FIXATION METHODS IN ORTHOPAEDICS

Dr Bhaskar B. Gohain MS,DNB,Fellow (Arthroplasty) I/C Orthopaedics NEIGRIHMS Shillong India

FIXATION METHODS IN ORTHOPAEDICS

EXTERNAL INTERNAL TRACTION SPLINTS

IMPLANT INSTRUMENTATION: SPINE PROSTHETIC DEVICE: THR/TKR

Who is he?

EXTERNAL FIXATOR: OPEN FRACTURE

Classification of Open #: Gustilo & Anderson (1976)

Wound size Extent of tissue injury Fracture geometry Vascular status

Spanning or bridging external fixator: Damage control orthopaedics

After skin grafting of raw areas

EXPOSED TENDONS

Knee mobilization after removing bridge

Upper limb: Fracture dislocation of wrist joint

Application of JESS in crush injury hand

ORIF
OPEN REDUCTION & INTERNAL FIXATION CR + IF: # NOF CR + EX FIX HYBRID FIXATION

Screw-Plate-Rods

HYBRID FIXATION

Hoffa fracture lateral femoral condyle fixed with screws & the deforming forces neutralized by the ex. Fix.

Arthrodesis for infected TKR

SLIDING HIP SCEWS: DHS/DCS

Major hip fracture

CR+ IF : NECK FEMUR: PARALLEL SCREWS

Fibular graft in the middle

Hip fracture Nonunion

FRACTURE REPARATIVE PROCESS HAS COME TO HALT: Disturbed fracture healing BIOLOGY

Variable angle sliding hip screw-plate

Fixation with angled plate and screw after valgusmedialization osteotomy

Nonunion united without grafting Ref to the Case in earlier slide

Delayed Reconstruction: Grade-II

MIPO after spanning fixator has been removed

Solid union at follow up

LOCKING PLATE: MIPO/LISS

MIPO in Pilon Fracture

ILIZAROV RING EXTERNAL FIXATOR in Open fracture: SHORTENING/UNION/LENGTHENING

Wound mangement with initial angulation to appose wound Correct angulation gradually to correct bony alignment Plastic surgical flaps may thus be avoided

BONE CEMENT ANTIBIOTIC BEADS

May use it after good debridement In open fractures especially near a joint

CAN USE HEAT STABLE ANTIBIOTICS

Gentamicin, Tobramycin Vancomycin cefuroxime

RING FIXATOR Knee rehab with frame in situ is excellent

SPINE: segmental instability causing pain

PEDICULAR SCREW-ROD-SYSTEM
POSTERIOR INSTRUMENTATION

BIPOLAR HIP PROSTHESIS: # NOF

Acetabular inclination: 30-45 degree

Femoral side fixation The stem

Sir John Charnley, UK

CEMENTED TOTAL HIP

PMMA: BONE CEMENT

TKR

TKR

Neglected CTEV In 7 Year Old Boy: BONY OR SOFT TISSUE PROCEDURE!

Wish best wishes Case done yesterday with Dr Vrisha Madhuri, CMC,Vellore

Neglected clubfoot JESS after limited PMSTR The Calcaneal & Ant. Tibial Pin are Criucial

Toggling

DIFFERNETIAL DISTRACTION 2ND GA3RD GA Labour intensive procedure for both Pin tract infection not a real obstacle

COST FACTORS: SEQUENTIAL frame

Planter flexion of great toe with distraction common Stindlers release

Pediatric size frame problem of threaded rod bending

E-mail: bhaskarborg@gmail.com Mobile: 9436706397

Dr. Bhaskar Borgohain.

MS orth, DNB orth, MNAMS Fellow (Joint Replacement)

Associate Profeesor of Orthopaedics

North-Eastern Indira Gandhi Regional Institute of Health & Medical Sciences. Govt. of India, Shillong::793018
Journal Editor, North East Regional Orthopaedic Surgeons Association (NEROSA) Life member, Society for Biomaterial and Artificial Organ (India)