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