call 866.979.TOBY (8629)


PANTERA® Cleaning and Sterilization Instructions


Toby Orthopaedics, Inc.
401 SW 42nd Ave, Suite 200
Miami, Florida 33134  USA
Domestic Toll-free: 866.979.TOBY (8629)
Office: 406.556.3260


Atlantico Systems LTD
34 Oldfield
Phone: +35 391443609


PANTERA® Fracture Fixation Plate System


  1. Implantable devices (plates, screws, etc.) are single use only.
  2. Reusable instruments that are provided clean and ready to use are non-sterile unless the packaging indicates otherwise.
  3. Clean and sterilize prior to each use, unless device is already provided in clean / sterile packaging.
  4. Where applicable, disassemble instruments prior to cleaning.
  5. For additional warnings, reference the PANTERA® Instructions For Use (Doc 60000010).


  1. Implantable devices are single use only and may not be reused once in contact with bodily fluid, soft tissue, bone, or other sources of contamination.
  2. Repeated processing has minimal effect on reusable PANTERA® surgical instruments. End of life is normally determined by wear and damage due to the use of the instruments.

Intended Use

  1. The PANTERA® system is indicated for fractures and fracture dislocations, osteotomies, and non-unions of the proximal humerus.
  2. The plates and screws contained within the system are single use devices, which are designed for implantation per the relevant surgical procedure.
  3. The drill bits, drill guides, depth gauges, k-wire, drivers, and other instrumentation are designed for use during the surgical procedure and require decontamination and cleaning prior to reuse.  The instruments typically contact blood, bone, tissue and bodily fluids during normal use, and therefore, require that the cleaning and processing steps are completed for each usage.

Point of Use

  1. Remove gross soiling by submerging the instrument into cold water (<40ºC) immediately after use.
  2. Don’t use a fixating detergent or hot water (>40ºC) as this can cause the fixation of residue, which may influence the result of the reprocessing process.
  3. Remove surface contamination with paper tissue.

Containment / Transportation

  1. Hospital precautions for the handling of contaminated/bio-hazardous materials should be followed.
  2. Instruments should be cleaned within 30 minutes after use to minimize the potential of staining, damage, and drying.

Preparation for Decontamination

If possible, the devices must be reprocessed in a disassembled or opened state.

  1. Disassemble the Depth Gauge to clean each component of the assembly: Depth Gauge Tip, Slide and Housing.
    1. Fully retract the Slide into the Housing so that the scale reads zero.
    2. Apply angular pressure on the Tip until the groove is visible.
    3. Fully separate the Tip from the Housing while taking care to not bend the Slide.
  2. Remove the K-Wire sleeve(s) from the corresponding Post Drill Guide and Cross Element Guide by turning the threaded sleeve counterclockwise.


Rinse with cold water for approximately 3 minutes.

Manual Cleaning Procedure

Applicable towards reusable devices and instrumentation.  All reusable instrumentation shall be considered critical, especially the items with small lumens / cannula or silicone surfaces.

  1. Immerse the device(s) in an enzymatic detergent solution prepared in warm (30-35ºC) tap water (8 mL EcoLab Neutral Enzymatic Detergent per liter or equivalent detergent solution) and allow device(s) to soak for not less than five (5) minutes.
  2. Aspirate not less than sixty (60) mL of the detergent solution through any lumens present, as applicable, using an appropriate sized syringe.
  3. Brush all lumens present on device(s), as applicable, using an appropriately sized nylon bristled channel brush.  Wet the brush in the detergent solution and run the brush down the entire length of each lumen and back, not less than five (5) times.  The brush should also be used to remove any visible soil.
  4. Brush any silicone surface with a nylon bristled instrument cleaning brush for not less than two (2) minutes per device where silicone material is present.
  5. Prepare an enzymatic detergent solution in a sonicating water bath (35 kHz has shown to be effective) using purified water (2 mL EcoLab Neutral Enzymatic Detergent per liter of water or equivalent detergent solution).
  6. Sonicate the device(s) for not less than ten (10) minutes in the enzymatic detergent solution.
  7. Upon completion of the manual brushing and sonication steps, process the device(s) through a standard washer / disinfector surgical instruments cycle with the following parameters (or equivalent):automated-cleaning-cycle-chart
  8. Perform a final rinse of the device(s) in running purified water, not less than ~250 mL per device, and allow the device(s) to air dry.
  9. Perform a visual inspection of the device(s) to ensure that all contaminants have been removed.  Residual bodily fluids, excessive discoloration, unacceptable corrosion, etc., are typical reasons to further process the device(s).  If the device(s) are determined to not be visually clean, the above relevant steps shall be repeated.  If the device cannot be cleaned effectively, then it shall be disposed of safely or Toby Orthopaedics’ Customer Service shall be contacted at the phone number listed above.

Automated Cleaning Procedure

Automated systems are only recommended for the PANTERA® surgical instruments when combined with the manual cleaning procedure detailed in the section above.


  1. Submerge instruments in a disinfection detergent according to the detergent manufacturer’s instructions.
  2. Rinse the instruments with sterile water to remove the detergent

Note:  Disinfection is only a supplementary step and does NOT replace the steam sterilization.


Dry the instruments with a lint-free towel. The instruments may never be heated up >140ºC. To avoid water residues, insufflate cavities of instruments by using sterile compressed air.  It is critical that all areas of the devices are completely dry, as residual moisture causes possible corrosion and premature deterioration of the instrument.

Inspection / Function Testing

  1. Carefully inspect each device to ensure that all visible blood and soil has been removed.
  2. Visually inspect for damage, corrosion and/or wear.
  3. Check the action of moving parts to ensure smooth operation throughout the intended range of motion.
  4. Check instruments with long slender features (particularly rotating instruments) for distortion.
  5. Where instruments form part of a larger assembly, check that the devices assemble readily with mating components.

Note:  If damage or wear is noted that may compromise the function of the instrument, contact your Toby Orthopaedics® representative for a replacement. 


Lubricate hinges, threads and other moving parts with a commercial water-based surgical grade instrument lubricant (such as instrument milk) to reduce friction and wear.

Reuse Life

  1. Implantable components may not be reused, but may be resterilized, as required, through the moist heat method described herein.  The implantable components have been validated for undergoing at least 15 sterilization cycles without loss of performance.
  2. Drill guides, drill guide sleeves, drivers, and similar instruments may be reused as long as the functionality of the device is sufficient to perform the intended use.  Typically these types of instruments have a lifetime of 50+ surgical cases unless the threads or driver tip is damaged during use.
  3. The depth gauge assembly and drill bits / k-wires may be reused as long as the functionality of the device is sufficient and any marking used for measurements are clearly legible.  The depth gauge scale and other similar laser markings on these devices begin to deteriorate after 10 to 15 sterilization / cleaning cycles, and should be visually inspected to ensure accuracy is still guaranteed.  The cutting edges of the drill bits / k-wires deteriorate at various times based on use, and the drill bits should be safely discarded once the edges become dull.  The edges can become dull after one use or may last 10 to 15 surgical cases.  Dull drill bits should be safely discarded to prevent localized burning of the bone during use.  Similarly, it is not recommended that K-wire or drill bits be reused for multiple cases due to the high velocity rotation of the devices causing possible deformation of the item and deterioration of performance.
  4. The sterilization trays are designed to last hundreds of sterilization / cleaning cycles and only require replacement when functionality is lost or excessive contamination cannot be remedied.


Instruments shall be loaded into the dedicated PANTERA® sterilization tray for sterilization. If applicable, use standard medical grade steam sterilization wrap following the AAMI double wrap method (ANSI/AAMI ST79).


Steam sterilize using a pre-vacuum cycle for 3 minutes at a minimum temperature of 135ºC.  20 Minute minimum drying time in accordance with ANSI/AAMI ST79.

Note: Flash Sterilization is not recommended for PANTERA®


PANTERA® surgical instruments should be stored in a cool dry place.

This document is in accordance with ISO 17664 current revision  

CONFIDENTIAL:  This document is property of Toby Orthopaedics, Inc., and shall not be reproduced or distributed without the express written consent of Toby Orthopaedics, Inc.