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Retractors
Used to retract soft tissue while operating on particular site
Bone lever
Used to lever out the bone from depth
Bone awl
Used to enter medullary cavity
Bone hook
Bone is pulled up from fracture site by introducing hook into the medullary cavity
hook
Periostium elevator
Bone holding forceps
Self retaining( Heygroves
Non self retaining ( Lion )
Bone nibbler
Used for nibbling the bone
Bone cutter
Used for cutting bone
Mallet
Used to hammer chisel , osteotome etc.
Bone chisel
Only one side is bevelled
Used to remove a protruding boneLevelling the bone
OsteotomeUsed for osteotomy-cutting the boneBoth edges will be bevelled
curved
straight
Bone gougeIt is a concave bladed chisel
Used for cutting round bones
To make a hole in the bone
Bone curette
Reduction clamps
Plate holding forceps
AO type
Low mans type plate holding forceps
Used for holding plates in femoral fractures
Patellar clamps
Used to hold patella after reducing the fracture while putting circlage wire in the shape of 8
chuck
Introduced at this point to adjust the drill bit
Drill bit will be fitted here
Universal drill (Manual drill)
Drill bit
Drill bit is inserted at this point of universal drill
Drill guide
Used to mark drill point at which screw has to be placed while fixing with DCP
T handle
Used to hold shanz pin while introducing into bone Pin is
introduced at this point
2 3 4 5 6 7 8 9 10
Depth gauge
It is used to measure the length of medullary cavity
Markings for measurements
Screw driver
Different type of tips are available – hexagonal, square etc.
Cutting player (wire cutter)
Used to cut wire in approximate size
Spanner
Used to tighten the nuts in external fixators
Amputation saw
Blade can be changed
Bone file
Used to blunt the sharp edges of bone after amputation
It is defined as a material It is defined as a material inserted or grafted into inserted or grafted into intact tissues or body intact tissues or body cavity with some specific cavity with some specific purposepurpose
Implant
MetallicMetallicIronCobaltTitanium
Nonmetallic
Types
PlatesPlatesScrewsScrews
Extra medullary fixation
Thick plateWith round holesUsed in combination with screws in Diaphysial fractures
AO plates
The holes are designed to utilise spherical gliding principleLess surgical exposureCan fit in any positionScrew can be inserted at any angle Indications >fracture shaft humerus >Monteggia fracture >fracture of both radius & ulna >fracture shaft femur
Dynamic Compression plate
Least contact dynamic compression plate(LCDCP)
Used In osteoporotic boneIndications >fracture of both radius & ulna >Montegia fracture
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
Cobra plateT plate
Reconstruction plate
Thickness is between DCP & buttress plateScallop like notches presents between holesCan be contoured in 3 planes Indications >Fracture clavicle >Supracondylar fracture >intercondylar fracture >Fracture acetabullum
T - plate Oblique T plate
Indications >intercondylar fracture of humerus>Condylar fracture of tibia
Y - plate
Indication >intercondylar fracture of humerus
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
Thinner core diameter
Wider & deeper threads for better grip in
“spongy bone”
Fully/Partially threaded
Indications >Fracture of surgical neck of humerus
Cancellous screws
head
tip
Modified hollow screws
Indications
>fracture neck femur
>Intercondylar fracture of femur
>Intercondylar fracture of tibia
Sharp pointed tip
Can be inserted without drilling
Indications
>bimalleolar fracture
>medial/lateral malleolar fracture
Pointed tip
Prevents another surgery for removal of implantsSlowly disintegrates & gets absorbed during fracture union
Internal fixation of tibial fracture using DCP & cortical screws
Standard IM nail
Interlocking nail
Flexible medullary nail
Kuntscher nail
IndicationsFracture shaft humerus fracture shaft femurfracture tibia
Clover leaf pattern
Eye (to postero medial side)
Slot
V nail
V shaped on cross section
Indications >fracture shaft humerus >fracture shaft femur >fracture shaft tibia
Square nail
Square shaped on cross section
Indications >fracture of both ulna & radius
Rush nail
Indication >fracture of ulna & radius
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
Humeral interlocking nail
Used in fracture shaft humerus Can be used along with DCP/cortical screws
Fracture shaft humerus Internal fixation done by
intramedullary nail
Femoral interlocking nail
Indications > subtrochanteric fracture >fracture shaft humerus
Tibial interlocking nail
Used in fracture shaft tibia
Femoral recon nail
Used specially for tbiocalcaneal fractures
Enders nail
Rush nail
Flexible medullary nail (condylo cephalic nail)
Passed from distal to proximalFracture fixation is achieved by three point pressure system
K wire
Threaded tipTrocar tip
Centrally threaded K wire
threadsIndications for K wire >fracture clavicle >fracture surgical neck of humerus >Montaggia fracture >olecranon fracture >Colles fracture >metacarpal & phallengeal fracture >fracture patella >metatarsal fracture
Reduction achieved through the K wire
SS wire (stainless steel)
Indications >olecranon fracture >fracture patella >any comminuted fracture
Drummers wire
Circlage wire
Hip implants
Austin Moore pins
Knowles pin
Used for fracture neck femurCan be used for fracture clavicle
Dynamic hip screw
Has lag screw & barrelIndications >fracture neck femur >trochanteric fracture of femur >subtrochanteric fracture
Austin Moore prosthesis (Unipolar)
In elderly patients with fracture neck femur, for replacing head of femurCan be removed once the bone growsFenestrations 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
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.
HRA done with Bipolar Prosthesis
Charnley's prosthesis
Into the medullary cavity
neck
Head of femur
Acetabulum cup
Total hip replacement Indicated in fracture neck femur
Smith Peterson nailCannulated triflanged nailPrevents axial rotation of the fragmentsCuts only a little bone to give good stabilityIndications > fracture neck femur >Intertrochanteric fracture
Jewette nail plate
Used introchateric fracture – elderly patients - osteoporotic bone
Condylar plateIndications >supracondylar fracture of humerus >supracondylar fracture of femur >intercondylar fracture of femur
Dynamic condylar plate
Richards screw
Indication- supracondylar fracture femur
L plate
Indications >subtrochanteric fracture >inter trochanteric fracture
StaplesConventional type
U type
To arrest the growth of the epiphysis Fixation of valgus deformity For arthrodesis of small joints
It is the method of fixing the fracture with the cluster of pins connected with bars
Provides stable fixationForce can be applied along any axis
Helps in wound care & reconstructive surgery
Pin (shanz)
Clamp
Rod (Tubular)
External fixators for forearm
Used for comminuted fracture of distal end of radius
Mini external fixator
Used for fracture of metacarpal & phalanges (with K wire)
Triangular external fixator
Tubular rods
Shanz pin
Pin clamps
Intertubular clamps
External fixator with bilateral frame
Adjustable external fixator
Pin less external fixator
Ilizarov’s fixation system
It Is ring fixatorIndicated in limb lengthening, nonunion, deformity correction, osteomyelitis, Provides distraction force which will help in growth of bone