ORTHOPAEDIC INSTRUMENTS AND

IMPLANTS

Jibril mohamed Abdullah ID:165

INSTRUMENTS
PERIOSTEUM ELEVATOR
 The periosteum elevator is used to elevate the periosteum.

Elevation of the periosteum is necessary in all operations on the

bone because all the important structures such as vessels, nerves,
tendons, etc. are outside the periosteum, and therefore, once the
periosteum is elevated, the surgeon is in a safe plane.
BONE LEVER
 It is used to lever out a bone from the depth of a wound after the

periosteum has been elevated (Fig-2). It is placed between the bone

and the periosteum, and thus retracts the soft tissues.
BONE NIBBLER
 It is used for nibbling the bone (Fig-3a)

 Some of the common bone nibblers are:

(i) straight nibbler

(ii) curved nibbler – for spinal surgery;
(iii) double action nibbler – straight or curved
BONE CUTTER
 It is used for cutting a bone into small pieces e.g., for cutting bone

grafts
OSTEOTOME
 It is used for osteotomy – cutting a bone. Its both edges are

bevelled
 Some of the osteotomies commonly performed are:

(i) McMurray’s osteotomy for fracture of the neck of the femur

(ii) corrective osteotomy for deformities
MALLET
 It is used for hammering osteotome, chisel etc

BONE CURETTE
 This is used for curetting a cavity in the bone or for removing fibrous

tissue from fracture ends of an old fracture

BONE GOUGE
 This is a concave bladed chisel used for cutting on round bone

surfaces (Fig-7), or sometimes for making a round hole in the bone.

BONE AWL
 This is a pointed thin instrument for making a hole in the bone (Fig-

8). There is an eye at its tip to thread a wire through the bone e.g.,
for tendon attachment
BONE HOLDING FORCEPS
 There are different types of forceps for holding a bone

 These are :

(i) Lane’s forceps – for holding the femur, tibia, etc.

(ii) lion-toothed forceps
(iii) self-retaining – AO type forceps.
Plate-holding forceps:
 Once the reduction is achieved, a plate of suitable size is placed

over
the fracture and held with the help of the following plate holding
forceps:
(i) Lowman’s clamp
(ii) AO type self-retaining forceps
TRACTION INSTRUMENTS
Kirschner wire :
 This is thin, straight steel wire, of diameter ranging from 1 to 3 mm

 It is used (i) for internal fIxation of small bones

Steinmann pin:
 This is a stout, straight steel rod, of diameter ranging from 3 to 6

mm
 It is used for skeletal traction— common sites being upper end of

tibia, supracondylar region of the femur and calcaneum.

K-wire stirrup with tensioner:
 When skeletal traction is to be applied with the help of K-wire, the

strength of the wire is increased by subjecting it to an axial tension

by a tensioner
Skull traction tongs:
 These are tongs to apply skull traction in cases of cervical spine

injury
or disease Examples are Crutchfield tongs, Blackburn tongs, etc.
IMPLANTS
NAILS
 Nails are devices used for the intra-medullary fixation of fractures of

 long bones Some of the nails used commonly are as follows:

1. Kuntscher’s nail: This is used for internal fixation of fracture of the

femoral shaft.
2. Smith Petersen nail (SP nail): This is used for internal fixation of
fracture of the femoral neck.
3. V Nail: This is used for internal fixation of fracture of the tibial
shaft.
4. Talwalkar nail: This is used for fractures of forearm bones.
5. Rush nail: This is used for some special situations in long bone
fractures.
6.Ender’s nail: This is used for internal fixation of intertrochanteric
fractures of the femur
PLATES AND SCREWS
 These are used for fixing two bony fragments.

 Different types of plates are available

 Screws may be used alone or in combination with a plate.

 Different types of screws used in orthopaedic practice are as shown

in Fig-13
Dynamic Hip Screw (DHS):
 This is a device used for the internal fixation of trochanteric

fractures
 It has two components – the lag screw and the barrel.