PediLoc. Locking Proximal Femur System. Design Advantages

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1 Design Advantages PediLoc Locking Proximal Femur System The PediLoc Locking Proximal Femur System is an evolved, user friendly system that helps surgeons make reproducible adjustments to patient anatomy because of its advanced features: Optimal configuration of proximal screws for anatomical fit Converging instead of diverging proximal screws provide the same amount of stability but are easier to correctly position in a narrow pediatric femoral neck. In addition, it allows larger, stronger, constructs to be used in smaller patients. Two offsets per size The offset plates allow the surgeon to restore the mechanical axis of the femur, especially in cases with large deformity corrections. Cannulated proximal screws Cannulated proximal screws are manufactured from a special, high strength, Stainless Steel alloy (Biodur 108), which is much stronger than those typically used in Trauma applications. Innovative, user friendly instrumentation The system includes unique instrumentation options that help the surgeon perform a straightforward, reproducible operation. Cannulated instrumentation and implants allow wire placement to be modified prior to drilling, without compromising screw fixation. Guide pins manufactured from CoCr alloy provide the high stiffness needed to maintain screw trajectory and proximal osteotomy fragment control throughout the procedure. Multiple angle, hole and offset plate options Easier to treat a wide variety of bony anatomic variants. The PediLoc Locking Proximal Femur System is designed to provide the surgeon with the ability to more easily treat a broader variety of patient deformities, while providing increased construct strength and a wider safety margin for implant placement.

2 Optimal Configuration of Proximal Screws for Anatomical Fit Proximal segment screw configuration is more anatomically appropriate for the pediatric proximal femur: The cluster of three screws in the head of the plate allows the surgeon to position the plate in the optimal anatomic location in order to achieve the best possible fixation in the hip. Observe how close the screws are located on the left implant compared to the OrthoPediatrics one on the right. The wider screw configuration on the OrthoPediatrics plate helps increase the rotational stability of the bone-plate construct, as the screws obtain purchase further away from the center of the femoral neck. In addition, the increased distance between the screw holes makes it easier to place locking drill guides and screws. Unlike the plate on the left, the screws on the OrthoPediatrics implant converge. As a result, maximum strength of the construct is achieved, while the possibility for the screws perforating the cortex of the femoral neck, or cutting out from the superior neck is greatly reduced. This feature provides the surgeon with the option to use longer screws, creating a stronger construct. Locking Proximal Femur 1

3 Optimal Configuration of Proximal Screws for Anatomical Fit With the system pictured in front, the most distal of the three screws is aiming caudally, toward the osteotomy. The distal screw the OrthoPediatrics system is angled cephalad, towards the center of the femoral neck. Positioning the plate too superiorly on the femur can lead to screws cutting out of the proximal aspect of the femoral neck. Placing screws near or through the osteotomy site should be avoided, as this may interfere with the healing process. With a diverging screw pattern these two requirements are difficult to balance. In some cases surgeons tend to place the plate more superiorly, or alternatively they do not use the inferior screw. Both of these solutions are not optimal: As stated, by placing the implant too superiorly the possibility of screw cut-out is increased. If the distal screw is not used, the rotational stability of the proximal fragment and plate construct is reduced. Design Advantages 2

4 Optimal Configuration of Proximal Screws for Anatomical Fit The screws on the left plate are parallel and may perforate the femoral neck cortices, especially in a narrow femoral neck. This screw configuration does not allow much room for patient variability. In the OrthoPediatrics screw configuration (right), the two most proximal screws in the plate converge, which allows the surgeon to place the screws more easily in a pediatric femoral neck. With the OrthoPediatrics proximal screw cluster design, it is easier to correctly position the plate without compromising fixation while simultaneously avoiding the possibility of a screw cut-out. Locking Proximal Femur 3

5 Optimal Configuration of Proximal Screws for Anatomical Fit Preoperative Postoperative 6 weeks postoperative 6 month postoperative As a clinical illustration of the issue, note the position of the plate and the screws in the proximal part of the femur. It appears that the surgeon could not place the plate more superiorly, as there may be a risk of cutout of the screws through the femoral neck. As a result, the distal screw is aiming directly into the osteotomy site. This is not considered a complication, however, if the OrthoPediatrics system was used all three screws would be directed into the femoral neck. Design Advantages 4

6 Dual Offset Plates Allow for a More Anatomical Restoration of the Mechanical Axis Both of these OrthoPediatrics plates are 3.5 mm, 90 degrees. The difference between them is the offset. The first plate has 6 mm offset; the second plate has 12 mm offset. When the second plate is used, the femoral shaft is medialized compared to the first plate. The surgeon can decide which plate will reconstruct the mechanical axis better. With a single offset implant it is more difficult to accurately restore the mechanical axis. Effect of offset plates on anatomic axis restoration. In these two pictures the same proximal fragment is attached on the femoral shaft with two different offset plates. On the left is a plate with a 6 mm offset, on the right a 12 mm one. Notice how the mechanical axis is reconstructed differently with each plate. A higher offset plate medializes the shaft more, a very useful feature when dealing with large deformities. In other situations a standard offset may be more appropriate. An implant with dual offsets enables the surgeon to restore the mechanical axis of the femur more accurately by providing more options. Locking Proximal Femur 5

7 Cannulated Locking Screws in the Proximal Portion of the Femur The Pediloc Locking Proximal Femur system utilizes optional cannulated screws in the proximal portion of the plate that allow the surgeon to maintain control of the proximal femur after making the osteotomy. The cannulated screws are manufactured from BioDur 108, a high strength alloy, which provides increased fatigue strength compared to the more commonly used 316L steel. Easy, reproducible instrumentation The system features unique instrumentation, including a guide with an extended handle to assist in accurate placement of the proximal guide wires and the exact location of the osteotomy. Design Advantages 6

8 A Wider Variety of Plate Options The Pediloc Locking Proximal Femur includes plates with multiple angles, sizes and offsets which enables the surgeon to treat a broad range of hip deformities. The 3.5 and 4.5 mm plates included in the standard set cover a wide variation of angles, from 90 to 150 degrees. 4.5 mm Plates 3.5 mm Plates OrthoPediatrics The Orthopediatrics system offers almost twice as many 3.5 and 4.5 mm implant choices in the standard set. OrthoPediatrics 3.5mm LPF System Angle Holes Offset Competitor OrthoPediatrics 4.5mm LPF System Angle Holes Offset OrthoPediatrics, Children Are Not Just Small Adults, PediPlates, PediLoc, PediFlex, PLEO, PediNail, Response, Scwire, and the Pedi logo are trademarks of OrthoPediatrics Corp. OrthoPediatrics, Children Are Not Just Small Adults, PediPlates, PediLoc, Scwire and the Pedi logo are registered trademarks in the United States. The Pedi logo is a registered trademark in Australia and New Zealand, and a registered Community Trade Mark Frontier Drive Warsaw, IN ph: or fax: OrthoPediatrics Corp SA Rev A