instruments orthopaedics for mbbs students
TRANSCRIPT
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TONY KRISHNAKUMAR 2010 MBBS
Instruments ortho
TONY KRISHNAKUMAR 2010 MBBS
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TONY KRISHNAKUMAR 2010 MBBS
Pins and nails
TONY KRISHNAKUMAR 2010 MBBS
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TONY KRISHNAKUMAR 2010 MBBS
Circular in cross section
TONY KRISHNAKUMAR 2010 MBBS
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TONY KRISHNAKUMAR 2010 MBBS
Steinmann pin no threads
• Skeletal traction
• Compression arthrodesis
TONY KRISHNAKUMAR 2010 MBBS
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TONY KRISHNAKUMAR 2010 MBBS
Denham pin middle thread
• Skeletal traction in osteoporotic bone to prevent slipping
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TONY KRISHNAKUMAR 2010 MBBS
Schantz pin thread at ends
• External fixator
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Harrington rod
Blunt with threads at one end but each is far apart• Spine #• Scoliosis•
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Rush nail
For easy insertion
Hook for extraction
Indication• # humerus fibula Disadvantage• Chance of rotation due to circular cross section
TONY KRISHNAKUMAR 2010 MBBS
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Square cross section Intramedullary nail for forearm bones
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Ulnar square intramedullary nail
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Radius square nail
TONY KRISHNAKUMAR 2010 MBBS
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RADIUS square nail
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Kuntscher cloverleaf intramedullary nail /k nail****
Clover leaf shaped to prevent rotation
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TONY KRISHNAKUMAR 2010 MBBS
Kuntscher cloverleaf intramedullary nail /k nail• Indication
• # shaft of femur,humerus tibia
• Ideally • In a young patient with
• # at junction of upper & middle 1/3rd(narrowest portion)
• no comminution
• Transverse /short oblique #
TONY KRISHNAKUMAR 2010 MBBS
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Longitudinal slit occupies anterolateral part of femur
2 eyes for removal on posteromedial part of femur
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TONY KRISHNAKUMAR 2010 MBBS
K nail can be introduced by
• Open (retrograde) method• Open # site with a gluteal incision
• 100% redn but no hematoma formation
• Closed (anterograde )method• # site is not opened only gluteal incision
• Hematoma formn + bur not perfect reduction
TONY KRISHNAKUMAR 2010 MBBS
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Interlocking intramedullary nail
Comminuted # humerus tibia TONY KRISHNAKUMAR 2010 MBBS
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V nail
• Used for # tibia
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TONY KRISHNAKUMAR 2010 MBBS
TONY KRISHNAKUMAR 2010 MBBS
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Moores pin
# neck of femur in children other screws mays sisruptionof growth plate
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Screws
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• Cortical screws• More threads• Pitch and lead is less
• Cancellous • Less number of threads• Pitch and lead is more
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SCREWS
CORTICAL
• Fully threaded
• Used for diaphyseal #
• 3.5 mm• Radius ulna fibula
• 4.5mm• Humerus tibia femur
CANCELLOUS
• Partially threaded
• Used for metaphyseal & diaphyseal #
• 4mm• Medial & lateral malleoli
• 6.5mm • Condyles (tibial femoral )
• # neck of femur
TONY KRISHNAKUMAR 2010 MBBS
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Prosthesis
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Austin moore prosthesis ****
Eye for removal
Fenestration s • For detecting direction in x ray • For bone graft TONY KRISHNAKUMAR 2010 MBBS
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• Indication • Intracapsular # neck of femur( transcervical & subcapital #)
• With little bit of intact neck
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Austin moore prosthesis Thompsons
Basal # neck of femur with no neck
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TONY KRISHNAKUMAR 2010 MBBS
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Bipolar prosthesis (2 heads )
Used in young individuals to reduce wear & tearTONY KRISHNAKUMAR 2010 MBBS
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Bipolar prosthesis (2 heads )
Indication same as AM prosthesis
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• Complications• Sciatic n injury
• Loosening
• Infection
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Chisel & osteotome
Chisel
• one edge beveled
• used to chip the bone.
Osteotome
• both the edges beveled.
• used to cut /divide the bone.
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Chisel Osteotome
TONY KRISHNAKUMAR 2010 MBBS
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Chisel & osteotome
TONY KRISHNAKUMAR 2010 MBBS
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Periosteal elevator
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TONY KRISHNAKUMAR 2010 MBBS
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Bohler stirrup***
• Used for skeletal traction
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Thomas splint
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THOMAS KNEE-BED SPLINT
• Thomas splint.
• Devised by Hugh. Owen Thomas.
• Initially used for immobilisation for tuberculosis of the knee.
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PARTS OF THOMAS SPLINT
• Consist of:
Ring
Medial bar
Lateral bar
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USE
• Immobilisation of lower limb
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BOHLER BRAUN SPLINT
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• Bohler’s modification of braun splint.
• Consisted of only 1 pulley.
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• Pulley a-calcaneal/distal tibeal traction.
• Pulley b-distal femoral/proximal tibial traction
• Pulley c-change angle of traction
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ADVANTAGES
• Angle of traction can be changed without changing traction arrangements.
• Simultaneous tractions possible.
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DISADVANTAGE
• Not suitable for transportation.
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External fixator clamp
rod
Steinmann pin
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K wire / kirschner wire
Small fragment fixation Metacarpal # fixationJESSCTEV
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Stapler
To Arrest growth of epiphysis on one side • Correct genu valgum /varumArthrodesisIn OA (closed wedge osteotomy)
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Bone nibbler
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Joshi’s external stabilization system (JESS) retractor
Slot for k wire Screw for adjusting distance
Comminuted distal radius # CTEV distal tibial# TONY KRISHNAKUMAR 2010 MBBS
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Charnleys compression device
One slot for Steinmann pin
Arthrodesis by compression
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Smith Petersen nail for trochanteric #
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Jewett nail plate for trochanteric #
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Mclaughlin plate
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Dynamic hip screw
Angle of 135*
For trochanteric #
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Dynamic compression plate ***
Oval shaped
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Dynamic condylar plate
Angle of 95*
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Sherman plate
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one third tubular plate
• Thin
• Mouldable
• distal ulna lower tibia
•
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Thanks to
• Our teachers
• Rahul Das
• Vignesh A
• Jogin George
• Jomin George
TONY KRISHNAKUMAR 2010 MBBS