Orthopedic Surgery I & II

An abnormal thoracic curvature of the spine, often referred to as "hunchback" is called ____

Kyphosis

A joint that is surgically fused to prevent movement is called ____

Arthrodesis

The procedure in which the attenuated anterior capsule of the shoulder is reattached to the rim of the glenoid fossa with sutures is called ____

Bankart (procedure)

A Keller arthroplasty or McBride procedure is performed to treat and remove exotosis and _______

Hallux Valgus
(bunions)

Transposition

The procedure in which the ulnar nerve is moved from the ulnar groove position on the posterior of the humerus to the anterior of the humeral condyle is called a ____

Total hip Arthroplasty

Which procedure would require the postoperative use of an abduction splint?

Which instruments would be used to retract the muscles during a hip pinning?

Bennett retractor

Which is the best site for the removal of cortical bone for grafting purposes?

Ilium

Methyl methacrylate would most likely be used in ____

Total knee arthroplasty

Which is NOT a type of interlocking nail used for a closed intramedullary nailing?

Austin-Moore

Luque rods are used for ____

Spinal deformities

Osteoarthritis

A condition that would cause a patient to undergo a total hip arthroplasty?

Femoral shaft factures in an adult can be repaired by ____

Compression plating

Elderly

Intertrochanteric fractures most often occur in which age population?

A Neer prosthesis is used for repair of comminuted fractures of the ____

Humeral head

A fracture of the femoral shaft would require a ____

Hip spica cast

What procedure is performed to correct talipes valgus or talipes varus?

Triple arthrodesis

What instrument is used to prepare the drilled hole for the screw during an ORIF?

Tap

Involves removing the bunion by SOFT TISSUE RELEASE to realign the big toe. Commonly for early onset, but soft tissue release doesn't have the same effect as procedures w/bone cuts ( osteotomies).

McBride
(Hallux Valgus Repair)

Mayo (Hallux Valgus Repair)

This procedure removes a smaller portion of the metatarsal head,seen in severe cases of arthritis, trauma, or infection.

First Metatarsophalangeal Joint Arthroplasty - This involves removing the base of the big toe. Results w/great, pain-free motion, but patient loses push-off power w/big toe, and the big toe looks a little short aesthetically.

Keller
( Hallux Valgus Repair)

4 most common foot fractures are...?

1. Malleolus - bony part of ankle. Medial fx most common.
2. Fractured Calcaneous - heel, also hardest to repair
3. Fractured Talus - high median ankle bone
4. Metatarsal Fractures - one of the 5 long bones of foot.

Pertaining to skull, spine, ribs, lumbar, and sacrum

Axial Skeleton

Appendicular Skeleton

Refers to humerus, ulna, radius, carpals, femur, tibia (appendages)

206

How many bones are in the body?

Bones !!!

These provide form, structure, aid in homeostasis, provide blood formation and sources of vitamin d.

Bands of tissue that connect bone to bone
example: ACL

Ligaments

Bands of tissue that connect muscle to bone, also absorb impact.

Tendons

What specialized type of retractor is used during a rotator cuff repair that aids in exposure of the surgical site?

Bankart Retractor

Closest end to origin

Proximal

Farthest end from origin

Distal

Rounded "heads" or ends of a long bone, some cancellous (spongy) composition, red marrow can also be found here.

Epiphysis

What is the central cavity of the bone shaft where red marrow / yellow bone marrow (adipose tissue) is stored?
Also known as the medulla - the innermost

Medullary Cavity

the main or midsection (shaft) of a long bone. It is made up of cortical bone and usually contains bone marrow and adipose tissue (fat)

Diaphysis

Metaphysis

the wider portion of a long bone adjacent to the epiphyseal plate.

Articular Cartilage

This line joints and cushions blows; also a nonvascular fibrous connective tissue that is located in the joints, larynx, trachea, thorax, nose, and ear

Cancellous bone

Spongy bone, contains red marrow and vascular tissue, composed of trabeculae (used in grafts)

Cortical bone

compact bone - harder, stronger, and stiffer than cancellous bone. Cortical bone contributes about 80% of the weight of a human skeleton. The primary anatomical and functional unit of cortical bone is the osteon.

Periosteum

Outer membrane that covers bone, provides blood supply, nerve supply, and nutrients.

Endosteum

Thin membrane that lines the medullar cavity of a bone, osteoblasts make new bone here.

Condyles

Bony prominences on surface of bones where ligaments attach. Examples : distal femur and proximal tibia

Synarthrosis Joints

Immovable joints; Suture lines on the skull are an example

Amphiarthrosis Joints

Slight moveable type of joint; disks of fibrous cartilage connect the joint - Vertebrae and pubic symphisis

Diarthrosis Joints

Freely moveable joints; these include the following:
Ball and Socket, Gliding, Hinge, Pivot, Saddle, and Condyloid.

Name 6 types of Diarthosis Joints

1. Ball and Socket - Hip
2. Gliding - Carpals in wrist
3. Hinge - Knees / Elbows
4. Pivot - Axis of neck (2nd vertebrae)
5. Saddle - thumb
6. Condyloid - temporomandibular joint (jaw)

3 types of Mobile/Immobile Joints

Synarthrosis
Amphiarthrosis
Diarthrosis (synovial joint)

Arthritis

joint disorder w/ inflammation of one or more joints, can also be caused by depletion of synovial fluid.

Abduction

movement away from body or midline

Adduction

movement towards or to the body or midline

Circumduction

Moving a limb in a circular range of motion without moving rest of body

Rotation

Movement of a body part around a central axis

Flexion

Bending of a joint

Plantar Flexion

Bending of foot downward at ankle; toes pointed down

Dorsiflexion

Bending of foot upwards towards ankle, toes up

Extension

Straightening of a joint

Eversion

turning the foot outward at the ankle joint so the sole of the foot is pointing outward (pigeon-toed)

Inversion

turning the foot outward at the ankle joint so the sole of the foot is pointing inward

Pronation

positioning of body or body part pointing downwards
(face down)

Supination

pointing body or body parts upwards
(face up)

Osteomalacia

Softening of bone caused by abnormal calcium deposits, can be caused by lack of vitamin D (rickets)

Osteomyelitis

Inflammation of bone and or marrow

Osteoporosis

Condition of decreased bone density due to a loss of bony substance and diminished osteogenesis

Primary Osteoporosis

Occurs with reduction in calcium intake and hormonal imbalance. Most commonly seen in postmenopausal women.

Hallux Valgus

Outward turning of big toe away from midline.
(bunion)

Hallux Vargus

Inward turning of big to towards midline
(pigeon toes for real!)

Hammer Toe, Claw Toe, Mallet Toe

Acquired / Congenital deformities of the toes as a result of abnormal positioning of INTERPHALANGEAL JOINTS

COXA VALGA

Outward turning of the hip joint, the shaft of the femur is bent outward in respect to the neck of the femur.

COXA VARA

Inward turning of the hip joint, Femur shaft is bent at inward angle in respect to neck of femur

GENU VALGUM

KNOCK KNEED - The knees are positioned closely, opposed to the space between ankles

GENU VARUM

BOWLEGGED - Space between knees is abnormally greater versus between ankles, lower portion of legs bows inward

TALIPES VALGUS

Outward turning of foot away from midline, In talipes valgus, the foot rotates outward like the letter L.
Procedure to correct : Triple Arthrodesis

TALIPES VARUS

Inward turning of foot towards midline, In talipes varus, the most common form of clubfoot, the foot generally turns inward so that the leg and foot look somewhat like the letter J.
Procedure to correct : Triple Arthrodesis

Fracture

Any discontinuity of the normal alignment of a bone, a break

Closed Fracture/Simple Fx

fracture is in normal anatomical position, skin is intact

Open Fracture/Compound Fx

Broken end of bone has penetrated skin exposing the bone; Damage occurs to blood vessels, nerves, and muscle. EMERGENCY=contaminated wound

Causes of Fractures

Traumatic- torsion, impact
Pathological - Breakdown of bone; disease,stress

Greenstick / Stress

FX - that occurs in only one cortex of the bone, incomplete break; often seen in children

Pott's Fracture

FX - occuring in fibula @ ankle; often along w/ medial malleolus

Colles' Fracture

FX - of distal radius, occurs at the epiphysis w/in 2.54 cm of the wrist joint, forcing hand into dorsal/lateral position.Caused by direct force: falling and using hand to break fall (closed reduction)

Comminuted Fracture

FX with more than 2 pieces of bone fragments, associated w/ soft tissue trauma

Transverse Fracture

Horizontal fracture through the bone

Oblique Fracture

a diagonal, or slanted fracture of the shaft along the bone's long axis

Spiral Fracture

A fracture that curves around the bone, result of direct twisting force or torsion

Impacted Fracture

Broken ends of bone are forced into each other creating many shards/fragments of bone. Caused by compressive force

Stellate Fracture

Star-shaped fracture - occurs at a central point, additional breaks radiate out from the center.

Intra-Articular Fracture

Fracture lines are on the joint surfaces of the bone

Transcervical Fracture

Transverse (horizontal) fracture through neck of femur, often occurs closer to femoral head

Sprains

Injury to joint catagorized by the rupture of some or all fibers of the supporting ligaments

Dislocation

the displacement of bone from its socket, caused by trauma

Internal Derangement of Knee Joint

Disruption in arrangement of structure, affects the function of the knee

Bucket Handle Tear

Internal Abnormality of the knee; C-shaped meniscus tears on the medial/lateral edge with the opposite side still attached. (Torn edge resembles bucket handle)

Joint Mice

Loose particles in joint caused by repeated trauma to knee= irritation,pain and locking of knee

5 Steps of Bone Healing Process

1. Inflammation- @ time of injury, along with fracture hematoma; 2 days
2.Cellular Formation - Formation of fibrin mesh w/ soft/granulation callus; 2nd day to 3/4 weeks
3.Callus Formation - Hard portion of bone begins to form w/ collagen matrix; lasts 3/4

Ewings Tumor

Malignant bone tumor, affects boys ages 5-15, 60% cure rate

Multiple Myeloma/Plasma Cell Myeloma

Malignant tumor of plasma cells in marrow w/ the destruction of bone,w/ increased amounts of immunoglobulins, and Bence Jones protien

Osteogenic Sarcoma/Osteosarcoma

Malignant tumor of long bones esp. femur, metastasizing to the lungs.

Chondroma

Benign cartilage tumor

Giant Cell Tumor

Tumor of Epiphysis in long bones, esp. distal femur @ knee, seen in 20-40 age group

Osteoma

Benign bone tumor

Avulsion

Bone and tissues are pulled from normal anatomical attachments

Bucket Handle

Dual Vertical Fractures on the SAME SIDE of PELVIS

Butterfly

Associated w/comminuted fx, Bone fragments are shaped like a butterfly

Depressed

Occurs when bone is driven inward, seen w/ cranial fractures

Displaced

Fracture w/ both ends of bone out of anatomical alignment

Spontaneous/Pathological

Fracture that occurs w/o trauma; caused by drugs or disease

Distraction

Bone fragments are separated, granulated tissue fills spaces between delaying healing

Avascular Necrosis

Decrease in blood supply to bone, causes bone to die,circulation cannot be reestablished b/c of traumatic injury or vascular system is disrupted by other means

Delayed Union

Increased healing time of fracture due to: pathalogical (osteoporosis), mechanical (distraction of the fracture site or inadequate immobilization), or traumatic injury.

Nonunion

Fractured bones ends do not unite.

Malunion

Fracture heals in a way that does not resemble the original anatomical form of the bone, alters the mechanical funtion of the bone.

Compartmental Syndrome

Swollen tissue,intracompartmental bleeding, and bone fragments push against nerves and arteries w/in a closed space. Occurs in forearm/tibia. True emergency

Nerve Compression

Pressure on nerves caused by swollen tissue, often used as a clue to compartment syndrome

Fat Embolism Syndrome (FES)

Fat embolism - fat moves into veins and causes bleeding problems seen w/ pelvic fx, common complication of fractures

Thrombophlebitits

Inflammation of a vein due to a blood clot, most common complication of a fracture

4 Types of Bones

Long (femur), Flat (cranial bones), Irregular (vertebrae), Short (Carpal)

What is the most common site of injury to the knee?

The medial meniscus

Epihyseal Plate

growth plate" - located at the ends of long bones.

Antibiotic Irrigation

Bacitracin and Ancef reduce risk of osteomyelitis

General Anesthesia

Used for lumbar or spinal procedures

Regional Anesthesia

Used for arthroscopy and joint revision/repair

Local Anesthesia

Employed @ end of case, injected locally during closing sutures.

Esmarch

Rubber band used on extremity w/ aid of tourniquet to move blood away from site.

Tourniquet

Used when bloodless wound site is necessary, Cuffs may be Sterile/Unsterile.

Webril

Cast padding placed underneath tourniquet cuff that protects skin.

Tourniquet Pressures

250-350 mm Hg (Upper)
300-350 mm Hg (Lower extremity)

Max Inflation Time of a Tourniquet

1 Hour (Upper Extremity)
< 2 Hours (Lower) Check both @ 15 mins. after

Surgical Steel Suture

For Tendons, and bone to bone.
Used mainly on sternum

Polyester/Ethibond or Mersilene

Tendon Suture

Polypropelene (Prolene)

Tendon to bone Suture

Nylon Suture (Nurolon)

Tendon to bone

Chromic Gut

Periosteum

Polyglactin (Vicryl)

Periosteum

Reciprocating Saws

Power instrument with back & forth motion.

Oscillating Saws

Power instrument with side to side motion.

5 Processes of Osteogenesis
(bone healing)

1. Inflammation
2. Cellular Proliferation
3. Callus Formation
4. Ossification
5. Remodeling

Short Arm Cast

applied from below elbow to metacarpal heads, used for wrist fracture

Long Arm Cast

applied from axilla to metacarpal heads, for forearm or elbow fractures

Short Leg Cast

Applied from tibial tuberosity to metatarsal heads, ankle and foot fractures

Long Leg Cast

Cast from hip to metatarsal heads, for femoral fractures, tibia, fibula and ankle too.

Cylinder Cast

Applied from groin to ankle; required when complete immobilization of the knee is desired.

Hip Spica Cast

Applied to trunk, complete leg of affected side, and 1/2 of unaffected leg.

Body Jacket Cast

Applied to trunk of body to immobilize the spine.

Pedicles

2 short extensions or posterior projections from vertebrae

Pectoral Girdle Joints

glenohumeral, sternoclavicular, and acromioclavicular (AC) joints

Rotator Cuff Muscles

Infraspinatus, teres minor, subscapularis, and supraspinatus muscles. Provide strength/stability for shoulder joint.

Anterior Cruciate Ligament, and Posterior Cruciate Ligament

2 large ligaments in knee joint that help stabilize movement of the knee.

O.R.I.F

Open Reduction Internal Fixation

ORIF Fracture Procedure

1. Incision to expose bone
2. Fracture approximated
3. Fixation device selected
4. Screw Placement Steps: Drill, Measure, Tap, Screw

Closed Reduction

Fracture reduced externally by manipulation or skeletal traction.

External Fixation

Bone-anchoring devices, longitudal supporting devices, connecting elements

Greater/Lesser Trochanters

Attachment sites for hip ligaments

Intertrochanteric Hip Fracture

Use of cannulated screws Dynamic Hip Screw system; Hip pinning - incision inserting guide wire into femoral head w/ triple reamer this drills for lag screw, countersinks plate, reams for plate barrel. Abduction position for healing.

Femoral Neck Fracture

requires internal fixation and has a high incidence of non-union healing.

Femoral Head Fracture

Prosthesis may be used w/ head fx. Femoral Head is replaced if fx is severe.

PUTTI PLATT

subscapularis tendon is divided, attaching the distal to the glenoid margin and the proximal to the anterior capsule; loss of external rotation and surgical scarring of the anterior capsule is the mechanism of increased stability for the anterior shoulder

Baker's Cyst

A cyst in the popliteal fossa

Menisectomy

A bucket-handle tear in the medial cartilage of the knee is repaired by performing this procedure?

Bennet Retractor

Which instruments would be used to retract the muscles during a hip pinning?

Total Knee Arthroplasty

Methyl methacrylate (cement for implants) would most likely be used in this procedure...

Neer Prosthesis

prosthesis is used for repair of comminuted fractures of the Humeral head, also in total arthroscopic shoulder repair

Carpal Tunnel Release

What procedure is performed to relieve pressure on the median nerve?

Tendons, Tendon Sheaths, and Bursa Bunion

A bony prominence on the medial aspect of the first metatarsal. The condition is associated with hallux valgus deformity.

Bone Cement Restrictor

What item should be available during a total hip arthroplasty to be inserted into the reamed femoral canal that will prevent methyl methacrylate from entering the medullary canal?

Ganglion of tendon sheath

a cystic growth commonly occuring on the dorsum of the wrist

Secondary Osteoporosis

caused by extended drug use, particularly steriods, or by extended periods of inactivity.

Interruptions of bone healing

poor immobilization of the fracture distraction of the bone fragments, defiecient or nonexsistent blood supply to the bone, Infection, Interposition of not occur soft tissue

Arthrography

X-ray of a joint after injection of a contrast medium

Clavicle

referred to as the collarbone, is a long , slender , doubly curved bone that acts as a brace for the scapula and aids in keeping the shoulder in place.

AC Joint

located at the top of the shoulder , is an articulation between the lateral end of the clavicle and the flattened, small process located on the border of the acromion.

Humerus

longest and largest bone of upper body extremities.

Patella

is a sesamoid bone contained within the quadriceps tendon

Anterior Cruciate Ligament

Attached to the posterior lateral condyle of the femur and to a notch in the midline of tibia; between tibial condyles. Prevents femur from sliding posteriorly on the tibia.

Ankle and Foot joint?

The ankle joint consists of seven tarsal bones whose names are: Calcaneus, Navicular, cuboid, medial cuneiform, middle cuneiform, and lateral cuneiform.

Traction

used to immobilize a joint, fracture, and align a body part.

3 types of traction :

Manual, Skin, Skeletal (sterile procedure)

Lasers used during Arthroscopy

CO2 and Contat Nd:Yag lasers. Co2 used to remove Meth methacrylate during a revision arthroscopy.

Information for Implants

# of implants, type of implants, size of implants, Manufacturer's serial #

Non-Absorbable Suture

used to repair ligaments, tendons, muscles and bone; because length of duration.

Polymethyl Methacylate

Bone Cement - used during total joint arthroplasty. Stabilizes and keeps implants in position

Ortho Hemostatic Agents

Gelfoam, Avitene, Bone wax, and Thrombin

Bucket Handle

Most common tear in the meniscus

ACL Repair

Involves replacement of the ligament w/Autograft, synthetic ligament or allograft

Types of Allograft

patella tendon, achilles' tendon, Anterior tibialis tendon

Above the Knee Amputation

Diabetic patients who are prone to non-healing ulcers and poor circulation @ risk for amputation; esp. in foot and leg.

TCL - Transverse Carpal Ligament

Roof of the Carpal Tunnel

Carpal Tunnel Syndrome

is a common entrapment syndrome of the upper extremity that is frequently work related and possibly due to repeated motions.

Symptoms of Carpal Tunnel

Tingling in fingers,numbness in fingers, loss of sensation, decrease in motor control

Achilles Tendon

is most often ruptured, either partially or totally, by a traumatic incident sch as avulsion or laceration.

Total Knee Arthroplasty

indicated for patients who demonstrate radiographic intra-articular disease and severe knee pain or other symptoms that cannot be controlled by nonsurgical methods.

Avulsion Fracture

A fracture in which the ligament stays intact but in which a piece of bone is torn

Lordosis

lumbar curvature of spine
"swayback

Scoliosis

lateral S - curvature of spine; most common in female adolescents.

Harrington Rods

Interlocking plates w/ hooks and rods that correct or align spine

Laminectomy

a procedure that requires removing a portion of the posterior vertebral arch.ALSO --Performed in conjuntion w/ spinal fusions

Crosslink Spinal System

Implant often used for herniated disk repair; after spinal fusion takes place, crosslink supports anatomical alignment of spine.

Herniated Disk Treatments

POSTERIOR CERVICAL LAMINECTOMY - Decompression of nerve roots/spinal cord with OR
ANTERIOR CERVICAL DISCECTOMY W/FUSION- Approach from anterior to remove disk and fill with cancellous bone (fusion) from iliac crest.

Develepmental Dislocation of Hip (DDH)

pediatric dysplasia of hip-joint doesn't function w/acetabulum. Occurs mostly in females, 1st born, and breech births. Treated w/ Harness, Spica Cast, or surgery

Slipped Capital Femoral Epiphysis

Femoral head slides backwards due to weak growth plate. Occurs in adolescent, overweight males. Treatment : Insertion of screw (cannulated?)

Pelvic Osteotomy for Spastic Hip Dislocation

Portion of proximal femur and portions of ilium are removed due to spastic muscles. Cerebal Palsy patients have this surgery to release hamstrings due to spasticity.

Talipes Equinovarus/Valgus/Varys

Club foot (horse name?) Common in 9-12 month old children. Longer tendons are shortened, shorter tendons are lengthened. Valgus/Varys

Elevators

Freer, whale tale, woodson, key elevator, chandler, and periosteal types

Retractors

Hibbs, Cobra, Adson-Beckman, Bennet, Hohman

These instruments are used to remove tissue around bones

Rongeur, Kerrison, Lexal, Steelies,

What are Rongeurs used for?

Gouging bone or tissue

Cast Syndrome

caused when body cast is too tight and the mesentaric artery is compressed against the duodenum; causes pain, nausea and vomiting

External Fixation

The use of devices such as pins in fractured bone segments to keep them aligned outside the body.

Pseudoarthritis

False joint resulting from a faulty fx healing

RICE

Rest, ice, compression, elevation

Subtrochanteric Fracture

1 to 2 inches below lesser trochanter. Occurs because of direct trauma. Most often seen in persons under 60 years old. ORIF usual treatment.

Extracapsular Fx

Fracture occurs outside of the joint capsule

Intracapsular Fracture

inside joint capsule

Capital Fracture Fracture of the head of the femur

Fracture that is harder to heal because the blood supply enters the femur below the neck of the femur; greater likelihood that necrosis will occur because the fracture is cut off from the blood supply

Subcapital Fracture

Fx just below head of the femur

Skin Traction

non-surgical method of stabilizing fx. Bucks traction frequently used to temp immobilize fx.

Pelvis - Consists of ...

Sacrum, Coccyx, pelvic girdle and provides support for the trunk and femoral attachments

PCL

prevents femur from sliding forwards on tibia, prevents hyperextension

Instruments for taking a bone graft

Curettes, mallet, power saw, and osteotomes

ACL Fixation

Bone screws, staples, spiked washers, buttons

Debridement

A PROCESS IN WHICH A CONTAMINATED, INFECTED, AVASCULAR TISSUE OR DEBRIS IS CUT AWAY OR REMOVED FORM A WOUND.

Notchplasy

uses 4.5mm srthroplasty bur, osteotome, and rasp; widens the anterior portion of the condylar notch to prevent impingement on the ACL graft; portion of the ACL remains is debrided w/full radius resector to the arthroscopic shaver

Pituitary Rongeur

removes soft tissue that surrounds the outer portion of the femoral tunnel to facilitate passage of the graft

internal fixation of femoral shaft fractures

surgery is recommended right away. if delayed, leg should be placed in traction

intertrochanteric procedure

repair of hip fractures. AO dynamic hip screw/dynamic condylar screw (DHS/DCS)

Bone Wax

A WAXY SUBSTANCE USED TO CONTROL CAPILLARY BLEEDING ON THE SURFACE OF BONE.

Fasciotomy

A PROCEDURE IN WHICH FASCIA IS INCISED TO RELEASE PRESSURE CAUSED BY SWELLING WITHIN A MUSCLE BUNDLE.

Ream

TO ENLARGE A PRE-EXISTING HOLE, DEPRESSION, OR CHANNEL, SUCH AS THE MEDULLARY CANAL.

Slap Hammer

A TYPE OF IMPACTOR USED PRIMARILY IN ARTHROPLASTY TO SEAT A JOINT COMPONENT INTO THE BONE

Subluxation

Partial or incomplete displacement of the joint surface

Bone of the Spine

Cervical - 7
Thoracic - 12
Lumbar - 5

Anterior Glenohumeral Dislocation

Most common shoulder joint dislocation; can be popped back into place

3 types of Total Knees

UniCompartment, Bicompartment, TriCompartment

Positioning Equipment

Fracture Table (radiolucent procedure table)
Bean bag, McGuire (Pelvic) and Andrews Frame (kneeling)

Cortical Screws

Threads all the way down screw

Cancellous Screw

smooth with threads on bottom half

External Fixation

Bone-anchoring, longitudinal support, connecting devices. External pins used to set bones.

Hemi- Arthroplasty

Partial HipThe operation is similar to a Total, but involves only half of the hip. The hemiarthroplasty replaces only the ball portion of the hip joint, not the socket portion. In a total hip replacement, the socket is also replaced.

Total Hip

Replacing both the acetabulum and the femoral head while hemiarthroplasty generally only replaces the femoral head

Hip Reconstruction

Replaces the upper end of the thighbone (femur) with a metal ball and resurfaces the hip socket in the pelvic bone with a metal shell and plastic liner.

External Pelvic Fixator

to stabilize the pelvic area. This device has long screws that are inserted into the bones on each side and connected to a frame outside the body. The external fixator allows surgeons to address the internal injuries to organs, blood vessels and nerves.

Thomas Splint

Maintains traction before surger, for fractures in lower extremities (femur)

Tibia Fracture

Most common site for open fracture, treated w/ external fixator, followed by ORIF.

Types of Bone Holding Forceps

Lewin Clamp, Lohman Bone Clamp, 399 clamp

Patellectomy

reduces how knee joint is extended.

Tibial Plateau Fx

Joint surfaces involved, alignment of articular surfaces crucial to provide stability; treated w/immobilization for non-displaced, ORIF for displaced fx's

Knee Fx

Patellectomy or fixation by suturing and tension band wiring or screw inserted.

Hybrid Treatment

Reduction or Treatment with partial use of bone cement.

Bristow

Repair of rotator cuff injury involving the coracoid process.

Awl

T - shaped nail starter/reamer

Femoral Awl

taps bone to start hole for screw.

Olecranon Fx Repair

Plates, suture and internal K-Wire and Tension Banding (really strong suture)

Percutaneous Pinning

External Fixation w/ K-Wires - for closed olecranon fractures.

Radius and Ulna Fx

commonly seen in children, usually repaired externally w/ K - Wires

Arthroscopic Positioning Knee

Knees @ 90 degree angle

Total Knee

In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.