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FAQ

Company

  • How long has Synthes been producing veterinary products?
  • What are the differences between Synthes veterinary and human products?
  • What is Synthes' relationship with the AO?
  • How can I speak with a Synthes sales representative?
  • How can I get Synthes product information?

 

Technical

  • Can I mix competitors' implants with Synthes implants?
  • What drill size do I use for any particular screw?
  • Why does AO recommend self-tapping screws?
  • Do you manufacture cannulated screws?
  • Do you manufacture titanium implants?
  • I want to begin plating fractures, where do I start?

 

DCP and LC-DCP Plating

  • What is the real difference between DCP and LC-DCP?
  • Do I need a different drill sleeve for each style plate?

 

Locking Compression Plating (LCP)

  • How is LCP different than conventional compression plates?
  • When do I use locking screws and plates?
  • Why is there a StarDrive in Synthes Locking Screws?
  • Why does the Synthes Locking Screw have a very small thread?
  • Do I have to use a Torque Limiting Attachment (TLA) for inserting locking screws?
  • How do you use the Push Pull Reduction Device? 

 

Tibial Plateau Leveling Osteotomy (TPLO)

  • What are the benefits of the Synthes TPLO Plate?
  • How do you apply compression with the Synthes TPLO Plate?
  • When and how do you contour the Synthes TPLO Plate?

 

Company

How long has Synthes been producing veterinary products?
Synthes' Vet product portfolio contains plates, screws, biomaterials and a wide selection of instruments. Increasingly, new materials and technologies are being used to complement and improve current treatments in orthopaedic surgery. Synthes, Inc has been serving veterinary surgeons since 1969. In 2005, Synthes launched Synthes Vet, its new division dedicated to animal orthopedics. This division has a dedicated product development team and in-house sales consultants providing technical support to veterinary surgeons.

What are the differences between Synthes veterinary and human products?
Synthes produces both veterinary and human products with the same high-quality standards. Veterinary specific products (such as the TPLO Plate) are designed particularly for animal indications and anatomy. These products meet the stringent standards of the AO.

What is Synthes' relationship with the AO?
The AO Foundation (AO) is a non-profit organization comprised of a network of surgeons who are committed to the study, practice, and teaching of AO principles and their advancement in the field of trauma and musculoskeletal surgery.

Founded in Switzerland in 1958 under the name of "Arbeitsgemeinschaft für Osteosynthesefragen," or translated to "Association for the Study of Internal Fixation," the AO today represents the world's leading knowledge organization in osteosythesis. The AO organization works together with Synthes in the areas of research, development, education, and quality assurance in fracture treatment for the benefit of patients.

Synthes is the commercial partner that produces medical devices based on advice and approval of the AO and in turn pays a royalty back to the AO on Synthes product sales. This funding allows AO to grow and continue its mission. More about the AO Foundation...

How can I speak with a Synthes sales representative?

Synthes supports veterinarians via its network of country offices. See our listing of country offices at our corporate website for contact information.

Additionally, Synthes attends many major veterinary conferences in the United States and Europe. At these conferences, we exhibit our latest products and are available to answer your questions. See our listing of upcoming meetings...

How can I get Synthes product information? 
You can download many of the Synthes veterinary product brochures, wall charts, and other informative documents from the Technical Information page of this website.

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Technical

Can I mix competitors' implants with Synthes implants?
Synthes implants and instruments are manufactured with proprietary processes that produce superior products to those created by conventional manufacturing processes.  Though other companies may be able to estimate the Synthes general product design, Synthes product dimensions are proprietary.  The precision design of Synthes products is important for long term product function and optimal fit between implants. 

Only the finest quality materials are used to manufacture Synthes implants.  The metals Synthes uses have been scientifically proven to be of the best biocompatibility and quality available today.

With these features and qualities, the mixing of Synthes implants with the implants from other companies is not recommended.  The overall performance may be compromised due to differences in design, chemical composition, mechanical properties, and quality.

Given these qualities are trade-secret, no competitor of Synthes can make a genuine claim "the same as Synthes." Combining implants from other companies with Synthes implants could reduce product performance. Consequently, it is strongly recommended to not mix parts from different manufacturers.

What drill size do I use for any particular screw?
The Synthes Screw, Drill, and Tap Chart specifies the specific drill bit size needed for any particular screw. It is printed towards the front of the Synthes Veterinary Catalog and also available as a laminated wall chart.

Why does AO recommend self-tapping screws?
Synthes self-tapping screws have several advantages. The time required to tap a screw hole is eliminated thereby speeding the procedure. The osseous thread cutting is always done with a "new" cutting flute thereby guaranteeing optimal performance and minimal heat generation. And the expense of replacing taps is eliminated.

The disadvantages of self-tapping screws is that if a screw is being reinserted it could theoretically cut a new thread. Also, the screw flute is shallow and may become clogged during insertion into thick, dense cortical bone.

Do you manufacture cannulated screws?
Synthes has a full product line of cannulated screws. These screws are used primarily in human orthopedics for indications requiring precise screw placement. These screws and associated instruments can be ordered from the Synthes Trauma Catalog. Contact our Veterinary Sales Consultants for more information.

Do you manufacture titanium implants?
Synthes has a full product line of titanium implants used primarily in human orthopedics for patients with nickel sensitivity or where MRI visualization is very important. There are no known biocompatibility issues with Synthes titanium implants. Titanium has the added benefit of producing less MRI artifact than stainless steel. Titanium implants can be ordered by veterinarians from the Synthes Trauma Catalog. Contact our Veterinary Sales Consultants for more information.

I want to begin plating fractures, where do I start?
For small animal surgeons, the first step is to attend the AO Course Principles of Small Animal Fracture Management.  For this course you will receive 30 CME credits, and will learn bone healing, how it can be influenced with internal fixation of fractures, the scientific principles of fracture repair, and practical application of plating techniques. Second, the "AO Principles of Fracture Management in the Dog and Cat" is an AO text which is a step-by-step manual for treating fractures in dogs and cats. The book is designed to guide the surgeon through all stages of fracture management. Third, call Synthes at (610) 719-6599 to get started with a start-up instrument and implant set. The Veterinary Sales Consultant can guide you through your first order to set you up.

For equine surgery there are parallel courses and products available.

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DCP and LC-DCP Plating

What is the real difference between DCP and LC-DCP?
The DCP Plate was introduced by Synthes in 1966 and revolutionized compression plating. However, there is always room for improvement and in 1992 Synthes introduced the Limited Contact DCP Plate (LC-DCP), which quickly became the standard of the AO.

LC-DCP has several important design improvements over DCP: The bidirectional Dynamic Compression Unit (DCU) hole, scalloped undersurface, and uniform plate strength.

The DCU hole in the LC-DCP is symmetrical so it permits interfragmentary plate compression in both directions, anywhere along the plate. This allows the plate to be designed without a midsection. The underside of the hole is flared to increase screw angulation to 40° from 25° in the axial plate and screw angulation 20° from 7° in the transverse plane.

The scalloped undersurface of the LC-DCP serves two purposes: it reduces plate-bone contact and creates uniform strength along the plate. Reduction of the plate-bone contact minimizes the area of bone and periosteum that is damaged as a result of pressure and improves the potential for healing. The uniform strength of the plate allows smooth plate contouring and minimizes the affects of stress concentration from the plate holes without compromising overall plate strength. More information...

Do I need a different drill sleeve for each style plate?
LC-DCP and DCP plates have distinctly different holes. Therefore, a Load/Neutral Drill Guide for DCP cannot be used with LC-DCP and vice versa. The LCP further complicated this problem since it too has a different hole. But this problem was eliminated with the introduction of the Synthes Universal Drill Guide. It works in all plate designs of a given size from Synthes. To see more information about this and other instruments...

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Locking Compression Plating (LCP)

How is LCP different than conventional compression plates?
The Synthes Locking Compression Plate (LCP) was introduced in 2003. It is different from both LC-DCP and DCP in that it has the added feature of Synthes locking screw technology built into its Combi hole. The Combi hole allows placement of standard cortex and cancellous bone screws on one side or locking screws on the opposite side of each hole. Therefore, LCP can be used exactly the same way a LC-DCP when conventional screws are used. It has all the same features of the limited-contact design. But it can also accommodate a locking screw in every hole of the plate, thereby allowing a fixed-angle construct wherever the surgeon deems necessary. This is explained in greater detail in the LCP Technique guide.

It is important to note that the Synthes Universal Drill Guide must be used to place conventional screws in LCP Plates.

When do I use locking screws and plates?
The simplest answer to this question is that the decision to use locking screws in the LCP is ultimately surgeon preference. Currently there are no hard, fast rules established by the AO. Consequently, it is up to the surgeon in each specific case to determine if locking screws are desired based on the following benefits.

Locking screws create a fixed-angle construct with the plate. The threads on the head of the locking screw mate with the threaded Combi hole in the LCP to form a rigid, fixed-angle construct. This is radically different from conventional screws that squeeze the plate to the bone to achieve high friction which it turn produces stability.

Since locking screws do not pull the plate to the bone, and do not rely on friction for stability, locking screws can withstand higher loads, especially in compromised bone. This is achieved without requiring the plate to be precisely contoured to the bone. In fact, a locking plate works just as well slightly off the bone which protects the periosteum from vascular injury. This can be very helpful in minimally invasive plate osteosynthesis (MIPO) since a plate using only locking screws does not rely on plate-bone friction and need not be precisely contoured to the bone.

Examples of where locked plates are beneficial include:

  • Indications under very high load such as equine long bones or hyperactive patients
  • Bridge or biologic plating
  • Highly comminuted fractures
  • Metaphyseal fractures with less than six cortices on one side of the fracture
  • Locations where bicortical fixation is not possible such as fractures near a prosthesis or intramedullary pin
  • In conjunction with minimally invasive plate osteosynthesis
  • This is explained in greater detail in the LCP Technique guide.

Why is there a StarDrive in Synthes Locking Screws?
The StarDrive recess in the head of the locking screws can withstand 65% more insertion torque than conventional hexagonal screws. The StarDrive Screwdriver is also self-retaining, so there is no longer a need for a holding sleeve. It is important to note that use of the appropriate Torque Limiting Attachment (TLA) is recommended when inserting locking screws under power to reduce the risk of applying too much torque and causing cold-welding of the screw head in the plate.

Why does the Synthes Locking Screws have a very small thread?
The shallow bone-thread profile of the locking screws results from the larger core diameter. The fixed-angle construct does not rely on screw thread purchase to create friction between the plate and bone to achieve stability. 

Do I have to use the Torque Limiting Attachment (TLA) for inserting locking screws?
No, hand tightening locking screws is appropriate so long as you are close to the recommended torque. If locking with a power screwdriver, a TLA should be to reduce the risk of applying too much torque that can cause cold-welding of the screw head in the plate.

Recommended Torque for Locking Screws

  • 2.0mm Locking Screw 0.4 Nm
  • 2.4mm Locking Screw 0.8 Nm
  • 2.7mm Locking Screw 0.8 Nm
  • 3.5mm Locking Screw 1.5 Nm
  • 4.0mm Locking Screw 4.0 Nm
  • 5.0mm Locking Screw 4.0 Nm

For more information about the TLA and other instruments...

How do you use the Push Pull Reduction Device?
The Push Pull Reduction Device is a novel instrument developed for LCPs. If you want to achieve temporary compression of the plate to bone, the Push Pull Device is drilled through a plate hole and then temporary compression is achieved via the knurled nut. The Push Pull Device is self-drilling and self-tapping so it is quick to use. For more information on the Push Pull Device and other instruments...

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Tibial Plateau Leveling Osteotomy (TPLO)

What are the benefits of the Synthes TPLO Plate?
The Synthes Tibial Plateau Leveling Osteotomy (TPLO) Plate merges locking screw technology with conventional plating techniques in a new anatomically precontoured plate. The TPLO plate accepts either conventional or locking screws. The plate head is specifically designed to engage more bone in the caudal region. The plate head screw holes are angled away from the articular surface and osteotomy for optimal screw placement. The plate comes in left and right versions and six sizes: 2.0 mm, 2.4 mm, 2.7 mm, 3.5 small, 3.5 mm, and 3.5 mm Broad. Use of locking screws are mandatory, but when used creates a fixed-angle construct which can product greater stability and eliminates the need for a perfectly contoured plate. More information is available in the TPLO Technique Guide.

How do you apply compression with the Synthes TPLO Plate?
Applying compression with the Synthes TPLO Plate is different from other TPLO plates. Compression is achieved via cortex screws placed in compression mode in the shaft holes of the plate. Detailed information is available in the TPLO Technique Guide.

When and how do you contour the Synthes TPLO Plate?
The Synthes TPLO Plate must be precisely contoured to the bone surface when conventional screws are used in the plate. If locking screws are used in the plate head, typically very little if any adjustment of the plate precontour is required.

To contour the 3.5mm TPLO plates, it is best to use a tabletop bending press since these plates are very strong and difficult to bend with bending irons alone.

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