This document provides instructions for using a proximal femur implant system for fractures of the proximal femur. It describes patient positioning, indicates the implant is for fractures of the trochanteric region and femoral neck, and outlines an 8 step surgical technique. The technique involves inserting guide wires, measuring screw length, inserting locking and cortex screws to reduce and stabilize the fracture.

1. PROXIMALFEMURSURGICALTECHNIQUE
FOR TITANIUM AND STEEL IMPLANT SYSTEM

2. PROXIMAL FEMUR SURGICAL TECHNIQUE
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3. 3
PROXIMAL FEMUR SURGICAL TECHNIQUE
MAT Medical Advanced Technology |
LARGE FRAGMENT
LOCKING INSTRU-
MENT SET OVERVIEW

4. PROXIMAL FEMUR SURGICAL TECHNIQUE
4 | MAT Medical Advanced Technology
INDICATIONS
• Fractures of the trochanteric region including simple intertrochanteric, reverse intertrochanteric,
transverse trochanteric, complex multifragmentary and fractures with medial cortex instability
• Proximal femur fractures with ipsilateral shaft fractures
• Metastatic proximal femur fractures
• Proximal femur osteotomies
• Fractures in osteopenic bone
• Nonunions and malunions
• Basi/transcervical femoral neck fractures
• Subcapital femoral neck fractures
• Subtrochanteric femur fractures
SCREW OPTIONS
7.3 mm cannulated threaded and conical head screws
Standard 5.0 mm locking screws and 5.0mm cannulated locking screws
Standard 5.0 mm locking screws or 4.5 mm standard cortex screws

5. 5
PROXIMAL FEMUR SURGICAL TECHNIQUE
MAT Medical Advanced Technology |
PATIENT
POSITIONING
Place the patient in the supine or lateral position on a radio‐
lucent surgical table according to surgeon preference and
fracture pattern.
If using a fracture table, the foot of the affected limb is
placed in a foot holder or a skeletal traction pin is used to
achieve traction.
The unaffected limb is extended down and away from the
affected limb or placed up in a leg holder. Check the affected
limb for length and rotation by comparison to the unaffected
limb.
Rotate the C‐Arm to ensure optimal AP and lateral visualizati‐
on of the proximal femur. Note If using a radiolucent surgical
table, a distraction device may be helpful in reducing the
fracture.

6. PROXIMAL FEMUR SURGICAL TECHNIQUE
6 | MAT Medical Advanced Technology
SURGICAL TECHNIQUE
Step 1
Insert the wire and determain the path of the screw,
screw the drill sleeves into the first 3 proximal holes.
Use Drill sleeve 7.3 mm (3‐3521) in combination with
wire sleeve 2.5 mm (3‐3519) for the first 2 holes, Drill
sleeve 5.0 mm for the third hole.
Use the drill sleeves to hold and position the plate on
the proximal femur.
Insert a guide wire (004‐0740‐0166) through the wire
guide in each of the three proximal locking holes.
Note: For proper screw measurement, guide wires
should not penetrate subchondral bone.
Step 2
Measure correct screw length,
use the direct measuring device (3‐3523) to measure
screw length.
Place the measuring device over the guide wire.
Select the appropriate length 7.3 mm cannulated locking
screw.
Note: The screws have self‐drilling, self‐tapping flutes.
In case of dense bone use:
‐ drill bit 5.5 mm for 7.3 mm screws (3‐3525)
‐ drill bit 4.3 mm for 5.0 mm screws (3‐3505)

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PROXIMAL FEMUR SURGICAL TECHNIQUE
MAT Medical Advanced Technology |
SURGICAL TECHNIQUE
Step 3
Insert the screws,
with the large screw driver (009‐0368‐035) using
fluoroscopy.
Once the screw has been locked to the plate, the guide
wire may be removed.
Note: Recheck each locking screw prior to closing to
verify that the screws are securely locked to the plate.
If plates needs to be compressed to the bone use a
fully threaded 7.3 mm cannulated conical screw in the
proximal screw hole.
Insert the second screw by following the same steps.
Precaution: Angular stability can only be achieved by
using locking screws. In such case replace the conical
screws with a locking screws.
Step 4
Approximate the plate to the femoral diaphysis,
use a bone holding forceps to secure the plate to the
bone.
Adjust rotation as required.
Reduce fracture and restore length with appropriate me‐
ans (fracture table, the Articulated Tension Device, etc.).
If appropriate use the tension device at the end of the
plate to compress the fracture.
Note: Tension the plate, and compress the fracture
creates a load‐sharing construct. Alternatively, although
less desirable, the plate can be used as a bridging con-
struct in patterns with segmental comminution where
plate tensioning cannot be accomplished.

8. PROXIMAL FEMUR SURGICAL TECHNIQUE
8 | MAT Medical Advanced Technology
SURGICAL TECHNIQUE
Step 6
Measuring and 4.5mm cortex screw insertion,
measure for screw length using the depth gauge
(005‐0219‐006).
Select and insert the appropriate length 4.5 mm cortex
screw using the screwdriver (009‐0368‐035).
Insert as many standard 4.5 mm cortex screws as
necessary.
Step 5
4.5 mm Cortex screw insertion,
use a 3.2 mm drill bit (005‐0210‐031) and drill through
the universal drill guide (005‐0222‐025) to predrill the
bone.
To achieve compression, place the universal drill guide
at the end of the non‐threaded hole away from the frac‐
ture (do not apply downward pressure on the spring‐
loaded tip).
Notes : All 4.5 mm cortex screws must be inserted into
the plate shaft before locking screws are inserted into
the plate shaft.

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PROXIMAL FEMUR SURGICAL TECHNIQUE
MAT Medical Advanced Technology |
SURGICAL TECHNIQUE
Step 8
Insert 5.0 mm cannulated locking screw,
using the wire guide and guide wire previously inserted at
this hole location, measure for the screw length with the
measuring device.
The correct length measurement will place the screw at the
tip of the guide wire.
Remove the wire guide and insert the appropriate length
screw over the guide wire and into the bone using the tor‐
que limiting screwdriver (3‐3513).
Precautions – The need for this screw is fracture configurati‐
on dependent and should be determined during preoperati‐
ve planning. – Securely tighten all locking screws again prior
to closing.
Step 7
Locking screw insertion,
attach the 4.3 mm drill sleeve (3‐3509) to the threaded
portion of a hole in the plate shaft.
Carefully drill the screw hole using the 4.3 mm drill bit
(3‐3505).
Read the drilled depth directly from the laser mark on
the drill bit or determine the screw length with the
depth gauge.
Insert the appropriate length 5.0 mm locking screw
using the 3.5mm torque limiting screw driver (3‐3513).
Note : After one click, the optimum (4NM) torque is
reached.

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REV. 31.05.2017
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