Dsem TRM 0516 0677 - LR

Schanz Screws and Steinmann Pins
Surgical Technique
This publication is not intended for

distribution in the USA.
Instruments and implants

approved by the AO Foundation.
Image intensifier control
This description alone does not provide sufficient background for direct use
of DePuy Synthes products. Instruction by a surgeon experienced in handling
these products is highly recommended.
Processing, Reprocessing, Care and Maintenance

For general guidelines, function control and dismantling of m ulti-part
instruments, as well as processing guidelines for implants, please contact your
local sales representative or refer to:
http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance
For general information about reprocessing, care and maintenance of Synthes
reusable devices, instrument trays and cases, as well as processing of Synthes
non-sterile implants, please consult the Important Information leaflet
(SE_023827) or refer to:
http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance
Table of Contents
Introduction SELDRILL Schanz Screw 2
Self-tapping Schanz Screw 3
Hydroxyapatite-Coated Schanz Screw 4
Steinmann Pin 5
AO Principles 6
Intended Use, Indications and Contraindications 7
Surgical Technique Preoperative planning for all Schanz Screws

and Steinmann Pins 8
Setting the Schanz Screws and Steinmann Pins 12
SELDRILL Schanz Screw 12
Self-tapping Schanz Screw 16
Steinmann Pins 21
Product Information The SELDRILL Schanz Screws 24
Schanz Screw (Self Tapping) 25
Hydroxyapatite-Coated Schanz Screws 26
Steinmann Pins 28
Bibliography 30
MRI Information 31
Schanz Screws and Steinmann Pins Surgical Technique DePuy Synthes 1

SELDRILL Schanz Screw
The SELDRILL Schanz Screw has been spe- Standard vs self-drilling Schanz Screws1 (Axial insertion force 35N)
cifically designed to optimise the bone/pin
interface to reduce the occurrence of pin-
tract related complications in external fixa-
tion. 40
30
The unique design of the SELDRILL Schanz
Screw reduces heat generation and inser- 20
tion torque while improving pullout resis-
10 Standard 5.0 mm Schanz Screw
tance in cortical and can cellous bone.
(predrilled then inserted at 60 rpm)
0
Temperature Insertion Cortical Cancellous 5.0mm SELDRILL Schanz Screw
increase torque pullout pullout (inserted at 400rpm)
(°C) (Nm×10 –1) (N×102) (N×102)
Radial preload Radial preload2–4
Core diameter increase of screw in the Microradiographs – after inserting smooth pins for 6 weeks
near cortex resulting in:
Without radial preload:
–– enhanced anchorage in bone extensive bone resorption
–– sealing of intramedullary canal against
contamination
–– less bone resorption due to minimi
sation of micromotion in screw-bone
interface
Self-drilling and self-tapping With radial preload:

minimal bone resorption
–– Quick insertion
–– Precise geometry of bone thread
–– No need to search for pre-drilled pilot
hole
Materials Precise geometry of bone thread
–– Commercially pure titanium

–– Implant quality stainless steel
2 DePuy Synthes Schanz Screws and Steinmann Pins Surgical Technique

A Efficient drill bit and tap
A
–– One-step insertion
–– Precise pilot hole and threads B
–– Reduced heat generation
–– Decreased insertion torque
B S
hort, 2% core taper provides optimal radial
preload
–– Reduces micromotion and pin-tract infections
C Symmetrical thread profile

C
–– Improved pullout strength in diaphyseal and metaphyseal D
bone
–– Improved anchorage in cancellous bone due to increased
thread length
D Smooth thread/shaft transition area E
–– Reduced stress riser
E Standard shaft diameters
–– Compatible with Synthes external fixators
Self-tapping Schanz Screw
–– With trocar tip

–– Diameters of 4.0 mm, 4.5 mm, 5.0 mm and 6.0 mm
–– Lengths of 60 mm, 80 mm, 100 mm, 125/130 mm,
150/160 mm 190/200 mm and 250 mm
–– Available in Stainless Steel or Titanium alloy (TAN)
–– Sterile and nonsterile-packaged

Hydroxyapatite-Coated Schanz Screw
Hydroxyapatite Schanz Screw
–– Threads are coated with hydroxyapatite (HA) to enhance

fixation at the pin-bone interface and reduce the inci-
dence of pin loosening
–– Self-drilling or self-tapping versions
–– Diameters of 4.0 mm, 4.5 mm, 5.0 mm and 6.0 mm
–– Sterile-packaged

Steinmann Pin
Steinmann Pin with trocar tip

–– Available in Stainless Steel or Titanium alloy (TAN)
–– Diameters of 3.0 mm/3.5 mm/4.0 mm/4.5 mm and
5.0 mm
–– Lengths of 125 mm/ 150 mm /175 mm/ 200 mm/
–– For some diameters length of 225 mm/250 mm/275 mm/
300 mm
Steinmann Pin with middle thread and trocar tip

–– Available in Stainless Steel
–– Diameters of 4.5 mm and 5.0 mm
–– Lengths of 150 mm, 175 mm, 200 mm, 225 mm, 250 mm,
275 mm, 300 mm
Steinmann Pin with middle thread and trocar tip

–– Available in Titanium alloy (TAV)
–– Diameter of 5.0 mm
–– Lengths of 200 mm, 250 mm
Steinmann Pin with drill tip

–– Available in Stainless Steel
–– Diameters of 4.5 mm and 5.0 mm
–– Lengths of 125 mm, 150 mm, 175 mm, 200 mm, 225 mm,
250 mm, 275 mm, 300 mm

AO Principles
AO PRINCIPLES
In 1958, the AO formulated four basic principles, which have

In 1958, the guidelines
become AO formulated four basic
for internal principles,
fixation1,2. which
have become the guidelines for internal fixation1, 2.
4_Priciples_03.pdf 1 05.07.12 12:08
Anatomic
Anatomic reduction fixation
Stable fixation
Fracture reduction
Fracture reduction and
and fixation
fixation to Fracture
Fracture fixation
fixationproviding
providingabsolute
abso- or
to restore
restore anatomical
anatomical relationships.
relationships. relative stability,stability,
lute or relative as required
as by the
prequired
atient, theby injury, and thethe
the patient, personality
injury,
1 2 of
andthethe
fracture.
personality of the
fracture.
Early,
Early, active mobilization
mobilization Preservationof
Preservation of blood
blood supply
supply
Early and
Early and safe mobilization
mobilizationand
and 4 3 Preservation
Preservationof ofthe
theblood
bloodsupply
supply
rehabilitation the injured partand
rehabilitation of the injured part to
to soft tissues and bone bygentle
soft tissues and bone by
the patient
and as a whole.
the patient as a whole. reduction techniques
gentle reduction and careful
techniques and
handling.
careful handling.
1
Müller ME, M Allgöwer, R Schneider, H Willenegger. Manual of Internal
Fixation. 3rd ed. Berlin Heidelberg New York: Springer. 1991.
2
Rüedi TP, RE Buckley, CG Moran. AO Principles of Fracture Management.
2nd ed. Stuttgart, New York: Thieme. 2007.
1 Müller ME, Allgöwer M, Schneider R, Willenegger H. Manual of Internal Fixation.

3rd ed. Berlin, Heidelberg, New York: Springer. 1991.
2 Rüedi TP, Buckley RE, Moran CG. AO Principles of Fracture Management. 2nd ed.
Stuttgart, New York: Thieme. 2007.
4 DePuy Synthes Expert Lateral Femoral Nail Surgical Technique

Intended Use, Indications and
Contraindications
Intended Use
Synthes SELDRILL, Self-tapping, Hydroxyapatite-coated
Schanz Screws and Steinmann Pins are intended for use with
an external fixation system.
Indications
Synthes SELDRILL, Self-tapping, Hydroxyapatite-coated
Schanz Screws and Steinmann Pins are indicated for use with
an external fixation system.
Contraindications
No specific contraindications.
Warnings:
–– Synthes hydroxyapatite (HA) coated Schanz Screws are
only available sterile packed. Do not attempt to
re-sterilize.
–– Synthes SELDRILL, Self-tapping, Hydroxyapatite-coated
Schanz Screws and Steinmann Pins are not approved for
screw attachment or fixation to the posterior elements
(pedicles) of the cervical, thoracic, or lumbar spine.

Preoperative planning for all Schanz
Screws and Steinmann Pins
All External Fixators must be affixed within the recom-

mended zones described below.
The construction may not hinder the approach for a primary

wound debridement or for a secondary operation. Skin
transplants, sequestrectomies, bone grafting or a later
osteosynthesis must be performable without restriction.
Surgical approach to the tibia
The soft tissue zone through which Schanz Screws can be 60° 60°
inserted without damaging important structures (vessels,
nerves, muscles and tendons) is anteromedial to the tibia.
The angles of this safe zone vary.
If the lateral surface of the distal third of the tibia is avoided, 90°
damage to the anterior tibial artery can be avoided.
If the ventral zone of the distal tibia is avoided, interference

with the tendons can also be avoided. In addition, this mini-
mizes the probability of potential pin channel infection.
60°
Save
zone
Zones for pin placement in tibia

Surgical approach to the femur
A lateral approach to the femur within a 30° angle is recom-

mended. A medial approach is also possible from a distal
direction.

Preoperative planning for all Schanz
Screws and Steinmann Pins
Surgical approach to the pelvis
There are two recommended options for pin placement of

the external fixation assembly in the pelvis.
Supraacetabular pin placement

Given the pronounced bone structure, the more technically
difficult supraacetabular pin placement is preferred over that
of the iliac crest. Proceeding from the superior anterior crest,
the site of entry is approximately 4–6 cm in a caudal direc-
tion, and 3–4 cm in a medial direction. When the patient is
in a supine position, the alignment for drilling the screws is
angled approximately 20° in a cranial direction and 30° in-
ward.
Iliac crest pin placement
Precaution: To keep from damaging the femoral cutaneous

nerve, avoid insertion up to 15 mm in a dorsal direction from
the superior anterior iliac spine.
The orientation of the os ilium can be determined by palpa-

tion with a finger or an additional instrument. The screws
are then inserted delicately between the two laminae of the
os ilium.
Approach to the humerus
Distally, a dorsal approach to the humerus is appropriate.
Precautions: When dealing with the humerus, primary con-

sideration should be given to the radial and axillary nerves.
Distally, a dorsal approach to the humerus is appropriate.
Proximally, it is recommendable to introduce the Schanz
Screws from a ventrolateral direction, caudal to the path of
the axillary nerve.

Setting the Schanz Screws and
Steinmann Pins
The following steps will be explained with reference to a

B 5.0 mm self-drilling, self-tapping (SELDRILL) Schanz Screw,
and a B 5.0 mm Schanz Screw inserted in the diaphyseal re-
gion of the tibia.
Precaution: Select the appropriate Schanz Screw (self-

tapping, SELDRILL, Hydroxyapatite) or Steinmann pin for the
patient’s bony anatomy.
The SELDRILL is a self-drilling, self-tapping Schanz Screw. The

optimized radial preloading helps minimize the rate of pin
infections.
Note: When the new adaptors for Schanz Screws are used,
the SELDRILL Schanz Screws as well as all other self-drilling
and all Steinmann pins do not have to be clamped in the drill
chuck. The adapters are compatible with the universal chuck
and AO/ASIF Quick Coupling.
Note: The thread of the SELDRILL Schanz Screws does not

result in irritation of the soft tissue.
1
Set the drill sleeves on the bone
Required instruments
395.911 Handle for Drill Sleeve
395.921 Drill Sleeve 6.0/5.0 short, with thread
395.912 Drill Sleeve 5.0/3.5, short
394.181 Trocar B 3.5 mm, short
Insert the drill sleeve assembly through a stab incision and

set it directly on the bone surface. Then remove the trocar
B 3.5 mm and the drill sleeve 5.0/3.5.
Precautions:
–– Instruments and screws may have sharp edges or moving
joints that may pinch or tear user’s glove or skin.
–– Handle devices with care and dispose worn bone cutting
instruments in an approved sharps container.

Steinmann Pins
2
Insert SELDRILL Schanz Screws
X94.782–788* SELDRILL Schanz Screws B 5.0 mm
393.103 Adapter for SELDRILL Schanz Screws
B 5.0 mm
type-dependent Drill with attachment for AO/ASIF
Quick Coupling
Insert the SELDRILL Schanz Screw in the B 5.0 mm adapter,

and use the drill to screw it through the drill sleeve 6.0/5.0
until the drill tip is anchored in the distant cortical bone.
If it is difficult to determine whether the screw has entered

the opposite side of the cortical bone, it is recommendable
to check the screw’s penetration depth and position with the
image intensifier.
After screwing in the SELDRILL Schanz Screw, remove the

drill sleeve and the drill with the adapter.
Precautions:
–– The SELDRILL Schanz Screw has been developed to mini-
mize heat development. Nevertheless, slow insertion and
additional cooling (for example with a Ringer solution) are
recommended.
–– The tip of the SELDRILL Schanz Screw should be embed-
ded in the far cortex to effectively resist cantilever forces
and to provide sufficient stability.
Note: Less experienced users are advised to use a hand drill

when placing the SELDRILL Schanz Screw in the far cortex.
The SELDRILL Schanz Screw should be embedded in the far cortex:

* X=2 Stainless Steel
X=4 Titanium (TiCP)
Alternative technique:
X94.782–788* SELDRILL Schanz Screws B 5.0 mm
395.921 Drill Sleeve 6.0/5.0, short, with thread
393.103 Adapter for SELDRILL Schanz Screws
B 5.0 mm
393.100 Universal Chuck with T-Handle
Quick Coupling
Insert the SELDRILL Schanz Screw B 5.0 mm in the adapter,

and use the drill to screw it through the drill sleeve 6.0/5.0
into the near cortical bone.
Remove the drill and replace it with the universal drill chuck
with the T-handle (393.100). The screw can now be deli-
cately screwed manually into the middle of the distant
cortical bone. It is not necessary to completely penetrate the
distant cortical bone since anchoring the thread in the near
cortical bone and sinking the drill tip in the distant cortical
bone effectively absorbs bending force.
Remove the drill sleeve and the universal chuck with

T-handle.
Precaution: Only when bones are osteoporotic does the

SELDRILL Schanz Screw have to be screwed a bit further into
the d
istant cortical bone, and it may even slightly penetrate
through it since this can increase anchoring stability.
Note: A SELDRILL Schanz Screw can be turned back without

loosening as the thread is not conical.
Use in the metaphyseal region
The individual surgical steps are the same as when the

screws are used in the shaft area.

X=4 Titanium (TiCP)

Steinmann Pins
Self-tapping Schanz Screw
Instead of self-drilling Schanz Screws (SELDRILL), self-tapping

screws can also be used. In contrast to the SELDRILL Schanz
Screws, self-tapping screws must be predrilled.
1
Set the drill sleeve assembly on the bone
Insert the drill sleeve assembly through a stab incision and

set it directly on the bone surface and remove the trocar
B 3.5 mm.
2
Predrilling
310.370 Drill Bit B 3.5 mm, length 195/170 mm,
2-flute, for Quick Coupling
Quick Coupling
Drill through both sides of the cortical bone with the

B 3.5 mm drill bit, then remove the drill sleeve 5.0/3.5.

Steinmann Pins
3
Insert the self-tapping Schanz Screw
X94.520–570* Self-Tapping Schanz Screw
The Schanz Screw can now be screwed in through the drill

sleeve 6.0/5.0. The tip must be anchored in the distant corti-
cal bone to effectively absorb bending force.
Precaution:
The tip of the Self-tapping Schanz Screw should be embed-
ded in the far cortex to effectively resist cantilever forces and
to provide sufficient stability.

X=4 Titanium Alloy (TAN)
Alternative technique using the length gauge
Alternately, the length of the required Schanz Screw can also

be precisely checked using the length gauge.
393.780 Depth Gauge for Schanz Screws
After predrilling as described in step 2 on page 17, the

length gauge is guided through the drill sleeve 6.0/5.0 and
hooked in the distant cortical bone.
Then move the retaining disk to the height of the drill sleeve
and lock it with the locking screw.
Remove the length gauge, and insert the tip of the Schanz
Screw into the recess of the retaining disk. Slide the universal
chuck over the smooth shaft of the Schanz Screw to the
height of the tip of the length gauge, and tighten the chuck
on the Schanz Screw. Determining the length in this manner
will ensure that the screw will be firmly anchored in the
distant cortical bone.
The Schanz Screw can now be screwed in through the drill

sleeve 6.0/5.0 until the drill chuck stops on the drill sleeve.
Note: If the Schanz Screw is screwed in beyond this point,

it will strip the thread due to the resistance of the drill sleeve.

Steinmann Pins
Precautions:
–– Implant sites should be meticulously cared to avoid pin-
tract infection. Schanz Screws and Steinmann pins may
be surrounded with antiseptic coated foam sponges in an
effort to avoid infection. An implant-site care procedure
should be reviewed with the patient.
–– To minimize the risk of pin track infection the following
points should be observed:
a. Placement of Schanz Screws and Steinmann pins taking
anatomy into consideration (ligaments, nerves, arter-
ies).
b. Slow insertion and/or cooling, particularly in dense,
hard bone to avoid heat necrosis.
c. Release of skin tension at soft tissue entry point of
implant.
Steinmann Pins
The following steps will be explained with reference to a

symmetrical compression (generally required for arthrodesis
and osteotomies) that is best generated using a bilateral
frame construction with Steinmann pins.

Steinmann Pins
Bilateral frames for arthrodesis
X93.500– Steinmann Pin B 5.0 mm with trocar tip
X93.590*
394.800– Carbon Fibre Rod B 11.0 mm
394.870
390.008 Clamp, clip-on, self-holding
321.160 Combination Wrench B 11.0 mm
393.420 Protective Cap, for Schanz Screws and
Steinmann Pins B 5.0 mm
Knee arthrodesis
393.760 Compressor, open
310.370 Drill Bit B 3.5 mm, length 195/170 mm,
The large external fixator enables effective compression by

pretensioning the Steinmann pins in relation to each other.
Maximum stability is attained by first untightening the rele-
vant clamp nuts, then generating the desired compression
using the open compressor, and then retightening the nuts.

Ankle arthrodesis
Bilateral frames for Osteotomies
X93.500– Steinmann Pin B 5 mm with trocar tip
X93.590*
394.800– Carbon Fibre Rod B 11.0 mm
394.870
390.008 Clamp, clip-on, self-holding
321.160 Combination Wrench B 11.0 mm
393.420 Protective Cap, for Schanz Screws and
Steinmann Pins B 5.0 mm
393.760 Compressor, open
310.370 Drill Bit B 3.5 mm, length 195/170 mm, Proximal tibia osteotomy
In the case of osteotomies of the proximal and distal tibia,

inner fixation is generally preferred if there are no associated
soft-tissue problems.
Compression osteotomies with a bilateral frame construction

are supportive of the metaphysis of rapid bone healing.

Distal tibia osteotomy

Product Information
The SELDRILL Schanz Screws
Total Thread Item no. Pure titanium SELDRILL Schanz Screws

Item no. Diameter length length Stainless
Titanium (mm) (mm) (mm) steel
4.0/2.5 mm*, 4.0/3.0mm*
494.769 4.0/2.5* 80 20 294.769
494.771 4.0/3.0* 80 20 294.771
494.772 4.0/3.0* 100 20 294.772 4.0 mm
494.774 4.0 60 20 294.774 5.0 mm

494.775 4.0 80 20 294.775
494.776 4.0 100 30 294.776
6.0 mm
494.777 4.0 125 40 294.777
494.778 4.0 150 40 294.778
494.779 4.0 175 40 294.779
Stainless steel SELDRILL Schanz Screws

494.782 5.0 100 30 294.782
494.783 5.0 125 40 294.783
494.784 5.0 150 60 294.784 4.0/2.5 mm*, 4.0/3.0 mm*
494.785 5.0 175 60 294.785
494.786 5.0 200 80 294.786
4.0 mm
494.788 5.0 250 80 294.788
494.792 6.0 100 30 294.792 5.0 mm
494.793 6.0 125 40 294.793

494.794 6.0 150 60 294.794 6.0 mm
494.795 6.0 175 60 294.795
494.796 6.0 200 80 294.796
494.798 6.0 250 80 294.798
* Shaft/thread diameter. Shaft and thread diameters are the same for all other sizes
listed. All SELLDRILL Schanz Screws are available non-sterile or sterile packed.
Add suffix ”S“ to article number to order sterile product.
Schanz Screw (Self Tapping)
B (mm) Length (mm)

X94.300 4.0/3.0* 80/20
X94.430 4.0 60/25
X94.440 4.0 80/25
X94.445 4.0/2.5* 80/20
X94.450 4.0 100/25
X94.460 4.0 125/25
X94.520 5.0 100/50
X94.530 5.0 125/50
X94.540 5.0 150/50
X94.550 5.0 175/50
X94.560 5.0 200/50
X94.570 5.0 250/50
X94.650 6.0 100/50
X94.660 6.0 130/50
X94.670 6.0 160/50
X94.680 6.0 190/50
* Shaft/thread diameter
Shaft and thread diameters are the same for all other sizes.
X=2 Stainless Steel
All Schanz Screws Self-tapping are available non-sterile or sterile packed.

Add suffix “S” to article number to order sterile product.

Product Information
Hydroxyapatite-Coated Schanz Screws
Self-Drilling Schanz Screws, HA coating, Pure Titanium,

sterile
B (mm) Length (mm)
494.784SHA
494.784SHA 5.0 150
494.785SHA 5.0 175
494.786SHA 5.0 200
Self-Drilling Schanz Screws, HA coating,

Stainless Steel, sterile
B (mm) Length (mm)
294.784SHA
294.776SHA 4.0 100
294.777SHA 4.0 125
294.778SHA 4.0 150
294.779SHA 4.0 175
294.782SHA 5.0 100
294.783SHA 5.0 125
294.784SHA 5.0 150
294.785SHA 5.0 175
294.786SHA 5.0 200
294.788SHA 5.0 250
294.796SHA 6.0 200
Warning: Synthes Hydroxyapatite (HA) coated Schanz

Screws are only available sterile packed. Do not attempt to
re-sterilize.
Schanz Screws, HA coating, Stainless Steel,
sterile
B (mm) Length (mm)
294.54SHA
294.450SHA 4.0 100
294.460SHA 4.0 120
294.520SHA 5.0 100
294.530SHA 5.0 125
294.540SHA 5.0 150
294.550SHA 5.0 170
294.560SHA 5.0 200
294.570SHA 5.0 250
294.670SHA 6.0 160
294.680SHA 6.0 190
294.730SHA 4.5 125
294.740SHA 4.5 150
294.750SHA 4.5 175
294.760SHA 4.5 200
Warning: Synthes Hydroxyapatite (HA) coated Schanz

Screws are only available sterile packed. Do not attempt to
re-sterilize.

Product Information
Steinmann Pins
Steinmann Pin with trocar tip Stainless Steel

or Titanium Alloy (TAN)
B (mm) Length (mm)
X93.350 3.5 125
X93.360 3.5 150
X93.400 4.0 150
X93.410 4.0 175
X93.420 4.0 200
X93.440 4.5 125
X93.450 4.5 150
X93.460 4.5 175
X93.470 4.5 200
X93.480 4.5 250
X93.490 4.5 225
X93.500 5.0 150
X93.510 5.0 175
X93.520 5.0 200
X93.530 5.0 250
X93.540 5.0 300
X93.580 5.0 225
X93.590 5.0 275
X=2 Stainless Steel

Steinmann Pin with middle thread (Stainless Steel)

B (mm) Length (mm)
293.640 5.0 150
293.680 4.5 175
293.690 5.0 175
293.730 4.5 200
293.740 5.0 200
293.790 5.0 225
293.840 5.0 250
293.890 5.0 275
293.940 5.0 300
Steinmann Pin with ”middle“ thread (TAV)
B (mm) Length (mm)
493.740 5.0 200
493.840 5.0 250
Steinmann Pin with drill tip (Stainless Steel)

B (mm) Length (mm)
293.130 4.5 150
293.140 4.5 175
293.150 4.5 200
293.220 5.0 125
293.230 5.0 150
293.240 5.0 175
293.250 5.0 200
293.260 5.0 225
293.270 5.0 250
293.280 5.0 275
293.290 5.0 300
All Steinmann pins are available nonsterile or sterile packed.

Add suffix ”S“ to article number to order sterile product.
For product information about fixation components for External Fixator

(Clamps, Rods ,Adapters, Caps, Drill sleeves) please refer to the corresponding
surgical technique:
DSEM/TRM/0416/0651: Large and Medium External Fixator
DSEM/TRM/0416/0652: Quadrilateral surface Pelvic
DSEM/TRM/0416/0653: Small External Fixator
DSEM/TRM/0516/0675: Large Distractor Tibia
DSEM/TRM/0516/0676 : External Distal Radius Fixator
DSEM/TRM/0115/0292: Elbow Hinge Fixator
DSEM/TRM/0714/0108: Mefisto External Fixator
DSEM/TRM/0717/0113: Segment Transport Mefisto External Fixator
DSEM/TRM/0717/0114: Hybrid Ring fixator
DSEM/TRM/0717/0136: The Distraction Osteogenesis Ring System

Bibliography
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paediatric trauma. Injury, Int J Care Injured 31, 21–26. laren Rohrfixateursystem. Operative Orthopädie und Trauma-
tologie, No 21, 90–93.
Gausepohl T, Koebke J, Pennig D, Hobrecker S, Mader K
(2000) The anatomical base of unilateral external fixation in Rüter A, Brutscher R (1988) Die Behandlung ausgedehnter
the upper limb. Injury, Int J Care Injured 31, 11–20. Knochen defekte am Unterschenkel durch die Verschiebungs-
osteotomie nach Ilizarov. Der Chirurg, 59, 357–359.
Miner T, Carroll KL (2000) Outcomes of External Fixation
of Pediatric Femoral Shaft Fractures. Journal of Pediatric Alonso JE, Horowitz M (1987) Use of the AO/ASIF External
Orthopaedics, 20:405-410. Fixator in Children. Journal of Pediatric Orthopaedics,
7: 594–600
Rüedi TP, Murphy WM (2000) AO Principles of Fracture
Management. Thieme, Stuttgart, New York. Schavan R. (1994) Mechanische Testung von Schanzschen
Schrauben. Diplomarbeit, Aachen, Deutschland 1–92.
Ruland WO (2000) Is there a place for external fixation in
humeral shaft fractures? Injury. Int. J. Care Injured 31, 27–34. Biliouris T. L., Schneider E., Rahn B. A., Gasser B.,
Perren S. M. (1989) The Effect of Radial Preload on the Im-
Kapukaya A, Subasi M, Necmioglu S, Arslan H, Kesemenli lC, plant- Bone Interface: A Cadaveric Study. J Orthop Trauma
Yildirim K (1998) Treatment of closed femoral diaphyseal 3(4):323–332.
fractures with external fixators in children. Arch Orthop
Trauma Surg, 117: 387–389. Biliouris T. L., Bresina S. J., Rahn B. A., Perren S. M. (1990)
Untersuchung des Effekts unterschiedlicher radialer Kom-
Hull JB, Bell MJ (1997) Modern Trends for External Fixation pression bei der Insertion von Schanzschen Schrauben. Acta
of Fractures in Children: A critical Review. Journal of Pediatric Med Austriaca Suppl 17(40): 34.
Orthopaedics, 6:103–109.
Biliouris T. L., Gasser B., Schneider E., Perren S. M. (1990) Die
Gregory P, Pevny T, Teague D (1996) Early Complications Auswirkung einer radialen Vorlast auf den Knochen bei Ver-
with External Fixation of Pediatric Femoral Shaft Fractures. wendung von Fixateur externe Nägel. Acta Med Austriaca
Journal of Orthopaedic Trauma, Vol 10, No 3, 191–198. Suppl 17(40): 27–28.
Buckley SL (1995) Technique of External Fixation of grossly

unstable or open tibial shaft fractures in children. Operative
Techniques in Orthopaedics, Vol 5, No 2 (April): 157-163.
Davis TJ, Topping RE, Blanco JS (1995) External Fixation

of Pediatric Femoral Fractures. Clinical Orthopaedics and
Related Research, No 318, 191–198.
Aronson J, Tursky EA (1992) External Fixation of Femur

Fractures in Children. Journal of Pediatric Orthopaedics,
12: 157–163.
Gregory RJH, Cubison TCS, Pinder IM, Smith SR (1992)

External Fixation of lower limb fractures in children.
The Journal of Trauma, Vol 33, No 5, pp 691–693.
Heim D, Regazzoni P, Perren S (1992) Der Fixateur externe

bei offenen Frakturen: Gegenwärtiger Stand seiner Anwend-
ung. Injury, No 23, suppl. 2.
MRI Information
Non-clinical testing has been performed to assess Torque,

Displacement and Image Artifacts according to
ASTM F 2213-06, ASTM F 2052-06e1 and ASTM F 2119-07
and Radio-Frequency-(RF-)induced heating according to
ASTM F 2182-11a.
These tests have not been done on the individual implants

but on the entire external fixator construct.
Please refer to the surgical technique of the corresponding

External Fixator system.

© DePuy Synthes Trauma, a division of Synthes GmbH. 2016. All rights reserved. 036.000.338 DSEM/TRM/0516/0677 07/16
Synthes GmbH
Eimattstrasse 3 Not all products are currently available in all markets.
4436 Oberdorf
Switzerland This publication is not intended for distribution in the USA.
Tel: +41 61 965 61 11
Fax: +41 61 965 66 00 All surgical techniques are available as PDF files at
www.depuysynthes.com www.depuysynthes.com/ifu 0123

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Schanz Screws and Steinmann Pins

This publication is not intended for

Instruments and implants

Processing, Reprocessing, Care and Maintenance

Introduction SELDRILL Schanz Screw 2

Self-tapping Schanz Screw 3

Hydroxyapatite-Coated Schanz Screw 4

Intended Use, Indications and Contraindications 7

Surgical Technique Preoperative planning for all Schanz Screws

Setting the Schanz Screws and Steinmann Pins 12

SELDRILL Schanz Screw 12

Self-tapping Schanz Screw 16

Product Information The SELDRILL Schanz Screws 24

Schanz Screw (Self Tapping) 25

Hydroxyapatite-Coated Schanz Screws 26

Schanz Screws and Steinmann Pins Surgical Technique DePuy Synthes 1

Radial preload Radial preload2–4

Self-drilling and self-tapping With radial preload:

Materials Precise geometry of bone thread

–– Commercially pure titanium

2 DePuy Synthes Schanz Screws and Steinmann Pins Surgical Technique

–– Reduces micromotion and pin-tract infections

C Symmetrical thread profile

D Smooth thread/shaft transition area E

–– Reduced stress riser

E Standard shaft diameters

–– Compatible with Synthes external fixators

Self-tapping Schanz Screw

–– With trocar tip

Schanz Screws and Steinmann Pins Surgical Technique DePuy Synthes 3

Hydroxyapatite Schanz Screw

–– Threads are coated with hydroxyapatite (HA) to enhance

4 DePuy Synthes Schanz Screws and Steinmann Pins Surgical Technique

Steinmann Pin with trocar tip

Steinmann Pin with middle thread and trocar tip

Steinmann Pin with middle thread and trocar tip

Steinmann Pin with drill tip

Schanz Screws and Steinmann Pins Surgical Technique DePuy Synthes 5

In 1958, the AO formulated four basic principles, which have

4_Priciples_03.pdf 1 05.07.12 12:08

1 Müller ME, Allgöwer M, Schneider R, Willenegger H. Manual of Internal Fixation.

Stuttgart, New York: Thieme. 2007.

4 DePuy Synthes Expert Lateral Femoral Nail Surgical Technique

Schanz Screws and Steinmann Pins Surgical Technique DePuy Synthes 7

All External Fixators must be afﬁxed within the recom-

The construction may not hinder the approach for a primary

Surgical approach to the tibia

If the ventral zone of the distal tibia is avoided, interference

Zones for pin placement in tibia

8 DePuy Synthes Schanz Screws and Steinmann Pins Surgical Technique

A lateral approach to the femur within a 30° angle is recom-

Schanz Screws and Steinmann Pins Surgical Technique DePuy Synthes 9

Surgical approach to the pelvis

There are two recommended options for pin placement of

Supraacetabular pin placement

Iliac crest pin placement

Precaution: To keep from damaging the femoral cutaneous

The orientation of the os ilium can be determined by palpa-

Distally, a dorsal approach to the humerus is appropriate.

Precautions: When dealing with the humerus, primary con-

Schanz Screws and Steinmann Pins Surgical Technique DePuy Synthes 11

SELDRILL Schanz Screw

The following steps will be explained with reference to a

Introduction SELDRILL Schanz Screw 2

Self-tapping Schanz Screw 3

Hydroxyapatite-Coated Schanz Screw 4

Intended Use, Indications and Contraindications 7

Setting the Schanz Screws and Steinmann Pins 12

SELDRILL Schanz Screw 12

Self-tapping Schanz Screw 16

Product Information The SELDRILL Schanz Screws 24

Schanz Screw (Self Tapping) 25

Hydroxyapatite-Coated Schanz Screws 26

1 Müller ME, Allgöwer M, Schneider R, Willenegger H. Manual of Internal Fixation.