FINALS ORTHO

Key roles in ortho

• maintain sterility under complex, lengthy conditions

• Anticipate instrument needs during dynamic procedures

• Verify laterality, implants, and specimens aloud with circulator

• Ensure proper implant tracking/ documentation

What is the periosteum

Vascular membrane covering bone

What is the medullary canal

Cavity inside long bones housing yellow marrow

What are the different joints

• hinge (elbow/knee)

• Ball and socket (hip/shoulder)

• Pivot (C1/C2)

• Gliding (carpals)

What is osteoarthrosis

Cartilage breakdown, leads to joint replacement

What is rheumatoid arthritis

Autoimmune, synovial inflammation

What is subluxation

A partial dislocation

What is compartment syndrome

Pressure build up- ischemia risk

What is osteomyelitis

Bone infection, may require I&D or amputation

What is a CT

3D mapping of complex fractures

What is a MRI

Detailed soft tissue diagnosis (labrum, meniscus)

Pros of using robots for surgical navigation

• increases precision in arthroplasties

• Used anatomical landmarks and pre-op scans

Tools used for cutting/shaping

• osteotomes

• Saws

• Reamers

• Gigli saws

Tools used for fixation/reduction

• Bone-holding forceps, point to point clamp

• Plates, screws (often cannulated), IM nails, external fixtures

Tools used for arthroscopy

• probes

• Scopes

• Shavers

Why don’t we mix metal alloys together *implants*

It can lead to corrosion and infection

What is a fracture table used for

Hip/femur nailing

What is a beach chair used for

Shoulder surgery

What is a lateral decubitus used for

Used before tourniquet to force blood out

What is a esmarch band used for

Used before tourniquet to force blood out

What is a c arm fluoroscopy used for

Essential for fracture alignment, screw placement, and navigation

Steps of an arthroscopy

1. Multi portal entry, saline or LR as media

2. Scope → shaver → probe → repair or debridement

3. Used for ACL, meniscus, labrum, rotator cuff, etc.

How are fractures repaired

• closed reduction

• Percuteneous pinning

• External fixation

• ORIF

• intrsmedullary nailing (IM):

  • reamed canal

  • Uses “perfect circles” to lock distal screws under fluoroscopy

Types of total joint arthroplasty

• hip (anterior/posterior)

• Knee (including robotic ROSA

• Ankle

• Thumb

• Shoulder

• Reverse vs. an atomic shoulder depends on rotator cuff status

• Uses polymethylmethacrylate (PMMA) cement or press fit design

Bunionectomy techniques

• Austin

• Akin

• Chevron

• Keller

• McBride

• McKeever

I&D and amputation

• for infection control and trauma salvage

• Use of vancomycin powder or irrigation

• Instruments: gigli saw, Liston knife

bone healing phases

1. Inflammation

2. Cellular proliferation

3. Callus formation

4. Ossification

5. Remodeling

Infection prevention strategies

• laminar airflow, full body “space suits”, and implant healing

• Avoid flash sterilization for implants

• Antibiotic cement or vancomycin commonly used in TJA

What is the strongest tendon in the body and where is it located?

Achilles tendon, back of lower leg, connects calf muscle to heel bone (calcaneus)

What type of joint is the hip joint?

Ball and socket

What is a bucket handle tear and where does it occur?

Longitudinal tear were a portion of the meniscus flips inward towards the center of a joint occurs in the meniscus in the knee

what is the difference between ORIF and external fixation?

ORIF: Fracture openly exposed, stabilized internally with plates/screws

External: Stabilized externally, using pens and wires, connected to external frame, no large incision, manipulated through skin

What device is used to exsanguinate limb before tourniquet inflation?

esmarch

What does polymethyl methacrylate (PMMA) do in Orthopedic procedures

Bone cement

• Used to anchor implants/provide mechanical stability

What is the most commonly fractured bone in the body?

The clavicle (Collarbone)

What are some bone holding clamps

• Crab claw

• Point to point

• Weber

• Lane

• Lowman

• Verbrugge

What are rongeurs for?

For trimming bone

• Leksell

• Adson

What are curettes for?

Scoop out bone/tissue

What are saws and drills for?

Bone cutting

• sagittal

• Oscillating

• Reciprocating

• Gigli

What are reamers for?

Hollow tools to enlarge canal for nails/implants

What are rasp/files for?

Smooth bone edges

What are screwdrivers for?

Insert/remove bone screws (Often matched to set)

What is a powered shaver for?

To remove cartilage/debris in joints during arthroscopic procedures

What is a battery or electric power for?

To use with saws, reamers, inserting, wires, brews, etc

What is a rotator cuff repair?

Suturing torn tendons in the shoulder

What is an ACL reconstruction?

Using autographed or allograft to reconstruct anterior cruciate ligament

what is the epiphysis

End of bone (contains spongy/cancellous bone and red marrow)

What is the diaphysis

Shaft of bone (Compact/cortical bone)

What is metaphysis

Growth region between epiphysis and diaphysis

What is the Periosteum

Outer vascular covering of bone (Important for healing)

What is the meniscus?

Fibrocartilage pad in knee; Bucket handle tear is a common injury

what is the labrum?

Cartilage rim around shoulder and hip sockets for stability

What is the synovium?

Membrane lining joint capsule, produces lubricating fluid

What does the head of the femur bone articulate with?

The acetabulum (Hip joint)

What is the acetabulum?

Hip socket and pelvic bone

What is the glenoid cavity?

Shoulder socket

What is the Olecranon process?

Proximal end of ulna: Elbow point

What is the patella?

Largest sesamoid bone; Protects knee joint

What is the ACL

Anterior cruciate ligament: Stabilize tibia against forward movement

What is the PCL?

Posterior cruciate ligament: Stabilize his tibia against backward movement

What is the Achilles tendon?

Connects calf muscles to calcaneus; Strongest tendon in body

What is the rotator cuff?

Supraspinatus, infraspinatus, teres minor, subscapularis ( SITS muscles

What is a Hana fracture table used for?

For Femoral FX or anterior THA

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Sternum

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Humerus

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Sacrum

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Carpals

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Femur

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Fibia

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Metatarsals

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Phalanges

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Skull

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Maxilla

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Mandible

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Clavicle

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Scapula

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Rib cage

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Iliac crest

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Ulna

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Radius

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Metacarpals

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Phylanges

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Patella

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Tibia

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Tarsals