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 bone
Levelling the bone
Osteotome
Used for osteotomy-cutting the bone
Both edges will be bevelled
curved
straight
Bone
gouge
It 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 materialIt is defined as a material
inserted or grafted intoinserted or grafted into
intact tissues or bodyintact tissues or body
cavity with some specificcavity with some specific
purposepurpose
Implan
t
MetallicMetallic
Iron
Cobalt
Titanium
Nonmetallic
Type
s
PlatesPlates
ScrewsScrews
Extra medullary
fixation
Thick plate
With round holes
Used in combination with screws in
Diaphysial fractures
AO plates
The holes are designed to utilise spherical gliding
principle
Less surgical exposure
Can fit in any position
Screw 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 bone
Indications >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 plate
Scallop like notches presents between holes
Can 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
implants
Slowly 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
Indications
Fracture shaft humerus
fracture shaft femur
fracture 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 proximal
Fracture fixation is achieved by three
point pressure system
K wire
Threaded tip
Trocar tip
Centrally threaded K wire
threads
Indications 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 femur
Can be used for fracture clavicle
Dynamic hip screw
Has lag screw & barrel
Indications
>fracture neck femur
>trochanteric fracture
of femur
>subtrochanteric
fracture
Austin Moore prosthesis (Unipolar)
In elderly patients with
fracture neck femur, for
replacing head of femur
Can be removed once the
bone grows
Fenestrations 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
nailCannulated triflanged nail
Prevents axial rotation of the fragments
Cuts only a little bone to give good stability
Indications > fracture neck femur
>Intertrochanteric fracture
Jewette nail plate
Used introchateric fracture – elderly patients
- osteoporotic bone
Condylar
plate
Indications
>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
Staples
Conventional 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 fixation
Force 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 fixator
Indicated in limb
lengthening,
nonunion,
deformity
correction,
osteomyelitis,
Provides
distraction force
which will help in
growth of bone
Instruments  &  implants

Instruments & implants