OPERATIVE TECHNIQUE

CONTENTS

Introduction 4
Features & Benefits 5
Indications & Contraindications 6

Hansson Twin Hook & Hip Plate Assembly Technique 9

Guide Pin Insertion 11
Femoral Head / Neck Reaming 15
Hip Plate & Hansson Twin Hook Insertion 16
Plate Attachment 18
Hansson Twin Hook Removal 21

Lag Screw & Hip Plate Assembly Technique 22

Guide Pin Insertion 24
Femoral Head / Neck Reaming 28
Lag Screw Insertion 30
One-Step Insertion 32
Plate Attachment 33
Lag Screw Removal 36

Instrument Assembly Instructions 37

Combination Reamer Assembly 37
Hansson Twin Hook Assembly 38
Lag Screw Assembly 39

Ordering Information 41
Instruments 41
Implants 44
INTRODUCTION

The Omega 2 Compression Hip Screw System is a unique and innovative

system reflecting the long experience of Stryker Trauma
in the treatment of proximal hip fractures.

This modular system offers the surgeon a wide choice of slimlined hip plates
combined with a unique option of cephalic implants,
and state of the art instrumentation.

This system provides a simple and easy-to-use solution for all

surgeons facing hip fractures. All implants are delivered sterile
for traceability and inventory reduction.

4
FEATURES & BENEFITS

Low Prole Hip Plate Range State of the art

Available in both Standard Barrel instrumentation
(38mm) and Short Barrel (25mm)
Accurate angle guides:
styles and a full range of sizes
(2 to 14 holes) and angles. Radiolucency of the angle guide
body to precisely position the
Hip Plate barrel accepts instrument, and therefore
Omega Plus Lag Screws or the guide pin.
Hansson Twin Hook.
Bi-directional hole design from
Multiple guide pin holes for accurate
SPS system
placement of the guide pin without
All sideplate holes accept 6.5mm need to move the instrument.
cancellous or ASNIS III 6.5mm
Variable angle guide with
cannulated screws for additional
freehand technique option.
stabilization of a medial fragment.
Fully threaded Low Profile
Stiffer CoCr guide pin for
compression screw
reduced deflection.
SPS instruments for bone
screw placement.
Layout of the trays sequenced
according to the surgical technique.

CEPHALIC IMPLANT OPTION:

HANSSON Twin Hook Omega Plus Lag Screws
Minimized disruption 13mm Standard Lag Screw
The smooth profile of the implant allows the Leading edge of the cutting thread
Hansson Twin Hook to slide into place without engages quickly, with or without
turning or hammering, minimizing dislocation. tapping, and provides tactile control
Preserved bone integrity during final positioning and seating.
Minimum disruption to cancellous bone. 15mm Super Lag Screw
Full bone / implant surface contact for better stability. Provide superior resistance to
Reduced invasive surgery migration in case of
The complete procedure can be carried out osteoporotic bone.
through a 5 to 7cm skin incision. This can reduce
bleeding, tissue destruction, operative time,
and may help to limit post-operative pain
and rehabilitation time.
Simpler and atraumatic removal procedure
The Hansson Twin Hook can be removed
through a 10mm skin incision without need
to remove the plate, reducing the trauma
for the patient.

5
INDICATIONS / CONTRAINDICATIONS

Indications
The Omega 2 Compression Hip Screw is indicated for fractures of the Proximal Femur which may include:

Intertrochanteric Fractures Intracapsular and Basal Neck fractures

NOTE: Due to rotational instability, it is highly
recommended that an Asnis III 6.5mm
Cannulated screw or Hansson Pin
be added to stabilize the fracture.

Contraindications
The physicians education, training and professional judgement must be relied upon
to choose the most appropriate device and treatment. Conditions presenting an increased
risk of failure include:
Any active or suspected latent infection or marked local inflammation in or about the
affected area.
Compromised vascularity that would inhibit adequate blood supply to the fracture or
the operative site.
Bone stock compromised by disease, infection or prior implantation that can not provide
adequate support and/or fixation of the devices.
Material sensitivity, documented or suspected.
Obesity. An overweight or obese patient can produce loads on the implant that can lead
to failure of the fixation of the device or to failure of the device itself.
Patients having inadequate tissue coverage over the operative site.
Implant utilization that would interfere with anatomical structures or physiological performance.
Any mental or neuromuscular disorder which would create an unacceptable risk of fixation
failure or complications in postoperative care.
Other medical or surgical conditions which would preclude the potential benefit of surgery.

6
PREOPERATIVE PLANNING

Review the frontal and lateral X-Rays of the pelvis and

injured femur prior to surgery to assess fracture stability,
bone quality, as well as neck-shaft angle and to estimate
plate length required.

Use templates preoperatively to plan plate angle, plate length,

barrel length, and Hansson Twin Hook / Lag Screw length.

The Hansson Twin Hook / Lag Screw should be centered

in the head within 10 millimeters of subchondral bone,
and the plate should allow for fixation of four bone screws
below the fracture line. Application of the template to an
X-Ray of the uninvolved hip may help simulate reduction
of the fractured hip.

7
PATIENT POSITIONING

The patient is placed supine on the fracture table.

Satisfactory access to the hip with the C-arm in the frontal and lateral planes are verified.

The fracture is reduced by flexion, longitudinal traction, abduction and internal rotation on a fracture table.
In unstable fractures, guide pins can be placed, in order to stabilize the reduced fragments.

8
 HANSSON TWIN HOOK &
HIP PLATE ASSEMBLY TECHNIQUE
SKIN INCISION

Compared to a standard incision of up to 15cm, The corresponding landmark is established by placing

a reduced incision of approximately 5cm is possible
when using the Hansson Twin Hook together with
the Omega 2 Hip Plate. The procedure is performed
without exposing the fracture site and therefore involves
less tissue destruction, less bleeding, and reduced
operative time than conventional techniques.
This minimal access technique may help to reduce
post-operative pain and to shorten rehabilitation time
for the patient.
The barrel hip plate entry site on the femoral shaft
is situated about 2-3cm below the crest on which the
vastus lateralis originates. This distance is ample for
the insertion of the angle guide, without any need for
detaching the vastus lateralis from its trochanteric origin.
The continuity between the vastus lateralis and the
gluteus medius is preserved. All that needs to be done
is to detach the vastus lateralis from the femoral shaft,
and to reflect it anteriorly. Since the first 2cm of the
vastus are not affected by the procedure, the skin
incision used in the past to expose that part of the
muscle is not required for this procedure.
a guide pin on the skin under frontal view of the image
intensifier, centrally in relation to the femoral neck and
head. A 5cm longitudinal incision is made distal from
this point through the skin. After closure at the end of
the procedure, the line should be over the holes in the
side plate.
The incision is continued through the subcutaneous
tissue and tensor fascia lata in line with the skin incision.
Both proximally and distally, this incision is extended
beyond the limits of the skin incision.
The posterior part of superficial fascia of the vastus
lateralis is incised longitudinally. However, the vastus
is not detached from its origin at the base of the
greater trochanter.
The vastus is lifted with a Lambotte elevator.
The self-retaining Beckmann retractor is placed
underneath the vastus lateralis anteriorly and
the tensor fascia lata posteriorly.
In this way, the shaft is exposed over a distance
of 6-7cm. The angle guide is positioned against the
femoral shaft.

Optimal
skin
incision
point

Reduced skin incision

Standard skin incision

The optimal point for skin incision is located at a point

where the axis of the femoral neck intersects with the
skin (see picture above).

10
GUIDE PIN INSERTION

ORIENTATION AND PLACEMENT OF THE GUIDE PIN IS ONE OF THE MOST CRITICAL STEPS IN THIS PROCEDURE.

By utilizing one or more of the following visual There are two types of angle guides for the placement
landmarks, correct positioning of the guide pin can of the guide pin:
be achieved.
A Fixed Angle Guide which corresponds to the
With the guide pin placed at 135 angle, the pin crosses 135 barrel plate angle (angle most commonly indicated).
the lateral cortex at the level of the lesser trochanter;
at the insertion of the gluteus maximus at the
posterolateral edge of the femur; or two fingerbreadths
(2.5 to 3.5cm) below the crest of the greater trochanter
at the origin of the vastus lateralis.

Correct positioning of the guide pin is achieved

referencing anatomical and visual landmarks,
as shown in the figure below.

Lesser Trochanter Crest of the Greater A Variable Angle Guide in conjunction with an
Trochanter Elastosil T-Handle can be used to insert the guide pin
at 130, 135, 140, 145 and 150.
135
Insertion of gluteus
maximus

For each 5 change in hip plate angle, the guide pin

insertion point will be moved approximately
5mm distally (for increased angle) or proximally
(for decreased angle).

NOTE: The angle guides are radiolucent to help the

correct positioning of the angle guide and
the guide pin under image intensifier
(helpful when a reduced skin incision is
performed and direct visibility of the site
is therefore reduced).

11
GUIDE PIN INSERTION CONTINUED
Using image intensification, the guide pin is advanced
until it reaches the subchondral bone in the center of the
femoral head in both frontal and lateral views.
FRONTAL VIEW
LATERAL VIEW
While holding firmly the appropriate angle guide on
the femoral shaft, the 2.8mm guide pin is inserted in
the central hole of the angle guide and advanced into
the femoral head under image intensification.
If the guide pin is not positioned correctly, an additional pin
can be inserted 5mm above or below the central position in
the frontal plane, and 5mm anteriorly or posteriorly to the
central position in the lateral plane, without removing
the first guide pin.
NOTE: To insert a second pin near the first one, use a Quick
Coupling Chuck for 2.8mm guide pin (REF. 704027)
together with a 2.8mm guide pin with quick coupling
fitting (REF. 704012S), otherwise there is a risk that
the power drill chuck will touch the first guide pin.
12
Freehand technique for guide pin placement:
Place a 2.8mm guide pin anterior to the neck of the femur
and align it in the center of the head against the medial
cortex by using image intensification.
A 3.2mm drill bit can be used to make an opening in the
lateral cortex, allowing for easy insertion of the guide pin.
Using image intensification, the guide pin is advanced until
it reaches the subchondral bone in the femoral head.
After confirming appropriate tip position of the guide pin
on both frontal and lateral views, verify the appropriate
plate angle by using the Variable Angle Guide. To unlock
the mechanism, pull the cylinder of the guide (1) and turn
it by 90 (2).
(1) (2) (3)
Slide the Variable Angle Guide over the guide pin and
adjust it down to the lateral aspect of the femur (make sure
that all the spikes are in contact with the bone shaft).
The arrow on the cylinder will indicate at which angle
the guide pin has been inserted (3), and therefore the angle
of the barrel plate to be selected.
GUIDE PIN MEASUREMENT

The direct-reading Lag Screw Depth Gauge is used to determine the proper depth of penetration of the
guide pin. This reading determines the settings for the Combination Reamer and indicates the length of
the Hansson Twin Hook to be used.

To set the reaming depth,

and the Hansson Twin Hook length,
subtract 10mm from the reading.

EXAMPLE:
Direct reading depth gauge measurement: 110mm
Reamer depth setting: 100mm
Hansson Twin Hook length selected: 100mm

13
ANTI-ROTATION GUIDE PIN INSERTION

The Guide Pin Replacement Instrument can be used to

insert a second guide pin parallel to the primary guide pin.

Diam. 2.8mm hole

Diam. 3.2mm hole

This step is especially useful in providing temporary This instrument also accommodates a 3.2mm guide wire,
stability for femoral neck fractures and basal neck should the surgeon wish to insert a 6.5mm ASNIS III
fractures, where the head could rotate during reaming. Cannulated Screw for definitive rotational stability,
like in Basal Neck fractures or Femoral Neck Fractures.
Correct positioning of the anti-rotational wire can be
done by rotating the instrument anteriorly or posteriorly
(see illustration).

14
FEMORAL HEAD / NECK REAMING

Select and assemble the correct Barrel Reamer (according to

the standard or short barrel plate selected).
For assembling instructions see page 37.

NOTE FOR SHORT BARREL PLATES:

For more lateral intertrochanteric fractures or medial
displacement osteotomies, short barrel plates provide
fixation without the barrel crossing the fracture.

Reaming is accomplished using the Short Barrel

Reamer, following the same procedure for standard
barrel reaming.

The Combination Reamer is set and locked at the predetermined

reading (10mm less than the guide pin measurement). Ream over the
guide pin with the Combination Reamer until the stop reaches
the lateral cortex. Remove the Combination Reamer and the guide pin.

NOTE: All guide pins are Single-use products and therefore

must be discarded at the end of the surgical procedure.

15
HIP PLATE & HANSSON TWIN HOOK INSERTION

OMEGA 2 PLATE INSERTION HANSSON TWIN HOOK INSERTION

Select a Hansson Twin Hook of the appropriate length
and assemble it to the insertion instruments
(See Assembling Instruction Page 38).

The hip plate is slid through the small skin incision

under the vastus lateralis against the femoral shaft.

The Hansson Twin Hook is inserted through the

plate barrel, and the assembly is pushed into the reamed
channel. Use the insertion instruments as a joystick.

The plate is then rotated in order to position the

plate barrel toward the reamed channel.

16
HIP PLATE & HANSSON TWIN HOOK INSERTION

B C

(1)

(2)

When the Hansson Twin Hook is seen to be in position, The hooks are activated by turning the Introducer
the Introducer assembly is inserted through the channel of Assembly clockwise as far as it will go.
the Inner Introducer (1) and rotated clockwise (2) until it
meets resistance, that is, the tip of the Introducer touches
the tip of the inner Twin Hook.

D E

Both frontal and lateral image intensification
are utilized to ensure accurate placement.
NOTE: It is important that the Outer Introducer Handle
is pushed forward when activating the hooks.
Impaction of the fracture may be accomplished by using
the Plate Impactor.
The Introducer Assembly is then removed.

17
PLATE ATTACHMENT

Using standard screw insertion technique, fix the Omega 2 Hip Plate to the femoral shaft
beginning at the proximal end of the plate.
NOTE: When using the reduced skin incision technique, supplementary stab incisions can be
performed for distal screws placements.

Use the 3.2mm Drill bit through the

3.2 drill sleeve with the green ring
(Neutral) assembled to the Drill Guide
Handle, to drill the bone screw holes.

NOTE: If necessary it is possible to obtain

compression of a shaft fracture
or osteotomy site when using
the 3.2mm drill sleeve with the
yellow ring (1mm compression).

Determine appropriate cortical screw

length using the Depth Gauge.

Insert the screw using the 3.5mm

Hex Screwdriver with Elastosil Handle
and the Holding Sleeve, or the 3.5mm
Hex Screwdriver with AO fitting attached
directly to a power source.
However, final tightening should always
be done by hand.

Option

A 4.5mm Tap is available, to pre-tap in

extremely hard cortical bone.

18
FRACTURE COMPRESSION / END PROTECTION

When all screws are inserted and tightened, and all traction is released,
fracture compression can be accomplished by means of the compression screw.

Caution should be used when carrying out the compression.

The compression screw exerts a powerful force that must be correlated
with the quality of the bone.

Placement of the compression screw should be considered mandatory when

a short barrel plate is used. The compression screw is designed to hold the
Hansson Twin Hook / Hip plate assembly together.

The compression screw can also be used to protect the inner thread of the
Hansson Twin Hook against soft tissue ingrowth.

19
CLOSING THE WOUND

It is important to ensure that the Hansson Twin Hook is placed

within the femoral head. This is checked by removing traction
and rotating the hip under image intensification.

Closure of the wound is done in layers, closing separately

the fascia of the vastus laterali muscle and the fascia lata.
Carefully reapproximate the subcutaneous tissue and the
skin to facilitate prompt healing of the wound.

20
HANSSON TWIN HOOK REMOVAL
Should the need arise for implant removal, a 10mm skin
incision is made at the level of the Lesser Trochanter
(corresponding to the barrel plate position).
If a compression screw has been used, remove the screw
with the 3.5mm hex screwdriver. The end of the Hansson
Twin Hook can be identified manually or using image
intensification.
The Inner Extractor is placed against the Hansson
Twin Hook and rotated clockwise until it meets resistance (1).
The Outer Extractor is slid over the Inner Extractor (2).
Turn and push gently clockwise or anticlockwise the handle
of the Outer Extractor. When the Outer Extractor meets the
flat sides of the Inner Extractor (and stop the rotation of
the handle), push the Outer Extractor until it is in contact
with the outer pin of the Hansson Twin Hook (3).
(1)
(4)
21
Insert the tip of the Extractor Handle in the channel of the
Outer Extractor and turn it clockwise to engage the threaded
part in the Inner Extractor (4).
Continue to turn the Extractor. This withdraws the hooks back
into the outer pin.
NOTE: Check under image intensifier that the hooks are fully
retracted to prior pulling back the implant. This can
be done without removing the plate.
The Hansson Twin Hook can then be extracted by pulling
the extractor assembly laterally (5).
NOTE: Once the Hansson Twin Hook is removed the hooks
cannot be spread again for repositioning and must be
discarded.
(2)
(3)
(5)
 LAG SCREW &
HIP PLATE ASSEMBLY TECHNIQUE
SKIN INCISION

A 10 to 15 centimetre incision is made,

starting at the tip of the greater trochanter
and continuing straight distally.

The incision is continued through the

subcutaneous tissue and tensor fascia lata
in line with the skin incision. The vastus
lateralis is split longitudinally and
reflected upward to allow palpation of the
fracture line and inferior neck anteriorly.

23
GUIDE PIN INSERTION

ORIENTATION AND PLACEMENT OF THE GUIDE PIN IS ONE OF THE MOST CRITICAL STEPS IN THIS PROCEDURE.

By utilising one or more of the following visual There are two types of angle guides for the placement
landmarks, correct positioning of the guide pin can of the guide pin:
be achieved.
A Fixed Angle Guide which is corresponding to the
With the guide pin placed at 135 angle, the pin crosses 135 barrel plate angle (angle most commonly indicated).
the lateral cortex at the level of the lesser trochanter;
at the insertion of the gluteus maximus at the
posterolateral edge of the femur; or two fingerbreadths
(2.5 to 3.5cm) below the crest of the greater trochanter
at the origin of the vastus lateralis.

Correct positioning of the guide pin is achieved

referencing anatomical and visual landmarks,
as shown in the figure below.

A Variable Angle Guide in conjunction with

Lesser Trochanter Crest of the Greater
an Elastosil T-Handle can be used to insert the
Trochanter
guide pin at 130, 135, 140, 145 and 150.

135
Insertion of gluteus
maximus

For each 5 change in hip plate angle,

the guide pin insertion point will be moved
approximately 5mm distally (for increased angle)
or proximally (for decreased angle).

NOTE: The angle guides are radiolucent to help the

correct positioning of the angle guide and
the guide pin under image intensifier
(helpful when a reduced skin incision
is performed and direct visibility of the site
is therefore reduced).

24
GUIDE PIN INSERTION CONTINUED
Using image intensification, the guide pin is advanced until
it reaches the subchondral bone in the center of the femoral
head in both frontal and lateral views.
FRONTAL VIEW
LATERAL VIEW
While holding firmly the appropriate angle guide on
the femoral shaft, the 2.8mm guide pin is inserted in
the central hole of the angle guide and advanced into
the femoral head under image intensification.
If the guide pin is not positioned correctly, an additional pin
could be inserted 5mm above or below the central position
in the frontal plane, and 5mm anteriorly or posteriorly to
the central position in the lateral plane, without removing
the first guide pin.
NOTE: To insert a second pin near the first one, use a Quick
Coupling Chuck for 2.8mm guide pin (REF. 704027)
together with a 2.8mm guide pin with quick coupling
fitting (REF. 704012S), otherwise there is a risk that
the power drill chuck will touch the first guide pin.
25
Freehand technique for guide pin placement:
Place a 2.8mm guide pin anterior to the neck of the femur
and align it in the center of the head against the medial
cortex by using image intensification.
A 3.2mm drill bit can be used to make an opening in the
lateral cortex, allowing for easy insertion of the guide pin.
Using image intensification, the guide pin is advanced until
it reaches the subchondral bone in the femoral head.
After confirming appropriate tip position of the guide pin
on both frontal and lateral views, verify the appropriate
plate angle by using the Variable Angle Guide. To unlock
the mechanism, pull the cylinder of the guide (1) and turn
it by 90 (2).
(1) (2) (3)
Slide the Variable Angle Guide over the guide pin and
adjust it down to the lateral aspect of the femur (make sure
that all the spikes are in contact with the bone shaft).
The arrow on the cylinder will indicate at which angle the
guide pin has been inserted (3), and therefore the angle
of the barrel plate to be selected.
GUIDE PIN MEASUREMENT

The direct-reading Lag Screw Depth Gauge is used to determine the proper depth of
penetration of the guide pin. This reading determines the settings for the Combination
Reamer and Tap, and indicates the length of the Lag Screw to be used.

To set the reaming depth,

and the Lag Screw length,
substract 10mm from
the reading.

EXAMPLE:
Direct reading depth gauge measurement: 110mm
Reamer depth Setting: 100mm
Tapping depth (if required): 100mm
Lag Screw Length selected: 100mm

26
ANTI-ROTATION GUIDE PIN INSERTION

The Guide Pin Replacement Instrument can be used to

insert a second guide pin parallel to the primary guide pin.

Diam. 2.8mm hole

Diam. 3.2mm hole

This step is especially useful in providing temporary This instrument also accommodates a 3.2mm guide wire,
stability for femoral neck fractures and basal neck should the surgeon wish to insert a 6.5mm ASNIS III
fractures, where the head could rotate during reaming Cannulated Screw for definitive rotational stability,
or screw insertion. like in Basal Neck fractures or Femoral Neck Fractures.

Correct positioning of the anti-rotational wire can be

done by rotating the instrument anteriorly or posteriorly
(see illustration).

27
FEMORAL HEAD / NECK REAMING
Select and assemble the correct Barrel Reamer
(according to the standard or short barrel plate selected).
For assembling instructions see page 37.
The Combination Reamer is set and locked at the
predetermined reading (10mm less than the guide pin
measurement).
Ream over the guide pin with the Combination Reamer
until the stop reaches the lateral cortex.
Remove the Combination Reamer.
28
Should the guide pin be inadvertently withdrawn,
reverse the Guide Pin Replacement Instrument,
insert it into the femur, and reinsert the guide pin.
NOTE FOR SHORT BARREL PLATES:
For more lateral intertrochanteric fractures or medial
displacement osteotomies, the short barrel plates provide
fixation without the barrel crossing the fracture.
Reaming is accomplished using the Short Barrel Reamer,
following the same procedure for standard barrel reaming.
FEMORAL HEAD / NECK TAPPING

The Lag Screw Tap should be used when good quality,

dense bone is encountered; the Calibrated Tap Sleeve indicates
the proper depth of the Tap.

The Tap is advanced until the indicator ring on the Tap reaches
the correct depth marking on the Centering Sleeve.
(For assembling instructions see page 39).

EXAMPLE:
Direct reading depth gauge measurement: 110mm
Reamer depth setting: 100mm
Tapping depth: 100mm
Lag Screw length selected: 100mm

29
LAG SCREW INSERTION

Select a Lag Screw of the appropriate
length and assemble it to the
Lag Screw Adapter. Place into
the Lag Screw Inserter Assembly the
Lag Screw Adapter Assembly,
and direct it toward the bone
over the guide pin. (For assembling
instructions see page 39).
The Centering Sleeve on the Inserter
Assembly is advanced into the
pre-reamed hole, and the Lag Screw
is driven into the prepared channel.
Depth of insertion of the Lag Screw
is determined by observing the two
depth indicator rings on the inserter.
(See picture below).
The T-Handle of the insertion/extraction
wrench is aligned with the long axis of
the femur in preparation for placement
of the Hip Plate.
Position the flats of the Lag Screw to
ensure proper alignment with the barrel
of the Hip plate for the keyed system.

DEPTH INDICATOR RINGS

NO COMPRESSION 5mm COMPRESSION 10mm COMPRESSION

Depth indicator rings measure desired compression.

For typical anatomy (135 head/neck angle), advance the Lag Screw Inserter
Assembly until the ring marked 135 reaches the mark on the Inserter.
Center the sleeve corresponding to the amount of compression desired
(see picture above).
For Valgus anatomy (150 head/neck angle), advance the Lag Screw Inserter
Assembly until the ring marked 150 reaches the mark on the inserter.
Center the sleeve corresponding to the amount of compression desired.

30
PLATE INSERTION

Upon completion of Lag Screw

insertion, the Lag Screw Inserter
assembly is removed from the
Lag Screw, leaving the Lag Screw
Adapter in place.

The selected Hip Plate is now
placed over the Lag Screw
Adapter and advanced to
engage the Lag Screw.
The Plate Impactor should be used to fully seat
the plate. Unscrew the Lag Screw Adapter and
remove it. Then, remove the 2.8mm guide pin.
NOTE: All guide pins are Single-use products
and therefore must be discarded at the
end of the surgical procedure.

31
ONE-STEP INSERTION

As an option to the standard technique, the One-Step Insertion Instrument may be used to insert
the plate and the Lag Screw in a one-step procedure.

Assemble the appropriate Hip Plate and the Lag Screw
onto the One-Step Insertion Wrench (for assembling
instructions see page 39).
For Valgus anatomy (150 head/neck angle), advance the
One-Step Insertion Wrench until the ring marked 150
reaches the One-Step Insertion Sleeve.
Other angled plates should be inserted proportionally
between the marks.

At the conclusion of screw insertion, the handle of the

One-Step Insertion Instrument must be perpendicular
to the axis of the femoral shaft to allow proper keying
of the Lag Screw to the plate barrel.

Place the entire assembly over the guide pin and

introduce it into the reamed hole.
Advance the Lag Screw into the proximal femur to the
predetermined depth and verify using image intensification.
Depth of the insertion of the Lag Screw is determined by
observing the two depth indicator rings on the One-Step
Inserter Wrench.
Remove the One-Step Insertion Sleeve and advance the
Hip Plate onto the Lag Screw shaft.
The Plate Impactor should be used to fully seat the plate.
Unscrew the Connecting Bolt and remove the One-Step
Insertion Wrench from the back of the Lag Screw;
then remove the 2.8mm Guide Pin.

Stop inserting the Lag Screw when the

135 ring reaches the One-Step Insertion
Sleeve (when a 135 Hip plate is selected)

For typical anatomy (135 head/neck angle), advance the

One-Step Insertion Wrench until the ring marked 135
reaches the One-Step Insertion Sleeve
(see picture above).

32
PLATE ATTACHMENT

Using standard screw insertion technique, fix the Omega 2 Hip Plate
to the femoral shaft beginning at the proximal end of the plate.

Use the 3.2mm drill bit through the

3.2 drill sleeve with the green ring
(Neutral) assembled to the Drill Guide
Handle, to drill the bone screw holes.

NOTE: If necessary it is possible to obtain

compression of a shaft fracture
or osteotomy site when using
the 3.2mm drill sleeve with the
yellow ring (1mm compression).

Determine appropriate Cortical Screw

length using the Depth Gauge.

Insert the screw using the 3.5mm Hex

Screwdriver with Elastosil handle and
the holding sleeve, or the 3.5mm Hex
Screwdriver with AO fitting attached
directly to a power source.
However, final tightening should always
be done by hand.

Option

A 4.5mm Tap is available, to pre-tap in

extremely hard cortical bone.

33
FRACTURE COMPRESSION

When all screws are inserted and tightened, and all traction is released,
fracture compression can be accomplished by means of the Compression Screw,
or with the Compression Instrument connected to the Large Elastosil T-Handle.

34
CLOSING THE WOUND

Closure of the wound is done in layers, closing separately

the fascia of the vastus lateralis muscle and the facia lata.
Carefully reapproximate the subcutaneous tissue and the
skin to facilitate prompt healing of the wound.

35
REMOVAL

Should the need arise for hardware removal, the Lag Screw is extracted
after removal of the Hip Plate through use of the Large T-Handle
connected to the Lag Screw Inserter and the Connecting Bolt.
(See assembling instructions page 40).

36
INSTRUMENT ASSEMBLY INSTRUCTIONS

COMBINATION REAMER ASSEMBLY:

Step 1 Select the Barrel Reamer Assembly that corresponds
to the selected plate (Standard or Short Barrel).

Barrel Reamer Assembly, Standard Barrel Reamer Assembly, Short

Combination Reamer Drill

Flat sides
Step 2 Align the flat side of the Barrel Reamer to
the flat side of the Combination Reamer
Drill, and engage the Barrel Reamer over
the coupling end of the Combination
Reamer Drill.

Step 3 Slide the Barrel reamer until the stop has been adjusted to the right
measurement. Lock the Barrel Reamer by turning the Stop Sleeve firmly.

Barrel Reamer Assembly, Standard

37
INSTRUMENT ASSEMBLY INSTRUCTIONS

HANSSON TWIN HOOK ASSEMBLY:

Step 1 Select a Hansson Twin Hook
of the appropriate length.
The Inner Introducer is inserted
into the Outer Introducer.

Hansson Twin Hook Outer Introducer Inner Introducer

Step 2 The Inner Introducer is then

firmly engaged into the base
of the Hansson Twin Hook.

38
INSTRUMENT ASSEMBLY INSTRUCTIONS

LAG SCREW TAP ASSEMBLY:

Push the quick coupling sleeve on the Large Elastosil T-Handle and
insert the Lag Screw Tap fitting into the coupling.
Assemble the Lag Screw Tap Sleeve to the Lag Screw Tap by aligning
the flat sides of the Tap to the flat sides in the Tap Sleeve.

Calibrated Tap Sleeve Lag Screw Tap

Large Elastosil T-Handle

LAG SCREW ADAPTER ASSEMBLY:

The appropriate Lag Screw is prepared by placing the inner part of the Lag Screw Adapter (1)
through the outer part (2), and threading it into the Lag Screw (3).

Lag Screw (3) Lag Screw Adapter Lag Screw Adapter

(Outer part) (2) (Inner Part) (1)

LAG SCREW INSERTER ASSEMBLY:

Push the quick coupling sleeve on the Large Elastosil T-Handle and insert the Lag Screw Inserter into the coupling.
Slide the Lag Screw Inserter Sleeve over the Lag Screw Inserter.

Lag Screw Adapter Assembly Lag Screw Inserter Sleeve Lag Screw Inserter

Large Elastosil T-Handle

ONE-STEP INSERTION ASSEMBLY:
STEP ONE:
Assemble the Large Elastosil T-Handle to the One-Step Insertion Wrench as described in instruction below.
Slide the One-Step Insertion Wrench through the barrel of the Hip Plate.
The Connecting Bolt is inserted through the Large Elastosil T-Handle and threaded into the Lag Screw.

Lag Screw One-Step Insertion Wrench Connecting Bolt

Omega 2 Hip Plate Large Elastosil T-Handle

39
INSTRUMENT ASSEMBLY INSTRUCTIONS

ONE-STEP INSERTION ASSEMBLY:

STEP TWO:
Prior to assemble the One-Step Insertion Sleeve to the One-Step Insertion Wrench /Hip plate assembly, ensure that the
One-Step Insertion Sleeve is opened (mark on the inner sleeve lining up with the open mark on the outer sleeve).
Assemble the One-Step Insertion Sleeve to the One-Step Insertion Wrench between the Hip plate and the Lag Screw,
and lock the One-Step Insertion Sleeve.

One-Step Insertion Sleeve

To lock the One-Step Insertion Sleeve,

the inner and outer sleeve are twisted
in opposite directions until the mark
on the inner sleeve lines up with the
close mark on the outer sleeve.

To unlock the sleeve, align the mark

with the "open" mark on the outer sleeve.

LAG SCREW REMOVAL ASSEMBLY:

Assemble the Large Elastosil T-handle to the Lag Screw Inserter as described in instruction above.
The Connecting Bolt is inserted through the Large Elastosil T-handle and threaded in to the Lag Screw.

Lag Screw Lag Screw Inserter Connecting Bolt

Large Elastosil T-Handle

40
ORDERING INFORMATION INSTRUMENTS

Standard set configuration (Hansson Twin Hook and Lag Screw)

Reference Description Reference Description

CASES LOWER TRAY CONFIGURATION

901721 Omega 2 Standard Sterilisation Tray Lid 702823 Compression Drill sleeve
901723 Omega 2 Standard Upper Sterilisation Tray
901725 Omega 2 Standard Lower Sterilisation Tray 702824 Neutral Drill Sleeve
UPPER TRAY CONFIGURATION
702822 Drill Guide Handle
704013 Fixed Angle Guide 135

702402 Tissue Protection Sleeve

704014 Variable Angle Guide
700358 Drill Bit 3.2mm
700359 Drill Bit 4.5mm
704020 Large Elastosil T-Handle 702808 Tap 4.5mm
702809 Tap 6.5mm
704010 Lag Screw Depth Gauge
702878 Depth Gauge Assembly
704004 Connecting Bolt
702430 Medium Elastosil T-Handle
704005 Combination Reamer Assembly, Std
702844 Screwdriver Hex3.5mm
704009 Lag Screw Adapter Assembly 704006-20 Barrel Reamer Assembly, Short

704021 Lag Screw Inserter 702863 Screw Holder Assembly

704007 Lag Screw Tap

704022 Inserter Sleeve
704008 Lag Screw Tap Sleeve
704026 Cleaning Stylet
704019 Guide Pin Replacement Instrument
704001 Impactor Assembly
901713 Screw Rack
704601 Outer Introducer

704602 Inner Introducer

704606 Introducer

704607 Extractor Handle

704608 Outer Extractor

704609 Inner Extractor

41
ORDERING INFORMATION INSTRUMENTS

Lag Screw set conguration

Reference Description Reference Description

CASES LOWER TRAY CONFIGURATION

901724 Omega 2 Lag Screw Instruments Sterilisation Tray 702823 Compression Drill sleeve
901725 Omega 2 Standard Lower Sterilisation Tray
901728 Omega 2 Lag Screw Instruments Sterilisation 702824 Neutral Drill Sleeve
Tray Lid

UPPER TRAY CONFIGURATION 702822 Drill Guide Handle

704013 Fixed Angle Guide 135
702402 Tissue Protection Sleeve
700358 Drill Bit 3.2mm
704014 Variable Angle Guide
700359 Drill Bit 4.5mm
702808 Tap 4.5mm
704020 Large Elastosil T-Handle
702809 Tap 6.5mm

704010 Lag Screw Depth Gauge 702878 Depth Gauge Assembly

704004 Connecting Bolt 702430 Medium Elastosil T-Handle

704005 Combination Reamer Assembly, Std 702844 Screwdriver Hex 3.5mm

704006-20 Barrel Reamer Assembly, Short

704009 Lag Screw Adapter Assembly
702863 Screw Holder Assembly
704021 Lag Screw Inserter
704007 Lag Screw Tap

704022 Inserter Sleeve 704008 Lag Screw Tap Sleeve

704026 Cleaning Stylet 704019 Guide Pin Replacement Instrument

704001 Impactor Assembly 901713 Screw Rack

42
ORDERING INFORMATION INSTRUMENTS

Hansson Twin Hook conguration Optional instruments

Reference Description Reference Description

CASES CASES
901722 Omega 2 Hansson Twin Hook Sterilisation Tray Lid 901727 Optional Instruments Sterilization Tray
901726 Omega 2 Hansson Twin Hook Instruments 901729 Optional Instruments Sterilization Tray Lid
Sterilisation Tray
TRAY CONFIGURATION
TRAY CONFIGURATION 704020 Large Elastosil T-Handle
704020 Large Elastosil T-Handle
704030 Trial Side Plates 130
704031 Trial Side Plates 135
704601 Outer Introducer
704032 Trial Side Plates 140
704602 Inner Introducer 704033 Trial Side Plates 145
704034 Trial Side Plates 150
704606 Introducer
704023 Screwdriver Hex 3.5mm
704607 Extractor Handle 704002 One-Step Insertion Wrench
704003 One-Step Insertion Sleeve
704608 Outer Extractor 704024 Compression Instrument
702634 AO/Hall Coupling

704027 Quick Coupling for Guide Pin 2.8mm

704609 Inner Extractor

702939 Self-Centering Bone Forceps, Ball Spike, size 3

702946 Self-Centering Bone Forceps, Swivel Head, size 3

981010 X-Ray Template

REPLACEMENT PARTS
704001-1 Impactor Head

43
ORDERING INFORMATION IMPLANTS

CEPHALIC IMPLANTS

HANSSON TWIN HOOK LAG SCREW

Stainless Steel Length Stainless Steel Length

REF mm REF mm
394550S 50 3362-5-050 50
394555S 55 3362-5-055 55
394560S 60 3362-5-060 60
394565S 65 3362-5-065 65
394570S 70 3362-5-070 70
394575S 75 3362-5-075 75
394580S 80 3362-5-080 80
394585S 85 3362-5-085 85
394590S 90 3362-5-090 90
394595S 95 3362-5-095 95
394600S 100 3362-5-100 100
394605S 105 3362-5-105 105
394610S 110 3362-5-110 110
394615S 115 3362-5-115 115
394620S 120 3362-5-120 120
394625S 125 3362-5-125 125
394630S 130 3362-5-130 130
394635S 135
394640S 140

HANSSON TWIN HOOK COMPRESSION SCREW SUPER LAG SCREW

Stainless Steel Length Stainless Steel Length
REF mm REF mm
394500S 25 3362-8-050 50
3362-8-055 55
3362-8-060 60
3362-8-065 65
3362-8-070 70
3362-8-075 75
3362-8-080 80
3362-8-085 85
3362-8-090 90
3362-8-095 95
3362-8-100 100
3362-8-105 105
3362-8-110 110
3362-8-115 115
3362-8-120 120
3362-8-125 125
3362-8-130 130

OMEGA 2 COMPRESSION SCREW

Stainless Steel Length

REF mm

596001S 32.3

GUIDE PIN CoCR THREADED TIP

REF Length Diameter Fitting

mm mm

704011S 230 2.8 Jacobs chuck

704012S 230 2.8 Quick coupling
chuck

Recommended set item

NOTE: All the implants are sterile packed

44
ORDERING INFORMATION IMPLANTS

KEYED HIP-PLATE STANDARD BARREL KEYED HIP-PLATE SHORT BARREL

Stainless Steel Holes Angle Length Stainless Steel Holes Angle Length
REF mm REF mm
596302S 2 130 46 596504S 4 130 78
596303S 3 130 62 596505S 5 130 94
596304S 4 130 78 596514S 4 135 78
596305S 5 130 94 596515S 5 135 94
596306S 6 130 110 596524S 4 140 78
596308S 8 130 142 596525S 5 140 94
596310S 10 130 174 596534S 4 145 78
596312S 12 130 206 596535S 5 145 94
596322S 2 135 46 596544S 4 150 78
596323S 3 135 62 596545S 5 150 94
596324S 4 135 78
596325S 5 135 94
596326S 6 135 110
596328S 8 135 142
596330S 10 135 174
596332S 12 135 206
596342S 2 140 46
596343S 3 140 62
596344S 4 140 78
596345S 5 140 94
596346S 6 140 110
596348S 8 140 142
596350S 10 140 174
596352S 12 140 206
596362S 2 145 46
596363S 3 145 62
596364S 4 145 78
596365S 5 145 94
596366S 6 145 110
596368S 8 145 142
596370S 10 145 174
596372S 12 145 206
596382S 2 150 46
596383S 3 150 62
596384S 4 150 78
596385S 5 150 94
596386S 6 150 110
596388S 8 150 142
596390S 10 150 174
596392S 12 150 206

Recommended set item

NOTE: All the implants are sterile packed

45
ORDERING INFORMATION IMPLANTS

BONE SCREWS

CORTICAL SCREWS 4.5mm CANCELLOUS SCREWS 6.5mm 16mm thread CANCELLOUS SCREWS 6.5mm Fully threaded

Stainless Steel Diameter Length Stainless Steel Diameter Length Stainless Steel Diameter Length
REF mm mm REF mm mm REF mm mm

340614 4.5 14 341030 6.5 30 343020 6.5 20

340616 4.5 16 341035 6.5 35 343025 6.5 25
340618 4.5 18 341040 6.5 40 343030 6.5 30
340620 4.5 20 341045 6.5 45 343035 6.5 35
340622 4.5 22 341050 6.5 50 343040 6.5 40
340624 4.5 24 341055 6.5 55 343045 6.5 45
340626 4.5 26 341060 6.5 60 343050 6.5 50
340628 4.5 28 341065 6.5 65 343055 6.5 55
340630 4.5 30 341070 6.5 70 343060 6.5 60
340632 4.5 32 341075 6.5 75 343065 6.5 65
340634 4.5 34 341080 6.5 80 343070 6.5 70
340636 4.5 36 341085 6.5 85 343075 6.5 75
340638 4.5 38 341090 6.5 90 343080 6.5 80
340640 4.5 40 341095 6.5 95 343085 6.5 85
340642 4.5 42 341100 6.5 100 343090 6.5 90
340644 4.5 44 341105 6.5 105 343095 6.5 95
340646 4.5 46 341110 6.5 110 343100 6.5 100
340648 4.5 48 341115 6.5 115 343105 6.5 105
340650 4.5 50 341120 6.5 120 343110 6.5 110
340652 4.5 52 341125 6.5 125 343115 6.5 115
340654 4.5 54 341130 6.5 130 343120 6.5 120
340655 4.5 55 343125 6.5 125
340656 4.5 56 343130 6.5 130
340658 4.5 58
340660 4.5 60
340662 4.5 62
340664 4.5 64
340665 4.5 65
340666 4.5 66
340668 4.5 68
CANCELLOUS SCREWS 6.5mm 32mm thread ASNIS III CANNULATED SCREWS 6.5mm
340670 4.5 70
340672 4.5 72 Stainless Steel Diameter Length Stainless Steel Total Thread
340674 4.5 74 REF mm mm REF Length mm Length mm
340675 4.5 75
342045 6.5 45 326255S 55 40
340676 4.5 76
342050 6.5 50 326260S 60 40
340678 4.5 78
342055 6.5 55 326265S 65 40
340680 4.5 80
342060 6.5 60 326270S 70 40
340685 4.5 85
342065 6.5 65 326275S 75 40
340690 4.5 90
342070 6.5 70 326280S 80 40
340695 4.5 95
342075 6.5 75 326285S 85 40
340700 4.5 100
342080 6.5 80 326290S 90 40
340705 4.5 105
342085 6.5 85 326295S 95 40
340710 4.5 110
342090 6.5 90 326300S 100 40
342095 6.5 95 326305S 105 40
342100 6.5 100 326310S 110 40
342105 6.5 105 326315S 115 40
342110 6.5 110 326320S 120 40
342115 6.5 115
342120 6.5 120
342125 6.5 125
342130 6.5 130

Recommended set item

46
 The TGN is the latest development in the continuing evolution of the Gamma
Locking Nail family designed for rapid and secure fixation of intertrochanteric
and pertrochanteric fractures. Combining strength and biomechanical advantages of
the existing Gamma family it is the Golden standard for proximal femoral fractures.

The Long Gamma Nail is a specialised development of the original Gamma

Locking Nail allowing surgeons to extend the benefits of the highly successful
standard implant for trochanteric fractures. It has been designed to treat
subtrochanteric, ipsilateral neck and shaft fractures as well as for prophylactic use.

Based on the long Hansson Pin experience, the Hansson Twin Hook is a unique
alternative to the traditional lag screw, and is used together with the Omega 2
or the Omega Plus Hip plate. The operative procedure includes a minimally
invasive surgical approach. If necessary, cephalic implant revision can be
accomplished without removing the sideplate.

This new generation of Cannulated Screws has been designed to optimise surgical
outcomes while simplifying procedures. The ASNIS III System offers the surgeon
a complete choice of implants, material and packaging combined with a new
user-friendly instrumentation.

This innovative device has been developed for Femoral Neck Fracture and Slipped
Capital Femoral Epiphysis treatments. The Hansson Pin System is a simple and
precise instrumentation combined with a unique implant. This unthreaded pin
with a spreading hook allows a strong and stable fixation through a simple and
short procedure, thus preserving the blood supply and the bone integrity.

www.strykertrauma.com MANFACTURER: Stryker Trauma AG

Bohnackerweg 1
2545 Selzach
Switzerland

REF NO: 982270

2003 Stryker Corporation. All rights reserved.