OR Comp Flashcards
What is a cannulated screw used for?
-subcapital femoral neck fracture (femoral head/neck junction)
What is a DHS? What it is used for?
Dynamic Hip Screw
Used for intertrochanteric fracture
-fractures outside of the capsule, subcapsular, intertrochanteric, (fractures where blood vessels are left unharmed)
What is a DHS interchangable with?
Short gamma nail
What does a DHS require?
Intact lateral cortex
Short Gamma Nail is also known as?
Trochanteric Fixation Nail
What is a short gamma nail used for?
- fractures located outside the capsule (sub/inter trochanteric)
- interchangeable with the DHS
- also used for further down the neck
Birmingham?
- used on younger/active patients
- femoral neck maintained for potential future replacement
- patient likely to need total hip replacement in the future
Hemi Arthroplasty?
- replacement of femoral head/neck OR acetabulum, but not both
- cap and stem = single unit
- younger patients
- for fractures around stem: can occur during surgery or from trauma
What is the capsule of the hip?
Where the blood vessels are located
What is a THR/THA?
Total Hip Replacement/Arthroplasty
THR
- stem inserts into femur, ball that replaced head of femur, shell that linens acetabulum
- generally not applicable in trauma situations (patient have chronic pain and mobility issues after surgery)
What is a gamma nail used for?
- subtrochanteric or diaphyseal fracture
- intertrochanteric fractures with loss of bony cortex integrity
Components of gamma nail
- screw in neck, IM nail in femur, locking screw at knee
- may be performed antegrade or retrograde
- may use circlage wire as well (wraps and tightens bone)
TKR/TKA
Total Knee Replacement/Arthroplasty
- indications include pain, joint deformity, primarily from arthritis
- x-ray not required during OR procedure, but pre-op and 2 day post-op required
What does IM nail stand for?
Intramedullary
Tibial IM nail?
- tibial diaphyseal fracture
- fibula is non-weightbearing and is often not plated unless the integrity of the ankle joint is compromised
- may use circlage wire as well
Plate and Screw fixation
-used for absolute fixation on anatomy where callus formation would limit mobility, such as ankles, wrists, and spines
K-Wires
- used for finicky fractures (phalanges, metatarsals/carpals, calcaneus, wrists, etc.)
- fixates bone until the healing takes place, the wire is then removed
External fixation (ExFix)
- commonly used when swelling in the limb is an issue but fixation is still necessary
- surgeon will perform an ORIF 7-10 days later once the swelling has subsided
Pacemaker
- pt with inadequate cardiac pacing
- consists of 1 single chamber, 2 dual chamber, or 3 CRT levels with a greater generator, up at the left or right shoulder
- vascular (cine) runs are common
- always use cardiac appropriate C-arm
Total Hip Replacement (Dr. Burkart)
- X-table lateral pelvis done in OR
- patient positioned with affected side up
- increase technique to compensate for increased soft tissue density on the side down
- lines drawn on image post exam for measurement
X-table spines
- used to localize ROI and confirm hardware placement
- L-spine and C-spines
Why is I.I below table not recommended?
Increased dose due to scatter and increased OID (decreased image resolution, increase scatter)
Common uses of the C-arm
- hip pinnings
- open/closed fracture reduction
- cholangiography
