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Distal Femur Fractures
Updated: Dec 16 2024

[Blocked from Release] Pangea™ Distal Lateral Femur Plate

Images
https://upload.orthobullets.com/topic/423201/images/54fdf32e-8c76-4eb0-95e7-6fdca7342938_pangea_distal_lateral_femur_and_t2_alpha_retrograde_1.jpg
https://upload.orthobullets.com/topic/423201/images/95adc526-86fe-4dc6-b07e-53b6a56bdcc9_pangea_distal_lateral_femur_and_t2_alpha_retrograde_2.jpg
https://upload.orthobullets.com/topic/423201/images/3bbc1f0f-8286-40d8-b555-82308a7bc8a1_pangea_distal_lateral_femur_1..jpg
https://upload.orthobullets.com/topic/423201/images/55b6e48e-1a7e-4fa5-aaf9-15bba923fa4a_pangea_distal_lateral_femur_2..jpg
  • Pangea Design
    • Variable Angle Locking Technology
      • Pangea’s variable angle locking technology uses a CoCr locking screw, which is harder than the Ti6Al4V ELI plate, allowing for the screwhead’s threads to form a definitive plate-screw interface in the plate's locking hole by engaging the softer, Ti6Al4V material.
      • This technology allows the user to aim and lock the screw into the plate within a true 30° cone of the predetermined hole trajectory. The variable angle drill guide provided with the system offers guidance with respect to the limit of the 30° cone. The locking mechanism remains functional for up to three attempts at locking screw insertion.
    • Tapered End
      • Designed for atraumatic submuscular insertion
    • Staggered Screw Pattern
      • Designed to enable surgeon to choose point of fixation and allows for placement of screws around an implant in the intramedullary canal
    • Variable-Angle Screw Holes
      • Circular holes that accommodate screws are universal, accepting non-locking screws and locking screws within a 30° cone
    • 2 Metaphyseal Kickstand Screw Holes
      • Designed to improve construct stability in distal segment and reduce the potential for varus settling
    • 5.0mm Central Monoaxial Screw Hole
      • Can accommodate any screw in the distal femur plate indication and may serve as a parallel reference to the joint line
    • Oblique K-Wire Hole
      • Accommodates surgical approach when temporary distal plate fixation is desired
    • Converging and Diverging Screws
    • Scalloped Edges
      • Allow for placement of independent lag screws
  • Placement
    • The distal and anterior margin of the plate should sit along the border of the articular surface
    • Plate designed to sit 5-10mm from the anterior surface and 5-10mm from the distal surface of the femur
    • Plate is designed to sit more posterior in distal segment than other competitive plates to give space for independent lag screw fixation and is contoured to account for iatrogenic malalignment that is seen with other plate designs. 1,2
  • Fit
    • Designed with the use of SOMA: Stryker Orthopedics Modeling and Analytics
    • SOMA includes a database with CT scans from hospitals across the world and state-of-the-art algorithms to mine the data for shape variability, bone density, and implant fit. 3
    • Pangea Distal Lateral Femur plates were found to sit closer to the bone than VA-LCP. 3
    • From SOMA database findings, additional degrees of metaphyseal rotation are added to reduce the potential for iatrogenic malalignment seen with other plate designs. 1,2
    • Kickstand screws add additional medial column support by being more in line with medial column loading in comparison to direct lateral to medial screws
    • Distal plate shape and posterior placement of the plate on the distal segment allow for independent lag screws to be place initially for intercondylar fractures and reduce the interference of lag screws with the plate
    • 8 metaphyseal screw holes provide versatile fixation options
  • Technical specifications
    • Standard plate lengths: 4-20 holes (160-441mm)
    • Thickness: 5.0mm
    • Left and right anatomic plate options
    • Drill bits: Ø3.2mm x 145mm (542050) Ø3.2mm x 215mm (542051) Ø4.3mm x 145mm (542052) Ø4.3mm x 215mm (542053)
  • Evidence-Based Screw Trajectories
    • Converging and diverging screw trajectories in the metaphyseal region to increase fixation spread in the articular segment
    • Staggered diaphyseal holes to accommodate screw placement around an intramedullary nail, hip prosthesis, or stemmed knee prosthesis
    • The plate’s anterior placement and screw cluster in the metaphysis are designed to avoid interference in the intercondylar notch and nominal trajectories, reducing or eliminating the need to use shorter screws in the most posterior distal screw hole
    • Tip: To check the position of the locking screws in relation to the joint and the intercondylar notch, insert a K-wire into one of the distal locking screw holes utilizing a K-wire sleeve in conjunction with a drill sleeve
  • Screws
    • Pangea Distal Lateral Femur Plate
      • Pangea Distal Lateral Femur Plate
      • Multiaxial locking
      • 5.0 (14-120mm)
      • 4.0 (14-95mm)
      • 5.0 (10-20mm)
      • Cortex
      • 4.5 (14-150mm)
      • Cancellous
      • Partially threaded 6.0 (20-150mm)
      • Partially threaded 6.0 (30-150mm)
      • Fully threaded 6.0 (45-150mm)
  • References
    • 1. Lowe J, Alhandi A, Manoharan A, Ouellette E, Kaimrajh D, Milne E, Latta L. Axial and Rotational Malreduction (Golf Club Deformity) in Distal Femur Fractures. J Orthop Trauma. 2022 Oct 1;36(10):515-518. doi: 10.1097/BOT.0000000000002373. PMID: 35436242.
    • 2. Campbell ST, Bosch LC, Swinford S, Amanatullah DF, Bishop JA, Gardner MJ. Distal Femur Locking Plates Fit Poorly Before and After Total Knee Arthroplasty. J Orthop Trauma. 2019 May;33(5):239-243. doi: 10.1097/BOT.0000000000001431. PMID: 30614915.
    • 3. Internal Report № D0000262573, Rev AA, Selzach, Switzerland
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