In orthopaedic surgery, general instruments refer to commonly used surgical tools that assist in the implantation of orthopaedic devices (like plates, screws, nails, and prosthetics). These instruments are designed to facilitate access, preparation, fixation, and alignment of bone and implants.

 

Here’s a list of key general instruments used in orthopaedic implants:

Cutting Instruments

  • Bone saws (oscillating/sagittal saws): For cutting bone.
  • Osteotomes and chisels: Used for precise bone cutting or reshaping.
  • Rongeurs: For removing bone fragments.

Holding and Grasping Instruments

  • Bone-holding forceps (reduction forceps): For holding bone fragments during alignment.
  • Periosteal elevators: Used to strip periosteum and elevate soft tissues.
  • Needle holders: For suturing soft tissues around implants.

Drilling and Tapping Instruments

  • Drill guides/sleeves: Ensures accurate drill trajectory and protects soft tissue.
  • Drill bits: Used to make holes in the bone for screws or implants.
  • Taps: Create threads in bone for cortical or cancellous screws.

Measuring and Alignment Instruments

  • Depth gauges: Measure depth of drilled hole to determine screw length.
  • Rulers and calipers: For measuring dimensions of bones or implants.
  • Alignment guides/jigs: Maintain anatomical positioning during implant placement.

Implant-Specific Instruments

  • Screwdrivers (hex, AO, etc.): For inserting screws.
  • Plate benders: Used to contour plates to fit the bone anatomy.
  • Intramedullary nail insertion/extraction tools: Guide rods, impactors, and extractors.

Retractors and Soft Tissue Tools

  • Hohmann retractors: Common for exposing bone surfaces.
  • Self-retaining retractors (e.g., Gelpi, Weitlaner): Hold incisions open.
  • Curettes: Scraping away bone or tissue.

Bone Preparation Instruments

  • Reamers: Enlarge or shape the intramedullary canal.
  • Broaches: Prepare bone for press-fit implants (e.g., in arthroplasty).

Common Instrument Sets (Kits)

  • Basic orthopaedic set: Includes general tools for exposure and handling.
  • Plating set: Tools specific to dynamic compression plates, locking plates.
  • Nailing set: Includes guide wires, reamers, and nail insertion tools.
  • Arthroplasty set: For joint replacement surgeries.

Type of general instruments

Cutting Instruments

These instruments are used to cut bone or soft tissues.

Bone Saws

  • Types: Oscillating saw, sagittal saw, Gigli saw.
  • Use: Cutting bone during osteotomy or joint replacement.

Osteotomes and Chisels

  • Use: Precise bone cutting or sculpting.

Osteotome: Beveled on both sides.

  • Chisel: Beveled on one side only.

Rongeurs

  • Use: Remove bone or soft tissue fragments.
  • Types: Kerrison, Leksell, double-action.

Curettes

  • Use: Scrape bone or soft tissue, e.g., in debridement.

Grasping and Holding Instruments

Hold bone, implants, or tissues during procedures.

Bone-Holding Forceps

  • Types: Lane, Verbrugge, reduction clamps.
  • Use: Hold bone fragments during fixation or alignment.

Towel Clamps and Allis Forceps

  • Use: Secure drapes or hold soft tissue.

Needle Holders

  • Use: Hold suture needles for wound closure.

Drilling, Tapping, and Screw Insertion Instruments

Drill Bits

  • Use: Create holes in bone for screw placement.
  • Sizes: Correspond to screw size (e.g., 2.5mm for 3.5mm screw).

Drill Guides (Sleeves)

  • Use: Direct the drill accurately and protect soft tissue.

Taps

  • Use: Cut threads in bone before screw insertion (for cortical screws).

Screwdrivers

  • Types: Hex, AO, cruciform, cannulated.
  • Use: Drive or remove screws.

Measuring and Alignment Instruments

Depth Gauge

  • Use: Measures hole depth to choose correct screw length.

Rulers and Vernier Calipers

  • Use: Measure bone segments or implant dimensions.

Alignment Guides/Jigs

  • Use: Ensures proper alignment for plates, nails, or prostheses.

Retracting and Exposing Instruments

Hohmann Retractors

  • Use: Retract soft tissue and expose bone.

Self-Retaining Retractors

  • Types: Gelpi, Weitlaner
  • Use: Keep incisions open hands-free.

Freiberg, Bennett Retractors

  • Use: Common in joint replacement surgeries.

Bone Preparation Instruments

Reamers

  • Use: Enlarge intramedullary canal (e.g., femur for nail or prosthesis).

Broaches

  • Use: Shape bone for press-fit implants (common in arthroplasty).

Rasps

  • Use: Smoothen or shape bone surfaces.

Implant-Specific Tools

Plate Benders

  • Use: Contour plates to match bone curvature.

Impactors and Extractors

  • Use: Insert or remove nails or prostheses.

Guide Wires / K-Wires

  • Use: Initial positioning for screws, nails, or wires.

Miscellaneous General Tools

Bone Mallets

  • Use: Strike osteotomes or impact implants.

Suction Tips

  • Use: Remove blood and fluids for clear visualization.

Cement Guns or Mixers

  • Use: Used in joint replacement to apply bone cement.