A 54 year old male comes to the ER after RTA, on the day of injury. He has pain & swelling over the right leg. Co-morbidity- Renal stone.

Here are the pre-op & post op X-rays.

 

Let’s discuss the case here:

Q. What are the issues with this fixation? Which factors led to these issues during the fixation?

A. Fracture reduction is inadequate, Anatomical Articular fragment reduction is not achieved as advised in AO principles of fracture fixation. The incongruence of the knee joint in this patient will predispose it to early degenerative changes and early Osteoarthritis knee.

Adequate exposure and visualization of the articular surface is of prime importance in fixation of such fractures.

These fractures require pre-surgical planning in terms of approach required for accessing each fracture with adequate visualization of articular surface.

Some Surgeons advocate use of arthroscopy to visualize the articular continuity/reduction whereas other group prefer submeniscal arthrotomy for direct visualization of fracture reduction.

Selection of the implant is also important in case of Internal fixation is considered as wide variety of Proximal Tibial plates are available such as L shaped plates, L plates with curved Short limb, T shaped plates or anatomical plates.

These injuries are sometimes best treated with Illizarov Fixation system that allows Early mobilization, early restoration of functioning of the limb with minimal soft tissue damage.

Pre-plan the surgery in-terms of fixation system- Internal fixation/ external fixation. (read implant manual for ideal site of placement of plates)

Plan the necessary approach.

Plan for bone grafting if articular depression is not corrected/ Maintained after lifting the articular margin.

Always temporarily fix the reduction with K wires/ screw to prevent sagging of articular fragment and Visualize the articular congruity.

After confirming the fracture reduction the implant used for this scenario should be L plate instead of Anatomical Proximal tibial plate.

Lateral plate needs to be positioned slightly proximal and posterior in position to hold the posterior fragment.

Medial plate needs to be more posterior and slightly proximal or the fracture should have been adequately reduced and fixed with lag screw and posteromedial plate to be fixed in neutralization mode.

For GPC Medical, the priority is your health and quality of your life

Orthopedic implants are the devices that are surgically inserted into the body and are intended to reinstate function by restoring or strengthening a damaged structure. Global Orthopedic Implants Market is booming internationally. The orthopedics market covers a wide range of medical devices, from bone cement and surgical power tools to joint replacement implants and prosthetic limbs, all of which aim to provide patients with increased mobility. Driven largely by the aging population and patients’ desire to maintain an active lifestyle, the global orthopedics market was valued at $52.7B in 2017. GlobalData expects this market will grow to $66.3B in 2023 at a steady Compound Annual Growth Rate (CAGR) of 3.9%.

GPC Orthopedic Implants & Instruments are globally reputed for their high quality, precision and durability. Our Orthopedic Surgery Instruments & Implants, in large quantities are regularly exported to many different countries including those in Europe. Meeting customized requirements of Orthopedic Surgery Instruments and Implants is our specialty. Most of our Orthopaedic Implants including spinal system, intramedullary interlocking nail, locking/non-locking bone plates & screws are US FDA 510(K) approved. GPC is the only Indian Company so far to have achieved this distinction in the field of Orthopaedic/Medical Equipment.

Our wide range of Orthopaedic Implants & Surgical Equipment includes Bone Screws, Plates, Intramedullary Nails, Maxillofacial Implants, Knee Implants, Hip Prosthesis, Spinal Implant System, Locking Plate System, External Fixators, Power Tools, General Orthopedic Instruments, Instruments Sets, Surgical Drills, Arthroscopy Instrumentation, etc. etc.

 

Scope of orthopedic Implants

GPC Medical Orthopedic Implants occupy a lion’s share in the international orthopedic implant market. Orthopedic implants are associated with the musculoskeletal system. For instance, to treat a backache orthopedic implants such as bone plates or bone screws are utilized in spinal fusion surgery. Fixation of damaged bone fragments as well as implant components is used for hip, knee and any other joint replacement. The material applied in orthopedic implants must be biocompatible to avert rejection by the body.

Implant Potential

Orthopedic implants are manufactured to replace or support a missing or damaged bone or joint. These implants are intended to treat the deformities, stabilize body posture, and restore the normal skeletal function. The orthopedic implants market has witnessed a shift from conventional surgical procedures to the use of modern fixation and prosthetic devices. The demand for orthopedic implants has increased significantly, owing to rise in geriatric population that increases the risk of osteoporosis, osteoarthritis, technological innovations in the orthopedic implants, and other musculoskeletal disorders. GPC Medical knows how to keep up with technological demands and adapt via their innovation laboratories with experienced surgeons and engineers.

Orthopedic Implants Market Synopsis

Almost every orthopedic implant present in the market in the current scenario, come under the class III category, which is the most scientifically meticulous classification of medical devices. Individuals facing immobility issues due to terrible accidental or traumatizing cases have no other alternative but to opt for major joint replacement surgeries. This can eventually provoke a radical change in people’s quality of life by relieving pain and reviving their physical independence.

Key Segments

The global orthopedic implants market is segmented based on product, biomaterial, and geography. Based on product, it is classified as reconstructive joint replacements, spinal implants, dental implants, trauma & craniomaxillofacial, orthobiologics, and others. The reconstructive joint replacements market is further divided into the knee, hip, and extremities. Spinal implants are further categorized into spinal fusion devices, non-fusion devices/motion preservation devices, and invasive spinal bone stimulators. Dental implants are further bifurcated into root form dental implants and plate form dental implants. Trauma & Craniomaxillofacial are further categorized into screws, plates, staples, and others. Orthobiologics are further classified into allografts, bone graft substitutes, and cell-based matrices. Based on biomaterials, it is categorized into metallic, ceramic, polymeric, and natural biomaterials. Among biomaterials, the metallic segment occupied dominant share in 2016 and is expected to maintain this trend during the forecast period, owing to their exclusive load-bearing properties.

Factors Leveraging Market Share

Rising geriatric population susceptible to increased risk of osteoarthritis, osteoporosis, and obesity lowered bone density; increased body mass index and other musculoskeletal disorders are the vital factors driving the growth of the global orthopedic implants market. Furthermore, a significant rise in the number of sports-related injuries and road accidental cases are another contributors stimulating market growth. Besides, technological advancement, innovative procedures, and swiftly growing healthcare industry further incite the growth of the market.

Moreover, the launch of internal fixation devices and biodegradable implants holds the higher potential for future prospects of orthopedic implants. However, unfavorable reimbursement policies, rigid guidelines authorization procedures, the high cost of the treatment might hamper the market development.

Additionally, the risk associated with orthopedic implants including implants coming loose or breakage in the bone causing painful inflammation and infections together with the possibility of implant rejection could also serve major roadblock to market expansion.

Technological approach GPC Medical

The impact of the driving factors is expected to surpass the effect of restraints. Moreover, GPC Medical’s increase in R&D in orthopedic implants and the untapped emerging economies are expected to provide new innovative products to orthopedic implants market in the near future.

Future of Global Orthopedic Market

Moving into 2018, there are several areas to watch that GlobalData anticipates will affect the orthopedics markets. Patient-specific implants are expected to drive growth in the hip and knee markets, as is patient-specific instrumentation (PSI), a tool developed to improve accuracy in total knee arthroplasty procedures by customizing the surgical cutting blocks to the patient’s anatomy. Similarly in the vein of personalized healthcare, 3D printing in a variety of orthopedic markets, including spinal intrabodies, craniomaxillofacial implants, and prosthetic devices, will advance physicians’ ability to provide customized solutions to patients. GPC Medical Limited aims to absorb all these changes to make availability of the best quality implants based on these technologies.

A Futuristic Approach

GPC Medical believes in growth and advancement. This is why it keeps a futuristic approach with orthopedic implants. Minimally invasive and robotic surgical systems are a growing trend in orthopedic surgeries, and major orthopedic players, including Medtronic, Stryker, Smith & Nephew, and DePuy, are taking steps to ensure they remain competitive with their Mazor X, Mako, NAVIO, and PUREVUE systems, respectively. Lastly, a shift in the US towards value-based healthcare, including Medicare’s Comprehensive Care for Joint Replacement (CJR) model, will continue to impact both orthopedic manufacturers and physicians, as will the move towards outpatient procedures in ambulatory surgical centers (ASCs). GPC Medical Limited is not ready to stop at any point, as we keep adopting these technological advancements.

Why GPC Medical Limited?

GPC Medical Limited is the oldest orthopedic implants manufacturer and international supplier. Our technology labs remain busy in innovating and manufacturing Trauma Implants with modern technology machines viz. Sliding Head Turning Center, Multiple Axis VMC, CNC Wire Cutting, CNC Deep Hole Drilling, Mechanized sharpening & surface finishing machines.

Apart from our wonderful market acceptance along with the biggest manufacturing portfolio of over a thousand products in growing a worldwide market, we have built relationships based on trust and reliability. We follow internationally standardized protocols with precision throughout the manufacturing and innovating process.

GPC Medical Futuristic Facilities

GPC Medical Limited Manufactures Orthopedic Implants and Instruments product ranges which are packed in packages manufacture from the extraordinary material which is best and suited for orthopedic implants manufacturing process. Further, implants and instruments are marked with Cat Numbers, Batch Numbers and complete description with computer laser marking techniques. GPC medical remains conscious about its internationally renowned reputation and stringent compliance of international standards.

GPC Medical Ltd. – US FDA 510(k) Approved Orthopedic Implants

 

The External Fixation Process, Fractures and Broken Bones

External Fixations:

In the modern development of surgical tools, external fixators are utilized to stabilize and provide staunch rigidity to the bone and soft tissues. They are key tools that used for their indescribable convenience during surgery and operative procedures.

What are external fixators?

External fixators are basically tools that we use to provide surgical intervention in a matter of bone fractures or other bone discrepancies. It includes:

• Clamp: A clamping device is adjusted per a variation of sizes. It stabilizes the entire structure on to the designated bone.
• Schanz Pins: They fix the metal equipment in its place. It is placed in the structure to lock the rods in one place.
• Connecting rods: They are metal rods which contribute to the most important part of external fixators.

 

When do we need to use External Fixators?

This technique requires the utmost precision and is used to help treat patients in several cases.

• Open fractures that have severe implications in the long run.
• Nonunion regions of the bone require appropriate stabilization which is provided with the help of this technique.
• Length of the bone and limbs in general is a feature use of this equipment.
• Certain close fractures with soft tissue injuries.
• Pelvic ring disruptions
• Arthrodesis
• Ligamentotaxis
• Osteotomies

And other boney defects with soft tissues complication are also a great fit for external fixators.

How do we use it?

Holes are drilled onto the boney surface. It provides adequate space for fixing the metal rods in its place. We form a conjoining piece by combining the rod to a ball and socket joint. The external fixator can be aptly adjusted time and again by accessing the ball and socket joint.

External fixators are usually used to rectify a fracture that has no other alternative. But in the case for limb lengthening it is has a specific site. The surgeons allot to man-made fractures but dissecting the femur bone of the thigh and upper leg. This apparatus conveniently stretches the bone apart by slowly increasing the difference of length between the two parts of a bone. The most spectacular display would be the re-emerging of the bone substance in between this gap. The bone would grow and the limb lengthening procedure would be a success. This is referred to as the ‘distraction’ technique that requires immense patience for it to show results. It might take several months before there is any change whatsoever. Unlike the limb extension, fractures take a considerable shorter expansion of time. It has been observed that most fractures, big or small, only require 6-12 weeks at maximum to heal completely.

Precautions:

• Since this is an invasive procedure it is highly recommended to take special care for infection or foreign particles invading the body. Proper facilitation and precautions ensures a safe conduction of this surgical procedure.
• It is advisable to avoid weight bearing exercise, or excessive walking when you have an external fixator attached. This potentiates the effectivity of the entire procedure. It also prevents some undesirable complications.

 

 

Orthopedics in India: What You Should Know!

For those of you who are out of the loop or need a reminder, orthopedics is a branch of medicine that deals exclusively with the prevention and correction of injuries and/or disorders of the skeletal system, including all the joints, muscles and ligaments that are also present. The developments in orthopedic medicine have been quite astounding throughout the past years, with innovations now that can physically allow individuals to feel and function like a new person – especially those orthopedic instruments and implants that can be found at GPC Medical Ltd.

In the current world of medicine a huge number of individuals undergo invasive orthopedic procedures on a daily basis in order to correct a medical condition that has gone astray or an accidental injury, so that they can resume their normal routines and get back to a happy, healthy way of life.  Several health conditions and bodily injuries may lead health providers to recommending their patients to follow through with an orthopedic procedure, including arthritis or a fall that has resulted in disabling injuries.

GPC Medical Ltd. – US FDA 510(k) Approved Orthopedic Implants

In a nutshell, arthritis is a degenerative disorder that progressively worsens over the course of years and eventually causes the joints, especially the knees, to be “bone on bone” which inevitably causes the individual involved excruciating pain and a noticeable decline in how they function and go about their daily routines.  Once a decline in functioning becomes noticeable and the pain becomes more and more unbearable, these individuals may be candidates for total knee replacements.  On the other hand, unexpected injuries may also occur – such as falls – which may require individuals to undergo hip replacements, shoulder replacements, and more.  Ultimately, no matter what the problem is, the patient will deserve the best – and the best can be found at GPC Medical Ltd.

Having state of the art equipment to perform invasive orthopedic procedures is extremely important to ensure the quality of the joint that is being replaced, along with decreasing the chances of complications that the individual may suffer from during and after the procedure at any given time.  As the saying goes, “You get what you pay for,” and you cannot go wrong with the products that will be supplied to you from GPC Medical Ltd.  It may seem like the products and instruments are less expensive than other companies…well that’s the truth…because they absolutely are!  However, put the price aside and be grateful for saving money because the quality will both blow you away and greatly exceed your expectations.  GPC Medical Ltd. offers its products at factory prices because the company strives for the best patient outcomes.  We want to distribute our premium quality products worldwide to make a positive impact everywhere on the lives of others!

The products here are customized to your needs, backed by numerous years of experience, and will always remain competitive and up to date in order to provide the best outcomes for patients worldwide.  Everything you need can easily be found with us and all implants can be customized and fitted for the individual involved to provide for the best experience, allow them to get back to their life, and to leave all their nagging pain behind.  Products you can find with us are produced using premium, quality materials from start to finish.

For joint replacement and repair, you can find the best choices of products with GPC Medical Ltd., including:

• Pins, Wires and Staples – used in various areas of the body.
• Intramedullary Nailing System – intended to replicate natural anatomical shape of the various long bones in the body, to help restore the shape of any fractured bone to its pre-injured state, and more!
• Plating System – includes complex, contoured, and flat plates for spinal fixation,  fractures and fingers. Over 170 models!
• Spinal System – used to facilitate fusion, correct deformities, and stabilize/strengthen the spine. These products are also highly customizable to the patient involved in order to provide the absolute best outcome.
• Arthroplasty – these are used for hip replacements and are one of the most prosperous innovations in modern medicine. Use of these implants can reduce pain and greatly improve functioning. These top quality products at GPC Medical Ltd. are made from stainless steel and titanium.
• Arthroscopy – the joint will not have to be completely opened up in with arthroscopy, and the instruments provided by GPC Medical Ltd. are premium quality in order to decrease risk of complications during inspection of your joint injury.
• Implant Sets – GPC Medical Ltd. provides a wide range of premium quality implant sets that can be used to meet demands of your patient load. With these sets, you’ll be prepared for various injuries and health conditions that may place your patients in need of joint repair or replacement.

The list goes on!  GPC Medical Ltd. has so much more to offer including numerous customized external fixation devices, several different types of instruments (instrument sets, manual bone drills, general instruments, and so much more).  GPC Medical Ltd. also supplies power tools, both electric and battery operated, in order for the procedure to be carried out as smoothly and as efficiently as possible.

By now, you should finally realize why GPC Medical Ltd. is the number one company in India for orthopedic implants and instruments.  We understand how important patient satisfaction and patient outcomes are within the medical setting.  With use of the best equipment from the number one supplier in India, it will provide both the provider and the patient with the comfort of knowing that they are already a step ahead of everyone else undergoing invasive orthopedic procedures.

Products found with GPC Medical Ltd. can be utilized worldwide due to the highly customizable properties of the majority of the implants that are supplied.  If you’re still not 100% sure that GPC Medical Ltd. will provide you with the best products – good news – samples are available at discounted prices in order to provide the chance for complete satisfaction with every product that is offered.  Seriously, one could go on and on about GPC Medical Ltd.

Ultimately, another great characteristic of GPC Medical Ltd. is that you can immediately send the company your requirements and a response will be generated to you within a timely manner.  In this way, you may begin to decide which products you need to fulfill your orthopedic procedure needs.  In addition, company contact information is readily available at your fingertips to make your experience the best it can possibly be.  Do not hesitate to give GPC Medical Ltd. a try to fulfill your next supply order, you will not be disappointed!

Advantages of External Fixation

External fixation is a procedure of immobilizing bones that enables a fracture to heal. This procedure is done by placing screws or pins on both sides of the fracture into the bone. After this, the pins are secured together using rods and with clamps outside the skin. The rods and clamps are also known as the external frame.

 

 

Here is a list of advantages provided by external fixation.

• This procedure allows direct surveillance of the wound and limb status, which includes tense muscle compartments, wound healing, viability of skin flaps, and neurovascular status.
• This process is quick as well as easily applied.
• The risk of infection is minimal at the site of the fracture.
• Other treatment linked with fracture, such as irrigation, bone grafting, skin grafting and dressing changes is possible without disturbing the fixation or alignment of the fracture.
• This process allows simultaneous and aggressive treatment of both soft tissues and bone.
• With external fixation the limb can be positioned and moved without the stress of fracture position loss.
• With this procedure, fixed distraction, Compression or neutralization is possible of the fracture fragments. Moreover, the instant motion of the distal and proximal joints is also allowed. This helps in reducing nutrition and edema of articular surfaces as well as hampers joint stiffening, capsular fibrosis, osteoporosis and muscle atrophy.

Generally, this procedure is used in traumatic and serious injuries as they result in quick stabilization, however, the soft-tissues are still accessible and visible.  An external fixator helps in providing accessibility which is specifically crucial when there is major damage to blood vessels, skin, nerves, or muscle.

There are a number of indications where it is highly applicable to use external fixator. GPC Medical Limited offers a comprehensive variety of external fixation systems for addressing an extensive range of fracture patterns in multiple anatomic locations.