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Instruments & implants

Ortho for internals

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Instruments & implants

  1. 1. Retractors Used to retract soft tissue while operating on particular site
  2. 2. Bone lever Used to lever out the bone from depth
  3. 3. Bone awl Used to enter medullary cavity
  4. 4. Bone hook Bone is pulled up from fracture site by introducing hook into the medullary cavity hook
  5. 5. Periostium elevator
  6. 6. Bone holding forceps Self retaining( Heygroves Non self retaining ( Lion )
  7. 7. Bone nibbler Used for nibbling the bone
  8. 8. Bone cutter Used for cutting bone
  9. 9. Mallet Used to hammer chisel , osteotome etc.
  10. 10. Bone chisel Only one side is bevelled Used to remove a protruding bone Levelling the bone
  11. 11. Osteotome Used for osteotomy-cutting the bone Both edges will be bevelled curved straight
  12. 12. Bone gouge It is a concave bladed chisel Used for cutting round bones To make a hole in the bone
  13. 13. Bone curette
  14. 14. Reduction clamps
  15. 15. Plate holding forceps AO type
  16. 16. Low mans type plate holding forceps Used for holding plates in femoral fractures
  17. 17. Patellar clamps Used to hold patella after reducing the fracture while putting circlage wire in the shape of 8
  18. 18. chuck Introduced at this point to adjust the drill bit Drill bit will be fitted here Universal drill (Manual drill)
  19. 19. Drill bit Drill bit is inserted at this point of universal drill
  20. 20. Drill guide Used to mark drill point at which screw has to be placed while fixing with DCP
  21. 21. T handle Used to hold shanz pin while introducing into bone Pin is introduced at this point
  22. 22. 2 3 4 5 6 7 8 9 10 Depth gauge It is used to measure the length of medullary cavity Markings for measurements
  23. 23. Screw driver Different type of tips are available – hexagonal, square etc.
  24. 24. Cutting player (wire cutter) Used to cut wire in approximate size
  25. 25. Spanner Used to tighten the nuts in external fixators
  26. 26. Amputation saw Blade can be changed
  27. 27. Bone file Used to blunt the sharp edges of bone after amputation
  28. 28. It is defined as a materialIt is defined as a material inserted or grafted intoinserted or grafted into intact tissues or bodyintact tissues or body cavity with some specificcavity with some specific purposepurpose Implan t
  29. 29. MetallicMetallic Iron Cobalt Titanium Nonmetallic Type s
  30. 30. PlatesPlates ScrewsScrews Extra medullary fixation
  31. 31. Thick plate With round holes Used in combination with screws in Diaphysial fractures AO plates
  32. 32. The holes are designed to utilise spherical gliding principle Less surgical exposure Can fit in any position Screw can be inserted at any angle Indications >fracture shaft humerus >Monteggia fracture >fracture of both radius & ulna >fracture shaft femur Dynamic Compression plate
  33. 33. Least contact dynamic compression plate(LCDCP) Used In osteoporotic bone Indications >fracture of both radius & ulna >Montegia fracture
  34. 34. Prevents displacement of fracture from bending/shearing force C-Clover leaf plate Buttress plate Indications >fracture of surgical neck of humerus >Colles fracture >Condylar fracture of femur >Condylar fracture of tibia
  35. 35. Cobra plateT plate
  36. 36. Reconstruction plateThickness is between DCP & buttress plate Scallop like notches presents between holes Can be contoured in 3 planes Indications >Fracture clavicle >Supracondylar fracture >intercondylar fracture >Fracture acetabullum
  37. 37. T - plate Oblique T plate Indications >intercondylar fracture of humerus >Condylar fracture of tibia
  38. 38. Y - plate Indication >intercondylar fracture of humerus
  39. 39. They are threaded whole length Available in different size Functions as lag screw, positional screw Cortical screws Indications >fracture of surgical neck of humerus >fracture shaft humerus
  40. 40. Thinner core diameter Wider & deeper threads for better grip in “spongy bone” Fully/Partially threaded Indications >Fracture of surgical neck of humerus Cancellous screws
  41. 41. head tip Modified hollow screws Indications >fracture neck femur >Intercondylar fracture of femur >Intercondylar fracture of tibia
  42. 42. Sharp pointed tip Can be inserted without drilling Indications >bimalleolar fracture >medial/lateral malleolar fracture Pointed tip
  43. 43. Prevents another surgery for removal of implants Slowly disintegrates & gets absorbed during fracture union
  44. 44. Internal fixation of tibial fracture using DCP & cortical screws
  45. 45. Standard IM nail Interlocking nail Flexible medullary nail
  46. 46. Kuntscher nail Indications Fracture shaft humerus fracture shaft femur fracture tibia Clover leaf pattern Eye (to postero medial side) Slot
  47. 47. V nail V shaped on cross section Indications >fracture shaft humerus >fracture shaft femur >fracture shaft tibia
  48. 48. Square nail Square shaped on cross section Indications >fracture of both ulna & radius
  49. 49. Rush nail Indication >fracture of ulna & radius
  50. 50.  Can be used in simple & compound fracture  Can be used in segmental, comminuted, bone loss etc  For treatment of nonunion  For reconstruction following tumour excision  Low blood loss, low risk of infection  Short operative period Dynamic- locked at one end Static- locked at both ends
  51. 51. Humeral interlocking nailUsed in fracture shaft humerus Can be used along with DCP/cortical screws
  52. 52. Fracture shaft humerus Internal fixation done by intramedullary nail
  53. 53. Femoral interlocking nail Indications > subtrochanteric fracture >fracture shaft humerus
  54. 54. Tibial interlocking nail Used in fracture shaft tibia
  55. 55. Femoral recon nail
  56. 56. Used specially for tbiocalcaneal fractures
  57. 57. Enders nail Rush nail Flexible medullary nail (condylo cephalic nail) Passed from distal to proximal Fracture fixation is achieved by three point pressure system
  58. 58. K wire Threaded tip Trocar tip
  59. 59. Centrally threaded K wire threads Indications for K wire >fracture clavicle >fracture surgical neck of humerus >Montaggia fracture >olecranon fracture >Colles fracture >metacarpal & phallengeal fracture >fracture patella >metatarsal fracture
  60. 60. Reduction achieved through the K wire
  61. 61. SS wire (stainless steel) Indications >olecranon fracture >fracture patella >any comminuted fracture
  62. 62. Drummers wire Circlage wire
  63. 63. Hip implants Austin Moore pins Knowles pin Used for fracture neck femur Can be used for fracture clavicle
  64. 64. Dynamic hip screw Has lag screw & barrel Indications >fracture neck femur >trochanteric fracture of femur >subtrochanteric fracture
  65. 65. Austin Moore prosthesis (Unipolar) In elderly patients with fracture neck femur, for replacing head of femur Can be removed once the bone grows Fenestrations are present on the stem through which the bone supposedly grows & helps in fixation of the prosthesis Movement takes place between head part of prosthesis & acetabulum Bone graft placement
  66. 66. Bipolar Prosthesis  Indicated when neck of the femur is absorbed, like in old fracture of the femoral neck.  It Is bipolar ,that is movement at >acetabulum & acetabular component of prosthesis, >acetabular component & head component.
  67. 67. HRA done with Bipolar Prosthesis
  68. 68. Charnley's prosthesis Into the medullary cavity neck Head of femur Acetabulum cup Total hip replacement Indicated in fracture neck femur
  69. 69. Smith Peterson nailCannulated triflanged nail Prevents axial rotation of the fragments Cuts only a little bone to give good stability Indications > fracture neck femur >Intertrochanteric fracture
  70. 70. Jewette nail plate Used introchateric fracture – elderly patients - osteoporotic bone
  71. 71. Condylar plate Indications >supracondylar fracture of humerus >supracondylar fracture of femur >intercondylar fracture of femur
  72. 72. Dynamic condylar plate Richards screw Indication- supracondylar fracture femur
  73. 73. L plate Indications >subtrochanteric fracture >inter trochanteric fracture
  74. 74. Staples Conventional type U type  To arrest the growth of the epiphysis  Fixation of valgus deformity  For arthrodesis of small joints
  75. 75. It is the method of fixing the fracture with the cluster of pins connected with bars Provides stable fixation Force can be applied along any axis Helps in wound care & reconstructive surgery
  76. 76. Pin (shanz) Clamp Rod (Tubular)
  77. 77. External fixators for forearm Used for comminuted fracture of distal end of radius
  78. 78. Mini external fixator Used for fracture of metacarpal & phalanges (with K wire)
  79. 79. Triangular external fixator Tubular rods Shanz pin Pin clamps Intertubular clamps
  80. 80. External fixator with bilateral frame
  81. 81. Adjustable external fixator
  82. 82. Pin less external fixator
  83. 83. Ilizarov’s fixation system It Is ring fixator Indicated in limb lengthening, nonunion, deformity correction, osteomyelitis, Provides distraction force which will help in growth of bone