Orthopaedic Surgeries

Dr.S.A.Prem Kumar
 Arthrodesis
• The term arthrodesis refers to surgical fusion of
a joint.

• The indications for this are pain & instability in

a joint and, in some situations, following the
failure of joint replacement .

• With the increase & improvements in the field

of joint replacement arthrodesis is now carried
out much less frequently.
• Ideally arthrodesis is carried out as an intra-articular
procedure. All articular cartilage is removed from both
surfaces of the joint and the bone ends shaped to fit in the
required position.

• They are held there by internal fixation , an external fixator

device or external splintage (e.g. POP) or a combination of
these methods, until the fusion is sound.

• Where possible compression is applied to the bone ends to

promote fusion. Occasionally extra-articular arthrodesis is
carried out.
 Optimum positions

• ELBOW : 90° of flexion .

• WRIST: A few degree of extension

• THUMB: MCP joint in 20° of flexion. IP joint in slight

flexion.

• FINGERS: MCP joints in 20° -30° of flexion. (these joints are

rarely fused).
Proximal IP joints in 40° -45° of flexion (less in
middle & index fingers)
 Arthroplasty
• Is an orthopedic surgical procedure where the
articular surface of a musculoskeletal joint is
replaced, remodeled, or realigned
• Partial
• Total
 Osteotomy
• An osteotomy is a surgical operation whereby
a bone is cut to shorten or lengthen it or to
change its alignment.
Pelvis
 Spinal Stabilisation Surgeries
• Anterior
• Posterior
• Combined
 External Fixation
• Surgical technique of stabilization of a fracture
by implants outside the body
• To stabilise fractures when the pt can’t
tolerate definitive surgery
• In instances where the skin condition and
wound contamination precludes internal
fixation
Uniplanar Tubular Ex-Fix
Biplanar Ex-Fix
Ilizarov Ex Fix
 Limb Reattachments
• Involves attempts to reattach and reconstruct
a completely amputated limb or a part of it

• Age, Severity of Injury, Level Of Injury, Warm

Ischemia time, Prior disability
 Transport of Injured Limb
• It may be wrapped with sterile gauze or other clean
material, soaked in sterile lactated Ringer or saline,
and placed in a plastic bag, which is then sealed.
• It may be immersed in a plastic bag containing a
physiological solution such as lactated Ringer or
saline.
• The bag is placed on ice in an insulated container so
that the part is not touching the ice to avoid
freezing of the part.
 Ischemia Time
Warm Cold

Less Muscle 6 hours 12 hours

More muscle 8 hours 30 hours

 Sequence of Reconstruction
• Bone shortening and fixation
• Arterial Repair
• Nerve Repair
• Vein
• Tendons
• Skin
Thank You