- 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?
Ordering/Account Management:
- Can I purchase product without a Synthes account?
- How do I open a Synthes account?
- How do I place an order?
- How do I purchase Synthes products outside the U.S.?
- How do I contact Synthes outside the U.S.?
- How do I order Synthes products not found in the Vet Catalog?
Synthes began as the Swiss companies Mathys and Straumann. These two companies produced the first AO products in the early 1960's. In 1970, the first AO Vet Course in the United States was held at The Ohio State University. Synthes USA was formed in 1974 and began selling directly to veterinarians in the United States and Canada. These three companies have been merged to form Synthes, Inc., a global company serving both veterinary and human surgeons around the world. More on Synthes history...
Back to Top
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.
Back to Top
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...
Back to Top
In the United States, Synthes supports veterinarians through a team of Veterinary Sales Consultants located at its headquarters in West Chester, Pennsylvania. For technical questions, you can contact these consultants via the Technical Support Line or email.
In other countries, 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...
Back to Top
You can download many of the Synthes veterinary product brochures, wall charts, and other informative documents from the Technical Information page of this website.
Back to Top
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.
Back to Top
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.
Back to Top
What size implant is recommended for any particular indication and patient size?
AO Vet has created a Veterinary Plate and Screw Chart which cross-references animal weight, anatomic location, and recommended implant size. It is printed towards the front of the Synthes Veterinary Catalog.
Back to Top
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.
Back to Top
Can I mix implants of different metals?
The major factor regarding whether mixed metals can create clinical problems is related to a corrosion property known as galvanic corrosion. Galvanic corrosion is an accelerated form of corrosion that may occur when two dissimilar metals are coupled in the body. Each metal has a distinct corrosion potential in an electrochemically conductive fluid which are ever-present in the body. These dissimilar metals behave like the positive and negative terminals of a battery and corrosion currents may be generated.
The metal ions released from corrosion reactions can cause inflammatory response, metal sensitivity reactions, and/or long term detrimental systematic effects. In addition, the corrosion process can reduce the mechanical strength of the implants.
The scientific basis for determining whether various mixed metals will create galvanic corrosion effects in the body is a fairly complicated matter. The following table summarizes some of the Synthes mixed metal combinations that might be encountered.
Dissimilar Metal Combinations and Galvanic Corrosion:
| 316L Stainless Steel/Ti-6Al-7Nb |
Do Not Use |
| 316L Stainless Steel/CP Titanium |
Do Not Use |
| 316L Stainless Steel/Cobalt-base L-605 |
Do Not Use |
| 316L Stainless Steel/Ti-15Moly |
Do Not Use |
| CP Titanium/Ti-6Al-7Nb |
Acceptable |
| CP Titanium/Ti-15Moly |
Acceptable |
| CP Titanium/Cobalt-base L-605 |
Acceptable |
Mixing of stainless steel implants with unalloyed titanium, titanium alloys, and cobalt base alloy implants should be avoided for implants that are in contact with each other. Titanium, titanium alloy, and cobalt base implants can normally be mixed without encountering serious galvanic corrosion problems.
The use of mixed metals in the same bone is not a problem as long as the implants are not in direct contact with each other. For instance, the use of a stainless steel plate for a distal fracture and titanium plate for a proximal fracture on the same femur is acceptable so long as the implants are not in physical contact.
Back to Top
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.
Back to Top
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.
Back to Top
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.
Back to Top
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...
Back to Top
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...
Back to Top
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 or the Implant Guide under Technical Info.
It is important to note that the Synthes Universal Drill Guide must be used to place conventional screws in LCP Plates.
Back to Top
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.
Back to Top
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.
Back to Top
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.
Back to Top
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...
Back to Top
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...
Back to Top
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 three sizes: 2.7 mm, 3.5 mm, and 3.5 mm Broad. Use of locking screws are not required, 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.
Back to Top
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.
Back to Top
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.
Back to Top
Ordering/Account Management:
Can I purchase product without a Synthes account?
Synthes only sells products to licensed veterinarians. Customers must have an active Synthes account to purchase products.
Back to Top
How do I open a Synthes account?
A licensed veterinarian or authorized representative can apply for a Synthes customer account by submitting the Synthes customer information form. All requested information must be filled in, including veterinarian license number and social security number. The social security number is only used to check credit history. Fax the completed form to (610) 651-9050. If you have questions on opening an account please call (800) 523-0322.
Back to Top
How do I place an order?
With a current Synthes account, orders may be placed by toll-free telephone or fax. All orders are shipped UPS Standard (two-three business days), unless otherwise requested. F.O.B. Monument, Colorado; freight charges are prepaid and added to the invoice. For telephone and fax numbers...
Back to Top
How do I purchase Synthes products outside the U.S.?
Product orders outside the United State can be made directly to the nearest Synthes country office, located throughout the world.
Back to Top
How do I contact Synthes outside the U.S.?
A listing of all Synthes country offices can be found on the Synthes corporate website. Please contact the office in your country, or the next nearest office to your location.
Back to Top
How do I order Synthes products not found in the Vet Catalog?
If you know the product number of the product you wish you order, you may contact Customer Service directly. If you need more information, please call the Vet Sales Consultant via the Veterinary Technical Support telephone number.
Back to Top