Equipment Request Form – Trauma

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Meeting/Event Details

Complete this section if this request is related to a corporate sponsored event.

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(Exhibit, Cadaver Lab, etc.)

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Meeting/Event Name

Shipping Instructions

Requestor Name

Ship Date

Consign Sets To

Ship Attention To

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Phone number

Display Sets (Non-Cadaveric, Non-Sawbones)

System

Set Number & Description

ANTHEM Proximal Humerus

9168.9002DE: ANTHEM SS Proximal Humerus Implant and Instrument Demo Set
Full graphic case
9168.9012DE: ANTHEM SS Proximal Humerus Screw Demo Set
Full screw module

ANTHEM Distal Tibia

9170.9001DS: ANTHEM SS Distal Tibia Fracture Implant and Instrument Display Set
T and L plates and instruments (no screws)
9170.9003DS: ANTHEM SS Distal Tibia Screw Module Display Set
2.5mm and 3.5mm nonlocking and poly locking screws 8-65mm
9170.9005DS: ANTHEM SS Distal Tibia 2.5/3.5mm Plate Display Module
Medial and anterolateral plates (standard and wide), 2.5mm distally 3.5mm proximally
9170.9007DS: ANTHEM SS Distal Tibia 3.5mm Plate Display Module
One sample medial and standard anterolateral plate, 3.5mm throughout
9170.9009DS: ANTHEM SS Distal Tibia Metaphyseal Plate Display Module
T, Y and straight metaphyseal plates, in situ benders, bending pliers, metaphyseal plate bender, plate cutter

ANTHEM Distal Radius

9171.9001DE: ANTHEM SS Distal Radius Implant and Instrument Demo Set
Full graphic case
9171.9003DE: ANTHEM Distal Radius Screw Demo Set
Full screw module

ARBOR External Fixation

9173.9001DS: ARBOR Instrument Set
Full Instrument Set
9173.9000DS: ARBOR Implant Set
Full Implant Set

AUTOBAHN Troch Nail

9176.9000DS: AUTOBAHN Troch Nail Implant Display Set
Full Implant Set – 1 Nail, lag screw, locking screw
9176.9048DS: AUTOBAHN Trochanteric Nail Short Nail Instruments Display Set
Full Instrument Set
9176.9049DS: AUTOBAHN Trochanteric Nail Long Nail and Aux Instruments Display Set
Full Graphic Case

CAPTIVATE Headed 6.5/7.5mm

9178.9000DS: CAPTIVATE 6.5/7.5mm Instrument Set, Display
Full Instrument Set
9178.9001DS: CAPTIVATE 6.5 Partially Threaded Screw Module Display Set
Full screw module
9178.9002DS: CAPTIVATE 7.5 Partially Threaded Screw Module Display Set
Full screw module
9178.9003DS: CAPTIVATE 6.5/7.5mm Fully Threaded Screw Module Set, Display
Full screw module

CAPTIVATE Headed 3.5/4.0mm

9178.9202DS: CAPTIVATE SS 3.5mm/4.0mm Headed & VL Instrument Set, Display
Full graphic case
9178.9212DS: CAPTIVATE SS 3.5mm/4.0mm Headed & VL Screw Module, Display
Full screw module

ANTHEM Small Frag

9179.9001DE: ANTHEM SS Small Fragment Demo Set
Full graphic case
9179.9005DE: ANTHEM SS Small Fragment Screw Demo Set
Full screw module

ANTHEM Mini Frag

9181.9002DE: ANTHEM SS Mini Fragment Fracture System Instrument Demo Set
Full Instrument Set (no plates or screws)
9181.9152DE: ANTHEM SS Mini Fragment 1.5/2.0mm Screw Demo Module
1.5/2.0 screw module ( no 2.5 screws)
9181.9252DE: ANTHEM SS Mini Fragment 2.5mm Screw Demo Module
2.5 screw module (no 1.5/2.0 screws)
9181.9302DE: ANTHEM SS Mini Fragment 1.5/2.0mm Plate Demo Module
1.5/2.0 plate module (no 2.5/2.5mm plus plates)
9181.9402DE: ANTHEM SS Mini Fragment 2.5/2.5mm Plate Demo Module
2.5/2.5mm plus plate module (no 1.5/2.0 plates)

AUTOBAHN Reamer System

9182.9001DS: Universal Reaming Display Module
Full Reamer Set

AUTOBAHN Tibial Nail

9183.9000DS: AUTOBAHN Tibial Nail Implant Display Set
Full Implant Set
9183.9001DS: AUTOBAHN Tibial Nailing System Instrument Display Case 1
Full Instrument Set
9183.9002DS: AUTOBAHN Tibial Nailing System Instrument Display Case II
Full Instrument Set
9183.9004DS: AUTOBAHN Tibial Nailing System Small Fragment Display Module
Full Implant Set
9183.9005DS: AUTOBAHN Tibial Nailing System Compression Screw Display Module
Full screw module

ANTHEM Ankle

9185.9001DE: ANTHEM SS Ankle Fracture Implant and Instrument Demo Set
Precontoured fibula and small frag plates and instruments (no screws)
9185.9003DE: ANTHEM SS Ankle Fracture Screw Demo Set
Nonlocking and MonoAx 2.5mm and 3.5mm locking screws for ankle plates. Do not use these lockers with poly plates. Also contains 4.0mm cannulated screws and 4.0mm cancellous screws

ANTHEM Clavicle

9186.9002DE: ANTHEM SS Clavicle Implant and Instrument Demo Set
Full graphic case
9186.9012DE: ANTHEM SS Clavicle Screw Demo Set
Full screw module
9186.9022DE: ANTHEM SS Clavicle Hook Plate Demo Set
Full graphic case

ANTHEM Proximal Tibia

9187.9001DS: ANTHEM SS Proximal Tibia Facture System Implant Display Set
Partial Implant Set
9187.9003DS: ANTHEM CoCr Proximal Tibia Fracture System Screw Display Set
Partial Screw Module
9187.9004DS: ANTHEM SS Proximal Tibia Fracture System Small Fragment Display Set
Partial Implant Set
9187.9006DS: ANTHEM Proximal Tibia Fracture System Instrument Display Set
Full Instrument Set

CAPTIVATE Headless

9188.9900DE: CAPTIVATE Headless Screw Tradeshow Demo and Display Set

AUTOBAHN A/R Nail

9190.9100DE: AUTOBAHN Antegrade/Retrograde Nail Demo Set
9190.9200DE: AUTOBAHN Antegrade/Retrograde Nail Recon Demo Set

ANTHEM Distal Femur

9195.9001DS: ANTHEM Distal Femur Implant Display Set
Full graphic case of titanium left plates
9195.9005DE: ANTHEM Distal Femur Demo Set
Full graphic case of instruments with 1 of each style distal femur plate
9195.9005DS: ANTHEM Distal Femur Instrument Display Set
Full graphic case of instruments

ANTHEM Large Frag

9206.9003DE: ANTHEM Large Fragment Screw Demo Set
Full case of screws
9206.9003DS: ANTHEM Large Fragment Screw Display Set
Full case of screws
9206.9005DE: ANTHEM Large Fragment Instrument Demo Set
Full graphic case of instruments
9206.9005DS: ANTHEM Large Fragment Instrument Display Set
Full graphic case of instruments

AUTOBAHN EVO ANTEGRADE

9257.9101DS: AUTOBAHN EVO Antegrade Nail Instrument Display Set I
Full graphic case of instruments with a left sample nail
9257.9102DS: AUTOBAHN EVO Antegrade Nail Instrument Display Set II
Full graphic case of instruments
9257.9103DS: AUTOBAHN EVO Antegrade Nail Screw Display Caddy
Partial caddy of screws

AUTOBAHN EVO RETROGRADE

9257.9201DS: AUTOBAHN EVO Retrograde Nail Instrument Display Set I
Full graphic case of instruments
9257.9202DS: AUTOBAHN EVO Retrograde Nail Instrument Display Set II
Full graphic case of instruments with sample nail
9257.9203DS: AUTOBAHN EVO Retrograde Nail Screw Display Caddy
Partial caddy of screws
9257.9204DS: AUTOBAHN EVO Locking Washer Display Set
Full graphic case of washer implants/instruments
9257.9205DS: AUTOBAHN EVO Locking Washer Screw Display Caddy
Partial caddy of screws

Education Sets (Cadaveric Use Only)

System

Set Number & Description

ANTHEM SS Proximal Humerus

9168.9002ED: ANTHEM SS Proximal Humerus Implant and Instrument Education Set
Full graphic case
9168.9012ED: ANTHEM SS Proximal Humerus Screw Education Set
Full screw module

ANTHEM Ti Proximal Humerus

9168.9001ED: ANTHEM Ti Proximal Humerus Implant and Instrument Education Set
Full graphic case
9168.9011ED: ANTHEM Ti Proximal Humerus Screw Education Set
Full screw module

ANTHEM Distal Tibia

9170.9001ED: ANTHEM SS Distal Tibia Fracture Implant and Instrument Education Set
T and L plates and instruments (no screws)
9170.9003ED: ANTHEM SS Distal Tibia Screw Module Education Set
2.5mm and 3.5mm nonlocking and poly locking screws 8-65mm
9170.9005ED: ANTHEM SS Distal Tibia 2.5/3.5mm Plate Education Module
Medial and anterolateral plates (standard and wide), 2.5mm distally 3.5mm proximally
9170.9007ED: ANTHEM SS Distal Tibia 3.5mm Plate Education Module
One sample medial and standard anterolateral plate, 3.5mm throughout
9170.9009ED: ANTHEM SS Distal Tibia Metaphyseal Plate Education Module
T, Y and straight metaphyseal plates, in situ benders, bending pliers, metaphyseal plate bender, plate cutter

ANTHEM SS Distal Radius

9171.9001ED: ANTHEM SS Distal Radius Implant and Instrument Education Set
Full graphic case
9171.9003ED: ANTHEM Distal Radius Screw Education Set
Full screw module

ANTHEM Ti Distal Radius

9171.9002ED: ANTHEM Ti Distal Radius Implant and Instrument Education Set
Full graphic case
9171.9003ED: ANTHEM Distal Radius Screw Education Set
Full screw module

ARBOR External Fixation

9173.9001ED: ARBOR External Fixation Instrument Education Set
Full Instrument Set
9173.9002ED: ARBOR External Fixation Implant Education Set
Full Implant Set

AUTOBAHN Troch Nail

9176.9010ED: AUTOBAHN Troch Nail Screw Caddy, Education
Partial screw module
9176.9048ED: AUTOBAHN Trochanteric Nail System Short Nail Instruments Education Set
Full Instrument Set
9176.9049ED: AUTOBAHN Trochanteric Nail System Long Nail and Auxiliary Instruments Education Set
Full Instrument Set with 2 left and 2 right nails

CAPTIVATE Headed 6.5/7.5mm

9178.9000ED: CAPTIVATE 6.5/7.5 Instrument Education Set
Full Instrument Set
9178.9001ED: CAPTIVATE 6.5 Partially Threaded Screw Module Education Set
Full screw module
9178.9001ED: CAPTIVATE 6.5 Partially Threaded Screw Module Education Set
Full screw module
9178.9002ED: CAPTIVATE 7.5 Partially Threaded Screw Module Education Set
Full screw module

CAPTIVATE Headed 2.5/3.0mm

9178.9102ED: CAPTIVATE SS 2.5mm/3.0mm Headed & VL Instrument Set, Education
Full instrument set
9178.9112ED: CAPTIVATE SS 2.5mm/3.0mm Headed & VL Screw Module, Education
Partial screw module

CAPTIVATE Headed 3.5/4.0mm

9178.9202ED: CAPTIVATE SS 3.5mm/4.0mm Headed & VL Instrument Set, Education
Full instrument set
9178.9212ED: CAPTIVATE SS 3.5mm/4.0mm Headed & VL Screw Module, Education
Partial screw module

CAPTIVATE Headed 4.5/5.5mm

9178.9302ED: CAPTIVATE SS 4.5mm/5.5mm Headed & VL Instrument Set, Education
Full instrument set
9178.9312ED: CAPTIVATE SS 4.5mm/5.5mm Headed & VL Screw Module, Education
Partial screw module

ANTHEM Small Frag

9179.9001ED: ANTHEM SS Small Fragment Implant and Instrument Education Set
Full instrument set
9179.9005ED: ANTHEM SS Small Fragment Screw Education Set
Full screw module

ANTHEM Mini Frag

9181.9002ED: ANTHEM SS Mini Fragment Fracture System Instrument Education Set
Full Instrument Set
9181.9152ED: ANTHEM SS Mini Fragment 1.5/2.0mm Screw Education Module
Condensed 1.5/2.0 Screw Module (every other screw length for 1.5mm: 6-24mm, every other screw length for 2.0mm: 6-40mm)
9181.9252ED: ANTHEM SS Mini Fragment 2.5mm Screw Education Module
Condensed 2.5mm Screw Module (every other screw length for 2.5mm: 8-80mm)
9181.9302ED: ANTHEM SS Mini Fragment 1.5/2.0mm Plate Education Module
Condensed 1.5/2.0 Plate Module
9181.9402ED: ANTHEM SS Mini Fragment 2.5/2.5mm Plate Education Module
Condensed 2.5/2.5mm Plus Plate Module

AUTOBAHN Reamer System

9182.9001ED: Universal Reaming Education Module
Full Reamer Module

AUTOBAHN Tibial Nail

9183.9000ED: AUTOBAHN Tibial Nail Implant Education Set
Full Implant Set with sample nail
9183.9001ED: AUTOBAHN Tibial Nail Instrument Education Set I
Full Instrument Set
9183.9002ED: AUTOBAHN Tibial Nail Instrument Education Set II
Full Instrument Set
9183.9004ED: ANTHEM Small Fragment Education Module
Full Implant Set
9183.9005ED: CAPTIVATE Compression Screw Module
Full screw module

ANTHEM Ankle

9185.9001ED: ANTHEM SS Ankle Implant and Instrument Education Set
Precontoured fibula and small frag plates and instruments (no screws)
9185.9003ED: ANTHEM SS Ankle Screw Education Set
Nonlocking and MonoAx 2.5mm and 3.5mm locking screws for ankle plates. Do not use these lockers with poly plates. Also contains 4.0mm cannulated screws and 4.0mm cancellous screws

ANTHEM Clavicle

9186.9002ED: ANTHEM SS Clavicle Implant and Instrument Education Set
Full graphic case
9186.9012ED: ANTHEM SS Clavicle Screw Education Set
Full screw module
9186.9022ED: ANTHEM SS Clavicle Hook Plate Education Set
Full graphic case

ANTHEM Proximal Tibia

9187.9001ED: ANTHEM SS Proximal Tibia Implant Education Set
Partial Implant Set
9187.9003ED: ANTHEM Proximal Tibia Screw Education Module
Partial screw module
9187.9004ED: ANTHEM SS Proximal Tibia Small Fragment Education Module
Partial Small Frag Set
9187.9006ED: ANTHEM Proximal Tibia Instrument Education Set
Full Instrument Set

CAPTIVATE Headless

9188.9301ED: CAPTIVATE 3.0mm Headless Compression Screw Implant and Instrument Set, Ti
9188.9302ED: CAPTIVATE 3.0mm Headless Compression Screw Implant and Instrument Set, SS
9188.9401ED: CAPTIVATE 4.0mm Headless Compression Screw Implant and Instrument Set, Ti
9188.9402ED: CAPTIVATE 4.0mm Headless Compression Screw Implant and Instrument Set, SS

AUTOBAHN A/R Nail

9190.9100ED: AUTOBAHN A/R Nail Standard Education Set
Full Instrument Set
9190.9200ED: AUTOBAHN A/R Nail Recon Education Set
Full graphic case

ANTHEM Distal Femur

9195.9005ED: ANTHEM Distal Femur Instrument Education Set
Full Instrument Set
9195.9006ED: ANTHEM Distal Femur Plate Education Set
Full graphic case

ANTHEM Large Frag

9206.9003ED: ANTHEM Large Fragment Screw Education Set
Full case of screws
9206.9005ED: ANTHEM Large Fragment Instrument Education Set
Full graphic case

AUTOBAHN EVO ANTEGRADE

9257.9000ED: AUTOBAHN EVO Reamer Module
Full Reamer Module
9257.9101ED: AUTOBAHN EVO Antegrade Nail Instrument Education Set I
Full Instrument Set with sample PF (right and left) and GT( right and Left) nail
9257.9102ED: AUTOBAHN EVO Antegrade Nail Instrument Education Set II
Full Instrument Set
9257.9103ED: AUTOBAHN EVO Antegrade Nail Screw Education Caddy
Partial screw module

AUTOBAHN EVO RETROGRADE

9257.9000ED: AUTOBAHN EVO Reamer Module
Full Reamer Module
9257.9201ED: AUTOBAHN EVO Retrograde Nail Instrument Education Set I
Full Instrument Set
9257.9202ED: AUTOBAHN EVO Retrograde Nail Instrument Education Set II
Full Instrument Set with sample nail
9257.9203ED: AUTOBAHN EVO Retrograde Nail Screw Education Caddy
Partial screw module
9257.9204ED: AUTOBAHN EVO Locking Washer Education Set
Full Locking Washer Set
9257.9205ED: AUTOBAHN EVO Locking Washer Screw Education Caddy
Partial screw module

Sawbones Sets (Non-Cadaveric, Non-Display)

System

Set Number & Description

ANTHEM Proximal Humerus

9168.9001EDBM: Anthem Proximal Humerus Sawbones Instrument Set
Instruments in plastic case
9168.9002EDBM: Anthem Proximal Humerus Sawbones Implant Set
Plate and screws in plastic case

ANTHEM Distal Tibia

9170.9001EDBM: Anthem Distal Tibia Instrument Set (Use with BMO.213)
Reduction, plate bending, and screw insertion instruments in a plastic case
9170.9005EDBM: Anthem Distal Tibia Implant Set (Use with BMO.213)
Sample T, L, medial, wide anterolateral, and straight and T metaphyseal plates. 2.5 and 3.5mm screws in a plastic case.

Anthem Distal Radius

9171.9002EDBM: Anthem Distal Radius Sawbone Lab Kit
1 double row plate, 1 7 plate, instruments, 3 screw types (multiple quantities in one length) in plastic case

ARBOR External Fixation

9173.9001EDBM: Arbor External Fixation System (BMO.091)
Meant to build a Delta Frame: 4 Universal Clamps, 1 Multi-pin clamp, 2 attachment posts, two 350mm CF bars, Multitool and ratcheting handle, Ratcheting combination wrench, 11mm spanner wrench, drill bit for 3mm and 5mm pins, drill guide and trocar, one 5/6x350mm transfix pin, 1 self-drilling 3x90mm pin and 1 self-drilling 5x20mm pins in plastic case

AUTOBAHN Troch Nail

9176.9048EDBM: Autobahn Trochanteric Nail System Instrument Set, Sawbones (BMO.132)
Full Instrument Set
9176.9050EDBM: Autobahn Trochanteric Nail System Implant Set, Sawbones (BMO.132)
Full Implant Set with sample nail

ANTHEM Small Frag

9179.9001EDBM: ANTHEM Small Fragment Fracture Instruments and Implants Sawbones Set
Instruments and implants in a plastic case

AUTOBAHN Tibial Nail

9183.9000EDBM: Autobahn Tibial Nail System Implants
Full Implant Set with sample nail
9183.9001EDBM: Autobahn Tibial Nail System Instrument I (BM0.219)
Full Instrument Set
9183.9002EDBM: Autobahn Tibial Nail System Instrument II
Full Instrument Set

ANTHEM Ankle

9185.9001EDBM: Anthem Ankle Fracture Plating System (Use with BMO.123)
Sample lateral, universal, posterolateral, T, 1/3 tubular, and hook plates. Reduction, plate bending, and screw insertion instruments. Comes in plastic case.
9185.9003EDBM: Anthem Ankle Fracture Screw Module Sawbones Set (Use with BMO.123)
MonoAx and nonlocking 2.5mm, MonoAx and nonlocking 3.5mm, and partially threaded cannulated 4.0mm screws in a plastic case

ANTHEM Clavicle

9186.9001EDBM: Anthem Clavicle Sawbones Instrument Set
Instruments in plastic case
9186.9002EDBM: Anthem Clavicle Sawbones Implant Set
1 superior lateral plate, 1 anterior lateral plate, screws in plastic case

ANTHEM Proximal Tibia

9187.9001EDBM: Anthem Proximal Tibia Plating System-Implants (BMO.165)
Full Implant Set with sample plates
9187.9006EDBM: Anthem Proximal Tibia Plating System- Instruments
Full Instrument Set

ANTHEM Distal Femur

9195.9007EDBM: ANTHEM Distal Femur Sawbones Set
Ful Implant Set with Sample Plates

AUTOBAHN EVO ANTEGRADE

9257.9100EDBM: AUTOBAHN EVO Antegrade Nail Implant Set, Sawbones (BMO.132)
Screw Set (PF & GT) & sample left nail (GT & PF)
9257.9101EDBM: AUTOBAHN EVO Antegrade Nail Instrument Set I, Sawbones
Partial Instrument Set
9257.9102EDBM: AUTOBAHN EVO Antegrade Nail Instrument Set II, Sawbones
Full Instrument Set

AUTOBAHN EVO RETROGRADE

9257.9200EDBM: AUTOBAHN EVO Retrograde Nail Implant and Locking Washer Set, Sawbones (BMO.132)
Full Implant Set with Locking Washers
9257.9201EDBM: AUTOBAHN EVO Retrograde Nail Instrument Set I, Sawbones
Partial Instrument Set
9257.9202EDBM: AUTOBAHN EVO Retrograde Nail Instrument Set II, Sawbones
Partial Instrument Set

Sawbones Lab Equipment (Non-Cadaveric)

900.008EDBM: Electric Drill Set

900.006EDBM: Table Top Vice

900.007EDBM: Bone Clamp

Sawbones (Non-Cadaveric)

BMO.081: Large Left Radius. Includes a distal transverse fracture. (1027-12)

BMO.091: Tibia and Fibula. Medium Left (1101-4)

BMO.123: Medial and posterior malleolar fx of the tibia, and oblique fracture of the fibula. (1133-10)

BMO.132: Medium Left Femur, cancellous inner material, a canal of 15 mm, and length of 42 cm. (1121)

BMO.165: Tibia and Fibula W/ Bi-condylar fracture.

BMO.173: Ulna and Radius w/Oblique and Transverse fx (1017-3)

BMO.193: Humerus with Three-Part Head Fracture, Large, Left (1028-4)

BMO.213: Left Pilon

BMO.214: Sawbones, Left Clavicle with Butterfly Fracture (1020-51)

BMO.218: Medium Left Tibia / Fibula. (1144-2)

BMO.219: Medium Left Tibia / Fibula with patella (1144-3)

BMO.220: Femur with "T" Fracture

Sawbones Mat (Non-Cadaveric)

GMREF37: Tibial Nail Placemat

GMREF39: Distal Radius Placemat

GMREF57: Proximal Humerus Placemat

GMREF65: Clavicle Placemat

GMREF66: Proximal Tibia Placemat

GMREF79: Distal Tibia Placemat

GMREF98: Distal Femur Placemat

MEETING INVENTORY

EXM.001: Table Cover

GMBNR36: ANTHEM Distal Radius Pull-Up Banner

GMBNR37: ANTHEM Proximal Humerus Pull-Up Banner

GMBNR38: ANTHEM Ankle Pull-Up Banner

GMBNR44: AUTOBAHN Tibial Nail Pull-Up Banner

GMBNR45: AUTOBAHN Antegrade/Retrograde Femoral Nail Pull-Up Banner

GMBNR46: AUTOBAHN Troch Nail Pull-Up Banner

GMBNR48: ANTHEM Clavicle Pull-Up Banner

GMBNR58: ANTHEM Mini Fragment Pull Up Banner

GMBNR68: ANTHEM Distal Femur Pull Up Banner

GMBNR72: AUTOBAHN EVO Pull Up Banner

GMBNR73: AUTOBAHN EVO Antegrade Nail Pull Up Banner

ANTHEM Small Fragment Pull-Up Banner

Large Globus Trauma Pop-Up Backdrop

Equipment Request Form – Trauma

Meeting/Event Details

Shipping Instructions

Display Sets (Non-Cadaveric, Non-Sawbones)

System

Set Number & Description

Bone Models (Clear Acrylic)

System

Set Number & Description

Education Sets (Cadaveric Use Only)

System

Set Number & Description

Sawbones Sets (Non-Cadaveric, Non-Display)

System

Set Number & Description

Sawbones Lab Equipment (Non-Cadaveric)

Sawbones (Non-Cadaveric)

Sawbones Mat (Non-Cadaveric)

MEETING INVENTORY