Orthopedic surgery INSTRUMENTS (short overview).pptx

surgical instruments , orthopedic surgery instruments

1. Screws Cortical Screws Cancellous Screws

2. 1)- Cortical Screws 4.5 mm Cortical Screw Used with plates in Fr shaft femur, tibia,… 3.5 mm Cortical Screw Used with plates in Fr shaft Radius, Ulna,… Smaller diameter Smaller length of serration

3. 2)- Cancellous Screws 6.5 mm Cancellous Screws Fully Threaded Cancellous Screws Partially Threaded Cancellous Screws 4 mm Cancellous Screws Fr Med malleolus, Distal Humerus Larger diameter Larger length of serration

4. Plates Straight Plates Angled Plates Special Plates

5. Straight Plates 1)- Broad DCP Fr shaft femur – tibia – humerus Fixation : cortical 4.5 mm or Cancellous 6.5 mm Drill bit 3.2 mm Drill tap 4.5 & 6.5

6. Straight Plates 2)- Narrow DCP Fr shaft Tibia, Humerus Fixation : cortical 4.5 mm or Cancellous 6.5 mm Drill bit 3.2 mm Drill tap 4.5 & 6.5

7. Straight Plates 3)- Small DCP Fr shaft Radius & Ulna, SC fr humerus in adults , Fr . Fibula, Pelvis Fixation cortical 3.5 mm & cancellous 4 mm Drill bit 2.5 Drill tap 3.5 &4 mm

8. 4)- ⅓ Tubular plate Fr fibula, SC fr Humerus in adults, fr ulna Fixation: cortical 3.5 mm Straight Plates

9. 2)- Angled Plates 1 -Dynamic Hip Screw “DHS” 135 ° DHS Lag screw DHS Plate Fixation … like broad Trochanteric fr femur Basal neck ??? Why not used in #NOF ? Why called dynamic ?

10. 2)- Angled Plates 2-Condylar Blade plate 95 ° Fixed angle Fixation … like broad e.g. Subtrochanteric Fr Supracondylar Fr

11. 2)- Angled Plates 3-Reposioning Osteotomy plate 120 ° e.g. Subtrochanteric valgus osteotomy in non-united fr neck of femur

12. 4- DCS (Dynamic Condylar Plate) 95 ° Lag screw e.g. Subtrochanteric Fr Supracondylar Fr 2)- Angled Plates

13. 3)- Special Plates T- plate Medial tibial plateau, proximal humerus, pilon fr L- plate Lateral tibial plateau Fixation … like broad

14. 3)- Special Plates Small T Distal Radius with IA extension

15. Reconstruction plate - allow axial & transverse bending - 4.5 & 3.5 - Used in fr. Acetabulum

16. Compression technique Dynamic compression plate Lag principle Fully threaded (lag by technique/ Overdrilling ) Partially threaded (lag by design)

17. Intramedullary Nails

18. Intramedullary Nails Non-Locking Intramedullary Nail ( K üntscher Nail) tibial –femoral 2- Interlocking Intramedullary Nail

19. Intramedullary Nails Interlocking Femoral Intramedullary Nail Antegrade = piriformis/Trochanteric Retrograde condylar fossa

20. Intramedullary Nails Interlocking Tibial Intramedullary Nail

21. Endoprosthesis HIP 1- Hemiarthroplasty Monopolar (AM &Thompson) Bipolar 2-Total hip arthroplasty

22. Endoprosthesis Austin-Moore Prosthesis Thompson Prosthesis Both used in Fr Neck of Femur In elderly patients Thompson --- deficient calcar – osteoporosis – pthological fr

23. External Fixator Unilateral Ext Fix Ring Ext Fix

24. Unilateral External Fixator Schanz Screw Clamp rod

25. Unilateral External Fixator

26. Ring External Fixator ( Ilizarov ) Rings Wires Nuts Rods Schanz screw ADVANTAGES 1- Correct deformities in all planes 2- More compression on fr site = rapid healing 3- More rigid

27. Indications of External Fixation Open G II, III Fr. With burn Infection Bone lengthening ?? Arthrodesis Ligamentotaxis ?? C- clamp in fr pelvis Deformity correction ??

28. Tension band wiring Kirschner wire (K-wire) Guide wire Cerclage wire Indications Fr Olecranon Fr Patella Fr Med malleolus Gr trochanter Gr tuberosity Steinman pin Skeletal traction

29. Osteotome Beveled from both sides Used to cut bone = osteotomy Uses: Osteotomy to correct deformities In bone lengthening and shortening Cutting bone in ttt of malunited fr

30. Chisel Beveled on one side only ..... So remove one cortex only Uses: Removal of exostosis or osteophyte unicortical bone graft Guttering in ttt of chronic OM

31. Gouge Uses - pure cancellous bone graft - Deroofing in ch. OM

32. Bone curette Has a cupped end Used for bone curettage Uses: -bone biopsy -Bone graft -Refreshment of ends in old fr - Sequestrectomy

33. Bone nibbler Double joint bone cutting forceps Uses Bone graft Bone biopsy Soft tissue debridement

34. Spine