FIG. 7.20 A, Comminuted displaced intraarticular distal radius fracture (a.k.a. Colle fracture). B, After open reduction and internal fixation (ORIF) surgery with anatomic alignment. (From Donatelli RA, Wooden MJ: Orthopaedic physical therapy, ed 4, St Louis, 2010, Churchill Livingstone.)
• Bunionectomy (Keller, Austin)
• Triple arthrodesis
• ORIF of tibia
• ORIF of fibula
Basic Anatomy Affected
• All short and long bones
• Cancellous and cortical bone
Basic Equipment Required
• Fracture table
• Special arm board
• Imaging equipment: fluoroscopy, C-arm, image intensifier
• Power equipment: drill, saw, reamer
• Tourniquet (Esmarch)
• Minor and major orthopedic instrument sets
• Fixation implants: screws, plates, prosthesis
• Draping: extremity drape, split sheet, stockinette as needed
• Polymethylmethacrylate bone cement
• Scavenging system
• Screws: cancellous, cortical, cannulated
• Gigli saw
• Spacesuit/hood
Additional Facts to Remember
• Remember to verify that the correct implants are available and have been supplied before the patient is brought into the surgical suite.
Monitor tourniquet time carefully.
Most screws are self-tapping, but it’s important to remember the sequence of steps in screw insertion nonetheless:
• Know the various types of fractures (Fig. 7.21)
Mapping
Here’s the map for one common orthopedic surgery.
Ready to map? Here are the remaining procedures:
• AKA (above-the-knee amputation)
• BKA (below-the-knee amputation)
• ORIF of radius
• External fixation of Colles fracture
• ORIF of humerus
FIG. 7.21 Types of fractures. (From VanMeter KC, Hubert RJ: Gould’s pathophysiology for the health professions, ed 5, St Louis, 2014, Saunders.)
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