This document discusses various orthopaedic instruments and implants used in bone healing and surgery. It begins with describing instruments such as bone hooks, elevators, levers, holders, curettes, forceps, nibblers, osteotomes, chisels, gouges, and mallets. It then discusses implants like K-wires, pins, clamps, rods, external fixators, intramedullary nails, plates, and screws. The document concludes by mentioning prosthetics like the Austin-Moore, Thompson's, and bipolar prostheses, as well as total hip and knee replacements.

1. IMPLANTS AND INSTRUMENTS
HOME 2023

2. ORTHOPAEDIC INSTRUMENTS

3. BONE HEALING

4. CLINICAL SCENARIO
• MADHAN, 24/M, WAS BOUGHT TO CASUALTY
WITH H/O RTA
• NO HEAD/CHEST/ABDOMINAL/PELVIC INJURY
• ORTHO : CLOSED # SHAFT OF LEFT FEMUR
» NO NEURO-VASCULAR DEFICIT
•LETSIMAGINEWE AREOPERATINGTHEPATIENT
•THEREMAININGPRESENTATIONWILLIN THEORDEROF INSTRUMENTSUSED

5. SURGICAL BLADES
BP HANDLE
BLADES ACCORDING TO SIZE/SHAPE

6. ARTERY FORCEPS
• HEMOSTASIS
• DISSECTION
• SMALL SIZE–
”MOSQUITO”

7. BONE HOOK
• TO DELIVER THE BONE

8. PERIOSTEUM ELEVATOR
FARABEAUF BRISTO
• ONLY ONE SIDE IS BEVELLED
• BLUNT

9. BONE LEVERS
TRETHOVAN HOHMANNS

10. BONE HOLDERS
BURNS FERGUSSONS

11. LANE’S HAYGROOVES
•LESS DAMAGE TO PERIOSTEUM

12. AO TYPE

13. BONE& PLATE HOLDING FORCEPS
LOWMAN’S

14. BONE CURETTE(VOLKMANN’S)
•CURETTING CAVITY
•HAEMATOMA
•FIBROUS TISSUE
•BIOPSY
•INFECTI0NS

15. SEQUESTRECTOMY FORCEPS
• STOUT
• THICK TRANSVERSE
SERRATIONS
• GROOVE IN THE MIDDLE
• NO RATCHET

16. DOUBLE ACTION BONE NIBBLER
• CUTTING BONE
• NIBBLING OF BONE
• SPINE SURGERY

17. OSTEOTOME
FOR OSTEOTOMY BOTH EDGES ARE BEVELLED

18. BONE CHISEL
• ONE SIDE BEVELLED
• SHARP
• USES:
– REMOVINIG EXCESS CALUS
– OSTEOCHONDROMA
EXCISION
– LEVELLING THE BONE

19. BONE GOUGE
• MODIFIED CHISEL
• REMOVING BONE
• TAKING BONE GRAFT

20. MALLET
TO HAMMER
OSTEOTOME,CHISEL

21. BONE AWL
• FOR MAKING A HOLE IN THE
BONE
• TENODESIS

22. BASIC SPINAL SURGERY INSTRUMENTS

24. IMPLANTS

25. DEFINITION
• A non living material inserted into the human body
where it is intended to remain for a significant
period of time in order to perform a specific function.
• Examples : TENS,ILN etc

26. K-WIRE(KIRSCHNER WIRE)
• DIFFERENT DIAMETERS
• SMALL BONE FRACTURES
• TRACTION
• FRACTURES IN CHILDREN eg.
SUPRA CODYLAR
• ILIZAROV

27. SKELETAL TRACTION
STEINMANNN PIN
• POINTED AT ONE
END
• 3 TO 6MM
DIAMETER
• 150 TO 300 MM
LENGTH

28. DENHAMS PIN
• IN OSTEOPOROTIC
AND CANELLOUS
BONES
• THREADS FOR GRIP

29. BOHLER’S STIRRUP

30. SCHANZ PIN
• THREADS AT ONE END
• ATTACHABLE TO DRILL/ T
HANDLE AT THE OTHER
END
• SIZES :
2.5MM(METACARPAL) TO
5.5MM(FEMUR)
• FOR EXTERNAL FIXATION

31. CLAMPS
• AO CLAMP • UNIVERSAL CLAMP

32. ESCULAP (CIRCULAR) CLAMP
ROD TO ROD CONNECTOR ROD TO PIN CONNECTOR

33. CONNECTING RODS
• DIFFERENT LENGTH
AND WIDTH
• TO CONNECT TO
SCHANZ PINS OR OTHER
RODS USING CLAMPS

34. T - HANDLE
• FOR SIMPLE HAND
DRILLING OR REMOVAL
PURPOSES

35. EXTERNAL FIXATOR
• COMPOUND
FRACTURES
• TO MAINTAIN
REDUCTION TILL
INFECTION OR WOUND
SUBSIDES

36. ILIZAROV

37. • DRILL GUIDE
• CENTRAL
• ECCENTRIC

38. INTRA-MEDULLARY NAILS

39. RUSH NAIL
• FORE ARM #, FIBULAR #, PAEDIATRIC #
• COMPOUND FRAC

41. ENDER’S NAILS
• FOR
PERCUTANEOUS
CLOSED FIXATION
OF EXTRA
CAPSULAR #

42. TENS
• TITANIUM ELASTIC NAIL
• DIAPHYSEAL AND
CERTAIN METAPHYSEAL
# OF LONG BONES OF
CHILDREN AND YOUNG
ADULTS

43. ILN TIBIA

45. ILN FEMUR

47. PROXIMAL FEMORAL NAIL
•LONG PFN
•SHORT PFN

48. RECON NAIL

49. LENGTH OF THE NAIL
• TOTAL NAIL LENGTH :
– ANATOMICAL LENGTH
• WORKING LENGTH
– LENGTH OF NAIL TRAVERSING
FRACTURE SITE FROM DISTAL
POINT OF FIXATION IN
PROXIMAL SEGMENT TO
PROXIMAL POINT FIXATION IN
DISTAL FIXATION
IMPORTANCE:
•BENDING SFIFFNESS INVERSELY PROPORTIONAL TO SQUARE OF WORKING LENGTH
•TORSIONAL STIFFNESS IS INVERSELY PROPORTIONAL TO WORKING LENGTH
•IN OTHER WORDS : SHORTER THE WORKING LENGTH, STRONGER THE FIXATION

50. PLATES
• DCP 4.5MM NARROW AND BROAD
• DCP 3.5
• LCDCP 4.5MM,3,5MM
• LCP
• RECONSTRUCTION PLATE 3.5MM, 4.5MM
• TUBULAR 1/3RD PLATE (3.5)
• SEMI TUBULAR (4.5)

51. DYNAMIC COMPRESSION PLATE
8 HOLED DCP
PRINCIPLE OF DCP

52. LOCKING COMPRESSION PLATE
• ANGULAR STABILITY
• SCREW LOCKING
• RELATIVE STABILITY
• SECONDARY HEALING
(CALLUS +)

53. RECON PLATE
• DEEP NOTCHES BETWEEN
HOLES
• CAN BE BENT IN 2
DIMENSIONS
• TO RECONSTRUCT
COMPLEX CONTOURS
• EG : PELVIS, DISTAL
HUMERUS, CLAVICLE #

54. TUBULAR PLATES
• 3.5MM = ONE THIRD
TUBULAR
• 4.5MM = SEMI
TUBULAR PLATE
• FRACTURES OF LATERAL
MALLEOLUS,
OLECRANON, DISTAL
HUMERUS

55. DYNAMIC HIP SCREW
• PRINCIPLE : CONTROLLED
COMPRESSION
• INDICATIONS :
– STABLE INTER
TROCHANTERIC #
– BASI CERVICAL NECK #

56. • BARREL PLATE • RICHARDS SCREW
FOR COMPRESSION

57. DISTAL FEMORAL LOCKING PLATE

58. Jewet plate

59. L plate

60. EGGER PLATE

61. SHERANS PLATE

62. OSTEOTOMY PLATE VENWRIHTS PLATE

63. KESSELS PLATE

64. BUTRESS PLATE

65. SCREW
• Screw is a cylinder with spiral threads running
on its outer surface. It converts torsional
forces into compression.
• The primary functional objective in the design
of a screw is to dissipate and distribute the
mechanical load.

66. PARTS OF A SCREW

67. TYPES OF SCREWS
• MACHINE SCREWS, WOOD SCREWS

68. SCREW HEADS
PHILIPS HEAD HEXAGONAL HEAD

69. SLOTED HEAD

70. MALLEOLAR SCREW CANULATED SCREW

71. CORTICAL SCREW CANCELLOUS SCREWS
LARGER THREADS, HIGHER PITCH

72. SELF TAPPING NON SELF TAPPING SCREW

73. CANNULATED SCREWS

74. LOCKING SCREWS

75. HERBERT SCREW
• INTER FRAGMENTARY
COMPRESSION

76. LAG PRINCIPLE
• COMPRESSION BETWEEN
TWO BONE FRAGMENTS
• SCREW GLIDES FREELY IN
NEAR FRAGMENT AND
ENGAGES IN FAR
FRAGMENT
• PULLS DITAL FRAGMENT
TOWARDS PROXIMAL
FRAGMENT
(COMPRESSION)

77. IMPLEMENTATION
• WHENEVER SCREW CROSSES FRACTURE LINE, IT
SHOULD BE INSERTED AS LAG SCREW.
• WITH CORTICAL SCREW :GLIDING HOLE IN NEAR
CORTEX WITH DRILL BIT EQUAL OR LARGER
DIAMETER OF SCREW THREAD. DISTAL HOLE :
PRECISELY TAPPED.
• WITH CANCELLOUS SCREW : LONG SHAFTED
SCREW, SUCH THAT THREADED PORTION
ENGAGES IN THE FAR SEGMENT ONLY

78. SS WIRES

79. TENSION BAND WIRING

80. RADIOLOGY

83. PROSTHESIS
• AN ARTIFICIAL DEVICE WHICH REPLACES A
MISSING BODY PART WHICH IS LOST BY
TRAUMA , DISEASE OR CONGENITAL
CONDITIONS.
• EG: AMP, THOMPSONS, BIPOLAR

84. AUSTIN- MOORE ‘ PROSTHESIS
HEAD
STEM
FENESTRATIONS

85. INDICATIONS
– Failure of closed reduction of a displaced
intracapsular fracture in an elderly patient >60yrs
– Patient with rhematoid disease with minimal
arthritis of hip
– Neglected fractures (>1wk) and when there is no
acetabular damage
– Fracture associated with pagets disease when
there is minimal acetabular damage
– Fractures secondary to malignancy
– Acute displaced intracapsular Fracture

86. THOMPSON’S PROSTHESIS
• NO FENESTRATIONS
• Designed for non union
of fracture neck of
femur when there is no
neck available
• Designed to rest on the
intertrochanteric line

87. INDICATIONS
• Absence of neck
• Non union fracture neck of femur
• Malignancies
• Bony Secondaries- Pathological fracture
• Osteoporotic fracture with neck

88. BIPOLAR PROSTHESIS

90. TOTAL HIP REPLACEMENT

91. TOTAL KNEE REPLACEMENT

92. Kerrison Punch Down Cutting Murphy Lane bone skid
Volkman’s Cat’s paw Retractor
Plaster Spreader