Ex fix
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An external fixator is a device used to stabilize broken bones by holding bone fragments rigidly in place with metal pins placed into the bone and connected to an external frame. It is indicated for fractures with significant bone or soft tissue damage. The fixator provides stability against bending, torsion, and axial loads. Application involves planning pin placement, reducing the fracture, drilling pins into the bone, connecting the pins to a frame to align bone fragments, and regularly monitoring the patient's recovery. Complications can include infection, joint stiffness, or damage to surrounding tissues from pin placement.
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External fixator
External fixators are used to immobilize fractures by inserting pins through the skin and bone that are connected by a rigid scaffolding outside the limb. There are two main types - pin fixators and ring fixators. Pin fixators are applied quickly but have limitations in controlling deformities, while ring fixators can achieve complex reconstruction but are heavier. Professor Gavril Ilizarov developed ring fixators in the 1950s which use tensioned wires between rings to stabilize fractures. Ring fixators can be used to treat limb lengthening, deformity correction, non-unions, joint contractures and more complex fractures. They work by gradually distracting the bone between rings.
principles of External fixation
explaining the principles and techniques of external fixation - done during basic ortho skills course
Tips, tricks and pitfalls of proximal femoral nailing (PFN)
1. Proximal femoral nailing (PFN) requires thorough pre-operative planning including imaging and assessment of fracture pattern and patient comorbidities.
2. It is important to reduce the fracture before making the entry point, as the entry point will determine surgical success.
3. Factors such as varus reduction, medializing the shaft, high tip-apex distance, and penetration of the femoral head can lead to poor outcomes like nonunion.
Seminar k nail
Gerhard Küntscher developed intramedullary nailing during World War 2 to treat soldiers' fractures. He found that nails with elastic cross-sections like V-shapes or cloverleaves could better stabilize fractures by compressing to fill the medullary canal. Over decades, he refined nail designs and the nailing technique. Key principles were achieving stable fixation through flexible impingement in the bone and allowing weight bearing to promote healing. Factors like fracture pattern and bone anatomy determine suitability for nailing in the femur and tibia.
Humeral shaft
Humeral shaft fractures can often be treated nonoperatively with a brace, though operative options include plating, flexible nailing, or locked intramedullary nailing. Plates and nails have similar union rates but nails have more complications so plates are generally preferable. Flexible nails are also an effective option. Radial nerve palsy is a risk, especially with distal fractures, and may require exploration. Most humeral shaft fractures heal well with either operative or nonoperative treatment depending on the specific situation and patient factors.
Plating principles in Orthopaedics
conventional plates including different functions of screws, modes of plate application, Compression Mode.
Neutralization Mode.
Buttress plate.
Antiglide plate.
Bridge plating or span plating.
Tension band.
prebending precountouring
working length
lag screw
AO principles
biological fixation
MIPO
external fixation re
External fixation is a stabilization device placed outside the skin using pins or wires connected to bars. It has several advantages over internal fixation, including less soft tissue damage, adjustable rigidity, and lower risk of infection. However, it also has disadvantages like restricted motion and pin site complications. Proper pin placement and construct design are important to provide adequate stability while avoiding stress risers. Ring and hybrid fixators allow weight bearing and motion but pin fixators come in various configurations of increasing stiffness.
CORA (center of rotation of angulation)
This document discusses the concept of the center of rotation of angulation (CORA) in orthopedic surgery. The CORA is the point about which a deformed bone may be rotated to achieve correction of an angular deformity without introducing a translational deformity. Proper identification of the CORA allows selection of the optimal correction axis and type of osteotomy, such as opening, closing, or dome osteotomy, to realign the bone. Correction along the bisector line passing through the CORA ensures pure angular correction without residual translation. Identification of multiple CORAs indicates more complex multi-apical or translational deformities requiring different surgical techniques.
Recommended
External fixator
External fixators are used to immobilize fractures by inserting pins through the skin and bone that are connected by a rigid scaffolding outside the limb. There are two main types - pin fixators and ring fixators. Pin fixators are applied quickly but have limitations in controlling deformities, while ring fixators can achieve complex reconstruction but are heavier. Professor Gavril Ilizarov developed ring fixators in the 1950s which use tensioned wires between rings to stabilize fractures. Ring fixators can be used to treat limb lengthening, deformity correction, non-unions, joint contractures and more complex fractures. They work by gradually distracting the bone between rings.
principles of External fixation
explaining the principles and techniques of external fixation - done during basic ortho skills course
Tips, tricks and pitfalls of proximal femoral nailing (PFN)
1. Proximal femoral nailing (PFN) requires thorough pre-operative planning including imaging and assessment of fracture pattern and patient comorbidities.
2. It is important to reduce the fracture before making the entry point, as the entry point will determine surgical success.
3. Factors such as varus reduction, medializing the shaft, high tip-apex distance, and penetration of the femoral head can lead to poor outcomes like nonunion.
Seminar k nail
Gerhard Küntscher developed intramedullary nailing during World War 2 to treat soldiers' fractures. He found that nails with elastic cross-sections like V-shapes or cloverleaves could better stabilize fractures by compressing to fill the medullary canal. Over decades, he refined nail designs and the nailing technique. Key principles were achieving stable fixation through flexible impingement in the bone and allowing weight bearing to promote healing. Factors like fracture pattern and bone anatomy determine suitability for nailing in the femur and tibia.
Humeral shaft
Humeral shaft fractures can often be treated nonoperatively with a brace, though operative options include plating, flexible nailing, or locked intramedullary nailing. Plates and nails have similar union rates but nails have more complications so plates are generally preferable. Flexible nails are also an effective option. Radial nerve palsy is a risk, especially with distal fractures, and may require exploration. Most humeral shaft fractures heal well with either operative or nonoperative treatment depending on the specific situation and patient factors.
Plating principles in Orthopaedics
conventional plates including different functions of screws, modes of plate application, Compression Mode.
Neutralization Mode.
Buttress plate.
Antiglide plate.
Bridge plating or span plating.
Tension band.
prebending precountouring
working length
lag screw
AO principles
biological fixation
MIPO
external fixation re
External fixation is a stabilization device placed outside the skin using pins or wires connected to bars. It has several advantages over internal fixation, including less soft tissue damage, adjustable rigidity, and lower risk of infection. However, it also has disadvantages like restricted motion and pin site complications. Proper pin placement and construct design are important to provide adequate stability while avoiding stress risers. Ring and hybrid fixators allow weight bearing and motion but pin fixators come in various configurations of increasing stiffness.
CORA (center of rotation of angulation)
This document discusses the concept of the center of rotation of angulation (CORA) in orthopedic surgery. The CORA is the point about which a deformed bone may be rotated to achieve correction of an angular deformity without introducing a translational deformity. Proper identification of the CORA allows selection of the optimal correction axis and type of osteotomy, such as opening, closing, or dome osteotomy, to realign the bone. Correction along the bisector line passing through the CORA ensures pure angular correction without residual translation. Identification of multiple CORAs indicates more complex multi-apical or translational deformities requiring different surgical techniques.
intramedullary nailing
This document provides an overview of intramedullary nailing principles. It discusses the history and evolution of intramedullary nails from wooden sticks and ivory pegs used in the 16th century to modern nails like the Russell-Taylor nail. It covers nail types, biomechanics, insertion techniques, and key design considerations like diameter, cross-section shape, curves, and locking mechanisms. The goal of intramedullary nailing is to provide stable internal splinting of long bone fractures through closed fixation techniques.
Intertrochanteric fractures and its management with DHS or PFN or Arthroplast...
Intertrochanteric fractures and its management with DHS or PFN or Arthroplast...ASRAM Medical College, Eluru, Andhra Pradesh
This document discusses intertrochanteric fractures, including definition, epidemiology, classification systems, treatment options, and complications. It provides an overview of fracture anatomy, mechanisms of injury, evaluation with x-rays, and classifications including Boyd & Griffin, Evans, and AO. Treatment options discussed include non-operative management, internal fixation with devices like the dynamic hip screw and intramedullary nails, and prosthetic replacement. Post-operative rehabilitation and complications of treatment are also summarized.TENS
The document discusses the history and development of elastic stable intramedullary nailing (ESIN) for fractures in children. It describes early techniques using rigid pins and wires, and the development of the modern ESIN method in the 1980s using pre-bent titanium nails inserted from opposite sides of the bone for axial, lateral, and rotational stability. Key aspects of ESIN technique are outlined, including nail sizing, insertion points, pre-bending, and final positioning to stabilize fractures while minimizing soft tissue injury and allowing callus formation. Risks and special considerations for different bone fractures are also mentioned.
Poller screw
Poller screws, also known as blocking screws, are non-interlocking screws placed outside an intramedullary nail to improve fracture reduction and fixation. They provide a more rigid construct by serving as a surrogate cortex where nail-cortex contact is insufficient. Their placement helps centralize the guidewire in the medullary canal and maintains reduction through a blocking effect. While there is no consensus on their exact placement, they are generally inserted on the concave side of expected deformities to prevent malalignment during nailing.
Poller or blocking screw
Poller or blocking screws are used to stabilize fractures treated with small diameter intramedullary nails. They guide the nail like "poller" traffic devices guide vehicles. Blocking screws increase stability of distal and proximal metaphyseal fractures after nailing and can help manage malunited fractures. They work by narrowing the canal to guide the nail anteriorly and prevent sagittal plane deformity. Blocking screws are typically placed medially and laterally as close to the fracture as possible for optimal stabilization. Their placement on the concave side of deformities helps improve reduction by deflecting the nail.
Distal humerus fracture
This document provides information on distal humerus fractures, including:
- Anatomy of the distal humerus and surrounding structures
- Common causes and presentations of distal humerus fractures
- Classification systems including the OTA system
- Imaging techniques including x-rays and CT scans
- Surgical and non-surgical treatment options depending on the fracture type
- Details of posterior, anterior, medial and lateral surgical approaches for fixing distal humerus fractures
Principles Of Lag Screw + Platting
1) There are two types of bone healing - primary and secondary. Primary healing requires rigid fixation while secondary involves callus formation.
2) Different fixation methods, such as plates, screws, casts, result in different types of bone healing. Plates and screws typically lead to primary healing while casts usually involve callus formation.
3) Lag screws and plating techniques are methods to achieve compression across fractures, which is important for primary bone healing. A lag screw compresses by engaging only the far cortex while dynamic compression plates apply compression through eccentric screw placement.
Principles of external fixation
Slide 35
References
Tornetta P. Rockwood and Green's fractures in adults. Philadelphia: Wolters Kluwer; 2020.
Buckley R, Moran C, Apivatthakakul T. AO principles of fracture management. Davos Platz, Switzerland: AO Foundation; 2017.
Fractures of the olecranon
This document discusses fractures of the olecranon bone. It begins with the epidemiology, noting these fractures have a bimodal distribution in younger individuals due to high-energy trauma and older individuals due to simple falls. The anatomy section outlines the subcutaneous position of the olecranon making it vulnerable to trauma, as well as its articulation with the elbow joint. Clinical presentation, evaluation, classification systems, treatment objectives, nonoperative and operative treatment options including various surgical techniques are then covered in detail.
Calcaneal fractures
Calcaneal fractures typically result from high-energy injuries and can lead to long-term morbidity if not treated properly. While non-operative treatment is indicated for non-displaced fractures, open reduction internal fixation (ORIF) may be required for displaced or intra-articular fractures to restore anatomy and function. Careful surgical technique and postoperative management are needed to avoid complications and achieve good outcomes with ORIF. Treatment must be individualized based on fracture pattern and soft tissue status.
Tens
The document discusses the titanium elastic nailing system (TENS) used to treat fractures in children. TENS involves the use of flexible titanium nails inserted into the medullary canal. It is primarily used for diaphyseal and metaphyseal fractures in children ages 3-15. The appropriate use of TENS depends on considering the child's age as well as the type and location of the fracture. TENS provides stability while allowing bending and early ambulation.
Physeal injuries
Bone growth occurs through two mechanisms: endochondral ossification and intramembranous ossification. Physeal injuries represent 15-30% of fractures in children and commonly involve the phalanges, wrist, and distal tibia. Physeal fractures are classified using the Salter-Harris system from Type I to V based on the location of the fracture line and potential for growth disturbance. Types I-III involve the physis while Types IV-V cross into the epiphysis, increasing the risk of growth arrest or deformity. Proper classification guides treatment to restore anatomy and minimize long term sequelae.
Basics of knee arthroscopy for the beginners
arthroscopy of the knee joint is a relatively common orthopedic procedure to treat a host of sports injuries and other knee diseases. Commonly a 4 mm size scope is used via two standard arthroscopy portals. Arthroscopic examination of the knee confirms MRI findings. Synovial fluid and biopsy can be taken to confirm diagnosis.
Principles of external fixation
External fixation is a method of immobilizing fractures using pins through the skin and bone. It allows realignment, distraction, or compression of fracture elements. External fixation facilitates early mobility and decreased hospitalization times. Common indications include open fractures, limb lengthening, and arthrodesis. External fixators can be unilateral or bilateral, and uniplanar or biplanar. Proper pin placement, diameter, preloading, and frame construction are important for mechanical stability. Fracture healing occurs through indirect bone formation when treated with external fixation. Dynamization applies micromovement at the fracture site to stimulate healing.
Blood supply & fractures of scaphoid
The document discusses the blood supply and anatomy of the scaphoid bone in the wrist. It notes that the scaphoid receives most of its blood supply from the dorsal branches of the radial artery, putting it at high risk for osteonecrosis if fractured. It describes different classification systems for scaphoid fractures and presents options for management, including cast immobilization, percutaneous fixation, open surgery and arthroscopy. Complications of fractures like nonunion are also outlined.
Dynamic hip screw
This document discusses the dynamic hip screw (DHS), used to treat intertrochanteric hip fractures. The DHS provides controlled collapse and dynamic action to reduce complications like screw cut-out. Key steps of the procedure include closed reduction of the fracture, guide pin and plate insertion at 135 degrees, and measuring screw length. Factors like tip-apex distance and screw position are important to prevent complications. The DHS works by creating compression as the lag screw collapses into the barrel post-operatively.
Acetabular fractures
Acetabular fractures are typically caused by high-energy trauma and require careful evaluation using CT scans and plain radiographs to classify the fracture pattern according to the Letournel classification system, which describes fractures of the anterior and posterior columns. Operative treatment is indicated for displaced fractures while non-operative treatment with skeletal traction can be used for non-displaced or minimally displaced fractures.
Intramedullary nailing
This document discusses intramedullary nailing for fracture fixation. It begins with an introduction to intramedullary nailing, noting that it provides relative stability through internal splinting. It then covers the evolution of intramedullary nails from first to third generation designs, including different types based on entry point and direction. The document discusses applications and contraindications of intramedullary nailing. It explores the biomechanics and mechanics that provide stability. Finally, it outlines the ideal properties of an intramedullary nail and nail system.
ILIZAROV EXTERNAL FIXATOR
general discussion about Ilizarov external fixator with its history, principles, indication, application, advantage and disadvantage
Safe surgical dislocation for femoral head fractures.dr mohamed ashraf,dr rah...
This study evaluates the outcomes of 18 patients who underwent surgical dislocation of the hip using Ganz's technique to treat Pipkin fractures of the femoral head. Pipkin fractures are rare fractures that occur when the femoral head fractures as a result of a posterior hip dislocation. Traditional approaches provide limited exposure, while Ganz's technique allows 360 degree visualization through an anterior dislocation of the femoral head. The study found statistically significant improvements in functional scores at 1 year follow up, with no cases of avascular necrosis, demonstrating that Ganz's technique is an effective and safe method for treating these complex fractures.
Periprosthetic fracture
1. Periprosthetic fractures are fractures that occur near a joint replacement prosthesis. They can occur in the femur, patella, or tibia.
2. Risk factors include increasing age, female sex, osteoporosis, revision arthroplasty, rheumatoid arthritis, steroid use, and neurological diseases.
3. Surgical treatment depends on the fracture classification and stability of the prosthesis. Options include open reduction internal fixation with a locking plate, intramedullary nailing, or revision arthroplasty.
Armamentarium in implantology
This document provides an overview of the armamentarium and tools used in dental implant procedures. It describes the basic equipment needed like personal protective barriers and surgical setup. It then details the various diagnostic, measurement, surgical and bone grafting instruments. Specific tools for sinus lift procedures and second stage surgery are also outlined. The document concludes by discussing prosthetic components, lasers used in implantology, and maintenance tools.
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intramedullary nailing
This document provides an overview of intramedullary nailing principles. It discusses the history and evolution of intramedullary nails from wooden sticks and ivory pegs used in the 16th century to modern nails like the Russell-Taylor nail. It covers nail types, biomechanics, insertion techniques, and key design considerations like diameter, cross-section shape, curves, and locking mechanisms. The goal of intramedullary nailing is to provide stable internal splinting of long bone fractures through closed fixation techniques.
Intertrochanteric fractures and its management with DHS or PFN or Arthroplast...
Intertrochanteric fractures and its management with DHS or PFN or Arthroplast...ASRAM Medical College, Eluru, Andhra Pradesh
This document discusses intertrochanteric fractures, including definition, epidemiology, classification systems, treatment options, and complications. It provides an overview of fracture anatomy, mechanisms of injury, evaluation with x-rays, and classifications including Boyd & Griffin, Evans, and AO. Treatment options discussed include non-operative management, internal fixation with devices like the dynamic hip screw and intramedullary nails, and prosthetic replacement. Post-operative rehabilitation and complications of treatment are also summarized.TENS
The document discusses the history and development of elastic stable intramedullary nailing (ESIN) for fractures in children. It describes early techniques using rigid pins and wires, and the development of the modern ESIN method in the 1980s using pre-bent titanium nails inserted from opposite sides of the bone for axial, lateral, and rotational stability. Key aspects of ESIN technique are outlined, including nail sizing, insertion points, pre-bending, and final positioning to stabilize fractures while minimizing soft tissue injury and allowing callus formation. Risks and special considerations for different bone fractures are also mentioned.
Poller screw
Poller screws, also known as blocking screws, are non-interlocking screws placed outside an intramedullary nail to improve fracture reduction and fixation. They provide a more rigid construct by serving as a surrogate cortex where nail-cortex contact is insufficient. Their placement helps centralize the guidewire in the medullary canal and maintains reduction through a blocking effect. While there is no consensus on their exact placement, they are generally inserted on the concave side of expected deformities to prevent malalignment during nailing.
Poller or blocking screw
Poller or blocking screws are used to stabilize fractures treated with small diameter intramedullary nails. They guide the nail like "poller" traffic devices guide vehicles. Blocking screws increase stability of distal and proximal metaphyseal fractures after nailing and can help manage malunited fractures. They work by narrowing the canal to guide the nail anteriorly and prevent sagittal plane deformity. Blocking screws are typically placed medially and laterally as close to the fracture as possible for optimal stabilization. Their placement on the concave side of deformities helps improve reduction by deflecting the nail.
Distal humerus fracture
This document provides information on distal humerus fractures, including:
- Anatomy of the distal humerus and surrounding structures
- Common causes and presentations of distal humerus fractures
- Classification systems including the OTA system
- Imaging techniques including x-rays and CT scans
- Surgical and non-surgical treatment options depending on the fracture type
- Details of posterior, anterior, medial and lateral surgical approaches for fixing distal humerus fractures
Principles Of Lag Screw + Platting
1) There are two types of bone healing - primary and secondary. Primary healing requires rigid fixation while secondary involves callus formation.
2) Different fixation methods, such as plates, screws, casts, result in different types of bone healing. Plates and screws typically lead to primary healing while casts usually involve callus formation.
3) Lag screws and plating techniques are methods to achieve compression across fractures, which is important for primary bone healing. A lag screw compresses by engaging only the far cortex while dynamic compression plates apply compression through eccentric screw placement.
Principles of external fixation
Slide 35
References
Tornetta P. Rockwood and Green's fractures in adults. Philadelphia: Wolters Kluwer; 2020.
Buckley R, Moran C, Apivatthakakul T. AO principles of fracture management. Davos Platz, Switzerland: AO Foundation; 2017.
Fractures of the olecranon
This document discusses fractures of the olecranon bone. It begins with the epidemiology, noting these fractures have a bimodal distribution in younger individuals due to high-energy trauma and older individuals due to simple falls. The anatomy section outlines the subcutaneous position of the olecranon making it vulnerable to trauma, as well as its articulation with the elbow joint. Clinical presentation, evaluation, classification systems, treatment objectives, nonoperative and operative treatment options including various surgical techniques are then covered in detail.
Calcaneal fractures
Calcaneal fractures typically result from high-energy injuries and can lead to long-term morbidity if not treated properly. While non-operative treatment is indicated for non-displaced fractures, open reduction internal fixation (ORIF) may be required for displaced or intra-articular fractures to restore anatomy and function. Careful surgical technique and postoperative management are needed to avoid complications and achieve good outcomes with ORIF. Treatment must be individualized based on fracture pattern and soft tissue status.
Tens
The document discusses the titanium elastic nailing system (TENS) used to treat fractures in children. TENS involves the use of flexible titanium nails inserted into the medullary canal. It is primarily used for diaphyseal and metaphyseal fractures in children ages 3-15. The appropriate use of TENS depends on considering the child's age as well as the type and location of the fracture. TENS provides stability while allowing bending and early ambulation.
Physeal injuries
Bone growth occurs through two mechanisms: endochondral ossification and intramembranous ossification. Physeal injuries represent 15-30% of fractures in children and commonly involve the phalanges, wrist, and distal tibia. Physeal fractures are classified using the Salter-Harris system from Type I to V based on the location of the fracture line and potential for growth disturbance. Types I-III involve the physis while Types IV-V cross into the epiphysis, increasing the risk of growth arrest or deformity. Proper classification guides treatment to restore anatomy and minimize long term sequelae.
Basics of knee arthroscopy for the beginners
arthroscopy of the knee joint is a relatively common orthopedic procedure to treat a host of sports injuries and other knee diseases. Commonly a 4 mm size scope is used via two standard arthroscopy portals. Arthroscopic examination of the knee confirms MRI findings. Synovial fluid and biopsy can be taken to confirm diagnosis.
Principles of external fixation
External fixation is a method of immobilizing fractures using pins through the skin and bone. It allows realignment, distraction, or compression of fracture elements. External fixation facilitates early mobility and decreased hospitalization times. Common indications include open fractures, limb lengthening, and arthrodesis. External fixators can be unilateral or bilateral, and uniplanar or biplanar. Proper pin placement, diameter, preloading, and frame construction are important for mechanical stability. Fracture healing occurs through indirect bone formation when treated with external fixation. Dynamization applies micromovement at the fracture site to stimulate healing.
Blood supply & fractures of scaphoid
The document discusses the blood supply and anatomy of the scaphoid bone in the wrist. It notes that the scaphoid receives most of its blood supply from the dorsal branches of the radial artery, putting it at high risk for osteonecrosis if fractured. It describes different classification systems for scaphoid fractures and presents options for management, including cast immobilization, percutaneous fixation, open surgery and arthroscopy. Complications of fractures like nonunion are also outlined.
Dynamic hip screw
This document discusses the dynamic hip screw (DHS), used to treat intertrochanteric hip fractures. The DHS provides controlled collapse and dynamic action to reduce complications like screw cut-out. Key steps of the procedure include closed reduction of the fracture, guide pin and plate insertion at 135 degrees, and measuring screw length. Factors like tip-apex distance and screw position are important to prevent complications. The DHS works by creating compression as the lag screw collapses into the barrel post-operatively.
Acetabular fractures
Acetabular fractures are typically caused by high-energy trauma and require careful evaluation using CT scans and plain radiographs to classify the fracture pattern according to the Letournel classification system, which describes fractures of the anterior and posterior columns. Operative treatment is indicated for displaced fractures while non-operative treatment with skeletal traction can be used for non-displaced or minimally displaced fractures.
Intramedullary nailing
This document discusses intramedullary nailing for fracture fixation. It begins with an introduction to intramedullary nailing, noting that it provides relative stability through internal splinting. It then covers the evolution of intramedullary nails from first to third generation designs, including different types based on entry point and direction. The document discusses applications and contraindications of intramedullary nailing. It explores the biomechanics and mechanics that provide stability. Finally, it outlines the ideal properties of an intramedullary nail and nail system.
ILIZAROV EXTERNAL FIXATOR
general discussion about Ilizarov external fixator with its history, principles, indication, application, advantage and disadvantage
Safe surgical dislocation for femoral head fractures.dr mohamed ashraf,dr rah...
This study evaluates the outcomes of 18 patients who underwent surgical dislocation of the hip using Ganz's technique to treat Pipkin fractures of the femoral head. Pipkin fractures are rare fractures that occur when the femoral head fractures as a result of a posterior hip dislocation. Traditional approaches provide limited exposure, while Ganz's technique allows 360 degree visualization through an anterior dislocation of the femoral head. The study found statistically significant improvements in functional scores at 1 year follow up, with no cases of avascular necrosis, demonstrating that Ganz's technique is an effective and safe method for treating these complex fractures.
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1. Periprosthetic fractures are fractures that occur near a joint replacement prosthesis. They can occur in the femur, patella, or tibia.
2. Risk factors include increasing age, female sex, osteoporosis, revision arthroplasty, rheumatoid arthritis, steroid use, and neurological diseases.
3. Surgical treatment depends on the fracture classification and stability of the prosthesis. Options include open reduction internal fixation with a locking plate, intramedullary nailing, or revision arthroplasty.
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This document provides an overview of the armamentarium and tools used in dental implant procedures. It describes the basic equipment needed like personal protective barriers and surgical setup. It then details the various diagnostic, measurement, surgical and bone grafting instruments. Specific tools for sinus lift procedures and second stage surgery are also outlined. The document concludes by discussing prosthetic components, lasers used in implantology, and maintenance tools.
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The document provides an overview of principles of external fixation, including indications, advantages, disadvantages, components, mechanics, and biology. Some key points summarized:
- External fixation is useful for definitive or temporary stabilization of fractures, especially open fractures, and for deformity correction.
- Advantages include minimal invasiveness, flexibility, and reconstructive applications. Disadvantages include risk of pin site infection, mechanical issues like distraction of fracture site, and potentially precluding later internal fixation.
- Components include pins of varying diameters and lengths, clamps, connecting rods or rings. Larger pin diameter, increased pin spread and number improve mechanics. Frames must be stiff enough but not overbuilt.
-
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External fixators are devices used to stabilize fractures located outside the body. They minimize metal inside tissues and allow for easy wound access. Pin fixators use cantilevered pins for stabilization while ring fixators form an exoskeleton around the limb for deformity correction. Proper pin placement and preloading are important for stability at the pin-bone interface. Dynamization through loosening of the fixator over time stimulates healing. External fixators are indicated for open fractures, bone defects, and limb lengthening and have advantages of being minimally invasive.
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This document provides information about maxillomandibular fixation (MMF) screws used in oral and maxillofacial surgery. It describes the MMF system, including various screw designs that allow for flexible application. The surgical technique for placing the screws and securing wires or elastics is outlined. Product details such as specifications and packaging of MMF screws and related instruments are also included.
Custom Fit or Patient Specific Knee Replacement Surgery in Gurgaon by Dr Jaya...
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We offer most advanced technique of Knee replacement surgery-- Custom Fit implants. Dr Jayant Arora is a renowned Knee replacement surgeon in Gurgaon with years of experience in England and Scotland. He is the Chief of Orthopedic Surgery at Columbia Asia Hospital in Gurgaon since 2008. He is a pioneer of this technique in Gurgaon. Hundreds of patients have benefited from this latest technique leading to a painless quick recovery after the surgery. There are many advantages of this technique as compared to traditional way of doing the surgery, namely shorter surgery time, less blood loss, smaller incision and better precision in the fitting of the implants. This leads to your artificial knee feeling as natural knee!!
Feel free to email us at gurgaonkneeshoulderclinic@gmail.com if you have any queries about knee replacement surgeryManagement of metastatic bone disease
Surgical fixation should be considered for all pathologic long bone fractures to relieve pain and restore function. Accurate diagnosis of the lesion is important before fixation. PMMA bone cement can enhance the stability of fixation constructs. Implant choice (plates, nails, prostheses) depends on fracture location and extent of involvement, with the goals of achieving stable fixation and protecting against recurrent lesions or effects of further treatment. Prophylactic fixation may prevent impending fractures but also risks complications.
123.ppt
This document provides guidelines for maintaining dental implants. It discusses evaluating implant stability and health of surrounding tissues. Key parameters include checking for plaque, calculus, and bleeding. It recommends using plastic or titanium instruments to polish implants and surrounding tissues, as well as air abrasives, to minimize surface damage. Proper hygiene aids and instructions are important to maintain implant health and prevent bone loss from issues like peri-implantitis.
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The Arsenal Ankle Plating System utilizes threaded standard and locking bone screws in diameters of 2.7mm (8-50mm long), 3.5mm (10-70mm long), and 4.0mm (10-50mm long). Available plates, screws, and instrumentation will be packaged as a single system. System instrumentation includes drill bits, countersinks, guide wires, olive wires, depth gauges, bone clamps, bending instruments, drill guides, drill sleeves, a screw removal tool, cannulated screws, washers, driver shafts, handles, and ancillary instruments to facilitate the placement of the plates. The plates, screws, washers, drill bits, and guide wires are intended for single use only. All other system components are intended for reuse. Visit us at https://www.djoglobal.com/.
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Ex fix
- 1. External Fixator Dr Saurav Narayan Nanda, DNB Trainee, Orthopaedics Lilavati Hospital & Research Centre, Mumbai, India
- 2. Definition:- It is an arrangement by which bones & bone fragments are held rigidly by metal pins, which are themselves attached securely to a strong external frame.
- 3. Development of Ex- Fix System -Transfixing steinmann pin above & below the # site following POP cast -Charnley compression clamps for Arthrodesis -External fixator frames to control the osteotomy site in leg lengthening procedures by Putti, Abbott, hoffman & subsequently modified by Vidal
- 4. Indications:- Closed comminuted # # associated with excessive soft tissue damage # with significant loss of bone Multiple # Pelvic # with symphysis pubis disruption Limb lengthening Plastic surgical procedures Infected #
- 5. Contra-indications:- Soft osteoporotic bones Too small boney fragments Infected lesions at pin insertion site Impossible situation- irregular supervision Surgeon not familiar with the equipments and methods.
- 6. Types of frames:- Type 1: Unilateral Uniplanar Type 2: Uniplanar Bilateral Type 3 Classical: Bilateral Biplanar Type 3 Delta: Unilateral Biplanar
- 7. Choice of frames:- The frame of choice should fulfil- Anatomical needs: ‘Safe’ corridor Clinical needs: Wound access- Secondary procedures Mechanical needs: stability against bending, torque and axial load
- 8. Biomechanics:- Intrinsic stability of frame(S):- S= E I/L (E= Modules of elasticity=const) (I=Moment of Inertia= const) (L=Distance of frame from axis) Mechanics of Bone Pin interface:- Number, Pitch & Size of pins Mechanics of Bone Fixator composite:- -stability against Bending Loads - stability against Torsion - stability against Axial Load
- 9. Basic Componets:- Schanz screws:- 4.5 mm short threaded for diaphysis 5mm long threaded for metaphysis Clamps :- Universal clamps Open ended clamps Transverse pin adjusting clamps Tube to tube clamps Tubes:- 11mm (OD)
- 10. Instruments:- Drill:- Hand drill/ low speed , high torque power drill preferred Drill bits:- long drill bits (200mm) 3.5 and 4.5 mm diameter Triple guide assembly:- trocar(3.5mm), inner sleeve(3.4/5) & outer sleeve(5/6) T handle
- 11. Steps of application:- Pre- operative planning Procedures & techniques Post operative care
- 12. Pre- operative planning:- Consider the merits of the case Assessment of the extent of # with good quality radiographs Choosing Suitable types of pins and frames Choosing best site of pin insertion Trial run with the apparatus
- 13. Procedures & Techniques:- Aseptic precaution Wound cleaning if needed # reduction & stabilization with clamps Adequate stab wounds creation before inserting the pin in its entry & exit point Pins are drilled into the bone using hand brace Pins are advanced till engagement of the threaded portion of the pins to both cortices Pins in one group should be parallel & jig between two groups Frame is built & adjusted with radiographic view to achieve the boney fragments in desired position Dressing of pin site & covering of sharp ends with caps
- 14. Post operative care:- Daily examination of the limb & the apparatus Examination of skin condition- inflamed or tensed Regular radiographic assessment of boney fragments Encourage to exercise all affected joints on the day after application of the device Bed rest until skin wound is healed following non weight bearing mobilization with crutches Partial weight bearing after callus formation Frame is removed after radiographic evidence of # union Partial weight bearing for 1st 1-2wks after removal of the device
- 15. Complication:- Infection of skin wounds Infection of bone Development of joint stiffness Damage to blood vessel, nerve, or tendons by transfixing pins