Orthopedic Trauma Implants

Trauma is a physical injury derived from the Greek word meaning “a wound”. It involves transfer of kinetic energy. Orthopedic trauma involves fractures, subluxation or dislocation of bones and joints. Trauma can be of varying degrees and efficient evaluation of the severity of trauma by using ATLS system helps plan an effective management.

Orthopedic Trauma Implants

Implants in Orthopedic Trauma:

Out of various other options for the surgical management of orthopaedic trauma, one involves application of an implant or a device for permanently or temporarily restoring the physiology or anatomy of joint or other skeletal structures. An orthopedic implant is a medical device build to replace or support a lost joint or a damaged bone. Surgeon picks the implant by assessing the weight, size and type most appropriate to the individual. The strength of the implant is provided by stainless steel and titanium alloys used in its production and topped with a plastic coating to act as an artificial cartilage. The operation in orthopedic surgery that involves the implementation of such implants for the purpose of repairing a damaged or lost bone is called internal fixation. Pins, rods, screws and plates are among the few types of medical implants that are used to fixate the fractured bones while allowing them to heal.

Prevention of Infections in Implants:

Major concerns faced with implants are prevention of infection and amalgamation of the implant with the host-tissue. Infection has long been a serious issue leading to limb amputations and even death due to septicemia. Properties of the prosthesis used, such as its chemical composition, hydrophobicity, roughness of the surface are all important factors in the incidence of infection after an orthopedic implantation.

Advent of Antibiotics:

S.aureus and S.epidermitis are the main causative agents of implant-related infections in orthopedic surgery. Thanks to the discovery of antibiotics, the incidence of infections has been reduced and so has the mortality and morbidity associated with it. But the extensive use of antibiotics has produced a number of evolving resistant bacterial strains.

Coating methods:

A new method termed as coating is applied on the surface to further reduce the chances of bacterial invasion of the prosthetic and avoid loosening of the implant. These coatings are of different types such as antibiotic releasing and non-releasing coatings using different techniques such as active or passive methods. Hydroxyapatite is one of the non releasing coatings that require thermal method for application while dip or spray method is used to apply releasing coatings (antibiotic containing coatings) because of reduced thermal stability.

Implant Removal:

Implant removal is a common elective orthopedic operation that contributes 30% of planned surgical operations. In clinical practice the most common indications for implant removal include pain, irritation of soft tissue, and recommencement of strenuous activities after fracture healing or the patient’s demand. For children, it is important to remove implant early to avoid disturbances of the growing bone structure. Implant removal requires a second look operation as it may lead to scar tissue as well as increases chances of nerve damage.

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Orthopedic Nails, Wires, Pins & Staples used in Bone Fracture

Bones are made up of different connective tissues, which have the ability to heal themselves during a fracture. In the case of children and young adults or mild cases fracture, splints and casts are used for the treatment.

However, in all other cases, open reduction and internal fixation are required for which orthopedic nails, wires, pins, and staples are used to give the bone anchorage points so that it can heal properly. The internal fixation depends on the type of the fracture and which bone and parts of the bone are fractured.

Orthopedic Nails:

Nails are usually used for the fracture of long bones like the femur, humerus, tibia etc. The purpose of nails is to immobilize the bone in the correct alignment so that the bone ends do not overlap. There is no fascia or muscle interspersed between the fractured bone ends and both ends meet each other accurately to promote the callus formation. These are metal rods which are fixed in the medullary canal of the long bones to hold the fractured ends together. These are of different varieties and sizes according to the size of the bone and type of bone. Their varieties include:

Orthopedic Nails

Orthopedic Nails

Enders nail: They may be used for distal femoral, proximal humeral, subtrochanteric region of the femur and tibial shaft fractures as it provides three point fixation.

TENS nail: These are used for diaphyseal fractures of long bones, metacarpal, metatarsal fractures and complex fractures of the clavicle.

Other nail types include kuntscher nail, square nail, and rush nail.

Orthopedic Wires:

Wires are famous among children, for example, k-wires are used in sub-trochanteric fracture of humerus common in children. The wires are flexible and easy to bend and are usually used in the fractures of those bones where weight loading is minimal.

Internal fixation using wires is mostly done for the fractures of the small bones like phalanges, metacarpals, and metatarsal. It is also used for fracture of subparts like condyles of the proximal and distal humerus.

Orthopedic Wires

Orthopedic Wires

Its types include:

Suture wire: It is used for internal fixation and tendon repair.

K- wire: It is used for both temporary, permanent fixation, and skeletal traction.

Orthopedic Pins:

Pins are used to correct soft tissue damage and minimal bone fractures. The purpose of pins is that it provides provisional internal fixation so that it can be manipulated by further hardware use and inaccurate permanent fixation is avoided. It comes in different diameters and according to that, it can aid in screw fixation.

Orthopedic Pins

Orthopedic Pins

Various varieties include:

  1. Steinmann pin
  2. Austin Moore pin
  3. Knowles pin

Staples:

When there is vast damage and bone is broken into fragments then staples can be used between these fragments for internal fixation and bone reconstruction. They are more useful than inter-fragmental screws in these types of cases. Staples are usually used around the joints as in ankle and foot surgeries. These staples are also used in cases of soft tissue damage.

Orthopedic Staples

Orthopedic Staples

U-type stainless steel: These are used for internal fixation and bone reconstruction.

Coventry: It is also used for bone reconstruction and also for repair of soft tissue damage.

Types of Orthopedic Bone Screws

Orthopedic bone screws are titanium or stainless steel screws that are used during the surgery of fractured bones. These serve as a support for internal fixation of bones. The material of the bone screws is highly non-reactive, thus these screws do not cause any corrosive or allergic reactions inside the body. They can remain in your body for an entire life period without causing any harm to your bones or any other physical damage.

Orthopedic Bone Screws

Types of Orthopedic Bone Screws

Here is a list of some of the major types of bone screws that are categorized on the basis of the kind of fractures and the consistency of bone tissues.

This type of orthopedic bone screw is used particularly for hard bone tissue, such as shaft of long bones.

Cancellous Screw is specifically made for spongy bones present at the ends.

Pedicle Screws are used by orthopedists for spine fusion or fractures.

These are used to pass a guide wire through it for perfect placement of the screw.

This screw is designed for internal fixation of broken bones that includes the joint cartilage. The major feature of these screws is that they are headless, so even after the settlement of the screw; the joint movements are not clogged by a screw head.

Specialists use Malleolar Screws for the fixation of ankle fractures.

All these bone screws play a vital role in the treatment of serious bone injuries. However, it is necessary to use them properly; otherwise improper use can result in nonunion of the fractured bones, damage to body tissues and infection.

GPC Medical Limited offers a comprehensive variety of bone screws for internal fixation systems for addressing an extensive range of fracture patterns in multiple anatomic locations. GPC Medical Limited is the first company to offer US FDA 510(k) approved bone screws.

Intramedullary Interlocking Nails – An Overview

Intramedullary interlocking nails are used for fracture fixation. During this process, a long metallic implant is integrated through the medullary canal at one end of a long bone. The intramedullary nail may itself traverse a fracture or it may be used as a firm support for other nails, pins and screws that fixate a fracture. Nails are less flexible and thicker as compared to rods that are simple solid cylinders that can’t be fixated with pins or screws.

The nails generally comprise of distal and proximal holes for the insertion of interlocking pins and screws that fixate the implant to the bone. Nails can be both hollow and solid and can have square, circular or more complicated cross-sections.

The large diameter nails require the medullary cavity reaming prior to implantation. Besides, nails can also be located in a retrograde or antegrade manner. This means integration through the distal or proximal end of the medullary canal of a long bone. Usually, retrograde implantation is used for the treatment of the femoral diaphysis fractures.

Intramedullary Interlocking Nails

When nails are implanted without locking pins or screws, then this provides splintage, angulation of a fracture and lateral displacement control. However, this does not offer rotational control. Nails at both distal and proximal ends provide translational and rotational control of a fracture as well as prevent distraction and impaction. This is known as static locking.

When a femur or tibia fracture has healed to a specific degree, then it is possible to remove locking devices at one or the other end so that weight bearing can lead to dynamic compression of the fracture. This is known as the nail dynamization.

There is an extensive range of femoral nails due to the more complicated anatomy of the femur. These nails can be integrated in a retrograde or antegrade fashion.

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Locking Plate System – An Overview

gpc-locking-plate-screw

Screw and plate osteosynthesis has been clinically recognized and established for many years. Through the years, screw and plate technology has progressed to continually enhance surgical outcomes. GPC Medical offers an extensive range of screw and plate systems and is dedicated to improving existing treatments in orthopedic trauma surgery through its products.

Basically, the Locking Screw and Plate System combines locking advanced plate designs with the screw technology to create constructs that are used where poor bone quality or deficient bone stock is encountered or in comminuted fractures. These plates can be used as fracture compression tools and locking devices by combining compression slots with locking screw holes.

This transition in thickness of the plates combined with technical innovation provides surgeons the capability to lock in perfectly.

The locking plate system was specifically designed using the idea of internal fixators. This offers an innovative solution for the osteoporotic fracture fixation. The fixed angle between the plate and the screw increases the system’s pullout strength, so the fixation stability no longer relies completely on the quality of bones.

Major Benefits

Here is a list of some major benefits of using a locking screw/plate system:

  • There is no need of accurate contouring
  • The locking screw and plate system protects the local blood supply.
  • This system does not disrupt the underlying perfusion of cortical bone like other conventional plates that compress the plate’s undersurface to the cortical bone.
  • Another benefit of using locking screw/plate systems is that the screws are not likely to loosen from the plate. So, in case the screw is placed into a fracture gap, there is no risk of loosening of the screw.
  • This system has been shown to offer more stable fixation as compared to other traditional conventional non-locking screw/plate systems.

Check out the link below, to know more about different types of locking plates & screws:

http://www.indianorthopaedic.com/implants/plating-system/locking.html

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What is an Internal Fixation?

In orthopaedics internal fixation is a surgical procedure for holding together the fractured bone for the purpose of repairing a bone. This concept comes in the light in mid- 19th century and after that it is used for the routine treatment of the patients who suffered from the bone fracture. In internal fixation a broken bone must be carefully stabilized and supported to the point of time it is strong enough to handle the weight of the body. During the surgery of broken bones through internal fixation the bone fragments are first reduced into their normal alignment then they are hold together with the help of internal fixators such as plates, screws, nails and wires.

Open Reduction Internal Fixation:

It is a type of surgery used to fix broken bone. There are two parts of the surgery in the first part a broken bone is reduced or put back into place and in the next part internal fixation device is placed on the bone. This can be done with the use of internal fixators such as screws, plates, rods, wires or pins that are used to hold the broken bone together.

Close Reduction Internal Fixation:

In closed reduction internal fixation, without any open surgery fractures can be reduced closed with a very minor incision. In case if fracture is displaced after closed reduction which exceeds 2 mm then open reduction internal fixation is recommended.

Types of Internal Fixators:

These internal fixators may be made of stainless steel or titanium which are durable, strong and long lasting. If a joint is to be replaced rather than fixed these implants can also be made of chrome and cobalt. These fixators rarely cause any allergic reaction and are compatible with the body.

1) Metal plates:

Plates are attached to the bone with screw which holds the broken pieces of bone together. These are like internal splints and may be left in place or removed after healing is complete this depends upon case to case.

2) Pins or wires:

Pins or wires are often used to hold together pieces of bone that are very small to be fixed with screws. Some times in many cases wires are used in conjunction with other form of internal fixators, but they can be used alone to treat fractures of small bones which are found in the hand or foot. Wires are normally removed after a certain amount of time or they may be left in permanently for some fractures.

3) Rods or nails:

The best way to hold the fractures of the long bones pieces together is by implanting a rod or nail through the hollow centre of the bone that normally contains some marrow.  Screws are used to keep the fracture from shortening or rotating until the fracture is healed, which are placed at each end of the rod. Majority of fractures are treated through this method in the femur and tibia; nail and rod are left in the bone after healing the healing is complete.

4) Screws:

There are various design and size of screw available in the market based on the type of fracture. These screws can be used alone or used to hold the other fixators such as plates, rods and nails. Screws may be either left or removed after healing the bone.

Internal fixation is opposite of external fixation of a fracture which is done by using splint or cast. Orthopaedic surgeons are regularly developing and improving the methods of treating the fractures. These internal fixations are done by the experienced surgeon by using imaging machines like X-ray machines, ultrasound, MRI machines etc. All the procedures have some risks, but problem from this procedure are rare. Infection, bleeding, blood clots and infection to anaesthesia are some potential problems which will be reassess by your doctor.

Othopedic Implants Company India

Orthopedic Implants | External Fixators | Orthopedic Instruments | Surgical Power Tools

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