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IMplants

IMplants. Peter Hull With thanks to LVR March 2012. Fracture Fixation. Screws Plates Nails External fixators. Screws. Head Stops screw sinking in bone Connection to screw driver ? Locking screw, locks head into plate Shaft Core, Partial or fully threaded Thread Shape Depth Pitch

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IMplants

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  1. IMplants Peter Hull With thanks to LVR March 2012

  2. Fracture Fixation • Screws • Plates • Nails • External fixators

  3. Screws • Head • Stops screw sinking in bone • Connection to screw driver • ? Locking screw, locks head into plate • Shaft • Core, Partial or fully threaded • Thread • Shape • Depth • Pitch • Tip • Blunt • Self tapping

  4. Screw types • Cortical • Cancellous • Partially threaded • Headless • Locking • Fixed angle • Variable angle

  5. Locking screws/ plates

  6. Screw • Normal screw • Drill core • Measure • (Tap) • Countersink • Insert screw

  7. Lag Screw • Lag screw • Over drill near cortex Gliding hole • (thread diameter) • Drill core diameter • Measure • (Tap) • Countersink • Insert screw

  8. Compression screw (plate) • Compression screw • Anchor plate • Eccentric drill • Repeat

  9. Headless Compression Screws • Achieve compression via • Variable pitch in the thread • Examples • Herbert screw • Barouk screw • Acutrak / Acutrak 2

  10. Screws and drills

  11. Plates • 1/3rd tubular • Reconstruction plate • Dynamic Compression Plate – DCP • Low Contact Dynamic Compression Plate – LCDCP • Locking Compression Plate – LCP • Special plates • Pre contoured, anatomic, injury specific

  12. Intramedullary nail • Solid • Hollow, cannulated • Reamed • Un reamed • Titanium elastic nails (TENS) • Bending rigidity proportional to diameter 4 • Increasing diameter by 10% increases bending rigidity by 50% • Reaming allows increased torsional resistance due to larger contact area and allows larger nail with increased rigidity and strength

  13. External Fixation • Monolateral frame • Hybrid • Ilizarov frame

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