosities are fractured,

they will still have some connections

to the adjacent tissues and their

attached muscles.

1. Axillary artery

2. Posterior circumflex artery

3. Anterior circumflex artery

4. Anterolateral branch of the anterior circumflex artery

5. Greater tuberosity

6. Lesser tuberosity (anterior)

7. Tendon insertions a) infraspinatus, b) teres minor

8. Entry of anterolateral branch of the circumflex artery into the bone

9. Intertubular groove

Fig. 4

anterior view posterior view

1

2

3

6

8

5

4

9

1

2

3

5

7a

7b

6Zimmer Periarticular Proximal Humeral Locking Plate

Plate Positioning

Hold the appropriate Metaphyseal Jig on

the selected plate and finger tighten or

use the 2.5mm Screwdriver to tighten

the set screw (Fig. 6). Insert a 3.5mm

Standard Jig Sleeve into the center hole

of the Jig (Fig. 7) and thread the 1.6mm

Standard Cannula into the plate

hole (Fig. 8).

Before placing the plate on the bone,

thread the appropriate number of

Standard Cannulas into the proximal

holes in the head of the plate (Fig. 9).

It is easier to thread the cannulas into

the plate holes before the plate is

applied to the bone. The cannulas can

be used as handles to position the plate.

Fig. 8

Fig. 7

Reduction of Intra-articular

Fragments

It is imperative that accurate reduction

of the fracture be obtained prior to, or

through application of the plate, and

maintained during application of the

proximal humerus plate. Reduce the

intra-articular fragments using linear

bone clamps or Kirschner wires to

temporarily hold the reduction. Use

lag screws to secure the intra-articular

fragments. To help avoid inserting the lag

screws where they will interfere with the

plate placement, hold the plate on the

bone in its approximate position. Then

insert the lag screws as needed.

Fig. 6

Fig. 9

7

Zimmer Periarticular Proximal Humeral Locking Plate

Fig. 10

Use this construct to place the initial

1.6mm Drill Tip Guide Wire in the

metaphysis. Check plate placement –

visually and fluoroscopically if necessary.

Use anatomic landmarks and

fluoroscopic images to position the

plate. Because the humeral shaft

may not be aligned with the proximal

fragment, the plate head should be used

to determine the appropriate placement

of the plate. The plate head should

conform to the shape of the intact or

reconstructed proximal humerus. This

will determine the alignment of the shaft.

Note: The cannula inserter may be used

to tighten the cannula if necessary

(Fig. 10).

8Zimmer Periarticular Proximal Humeral Locking Plate

Hold the plate in the desired position

and insert a 1.6mm Drill Tip Guide Wire

through one of the Guide Wire Cannulas

until the tip engages or reaches the

subchondral bone (Fig. 11). Use the

fluoroscope to confirm the position

of the wire in both the A/P and lateral

planes. Adjust the wire location if

necessary. If preferred, use a linear bone

clamp or bone reduction instrument

to secure the plate.

When the first wire is satisfactory, rotate

the plate, if necessary. Then insert

Drill Tip Guide Wires through the other

proximal Guide Wire Cannulas to

help prevent rotation of the plate (Fig. 12).

NOTE: If desired, after removal of the

metaphyseal jig, additional 1.6mm Drill

Tip Guide Wires can be inserted through

the proximal K-wire holes to further

stabilize the plate (Fig. 13).

Use the fluoroscope for both A/P and

lateral views to confirm the position of

the plate head, shaft, and guide wires.

Fig. 11

Fig. 12

Fig. 13

9

Zimmer Periarticular Proximal Humeral Locking Plate

Screw Trajectory

10 Zimmer Periarticular Proximal Humeral Locking Plate

Fracture Fixation

Metaphyseal Screw Fixation

If required, lag screw reduction of a

fragment must be accomplished before

inserting any locking screws. The 3.5mm

Cannulated Conical Screws can be used

for lag screw fixation.

Slide the 3.5mm Cannulated Screw

Depth Gauge over the guide wires to

measure for the screw lengths (Fig. 14).

The tip of the gauge must contact the

end of the guide wire cannula for an

accurate measurement. This will position

the tip of the screw at the tip of the guide

wire. Read the proper screw length from

the guide.

Predrilling and tapping are typically not

necessary as the flutes of the screws

are self-drilling and self-tapping. If the

bone is dense, the lateral cortex can be

predrilled using the 2.7mm Cannulated

Drill and tapped using the 3.5mm

Cannulated Screw Tap.

Remove the Guide Wire Cannulas and

use the 2.5mm Hex-head Cannulated

Driver to insert a 3.5mm Cannulated

Conical or Cannulated Locking Screw

over each of the guide wires and into

as many proximal holes as necessary

(Fig. 15). Sleeves and cannulas may be

inserted into the additional proximal

plate holes if locked screws are

necessary in these holes.

Fig. 14

Fig. 15

11

Zimmer Periarticular Proximal Humeral Locking Plate

A driver shaft can be used to loosely

insert the screw under power, but the

final seating must be accomplished by

hand to avoid cross-threading of the

screws in the plate holes.

Follow the same procedure for each

proximal screw. Be sure that all screws

are securely tightened.

NOTE: Slide the Screwdriver Stop Ring

onto the screwdriver shaft and place it

at the level of the black ring etched on

the driver shaft (Fig. 16). Before the Blue

Stop Ring approaches the top of the

Jig Sleeve, power insertion must stop.

Screws must be seated by hand. The

Screwdriver Stop Ring is intended to be

a visual cue to stop power insertion of

locking screws.

NOTE: If the plate shifts during screw

insertion, all the pins and screws must

be removed and reinserted for the

screws to lock properly to the plate.

NOTE: If a plate screw impinges on

one of the intra-articular lag screws,

the lag screw must be removed and

repositioned.

Use direct or indirect reduction

techniques to reduce the proximal

humerus to the shaft. Confirm that the

arm is in proper rotation. Temporarily

secure the plate shaft to the bone with

plate holding forceps, a nonlocking

screw or the appropriate plate reduction

instrument.

If lag screws will be used through some

of the slots in the shaft, insert the first

lag screw to reduce the fracture or a

standard screw to reduce the plate to the

bone and compress the fracture.

Fig. 16

Black Ring

12 Zimmer Periarticular Proximal Humeral Locking Plate

Shaft Fixation

If both locking and nonlocking screws

will be used in the shaft, the nonlocking

screws must be inserted first. Insert

additional nonlocking screws through

the compression holes in the plate

as desired.

Apply the appropriate drill guide

([00-4808-035-01] 3.5mm/2.5mm

Double Drill Sleeve, [00-4808-035-02]

3.5mm/2.5mm Insert Drill Sleeve,

[00-4808-035-04] 3.5mm Universal

Drill Guide, [00-4808-035-05] 3.5mm

Compression Drill Guide) to one of the

nonlocking shaft slots, and use the

2.5mm QC Drill Bit [00-4806-110-25] to

drill through both cortices. Use the Depth

Gauge to measure the appropriate screw

length. Then insert a self-tapping screw.

Check the position of the screw with

the fluoroscope. Repeat this procedure

for each of the standard screws

to be inserted.

To insert solid locking screws, thread the

2.7mm Standard Cannula into the most

proximal shaft locking hole of the plate

(Fig. 17). Use the 2.7mm Standard Drill

through the cannula to drill a pilot hole

(Fig. 18). Check the depth and position

of the drill with fluoroscopic images.

Remove the cannula and use the Depth

Gauge to measure the appropriate screw

length (Fig. 19). Then insert the locking

screw (Fig. 20).

Tapping is typically not necessary as the

flutes of the screws are self-drilling and

self-tapping. If the bone is dense, the

lateral cortex can be tapped using the

3.5mm tap.

Insert locking screws as desired through

the remaining locking holes of the shaft

in the same manner.

Fig. 17

Fig. 18

Fig. 19

Fig. 20

13

Zimmer Periarticular Proximal Humeral Locking Plate

Strut Screw Fixation

A locking strut screw can be inserted

into the plate to buttress the medial

cortex. Insert the 1.6mm Standard

Cannula into the oblique locking hole

(Fig. 21). Then insert a 1.6mm Drill Tip

Guide Wire through the Cannula until

the tip engages or touches the medial

subchondral bone. Use the fluoroscope

to confirm the position of the wire in

both the A/P and lateral planes.

Slide the 3.5mm Cannulated Locking

Screw Depth Gauge over the guide wire

to measure for the screw length, making

sure that the tip of the gauge contacts

the end of the guide wire cannula

(Fig. 22). This will position the tip of the

screw at the tip of the guide wire. Read

the proper screw length from the guide.

Remove the Guide Wire Cannula and use

the 2.5mm Hex-head Cannulated Driver

to insert a Cannulated Locking Screw

over the guide wire (Fig. 23).

Make a final check of the limb alignment

and fracture reduction. Then make sure

that all locking screws in the head and

shaft are securely tightened before

closing (Fig. 24).

Fig. 21

Fig. 22

Fig. 23

Fig. 24

14 Zimmer Periarticular Proximal Humeral Locking Plate

Wound Closure

Use the appropriate method for surgical

closure of the incision.

Postoperative Treatment

Postoperative treatment with locking

plates does not differ from conventional

open reduction internal fixation

(ORIF) procedures.

Implant Removal

To remove locking screws, use the

Standard Hexagonal Screwdrivers

[00-2360-065-25, 00-2360-065-50] to

first unlock all screws from the plate and

then remove the screws completely.

Please refer to the package insert

for product information, including

contraindications, warnings, and

precautionary information.

Surgical Pearls

Depending upon the screw position in

the plate, the screw head may not be

flush with the plate surface. If unsure

that the screw is seated, loosen screw

and retighten.

If the locking screw is difficult to insert

or stops advancing before locking to the

plate, remove the screw and pre-drill with

the appropriate drill bit. Then reinsert the

screw. (This condition may be caused by

very dense or thick cortical bone.)

Cleaning of the cannulated instruments

is necessary for proper function. The

cleaning stylet can clear debris in the

cannulations and prevent binding of the

instruments. The cleaning brush should

be used postoperatively.

15

Zimmer Periarticular Proximal Humeral Locking Plate

1.6mm Standard Cannula 00-2360-021-16

1.6mm Standard Drill Tip Guide Wire 00-2360-033-16

Instrument and Implants

Cannula Inserter 00-2360-088-00

3.5mm Standard Jig Sleeve 00-2360-093-04

3.5mm Proximal Humeral Plate Jig,

Right 00-2360-092-01, Left 00-2360-092-02

3.5mm/2.7mm Locking Screw Depth Gauge

00-2360-040-35

2.7 Standard Drill 00-2360-205-27

16 Zimmer Periarticular Proximal Humeral Locking Plate

2.0mm Standard Drill 00-2360-175-20

2.5mm Hex Standard Cannulated Screwdriver

00-2360-166-25

2.7mm Standard Cannula 00-2360-020-27

3.5mm / 2.7mm Locking Plate Reduction Instrument

00-2360-011-01

2.0mm Standard Cannula 00-2360-020-20

2.5mm Hex Standard Screwdriver 00-2360-165-25

3.5mm / 2.7mm Plate Reduction Sleeve 00-2360-011-02

Spin Knob 00-2360-011-03

1

3

2

1

2

3

3.5mm Cannulated Locking Screw Standard Depth Gauge

00-2360-041-35

17

Zimmer Periarticular Proximal Humeral Locking Plate

2.7mm Locking Screw Tap 00-2360-153-27 3.5mm Locking Screw Tap 00-2360-153-35

3.5mm Cannulated Locking Screw Tap 00-2360-154-35

Cleaning Brush 00-1147-076-00 Cleaning Stylet 00-1147-071-00

18 Zimmer Periarticular Proximal Humeral Locking Plate

Order Information

Part Number Description

00-2360-000-02 3.5mm/2.7mm Periarticular Locking

Instrument Set

00-2360-021-16 1.6mm Standard Cannula

00-2360-033-16 1.6mm Standard Drill Tip Guide Wire

00-2360-011-01 3.5mm / 2.7mm Locking Plate Reduction

Instrument

00-2360-011-02 3.5mm / 2.7mm Locking Plate Reduction

Sleeve

00-2360-011-03 Plate Reduction Spin Knob

00-2360-041-35 3.5mm Cannulated Locking Screw Depth

Gauge

00-2360-171-27 2.7mm Standard Cannulated Drill QC

00-1147-071-00 Cleaning Stylet

00-1147-076-00 Cleaning Brush

00-2360-165-25 2.5mm Hex Standard Screwdriver

00-2360-166-25 2.5mm Hex Standard Cannulated Screwdriver

00-2360-088-00 Cannula Inserter

00-2360-020-27 2.7mm Standard Cannula

00-2360-205-27 2.7mm Standard Drill

00-2360-040-35 3.5mm/2.7mm Locking Screw Standard

Depth Gauge

00-2360-020-20 2.0mm Standard Cannula

00-2360-093-04 3.5mm Standard Jig Sleeve

00-2360-175-20 2.0mm Standard Drill

00-2360-153-27 2.7mm Locking Screw Tap

00-2360-153-35 3.5mm Locking Screw Tap

00-2360-154-35 3.5mm Cannulated Locking Screw Tap

00-2358-040-05 3.5mm/2.7mm Locking Screw and

Instrument Case

00-4812-045-00 Large Hex Screwdriver

00-2360-065-00 2.5mm Screwdriver Stop Ring

00-2360-080-00 Torque Limiting Attachment

00-4811-035-01 Handle, QC, Phenolic

00-4812-035-00 Small Hex Screwdriver

00-1147-053-00 Cannulated Ratchet Handle

00-2359-000-02 3.5mm / 2.7mm Locking Screw Set

00-2359-030-36 3.5mm Cannulated Locking Screw 30mm Lng

00-2359-035-36 3.5mm Cannulated Locking Screw 35mm Lng

00-2359-040-36 3.5mm Cannulated Locking Screw 40mm Lng

00-2359-045-36 3.5mm Cannulated Locking Screw 45mm Lng

00-2359-050-36 3.5mm Cannulated Locking Screw 50mm Lng

00-2359-055-36 3.5mm Cannulated Locking Screw 55mm Lng

00-2359-060-36 3.5mm Cannulated Locking Screw 60mm Lng

00-2359-065-36 3.5mm Cannulated Locking Screw 65mm Lng

00-2359-070-36 3.5mm Cannulated Locking Screw 70mm Lng

00-2359-075-36 3.5mm Cannulated Locking Screw 75mm Lng

00-2359-080-36 3.5mm Cannulated Locking Screw 80mm Lng

00-2359-085-36 3.5mm Cannulated Locking Screw 85mm Lng

00-2359-090-36 3.5mm Cannulated Locking Screw 90mm Lng

00-2359-030-37 3.5mm Cannulated Conical Screw 30mm Lng

00-2359-035-37 3.5mm Cannulated Conical Screw 35mm Lng

00-2359-040-37 3.5mm Cannulated Conical Screw 40mm Lng

00-2359-045-37 3.5mm Cannulated Conical Screw 45mm Lng

00-2359-050-37 3.5mm Cannulated Conical Screw 50mm Lng

00-2359-055-37 3.5mm Cannulated Conical Screw 55mm Lng

00-2359-060-37 3.5mm Cannulated Conical Screw 60mm Lng

00-2359-065-37 3.5mm Cannulated Conical Screw 65mm Lng

00-2359-070-37 3.5mm Cannulated Conical Screw 70mm Lng

00-2359-012-35 3.5mm Locking Screw 12mm Lng

00-2359-014-35 3.5mm Locking Screw 14mm Lng

00-2359-016-35 3.5mm Locking Screw 16mm Lng

00-2359-018-35 3.5mm Locking Screw 18mm Lng

00-2359-020-35 3.5mm Locking Screw 20mm Lng

00-2359-022-35 3.5mm Locking Screw 22mm Lng

00-2359-024-35 3.5mm Locking Screw 24mm Lng

00-2359-026-35 3.5mm Locking Screw 26mm Lng

00-2359-028-35 3.5mm Locking Screw 28mm Lng

00-2359-030-35 3.5mm Locking Screw 30mm Lng

00-2359-032-35 3.5mm Locking Screw 32mm Lng

00-2359-034-35 3.5mm Locking Screw 34mm Lng

00-2359-036-35 3.5mm Locking Screw 36mm Lng

00-2359-038-35 3.5mm Locking Screw 38mm Lng

00-2359-040-35 3.5mm Locking Screw 40mm Lng

00-2359-042-35 3.5mm Locking Screw 42mm Lng

00-2359-044-35 3.5mm Locking Screw 44mm Lng

00-2359-046-35 3.5mm Locking Screw 46mm Lng

00-2359-048-35 3.5mm Locking Screw 48mm Lng

19

Zimmer Periarticular Proximal Humeral Locking Plate

00-2359-050-35 3.5mm Locking Screw 50mm Lng

00-2359-052-35 3.5mm Locking Screw 52mm Lng

00-2359-054-35 3.5mm Locking Screw 54mm Lng

00-2359-056-35 3.5mm Locking Screw 56mm Lng

00-2359-058-35 3.5mm Locking Screw 58mm Lng

00-2359-060-35 3.5mm Locking Screw 60mm Lng

00-2359-065-35 3.5mm Locking Screw 65mm Lng

00-2359-070-35 3.5mm Locking Screw 70mm Lng

00-2359-075-35 3.5mm Locking Screw 75mm Lng

00-2359-080-35 3.5mm Locking Screw 80mm Lng

00-2359-085-35 3.5mm Locking Screw 85mm Lng

00-2359-090-35 3.5mm Locking Screw 90mm Lng

00-2359-010-27 2.7mm Locking Screw 10mm Lng

00-2359-012-27 2.7mm Locking Screw 12mm Lng

00-2359-014-27 2.7mm Locking Screw 14mm Lng

00-2359-016-27 2.7mm Locking Screw 16mm Lng

00-2359-018-27 2.7mm Locking Screw 18mm Lng

00-2359-020-27 2.7mm Locking Screw 20mm Lng

00-2359-022-27 2.7mm Locking Screw 22mm Lng

00-2359-024-27 2.7mm Locking Screw 24mm Lng

00-2359-026-27 2.7mm Locking Screw 26mm Lng

00-2359-028-27 2.7mm Locking Screw 28mm Lng

00-2359-030-27 2.7mm Locking Screw 30mm Lng

00-2359-032-27 2.7mm Locking Screw 32mm Lng

00-2359-034-27 2.7mm Locking Screw 34mm Lng

00-2359-036-27 2.7mm Locking Screw 36mm Lng

00-2359-038-27 2.7mm Locking Screw 38mm Lng

00-2359-040-27 2.7mm Locking Screw 40mm Lng

00-2359-042-27 2.7mm Locking Screw 42mm Lng

00-2359-044-27 2.7mm Locking Screw 44mm Lng

00-2359-046-27 2.7mm Locking Screw 46mm Lng

00-2359-048-27 2.7mm Locking Screw 48mm Lng

00-2359-050-27 2.7mm Locking Screw 50mm Lng

00-2359-052-27 2.7mm Locking Screw 52mm Lng

00-2359-054-27 2.7mm Locking Screw 54mm Lng

00-2359-056-27 2.7mm Locking Screw 56mm Lng

00-2359-058-27 2.7mm Locking Screw 58mm Lng

00-2359-060-27 2.7mm Locking Screw 60mm Lng

00-2358-000-05 Prox Lat Hum Lock Plt Set

00-2358-002-04 Proximal Lateral Humeral Locking Plate,

4 Hole 90mm Lng, Left

00-2358-002-06 Proximal Lateral Humeral Locking Plate,

6 Hole 114mm Lng, Left

00-2358-002-08 Proximal Lateral Humeral Locking Plate,

8 Hole, 138mm Lng, Left

00-2358-002-12 Proximal Lateral Humeral Locking Plate,

12 Hole, 186mm Lng, Left

00-2358-002-16 Proximal Lateral Humeral Locking Plate,

16 Hole, 234mm Lng, Left

00-2358-001-04 Proximal Lateral Humeral Locking Plate,

4 Hole, 90mm Lng, Right

00-2358-001-06 Proximal Lateral Humeral Locking Plate,

6 Hole, 114mm Lng, Right

00-2358-001-08 Proximal Lateral Humeral Locking Plate,

8 Hole, 138mm Lng, Right

00-2358-001-12 Proximal Lateral Humeral Locking Plate,

12 Hole, 186mm Lng, Right

00-2358-001-16 Proximal Lateral Humeral Locking Plate,

16 Hole, 234mm Lng, Right

00-2360-000-14 Prox Lat Hum Plate Std/Jig Set

00-2360-092-01 Proximal Lateral Humeral Plate Jig, Right

00-2360-092-02 Proximal Lateral Humeral Plate Jig, Left

00-2358-030-05 Proximal Lateral Humeral Plate/Jig Case

00-2360-093-03 Standard Jig Set Screw

Contact your Zimmer representative or visit us at www.zimmer.com

97-2347-041-00 Rev.3 0903-T0 3ML Printed in USA ©2006, 2009, 2010 Zimmer, Inc.

+H124972347041001/$090330C10