Indications The indications for use of these external fixation devices include: Stabilization of open and / or unstable fractures and where soft tissue precludes the use of other fracture treatments such as IM nailing or casting or other means of internal fixation Bone fracture fixation Osteotomy Arthrodesis Correction of deformity Revision procedure where other treatments or devices have been unsuccessful Bone reconstruction procedures Design Delta couplings: “Delta” design allows for 6 different pin/bar diameter connections through a single coupling Green: Ø5mm, Ø8mm, Ø11mm Grey: Ø4mm, Ø5mm, Ø6mm Inverted pin-to-rod offering for accessibility to thumbwheel in different frame configurations Built-in, removable thumbwheels for provisional tightening Multiplanar Delta Couplings allow for increased flexibility Snap-fit technology designed for a fast ex-fix application Prevent ”pop-out” with two turns of the thumbwheel Vectran coated carbon fiber rods Ø11mm carbon fiber rods 100mm – 650mm in length Vectran coating for electric insulation Pin clamps and rod couplers 5-hole and 10-hole pin clamps with customizable, fixed posts Modular or pre-welded versions available Straight, 30º, and 90º posts 30º fixed angle connection for Ø11mm rods Pelvic and knee bridging applications Asymmetric capability may aid in anatomic positioning Apex pin portfolio Self-drilling / self-tapping, blunt, cancellous, and transfixing Apex pins Stainless steel & titanium options, HA coating available Hybrid pins allow use of 3 & 4mm threads with the 5mm side of delta couplings Universal pin chuck allows stab-&-grab of all Apex pins Sterile field kits: Field kits with pre-sterilized components and instruments needed for multiple indications Available for civilian use Bridging and emergency options available Techniques Tibial frames Apex half pins can be placed in the medial face of the tibia from plateau to pilon Transfixing pins can be safely placed except in the distal third of the tibia proximal to the metaphysis and distal to the fibula head near the peroneal nerve Before insertion of anterior Apex half pins near the ankle joint, perform blunt dissection to bone to ensure safety of neurovascular bundle Ankle frames Apex half pins can be placed proximal to the ankle from medial to lateral in the anteromedial face of the tibia Apex pins can be placed distal to the crossing of the anterior tibial vessels just proximal to the ankle Before insertion of anterior Apex half pins near ankle joint, perform blunt dissection to bone to ensure safety of neurovascular bundle Hybrid pins can be placed from the medial or dorsomedial side 0-115° from the frontal plane Transfixing pins can be placed through the calcaneus from medial to lateral Femur frames Apex half pins can be placed in the femur from lateral to medial along the entire length of the bone Transfixing pins can be placed in the distal quarter of the femur distal to the passage of the femoral artery posteriorly Knee frames Apex half pins can be placed anterolaterally in the femur, and anteromedially in the tibia Pelvic frames Apex half pins can be placed in the iliac wings Apex half pins can be placed in the pelvis in the crest between the anterior-superior and anterior inferior iliac spines Pins Apex pin Four types of half pins are offered in the system: blunt / self-tapping half pins, blunt / cancellous half pins, self-drilling / self-tapping half pins, and self-drilling transfixing pins Pre-drilling is necessary when using blunt pins It is optional to pre-drill when using self-drilling pins Pin thread diameter Drill bit Location Ø3mm Ø2.2mm Ulna, radius, wrist, metacarpal Ø4mm Ø3.2mm – Ø3.5mm Radius, ulna, humerus, tibia, metatarsal Ø5mm Ø4.0mm – Ø4.5mm Tibia, femur, calcaneus, pelvis Ø6mm Ø4.5mm – Ø5.0mm Adult tibia, femur, pelvis