SlideShare a Scribd company logo
1 of 88
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 material
inserted or grafted into
intact tissues or body
cavity with some specific
purpose
Implant
Metallic
Iron
Cobalt
Titanium
Nonmetallic
Types
Plates
Screws
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 plate
T 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
instrumentsimplants-150505115740-conversion-gate02.ppt

More Related Content

Similar to instrumentsimplants-150505115740-conversion-gate02.ppt

Sx Instruments2 Emily Dzek
Sx Instruments2 Emily DzekSx Instruments2 Emily Dzek
Sx Instruments2 Emily Dzekmeckelbt
 
DISCUSS PRIN & ADVANCES OF INT FIXATION OF FRACTURES.pptx
DISCUSS PRIN & ADVANCES OF INT FIXATION OF FRACTURES.pptxDISCUSS PRIN & ADVANCES OF INT FIXATION OF FRACTURES.pptx
DISCUSS PRIN & ADVANCES OF INT FIXATION OF FRACTURES.pptxObinnaOgboji2
 
Bone and joint care
Bone and joint careBone and joint care
Bone and joint careArman Care
 
Inra medullary nailing - basic concepts
Inra medullary nailing - basic conceptsInra medullary nailing - basic concepts
Inra medullary nailing - basic conceptsharivenkat1990
 
TOTAL KNEE REPLACEMENT (TKR) correction of varus and tibial bone defect
TOTAL KNEE REPLACEMENT (TKR)  correction of varus and tibial bone defectTOTAL KNEE REPLACEMENT (TKR)  correction of varus and tibial bone defect
TOTAL KNEE REPLACEMENT (TKR) correction of varus and tibial bone defectAhammad Siyad
 
Standard implant surgical procedures
Standard implant surgical procedures   Standard implant surgical procedures
Standard implant surgical procedures Manoj Paradhi
 
Dr. radheyshyam (principles and techniques of ao)
Dr. radheyshyam (principles and techniques of ao)Dr. radheyshyam (principles and techniques of ao)
Dr. radheyshyam (principles and techniques of ao)rsd8106
 
RIGID INTERNAL.pptx
RIGID INTERNAL.pptxRIGID INTERNAL.pptx
RIGID INTERNAL.pptxFaisal Mohd
 
Bone defects in tkr
Bone defects in tkrBone defects in tkr
Bone defects in tkrankitjose
 
Surgical Approaches to distal humerus fractures - DR.S.SENTHIL SAILESH, M.S...
 Surgical Approaches to distal  humerus fractures - DR.S.SENTHIL SAILESH, M.S... Surgical Approaches to distal  humerus fractures - DR.S.SENTHIL SAILESH, M.S...
Surgical Approaches to distal humerus fractures - DR.S.SENTHIL SAILESH, M.S...Senthil sailesh
 
Implant prototypes and_designs
Implant prototypes and_designsImplant prototypes and_designs
Implant prototypes and_designsMurtaza Kaderi
 
Bone consideration implant.pptx
Bone consideration implant.pptxBone consideration implant.pptx
Bone consideration implant.pptxKhalidAhmed62002
 
Nailing it hip fractures short versus long; locked versus non locked
Nailing it hip fractures short versus long; locked versus non lockedNailing it hip fractures short versus long; locked versus non locked
Nailing it hip fractures short versus long; locked versus non lockedLove2jaipal
 
Instruments in oral surgery i
Instruments in oral surgery iInstruments in oral surgery i
Instruments in oral surgery iRobin Luna
 

Similar to instrumentsimplants-150505115740-conversion-gate02.ppt (20)

Trauma Implants.doc
Trauma Implants.docTrauma Implants.doc
Trauma Implants.doc
 
Hemiarthroplasty of Hip joint
Hemiarthroplasty  of  Hip joint Hemiarthroplasty  of  Hip joint
Hemiarthroplasty of Hip joint
 
Sx Instruments2 Emily Dzek
Sx Instruments2 Emily DzekSx Instruments2 Emily Dzek
Sx Instruments2 Emily Dzek
 
DISCUSS PRIN & ADVANCES OF INT FIXATION OF FRACTURES.pptx
DISCUSS PRIN & ADVANCES OF INT FIXATION OF FRACTURES.pptxDISCUSS PRIN & ADVANCES OF INT FIXATION OF FRACTURES.pptx
DISCUSS PRIN & ADVANCES OF INT FIXATION OF FRACTURES.pptx
 
Knee
KneeKnee
Knee
 
Bone and joint care
Bone and joint careBone and joint care
Bone and joint care
 
Inra medullary nailing - basic concepts
Inra medullary nailing - basic conceptsInra medullary nailing - basic concepts
Inra medullary nailing - basic concepts
 
TOTAL KNEE REPLACEMENT (TKR) correction of varus and tibial bone defect
TOTAL KNEE REPLACEMENT (TKR)  correction of varus and tibial bone defectTOTAL KNEE REPLACEMENT (TKR)  correction of varus and tibial bone defect
TOTAL KNEE REPLACEMENT (TKR) correction of varus and tibial bone defect
 
Hard tissue replacent
Hard tissue replacentHard tissue replacent
Hard tissue replacent
 
Implant components and basic techniques3
Implant components and basic techniques3Implant components and basic techniques3
Implant components and basic techniques3
 
Standard implant surgical procedures
Standard implant surgical procedures   Standard implant surgical procedures
Standard implant surgical procedures
 
Dr. radheyshyam (principles and techniques of ao)
Dr. radheyshyam (principles and techniques of ao)Dr. radheyshyam (principles and techniques of ao)
Dr. radheyshyam (principles and techniques of ao)
 
RIGID INTERNAL.pptx
RIGID INTERNAL.pptxRIGID INTERNAL.pptx
RIGID INTERNAL.pptx
 
Bone defects in tkr
Bone defects in tkrBone defects in tkr
Bone defects in tkr
 
Orthopaedics
OrthopaedicsOrthopaedics
Orthopaedics
 
Surgical Approaches to distal humerus fractures - DR.S.SENTHIL SAILESH, M.S...
 Surgical Approaches to distal  humerus fractures - DR.S.SENTHIL SAILESH, M.S... Surgical Approaches to distal  humerus fractures - DR.S.SENTHIL SAILESH, M.S...
Surgical Approaches to distal humerus fractures - DR.S.SENTHIL SAILESH, M.S...
 
Implant prototypes and_designs
Implant prototypes and_designsImplant prototypes and_designs
Implant prototypes and_designs
 
Bone consideration implant.pptx
Bone consideration implant.pptxBone consideration implant.pptx
Bone consideration implant.pptx
 
Nailing it hip fractures short versus long; locked versus non locked
Nailing it hip fractures short versus long; locked versus non lockedNailing it hip fractures short versus long; locked versus non locked
Nailing it hip fractures short versus long; locked versus non locked
 
Instruments in oral surgery i
Instruments in oral surgery iInstruments in oral surgery i
Instruments in oral surgery i
 

Recently uploaded

Russian Call Girls Chennai Madhuri 9907093804 Independent Call Girls Service ...
Russian Call Girls Chennai Madhuri 9907093804 Independent Call Girls Service ...Russian Call Girls Chennai Madhuri 9907093804 Independent Call Girls Service ...
Russian Call Girls Chennai Madhuri 9907093804 Independent Call Girls Service ...Nehru place Escorts
 
Call Girls Chennai Megha 9907093804 Independent Call Girls Service Chennai
Call Girls Chennai Megha 9907093804 Independent Call Girls Service ChennaiCall Girls Chennai Megha 9907093804 Independent Call Girls Service Chennai
Call Girls Chennai Megha 9907093804 Independent Call Girls Service ChennaiNehru place Escorts
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...CALL GIRLS
 
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...narwatsonia7
 
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort ServiceCall Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Serviceparulsinha
 
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safenarwatsonia7
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalorenarwatsonia7
 
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...Miss joya
 
Hi,Fi Call Girl In Mysore Road - 7001305949 | 24x7 Service Available Near Me
Hi,Fi Call Girl In Mysore Road - 7001305949 | 24x7 Service Available Near MeHi,Fi Call Girl In Mysore Road - 7001305949 | 24x7 Service Available Near Me
Hi,Fi Call Girl In Mysore Road - 7001305949 | 24x7 Service Available Near Menarwatsonia7
 
VIP Call Girls Pune Vrinda 9907093804 Short 1500 Night 6000 Best call girls S...
VIP Call Girls Pune Vrinda 9907093804 Short 1500 Night 6000 Best call girls S...VIP Call Girls Pune Vrinda 9907093804 Short 1500 Night 6000 Best call girls S...
VIP Call Girls Pune Vrinda 9907093804 Short 1500 Night 6000 Best call girls S...Miss joya
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Miss joya
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escortsvidya singh
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...narwatsonia7
 
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original PhotosCall Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photosnarwatsonia7
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...Garima Khatri
 
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Booking
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment BookingHousewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Booking
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Bookingnarwatsonia7
 
Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliRewAs ALI
 
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...Miss joya
 
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...Miss joya
 
Call Girl Chennai Indira 9907093804 Independent Call Girls Service Chennai
Call Girl Chennai Indira 9907093804 Independent Call Girls Service ChennaiCall Girl Chennai Indira 9907093804 Independent Call Girls Service Chennai
Call Girl Chennai Indira 9907093804 Independent Call Girls Service ChennaiNehru place Escorts
 

Recently uploaded (20)

Russian Call Girls Chennai Madhuri 9907093804 Independent Call Girls Service ...
Russian Call Girls Chennai Madhuri 9907093804 Independent Call Girls Service ...Russian Call Girls Chennai Madhuri 9907093804 Independent Call Girls Service ...
Russian Call Girls Chennai Madhuri 9907093804 Independent Call Girls Service ...
 
Call Girls Chennai Megha 9907093804 Independent Call Girls Service Chennai
Call Girls Chennai Megha 9907093804 Independent Call Girls Service ChennaiCall Girls Chennai Megha 9907093804 Independent Call Girls Service Chennai
Call Girls Chennai Megha 9907093804 Independent Call Girls Service Chennai
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
 
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...
Russian Call Girls in Bangalore Manisha 7001305949 Independent Escort Service...
 
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort ServiceCall Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
 
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% SafeBangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
Bangalore Call Girls Majestic 📞 9907093804 High Profile Service 100% Safe
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
 
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
 
Hi,Fi Call Girl In Mysore Road - 7001305949 | 24x7 Service Available Near Me
Hi,Fi Call Girl In Mysore Road - 7001305949 | 24x7 Service Available Near MeHi,Fi Call Girl In Mysore Road - 7001305949 | 24x7 Service Available Near Me
Hi,Fi Call Girl In Mysore Road - 7001305949 | 24x7 Service Available Near Me
 
VIP Call Girls Pune Vrinda 9907093804 Short 1500 Night 6000 Best call girls S...
VIP Call Girls Pune Vrinda 9907093804 Short 1500 Night 6000 Best call girls S...VIP Call Girls Pune Vrinda 9907093804 Short 1500 Night 6000 Best call girls S...
VIP Call Girls Pune Vrinda 9907093804 Short 1500 Night 6000 Best call girls S...
 
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
Low Rate Call Girls Pune Esha 9907093804 Short 1500 Night 6000 Best call girl...
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
 
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original PhotosCall Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
 
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Booking
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment BookingHousewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Booking
Housewife Call Girls Hoskote | 7001305949 At Low Cost Cash Payment Booking
 
Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas Ali
 
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
Call Girls Service Pune Vaishnavi 9907093804 Short 1500 Night 6000 Best call ...
 
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...
VIP Call Girls Pune Vani 9907093804 Short 1500 Night 6000 Best call girls Ser...
 
Call Girl Chennai Indira 9907093804 Independent Call Girls Service Chennai
Call Girl Chennai Indira 9907093804 Independent Call Girls Service ChennaiCall Girl Chennai Indira 9907093804 Independent Call Girls Service Chennai
Call Girl Chennai Indira 9907093804 Independent Call Girls Service Chennai
 

instrumentsimplants-150505115740-conversion-gate02.ppt