T2

Arthrodesis Nailing System

Operative Technique

1
Knee Arthrodesis Nailing System
Contributing Surgeons
Stephen Incavo
MD University of Vermont
Department of Orthopaedics & Rehabilitation
Burlington/Vermont, USA
Prof. Dr. Dr. Gunther O. Hofmann
Chief of Surgical Services
Medical Director of Halle Trauma Center
Halle, Germany
Director of Trauma Department
Friedrich-Schiller-University
Jena, Germany
Reference
1. Incavo S., Lily J. ,Churchill
Bartlett C., Arthrodesis of the Knee:
Experience with Intramedullary
Nailing. Journal of Arthroplasty
15 (7) 871−876, 2000
2. Hofmann G.O., Therapeutische
Optionen bei persistierendem
Kniegelenkinfekt, Trauma
Berufskrankheit 5 (2003), 221−224
2
This publication sets forth detailed
recommended procedures for using
Stryker Osteosynthesis devices and
instruments.
It offers guidance that you should
heed, but, as with any such technical
guide, each surgeon must consider
the particular needs of each patient
and make appropriate adjustments
when and as required.
A workshop training is required prior
to first surgery.
All non-sterile devices must be
cleaned and sterilized before use.
Follow the instructions provided in
our reprocessing guide (L24002000).
Multi-component instruments must
be disassembled for cleaning. Please
refer to the corresponding assembly/
disassembly instructions.
See package insert (L22000007) for
a complete list of potential adverse
effects, contraindications, warnings
and precautions. The surgeon must
discuss all relevant risks, including
the finite lifetime of the device, with
the patient, when necessary.
Warning:
All bone screws referenced in this
document here are not approved
for screw attachment or fixation
to the posterior elements
(pedicles) of the cervical,
thoracic or lumbar spine.
Contents

Page
1. Introduction 4
Implant Features 4
Instrument Features 4
2. Indications, Precautions & Contraindications 5
Indications 5
Precautions 5
Relative Contraindications 5
3. Technical Details 6
System Specifications 6
4. Operative Technique 7
Pre-operative Planning 7
Patient Positioning 7
Knee Incision 7
Hip Incision and Entry Point 7
Reaming 8
Nail Assembly 8
Nail Insertion Preparation 9
Nail Insertion 10
Guided Locking Mode (via Targeting Device) 11
Static Locking 12
Apposition/Compression Locking Mode 14
Freehand Distal Locking 15

Ordering Information – Implants 16

Ordering Information – Instruments 17

3
Introduction
The T2 Nailing System represents
Stryker´s latest and most com-
prehensive development of the original
intra-medullary principles presented
by Prof. Gerhard Küntscher in 1940.
Stryker has created a new generation
locking nail system, bringing together
all the capabilities and benefits of
separate nailing systems to create a
single, integrated surgical resource for
fixation of long bones.
Implant Features
The T2 Arthrodesis Nail is the
realization of strong biomechanical
intramedullary stabilization using
small caliber cannulated implants for
internal fixation of long bones.
The design of the T2 Arthrodesis
Nail features a unique curvature
which incorporates both femur
antecurvature and knee valgus bend.
This design dictates the need for both
left and right implants providing
an improved fit for each patient’s
individual needs. All T2 Arthrodesis
Nail implants are made of Type II
anodized titanium alloy (Ti6Al4V)
for enhanced biomechanical and
biomedical performance. All implants
are provided in sterile packaging.
In addition to the T2 Femoral, Tibial,
and Humeral Nailing Systems,
Stryker developed the T2 Arthrodesis
Nail to provide treatment of Knee
Arthrodesis.
Through the development of a
common, streamlined and intuitive
surgical approach, both in principle
and in detail, the T2 Arthrodesis Nail
offers significantly increased speed
and functionality for the treatment
of Knee Arthrodesis as well as simpli-
fying the training requirements for all
personnel involved.
Instrument Features
The T2 Arthrodesis Nail is inserted
with the existing T2 Basic Set, Long
together with the Femur Indication
Set.
Note:
The core instruments of the T2
system provide the platform for
all current and future Stryker
Nailing Systems, thereby reducing
complexity and inventory.
Refer to the T2 Femoral Nailing
System Operative Technique
(REF B1000004) and T2 Tibial
Nailing System Operative
Technique (REF B1000005) for
more detailed system protocols.
4
Indications, Precautions and Contraindication

Indications Precautions
Aseptic failed total knee arthro-plasty The T2 System has not been evaluated
with or without bone loss for safety and compatibility in the MR
• Failed external fixation, environment.
nonunions and malunions The T2 System has not been tested
• Periarticular fractures where for heating or migration in the MR
repair is not possible environment.
• Pathologic fractures, impending
pathologic fractures and tumor
resections
• Pseudoarthrosis and correction
osteotomy
• Ipsilateral femur fractures
• Open and closed femoral fractures

Relative Contraindications
The physician’s 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 • Implant utilization that would
infection or marked local interfere with anatomical
inflammation in or about the structures or physiological
affected area. performance.
• Compromised vascularity that • Any mental or neuromuscular
would inhibit adequate blood disorder which would create an
supply to the fracture or the unacceptable risk of fixation
operative site. failure or complications in
• Bone stock compromised by postoperative care.
disease, infection or prior implan- • Other medical or surgical
tation that can not provide conditions which would preclude
adequate support and/or fixation the potential benefit of surgery.
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.

5
Technical Details

System Specifications
Two Nails, Left and Right
0mm

Diameters: 11.5 & 13mm

Lengths: 540 − 780mm
in 40mm increments
32.5mm
35mm
Compression Range:
45mm
Total Length of Slot 15mm 47.5mm
Less Screw Diameter (−) 5mm 60mm

Maximum Movement of Screw 10mm

Screws, End caps &

Compression Screw

(See Page 16 for complete description
and catalog numbers)

75 mm

35 mm
25 mm

0 mm

6
Operative Technique
Pre-operative
Planning
An X-Ray Template (1806-0011) is
available for pre-operative planning.
Implant sizing is best determined
using full length A/P and Lateral
X-Rays of both the affected and
contralateral legs. C.T. Scan for canal
diameter and leg length may be useful.
The knee should be placed in 5−10˚ of
flexion and 5˚ valgus. The leg should
be 1cm shorter than the opposite
side. This position allows for more
normal gait and foot clearance during
walking.
Ultimately, 1 cm of leg shortening
is the goal, therefore in cases with
more significant bone loss, additional
flexion should be avoided to minimize
additional shortening.
Nail Length
The nail length is surgeon dependent
with regards to the individual
situation of the patient and with
regards on how long the nail should
extend into the Tibia.
Patient Positioning
Patient positioning is surgeon
dependent. The patient may be
positioned supine (elevate the affected
hip), lateral or semi-lateral on a
radiolucent table.
Use image intensification (A/P and
Lateral) for confirmation throughout
each step.
Knee Incision
A vertical skin incision is made
extending from the femoral condylar
region to the tibial tubercule, followed
by a parapatellar capsular incision.
In cases with a previous incision, this
one could be used. Knee arthroplasty
instruments may be used to recut
tibial and femoral surfaces.
Hip Incision and Entry Point
A skin incision is made beginning at
the level of the Greater Trochanter Noting any deformity of the axis
extending proximal and slightly of the tibial shaft, and using either
posterior, in line with the Gluteus the Awl or Rigid Reamer over the
Muscle, exposing the Piriformis K-Wire, open the anterior central
Fossa. Alternatively, the Tip of the medial aspect of the tibia using the
Greater Trochanter can be located tibial tubercle as a reference to the
by palpation, and a horizontal skin medullary canal.
incision is made from the Greater
Trochanter to the Iliac Crest. The Insert the 1250mm Ball Tip Guide
medullary canal is opened with the Wire (1806-1250S) from the hip
curved awl (1806-0040), or with a through the knee and advance into the
3×285mm K-Wire (1806-0050) and tibial shaft to the depth at which you
Ø12mm Rigid Reamer (1806-2014) want the nail to end.
combination.
The Guide Wire Ruler (1806-0022)
Alternatively, a minimal skin incision features dedicated marks to identify
of the hip region can be made if the the to be choosen nail length when
femoral canal is reamed in retrograde using the 1250mm Guide Wire.
fashion from the knee joint. To
accomplish this, the 3×1250mm Caution:
Ball Tip Guide Wire (1806-1250S) Use image intensification (A/P
is advanced from the distal femoral and Lateral) for confirmation
canal proximally to the greater
trochanteric / piriformis fossa region.
throughout each step.
Warning:
Avoid the femoral neck. The
Guide Wire is then gently
advanced through the cortex by
gently tapping the strike plate
on the Guide Wire Handle/
Chuck assembly. Fluoroscopic
visualization is necessary for this
step. Once the Guide Wire exits
the bone, it is retrieved through a
small skin incision made over the
tip of the Guide Wire.
7
Operative Technique

Reaming
Nailing Holding Screw
Using a 885mm Bixcut Modular
Reamer Shaft (REF Numbers on
page 16), reaming is commenced in Strike Plate
0.5mm increments. Generally, the
femur is reamed 1.5 – 2.0mm larger
than the diameter of the nail selected,
and the tibia is reamed line to line. Fixation Screw
The proximal end of the tibial shaft Clamp
may be over-reamed if there is any
question of final Femoral-Tibial
alignment. Final determination of how Fixation Screw
much to ream either the femur or the
tibia must be made by the surgeon
based on many factors including Nail Handle
bone quality and whether the nail
will be cross-locked with screws
distally in the tibia. As stated above,
in some cases, surgeons may opt to
use standard length Guide Wires
and Reamers and ream the femur in
retrograde fashion first and then the
tibia separately.
K-Wire Hole

Nail Assembly
The selected nail is assembled onto the Targeting Arm
Target Device (1806-1005) with the
Femoral Holding Screw (1806-0165)
(Fig. 1). Tighten the Nail Holding
Screw with the Universal Socket
Wrench (1806-0400) securely so that it
does not loosen during nail insertion.

Alternatively, the Fixation Screw

Clamp (1806-0273) can be used to fix
the Targeting Arm to the Nail Handle.
After clamping it on the Targeting
Arm the knob will tighten the sleeve
to the Targeting Arm.

Caution:
Curvature of the nail must match
the curvature of the femur and
knee valgus.

Fig. 1

8
Operative Technique

Nail Insertion Preparation

Upon completion of reaming, the
appropriate size nail is ready for
insertion over the 3×1250mm Ball Tip
Guide Wire (1806-1250S).
The Slotted Hammer can be used
on the Strike Plate, or if dense bone
is encountered, the Universal Rod
(1806-0110) may be attached to the
Nail Holding Screw and used in con-
junction with the Slotted Hammer to
insert the nail (Fig. 2).

Caution:
Prior to insertion, check for
correct assembly into the nail Fig. 2
by passing a drill Bit through
the Target Device and through
the nail holes to help check
alignment. 2 mm

DO NOT hit on the Targeting

Device.
5 mm Static
When locking the nail in the Static
Mode, the nail is countersunk a 10 mm Dynamic

minimum of 5mm (Fig. 4). When the 15 mm Apposition/Compression

implant is inserted in the dynamic
mode, without active apposition/
compression, or when the implant Fig. 3
is inserted with active apposition/
compression, the recommended depth
of insertion is 15mm (Fig. 5).

Caution:
• The system offers the option
of different locking modes.
In addition to static locking,
a controlled dynamization
or a controlled apposition/
compression can be mechanically
applied with an optional internal
compression screw.
• In cases where the compression Fig. 4
feature is used, the tibia must
be locked with cross-locking
screws before the compression is
applied proximally. Up to 10mm
of mechanical compression can be
applied.
• Additionally, the 3×285mm
K-Wire may be inserted through
the Target Device which indicates
the junction of the nail and
insertion post (see Fig. 1).

Fig. 5

9
Operative Technique

Nail Insertion
To start the insertion of the nail, it is
recommended that the Target Device
is internally rotated to accommodate
the individual patient’s anatomy
(see Fig. 6, Position 1 for appro-
ximated example).

As the nail is passed down the femur

towards the knee, a controlled external
rotation of the Target Device is applied
Position 1
to better accommodate the unique
dual curvature of the nail passing
through the medullary canal
(Fig. 7 position 2, 3, 4).
Fig. 6

Caution:
The amount of internal rotation,
and the timing of the external
rotation is based on the individual
patient’s anatomy and as such,
the surgeon’s judgement. The
final position of the Target Device
must be directly lateral to the
femur. In this final position, the
hole pattern of the nail is properly
lined up for screw insertion.
Since every Arthrodesis case is
different, the choice of whether to
dynamize, actively compress, or
Position 4 Position 3 Position 2 Position 1
statically lock the nail is up to the
surgeon based on the individual
patient’s indications. Fig. 7

Check the alignment of the leg in all

axis with proper full length X-Rays
and throughout the surgery (Fig. 8).

Caution:
As the nail is beginning to be
introduced into the tibia, the
final position of the foot must
be determined with the foot
being held in place accordingly
as the nail is impacted to its final Fig. 8
position. The amount of external
rotation of the foot, generally
0 − 10˚, is left to the surgeon’s
discretion.

10
Operative Technique

Guided Locking Mode (via Target Device)

In controlled Dynamic Mode, and/or
controlled Apposition/Compression
Mode, the dynamic hole is required
(Fig. 9).
4. Dynamic

In Advanced Locking Mode, the

dynamic hole is required. After
utilizing compression with the
Compression Screw, the distal static
hole is used. (Fig. 10). 4
3. Static
4. Dynamic
Fig. 9
In Static Locking Mode, the distal
static hole and the static position of
the oblong hole are required (Fig. 10).
2. Static
3. Static

Caution:
Never use the most proximal
static hole of the Target Device!
There is no corresponding hole in
the Arthrodesis Nail.

The Long Tissue Protection Sleeve

(1806-0185) together with the Long 3
2 4
Drill Sleeve (1806-0215) and the Long
Trocar (1806-0315) is inserted into the
Target Device by pressing the safety
clip (Fig. 11). The mechanism will Fig. 10
keep the sleeve in place and prevent it
from falling out. It will also prevent
the sleeve from sliding during screw
measurement. To release the Tissue
Protection Sleeve, the safety clip must
be pressed again.

Note:
Remove the Guide Wire prior to
drilling and inserting the Locking
Screws.

locked
released

Fig. 11

11
Operative Technique

Static Locking Mode

The Long Tissue Protection Sleeve
together with the Long Drill Sleeve
and Long Trocar, are positioned
through the most distal static loc-
king hole on the Target Device. A
small skin incision is made, and the
assembly is pushed through until it
is in contact with the lateral cortex of
the femur (Fig. 12).

Alternatively, the Trocar (1806-0311)

can be advanced together with the
Tissue Protection Sleeve. Push the Fig. 12
assembly down to the bone.
The paddle tip design may help to pass
the soft tissue and prepare the way
for drilling. Remove the the Trocar to
insert the Drill Sleeve.

Caution:
Make sure the Tissue Protection
Sleeve/Drill Sleeve Assembly is
seated on bone prior to selecting
final screw length.

Fig. 13

50mm

The Trocar is removed, with the

Tissue Protection Sleeve and the Drill
Sleeve remaining in position.
To help ensure accurate drilling and
easy determination of screw length,
use the center tipped, calibrated
Ø4.2×340mm Drill (1806-4260S). The
centered Drill is forwarded through
the Drill Sleeve and pushed onto the
cortex.

12
Operative Technique

After drilling both cortices, the screw

length may be read directly off of the
calibrated Drill at the end of the Drill
Sleeve (Fig. 13).

When the Drill Sleeve is removed,

the correct Locking Screw is inserted
through the Tissue Protection Sleeve
using the Long Screwdriver Shaft
(1806-0227) with Teardrop Handle
(702429) (Fig. 14).

Caution: Fig. 14
The coupling of Elastosil handles
contains a mechanism with
one or multiple ball bearings.
In case of applied axial stress
on the Elastosil handle, those
components are pressed into the
surrounding cylinder resulting in
a complete blockage of the device
and possible bending.
To avoid intra-operative com-
plications and secure long-term
functionality, we mandate that
Elastosil handles be used only for
their intended use.
Fig. 15
DO NOT HIT any Elastosil
handles.

The screw is advanced through both

cortices. The screw is near its proper
seating position when the groove
around the shaft of the screwdriver
is approaching the end of the Tissue
Protection Sleeve.
Repeat the locking procedure for the
other statically positioned Locking
Screw (Fig. 15)

13
Operative Technique

Apposition/Compression Locking Mode

Note:
Distal freehand static locking
with at least two Fully Threaded
Locking Screws must be
performed prior to applying
active, controlled apposition/
compression to the fusion site.

If active apposition/compression is
required, a Partially Threaded Locking
Screw (Shaft Screw) is inserted via the
Target Device in the dynamic position
of the oblong hole. This will allow
for a maximum of 10mm of active,
controlled apposition/compression. In
order to insert the Shaft Screw, drill Fig. 16
both cortices with the Ø4.2×340mm
Drill (1806-4260S). Next, drill
the near cortex, ONLY, with the
Ø5.0×230mm Drill (1806-5000S).

After the opposite cortex is drilled

with the Ø4.2×340mm Drill, the
correct screw length can be read
directly off of the calibrated Drill at
the end of the Drill Sleeve.

After the Shaft Screw is inserted,

the Nail Holding Screw securing the
nail to the insertion post is removed,
leaving the insertion post intact with
the nail (Fig. 16). This will act as a
guide for the Compression Screw. The Fig. 17
Compression Screw is inserted with
the Screwdriver Shaft (1806-0227)
assembled on the Teardrop Handle
through the insertion post
(Fig. 17 & 18).

As the Compression Screw is advanced

against the 5mm Partially Threaded
Screw (Shaft Screw), active apposition/
compression is applied at the knee site.

Caution:
• Apposition/compression should
be carried out under X-Ray
control.
• An End Cap can not be inserted
if a Compression Screw has been
used.
Fig. 18
For optional apposition/compression
using the external compression device,
please refer to the T2 Femur Operative
Technique (B1000004).

14
Operative Technique

Freehand Distal Locking

The freehand technique is used to
insert Locking Screws into the M/L
holes in the nail. Rotational alignment
must be checked prior to locking the
nail statically.
Multiple locking techniques and
radiolucent drill devices are available
for freehand locking. The critical step
with any freehand locking technique is
to visualize a perfectly round locking
hole with the C-Arm.

The center-tipped Ø4.2×230mm Drill

(1806-4290S) is held at an oblique
angle to the center of the locking hole
(Fig. 19). Upon X-Ray verification, the
Drill is placed perpendicular to the Fig. 19
nail and drilled through the medial
cortex. Confirm in both the A/P and
M/L planes by X-Ray that the Drill
passes through the hole in the nail.

After drilling both cortices the screw

length may be read directly off of the
calibrated Screw Scale, Long (1806-
0365) at the green ring on the center-
tipped Drill.

Alternatively, the Screw Gauge can be

used to determine the screw length.

Note:
The position of the end of the drill
is equal to the end of the screw as
they relate to the far cortex.

Routine Locking Screw insertion

is employed with the assembled
Screwdriver Shaft and Teardrop
Handle.

15
Ordering Information − Implants

T2 Arthrodesis Nail, left T2 Arthrodesis Nail, right

REF Diameter Length REF Diameter Length

mm mm mm mm

1829-1104S 11.5 540 1829-1154S 11.5 540

1829-1108S 11.5 580 1829-1158S 11.5 580
1829-1112S 11.5 620 1829-1162S 11.5 620
1829-1116S 11.5 640 1829-1166S 11.5 640
1829-1120S 11.5 700 1829-1170S 11.5 700
1829-1124S 11.5 740 1829-1174S 11.5 740
1829-1128S 11.5 780 1829-1178S 11.5 780
1829-1304S 13.0 540 1829-1354S 13.0 540
1829-1308S 13.0 580 1829-1358S 13.0 580
1829-1312S 13.0 620 1829-1362S 13.0 620
1829-1316S 13.0 640 1829-1366S 13.0 640
1829-1320S 13.0 700 1829-1370S 13.0 700
1829-1324S 13.0 740 1829-1374S 13.0 740
1829-1328S 13.0 780 1829-1378S 13.0 780

Partially Threaded Locking Screw Fully Threaded Locking Screw

REF Diameter Length REF Diameter Length

mm mm mm mm

1891-5025S 5.0 25 1896-5025S 5.0 25

1891-5030S 5.0 30 1896-5030S 5.0 30
1891-5035S 5.0 35 1896-5035S 5.0 35
1891-5040S 5.0 40 1896-5040S 5.0 40
1891-5045S 5.0 45 1896-5045S 5.0 45
1891-5050S 5.0 50 1896-5050S 5.0 50
1891-5055S 5.0 55 1896-5055S 5.0 55
1891-5060S 5.0 60 1896-5060S 5.0 60
1891-5065S 5.0 65 1896-5065S 5.0 65
1891-5070S 5.0 70 1896-5070S 5.0 70
1891-5075S 5.0 75 1896-5075S 5.0 75
1891-5080S 5.0 80 1896-5080S 5.0 80
1891-5085S 5.0 85 1896-5085S 5.0 85
1891-5090S 5.0 90 1896-5090S 5.0 90
1891-5095S 5.0 95 1896-5095S 5.0 95
1891-5100S 5.0 100 1896-5100S 5.0 100
1891-5105S 5.0 105 1896-5105S 5.0 105
1891-5110S 5.0 110 1896-5110S 5.0 110
1891-5115S 5.0 115 1896-5115S 5.0 115
1891-5120S 5.0 120 1896-5120S 5.0 120

End Caps Compression Screw

REF Diameter Length REF Diameter

mm mm mm
Standard +5mm
1822-0003S 8.0 Standard 1825-0000S 8.0
1822-0005S 11.5 + 5mm
1822-0010S 11.5 +10mm
1822-0015S 11.5 +15mm
+10mm +15mm 1822-0020S 11.5 +20mm
1822-0025S 11.5 +25mm
1822-0030S 11.5 +30mm
1822-0035S 11.5 +35mm

+20mm +25mm

+30mm +35mm
Note:
Federal law (U.S.A) restricts this
device to sale by or on the order of a
licensed physician.
16
Ordering Information − Instruments

REF Description REF Description Quantity

T2 Basic Long T2 Femur

702429 Teardrop Handle, AO 702427 T-Handle, AO Coupling

Coupling
0152-0218* K-Wire 1,8x310mm 2
703165 Protection Sleeve,
Retrograde 1806-0015 X-Ray Ruler, Femur

1806-0022 Guide Wire Ruler 1806-0050 K-Wire 3x285mm 2

1806-0065 8mm Hex Screwdriver bit,

ball tip

1806-0032 Awl Plug 1806-0165 Nail Holding Screw, 2

Femur
1806-0041 Awl
1806-0255 Screwdriver, Condyle 2
1806-0110 Universal Rod Screw

1806-0125 Reduction Spoon 1806-0257 Revision Screwdriver Bit

1806-0130 Wrench 8mm/10mm 1806-0272 External Compression

Device
1806-0135 Insertion Wrench, 10mm
1806-0273 Fixation Screw Clamp

1806-0150 Strike Plate 1806-0311 Trocar, Paddel

1806-0170 Slotted Hammer 1806-0400 Socket Wrench,

Universal Joint 10mm
1806-0185 Tissue Protection Sleeve,
Long 1806-1005 Target Device, Femur
(2 components)
1806-0203 Screwdriver, Self-Holding,
Extra Short (3.5)

1806-0215 Drill Sleeve, Long 1806-2016 Countersink for Condyle

Screws
1806-0227 Screwdriver Shaft AO,
Long 1806-4260* Drill Ø4.2x340, AO

1806-0233 Screwdriver, Self-Holding, 1806-4270* Drill Ø4.2x180, AO

Long (3.5)
1806-4290* Drill Ø4.2x230, AO
1806-0268 Screwdriver Shaft,
Compression (hex3.5) 1806-5000* Drill Ø5.0x230, AO

1806-0271 Guide Wire Pusher 1806-5020* Drill Ø5.0x340, AO

1806-0315 Trocar, Long 1806-9920 T2 Femur Instrument Tray

1806-0325 Screw Gauge, Long

1806-0331 Screw Gauge (20-120mm)

1806-0350 Extraction Rod,

Conical (Ø8mm)
Optional Instruments
1806-0365 Screw Scale, Long
1806-0011 X-Ray Template
1806-1095 Guide Wire Handle
1806-1250S Guide Wire, 1250mm
1806-1096 Guide Wire Handle
Chuck

1806-2014 Rigid Reamer Ø12mm

1806-9900 T2 Basic Long

Instrument Tray

* Instruments designated “Outside of the U. S.” may not

be ordered for the U. S. market.
17
Ordering Information – Instruments

Bixcut Complete range of modular and

fixed-head reamers to match
surgeon preference and optimize
O. R. efficiency, presented in fully
sterilizable cases.

Large clearance rate resulting from reduced number

of reamer blades coupled with reduced length of
reamer head to give effective relief of pressure and
efficient removal of material.

Cutting flute geometry optimized to lower pressure

generation.

Forward- and side-cutting face combination produces

efficient material removal and rapid clearance.

Double-wound shaft transmits torque effectively and

with high reliability. Low-friction surface finish aids
rapid debris clearance.

Smaller, 6 and 8mm shaft diameters significantly

reduce IM pressure.
Typical Standard Bixcut
Reamer Ø14mm Reamer Ø14mm

Studies1 have demonstrated that
the pressures developed within
the medullary cavity through the
introduction of unreamed IMnails can
be far greater than those devel­oped
Clearance area  : Clearance area  : during reaming − but this depends
32% of cross section 59% of cross section
very much upon the design of the
reamer.

After a three year development study2

involving several universities, the
factors that determine the pressures
and temperatures developed during
reaming were clearly established.
These factors were applied to the de­-
velopment of advanced reamers that
demonstrate significantly better per­-
form­ance than the best of previous
designs.

1
Jan Paul M. Frolke, et al. ;
Intramedullary Pressure in Reamed Femoral
Bixcut Nailing with Two Different Reamer Designs.,
Eur. J. of Trauma, 2001 #5

2
Medhi Massau, et al.;
Pressure Changes During Reaming with Different
Parameters and Reamer Designs,
Clinical Orthopaedics and Related Research
Number 373, pp. 295-303, 2000

18
Ordering Information – Instruments
Bixcut Modular Head Bixcut Fixed Head − AO Fitting**

REF Description Diameter REF Diameter Length

mm mm mm

0226-3090 Bixcut Head 9.0 0225-5060 6.0* 400

0226-3095 Bixcut Head 9.5 0225-5065 6.5* 400
0226-3100 Bixcut Head 10.0 0225-5070 7.0* 400
0226-3105 Bixcut Head 10.5 0225-6075 7.5 480
0226-3110 Bixcut Head 11.0 0225-6080 8.0 480
0226-3115 Bixcut Head 11.5 0225-6085 8.5 480
0226-3120 Bixcut Head 12.0 0225-6090 9.0 480
0226-3125 Bixcut Head 12.5 0225-6095 9.5 480
0226-3130 Bixcut Head 13.0 0225-6100 10.0 480
0226-3135 Bixcut Head 13.5 0225-6105 10.5 480
0226-3140 Bixcut Head 14.0 0225-6110 11.0 480
0226-3145 Bixcut Head 14.5 0225-8115 11.5 480
0226-3150 Bixcut Head 15.0 0225-8120 12.0 480
0226-3155 Bixcut Head 15.5 0225-8125 12.5 480
0226-3160 Bixcut Head 16.0 0225-8130 13.0 480
0226-3165 Bixcut Head 16.5 0225-8135 13.5 480
0226-3170 Bixcut Head 17.0 0225-8140 14.0 480
0226-3175 Bixcut Head 17.5 0225-8145 14.5 480
0226-3180 Bixcut Head 18.0 0225-8150 15.0 480
0226-4185 Bixcut Head 18.5 0225-8155 15.5 480
0226-4190 Bixcut Head 19.0 0225-8160 16.0 480
0226-4195 Bixcut Head 19.5 0225-8165 16.5 480
0226-4200 Bixcut Head 20.0 0225-8170 17.0 480
0226-4205 Bixcut Head 20.5 0225-8175 17.5 480
0226-4210 Bixcut Head 21.0 0225-8180 18.0 480
0226-4215 Bixcut Head 21.5
0226-4220 Bixcut Head 22.0
0226-4225 Bixcut Head 22.5 Optional Instruments
0226-4230 Bixcut Head 23.0
0226-4235 Bixcut Head 23.5 REF Description
0226-4240 Bixcut Head 24.0
0226-4245 Bixcut Head 24.5 5235-6-606 Hand Reamer 6 mm w/T-Handle
0226-4250 Bixcut Head 25.0 5235-6-607 Hand Reamer 7 mm w/T-Handle
0226-4255 Bixcut Head 25.5 5235-6-608 Hand Reamer 8 mm w/T-Handle
0226-4260 Bixcut Head 26.0 5235-6-609 Hand Reamer 9 mm w/T-Handle
0226-4265 Bixcut Head 26.5 0227-0060 Hand Reamer 6 mm
0226-4270 Bixcut Head 27.0 w/Mod Trinkle connection
0226-4275 Bixcut Head 27.5 0227-0070 Hand Reamer 7 mm
0226-4280 Bixcut Head 28.0 w/Mod Trinkle connection
0227-0080 Hand Reamer 8 mm
w/Mod Trinkle connection
Bixcut Shafts (Sterile)1,2,3, 4 0227-0090 Hand Reamer 9 mm
w/Mod Trinkle connection
REF Description Length 1806-6520 Curved Reduction Rod 8.5 mm
mm w/Mod Trinkle connection
1806-6500 T-Handle w/Mod Trinkle connection
0227-8240S Mod. Trinkle 284
0227-3000S Mod. Trinkle 448
0227-8510S Mod. Trinkle 510 Bixcut Trays empty
0227-8885S Mod. Trinkle 885 REF Description
0226-8240S AO 284
0226-3000S AO 448 0225-6000 Tray, Modular Head
(up to size 22.0mm)
Shaft Accessories 0225-6001 Tray, Modular Head
(up to size 28.0mm)
0225-8000 Tray, Fixed Head
REF Description
(up to size 18.0mm)
3212-0-210 Grommet (pack of 25) 0225-6040 Mini Trauma Tray
3212-0-220 Grommet inserter/extractor (for modular heads 9-18)
0225-6010 Grommet Case 0225-6050 Mini Revision Tray
(for modular heads 9-28)
Note:
Bixcut Fixed Head − Modified Trinkle fitting available in same diameters and length as the
AO Fitting (REF No: 1227-xxxx)
* Use with 2.2mm × 800mm Smooth Tip and 2.5mm × 800mm Ball Tip Guide Wires only.
** Use with Stryker Power Equipment.
1. Non-Sterile shafts supplied without grommet. Use new grommet for each surgery. See Shaft
Accessories.
2. Sterile shafts supplied with grommet pre-assembled.
3. For Non-Sterile leave “S” off the REF Number when ordering (510 and 885mm available only sterile
Modified Trinkle Fitting).
4. Non-Sterile, AO Fitting Shafts in 510 and 885mm are available as build to order items:
• CM810921 AO Fitting Shaft, length 510mm
• CM810923 AO Fitting Shaft, length 885mm.

19
 Stryker Trauma GmbH
Prof.-Küntscher-Straße 1-5
D-24232 Schönkirchen
Germany

www.osteosynthesis.stryker.com

This document is intended solely for the use of healthcare professionals. A surgeon must always rely on his or her
own professional clinical judgment when deciding whether to use a particular product when treating a particular
patient. Stryker does not dispense medical advice and recommends that surgeons be trained in the use of any par-
ticular product before using it in surgery. The information presented in this brochure is intended to demonstrate a
Stryker product. Always refer to the package insert, product label and/or user instructions including the instructions
for Cleaning and Sterilization (if applicable) before using any Stryker products. Products may not be available in all
markets. Product availability is subject to the regulatory or medical practices that govern individual markets. Please
contact your Stryker representative if you have questions about the availability of Stryker products in your area.

Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following
trademarks or service marks: Stryker, BixCut and T2.

All other trademarks are trademarks of their respective owners or holders.

The products listed above are CE marked.

Literature Number  : B1000010

LOT F0710

Copyright © 2010 Stryker