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Instrument:
DRILL GUIDE
Other names:
Drill sleeve, drill bit guide
Category:
Accessory
Description:
The working end is a hollow tube called a sheath or cannula into which the drill bit
slides. These can be single- or double-ended and may be straight or have angles of
varying degrees. The rim of the sheath has V-shaped edges that seat the guide into
the bone to prevent slipping.
Use(s):
Provides a more precise drill hole. Used to align the drill bit in the center of the hole
in the plate, protects the soft tisue from damage, and prevents the drill from slipping
and making a larger hole.
Instrument insight:
Some surgeons prefer that you slide the guide on the drill bit before handing the
drill to them, while others prefer to place the guide first and then insert the drill bit
into the guide.
393
Instrument:
BONE CEMENT INJECTOR
Other names:
Cement gun
Category:
Accessory
Description:
The proximal end has a plunger-type disk that moves forward when the handles are
compressed. This forces the glue through the chamber and out the tip, similar to a
caulk gun.
Use(s):
Used for injecting polymethyl methacrylate (PMMA) bone cement during total joint
procedures.
Instrument insight:
Setting time for PMMA is approximately 8 to 16 minutes after the prosthesis is
positioned. The surgeon will need to know how the glue is setting; be sure to obtain
a small amount of glue to test for heat and hardening and record the time when the
glue was placed in the gun.
394
Instrument:
BONE CEMENT SYSTEM
Category:
Accessory
Description:
A funnel-shaped mixing bowl that has a lockdown lid with attached stirring paddles
on the underside and a crank handle on top. Screwed to the bowl is the injection
cartridge with a removable supporting base. Attached to the base is the vacuum
tubing. This system is a disposable closed vacuum system.
Use(s):
Used for mixing the liquid (monomer) and powder (polymer) to produce bone
cement, also known as polymethyl methacrylate (PMMA).
Instrument insight:
The manufacturer recommends double gloving when mixing cement. Nonlatex
gloves are not recommended because the liquid monomer can be absorbed through
gloves.
Caution:
The liquid monomer is highly flammable; the electrosurgical pencil should never be
used near the liquid or the uncured cement.
395
Instrument:
PUMP TUBING
Category:
Accessory
Description:
Hollow tubing with bifurcated spike ports and tubing clamps on one end, and the
pump attachment mechanism and a Luer-Lok attachment at the other end.
Use(s):
Attaches irrigation fluid bags to pump at one end, with the other end attached to the
arthroscopic irrigation cannula.
396
Instrument:
4-MM SHEATH WITH BLUNT OBTURATOR
Category:
Accessory
Description:
A hollow stainless-steel sheath with a blunt-tipped obturator that fits inside.
Use(s):
Creates a port into which the endoscope is introduced and exchanged through the
sheath or cannula.
Instrument insight:
The blunt tip is less traumatic on the tissues. Tip can be various sizes, depending on
the size of the joint.
Instrument:
4-MM SHEATH AND SHARP OBTURATOR
Category:
Accessory
Description:
This is a hollow stainless-steel sheath with a sharp-tipped obturator that fits inside.
Tips are available in various sizes, depending on the size of the joint.
397
Use(s):
Creates a port into which the endoscope is introduced and exchanged through the
sheath or cannula.
Instrument insight:
The sharp tip is used to pass through tough tissue.
Instrument:
ABLATION WAND
Other names:
Cool cut wand
Category:
Accessory
Description:
Radiofrequency ablation device with a white and blue plastic handle with buttons
for cut and coagulation. A long insulated shaft advances from the handle, which
leads to a 90-, 50-, or 30-degree tip. The working tip has two metal scalloped rings on
it that facilitate the ablation.
Use(s):
To clean up and smooth out meniscus and articular surfaces during an arthroscopy.
Instrument insight:
398
Instrument:
CHUCK AND KEY
Other names:
Drill chuck
Category:
Accessory
Description:
A chuck is a specialized type of clamp in which the jaws, which are arranged in a
radially symmetric pattern like the points of a star, are used to hold a cylindric
object.
Use(s):
Most commonly used to hold rotating devices, such as the drill bit or a pin in a
power tool. Some chucks can also hold irregularly shaped objects and those that lack
radial symmetry. Often the jaws will be tightened or loosened with the help of a
chuck key, which is a wrench-like device made to tighten or loosen the jaws.
402
Instrument:
UNIVERSAL SCREWDRIVER SET
Other names:
Screwdriver kit
Category:
Accessory
Description:
Set consists of a handle that accommodates any of the four double-ended
screwdriver bits and one each of small and large single-slot, cross and cruciate, 3.5-
mm and 4.5-mm hex, and small and large Phillips heads.
Use(s):
Used during revision of total joint surgery in which screws were used, removal of
bone plates, fracture fixation screws, or bone graft screws.
Instrument insight:
The set helps eliminate the opening of multiple sterile packs when a specific size or
style of screwdriver is needed.
403
Instrument:
PLATE-BENDING PLIERS
Other names:
Plate bender
Category:
Accessory
Description:
Pictured are large forceps. The plate is slid into the jaws and compressed to bend the
plate. These come in various sizes and designs depending on the type of plating
system that is being used and the size and type of bone that is being fixated.
Use(s):
Used during open reduction internal fixation (ORIF) to bend the plate to conform to
the contour of the bone in which it is being implanted.
Instrument insight:
Often plate benders will be found in the fixation set that you are using.
404
Instrument:
LEAD HAND
Category:
Accessory
Use(s):
Often used during hand procedures to position the hand open for exposure.
Description:
A hand-shaped malleable metal device with tabs.
Instrument insight:
The patient’s hand is generally laid onto the lead hand palm up. The metal fingers
are bent up over the top of the patient’s fingers to hold them down; then the tabs are
molded around the wrist, index finger, and little finger to secure the hand open.
405
Instrument:
GIGLI SAW
Category:
Cutting and Dissecting
Description:
A flexible, twisted wire cable with looped ends that affix to the hooks on the two T
handles. The handles may also be oval or box shaped. The wire cable may be
replaced after each use or when it becomes dull.
Use(s):
A type of hand saw used for cutting bone. A back and forth movement of the T
handle slides the cable over the bone, creating a notch that continues through the
bone. Often used for amputations and can be use to open the skull for craniotomies.
Caution:
Do not run fingers and/or hand along the blade; this could tear gloves and skin.
406
Instrument:
STRYKER SYSTEM 6 POWER
Category:
Cutting and Dissecting
Description:
All-in-one battery-powered system that consists of an oscillating saw, reciprocating
saw, sternal saw, and a rotary handpiece. The rotary handpiece is used for reaming
or drilling and has a variety of attachments and chucks that are used for a specific
purpose.
Use(s):
Used for cutting, reaming, or drilling large bones.
407
Instrument insight:
Check batteries for a full charge. Check the surgeon’s preference card for the
appropriate saw blades. Power instruments should never be submerged in water.
Instrument:
STRYKER CORE SYSTEM
Other names:
TPS system
Category:
Cutting and Dissecting
Description:
An all-in-one electrical-powered system that consists of sagittal, oscillating, and
reciprocating saws, microdrill, and a universal driver handpiece. The universal
drivers are capable of pin and wire driving, sawing, drilling, tunneling, or reaming
and have a variety of attachments, collets, and chucks that are used for a specific
purpose.
Use(s):
Used for cutting, drilling, or burring small bones.
Instrument insight:
Refer to the surgeon’s preference card for type of blades or burrs used. Power
instruments should never be submerged in water.
408
Instrument:
CORDLESS DRIVER 4
Other name:
CD4 power system
Category:
Cutting and Dissecting
Description:
All-in-one battery-powered system that consists of sagittal, oscillating, and
reciprocating saws, microdrill, and universal driver handpiece. The universal drivers
are capable of pin and wire driving, sawing, drilling, tunneling, or reaming and have
a variety of attachments, collets, and chucks that are used for a specific purpose.
Use(s):
Used for cutting, drilling or burring bones.
Instrument insight:
Check batteries for a full charge. Check the surgeon’s preference card for the
appropriate saw blades. Power instruments should never be submerged in water.
409
Instrument:
DRILL BIT SET
Other names:
Drill box
Category:
Cutting and Dissecting
Description:
The drill bits in this case range from 1.6 to 4.7 mm.
Use(s):
Drill bits are used to drill holes in bone, usually before the placement of a screw.
410
Instrument:
LITTLER SCISSORS
Category:
Cutting and Dissecting
Description:
Slightly curved, blunt-tipped, sharp blades. The holes on the blades serve to draw
suture or muscle through a tunnel dissection.
Use(s):
Used for fine tissue dissection.
Instrument insight:
Use caution when passing because of sharp edges; only use on tissue—never use to
cut drapes or sutures.
Instrument:
UTILITY SCISSORS
Other names:
Bandage scissors
Category:
411
Cutting and Dissecting
Description:
Serrated edge with a blunt tip on the lower jaw to prevent cutting tissue or skin.
Use(s):
Cut bandages, casting material, clothing, and other nonsterile items.
Instrument insight:
Used to cut dressing, drapes cast material, etc. These scissors should never be used
to cut tissues or suture.
Instrument:
BONE FILE
Other names:
Rasp
Category:
Cutting and Dissecting
Description:
A single-handle instrument with a flat end with serrations in a crisscross pattern.
Use(s):
412
Used for smoothing rough edges or surfaces of large bones.
Instrument insight:
This should always be available during total joint procedures to smooth bone
surfaces.
Instrument:
MILLER RASP
Other names:
Small rasp
Category:
Cutting and Dissecting
Description:
A double-ended instrument with tear-shaped ends. One end has fairly thick ridges
in parallel lines; the ridges on the other end are closer together.
Use(s):
Used for smoothing rough edges or surfaces of small bones.
Instrument insight:
Instrument is used to smooth bone surfaces in small areas or when the areas are hard
to reach.
413
Instrument:
PUTTI BONE RASP
Other names:
Putti-Platte rasp, rat tail
Category:
Cutting and Dissecting
Description:
A flattened, double-ended rasp with a rounded blade on one end and a half-rounded
blade on the other end. The blade surfaces are covered with tiny spikes.
Use(s):
Used for smoothing rough edges or surfaces of large bones.
Instrument insight:
Immerse and gently stir the rasp in water to keep instrument surface clean between
uses.
Caution:
Do not run fingers and/or hand along the blade; this could tear gloves and skin.
414
Instrument:
KEY ELEVATOR
Category:
Cutting and Dissecting
Description:
A solid, smooth, octagonal handle with a squared, flat, and sharp working end that
comes in a variety of sizes.
Use(s):
Dissects or separates hard tissue (e.g., periosteum from bone).
Instrument insight:
Inspect edge before and after each use for nicks to ensure sharpness.
415
Instrument:
CREGO ELEVATOR
Category:
Cutting and Dissecting
Description:
Thick handle with long, thin, curved, flat edge.
Use(s):
Dissects or separates tissue; retracts tissue.
Instrument insight:
Inspect edge for nicks to ensure sharpness.
416
Instrument:
FREER ELEVATOR
Category:
Cutting and Dissecting
Description:
Round handle with flattened, tear-shape tips at both ends; one end is sharper than
the other.
Use(s):
Lifts the periosteum from bone or retracts in confined spaces.
Instrument insight:
Small balls of bone wax are pressed onto the tip and then are smeared in bone edges
for hemostasis.
Instrument:
LISTON BONE CUTTING FORCEPS
Other names:
Large bone cutters
Category:
417
Cutting and Dissecting
Description:
Large double-action forceps with curved or straight blades that are rounded to the
tip with sharp inner jaw edges.
Use(s):
Used for cutting large bones.
Instrument insight:
The double action gives the forceps more torque at the tip for better cutting action.
Instrument:
STILLE BONE GOUGE
Category:
Cutting and Dissecting
Description:
A flat, round impaction platform with a solid octagonal handle that extends to a
trough-like blade that has a sharp cutting edge. Gouges are available in cases or in
sets with a variety of sizes.
Use(s):
Used to cut or scoop out a channel of bone.
418
Instrument insight:
Always hand the gouge to the surgeon with a mallet. Inspect edges for breaks or
nicks to ensure precision, sharpness, and patient safety.
Instrument:
STILLE BONE CHISEL
Category:
Cutting and Dissecting
Description:
A flat, round impaction platform with a solid octagonal handle that extends to a
flattened, flared blade with a beveled edge. Chisels are available in cases or in sets
with a variety of sizes.
Use(s):
Used to cut or shape bone. The chisel is often used when harvesting a bone graft.
Instrument insight:
Always hand the chisel to the surgeon with a mallet. Inspect edges for breaks or
nicks to ensure precision, sharpness, and patient safety.
419
Instrument:
STILLE BONE OSTEOTOME
Category:
Cutting and Dissecting
Description:
A flat, round impaction platform with a solid octagonal handle that extends to a
flattened, flared blade. Osteotomes are available in cases or in sets with a variety of
sizes.
Use(s):
Used to cut or shape bone. The osteotome is often used when harvesting a bone
graft.
Instrument insight:
Always hand the osteotome to the surgeon with a mallet. Inspect edges for breaks or
nicks to ensure precision, sharpness, and patient safety.
420
Instrument:
LAMBOTTE OSTEOTOME
Category:
Cutting and Dissecting
Description:
A flattened stainless-steel ribbon that tapers to a sharp cutting edge; osteotomes are
available in widths of various sizes.
Use(s):
Used to cut or shape bone. An osteotome is often used when harvesting a bone graft.
Instrument insight:
Osteotomes may come in cases or sets with a variety of sizes and may be straight or
curved. Inspect edges for breaks or nicks to ensure precision, sharpness, and patient
safety.
421
Instrument:
CANNULATED PIN CUTTER
Other names:
Pin cutter
Category:
Cutting and Dissecting
Description:
Heavy, curved handles with extremely curved jaws that meet flush against one
another and have extremely sharp edges. There is a circular pin channel between the
jaws that runs through the lock box and between the handles. The channel allows the
pin to slide through the jaws so the proper length can be cut.
Use(s):
Used for cutting wire or small pins, such as Kirschner wires (K wires) or Steinmann
pins.
Instrument insight:
Inspect jaw edges for breaks or nicks to ensure precision and sharpness.
422
Instrument:
DIAMOND PIN CUTTER
Other names:
Pin cutter
Category:
Cutting and Dissecting
Description:
Heavy, curved handles with a guillotine-action tip. The working end has an angled
channel that allows the pin to be placed into the jaw so the proper length can be cut.
Use(s):
Used for cutting wire or small pins, such as Kirschner wires (K wires) or Steinmann
pins.
Instrument insight:
Double-action jaws allow for more power when cutting. Inspect for sharpness and
smooth action of jaw and cutting surfaces.
423
Instrument:
LARGE PIN CUTTER
Other names:
Bolt cutter, rod cutter
Category:
Cutting and Dissecting
Description:
Very long handles with double-action hinges and a sharp, small cutting surface.
Use(s):
Used for cutting heavy pins and rods.
Instrument insight:
A long handle with double action allows a great amount of force to be applied to the
jaws.
Caution:
When setting up, always check the screw to ensure it is tightened down and can not
fall out into the wound when in use.
424
Instrument:
BRUNS OVAL BONE CURETTES
Other names:
Curettes
Category:
Cutting and Dissecting
Description:
Thick handles with a small scoop at one end; scoops have a variety of shapes and
angles.
Use(s):
Used for scooping out tissue or material from small, tight areas.
425
Instrument:
STILLE-LUER RONGEUR
Other names:
Straight rongeur, large-mouthed rongeur
Category:
Cutting and Dissecting
Description:
Large-handled, double-action mechanism with large, oval cup-shaped jaws.
Use(s):
Used to grasp, bite, and detach large amounts of tissue.
Instrument insight:
Frequently used instrument for large cases that require significant dissection or
cleaning of the area.
Caution:
When setting up, always check the screw to ensure it is tightened down and not fall
out into the wound when in use.
426
Instrument:
ZAUFEL-JANSEN RONGEUR
Other names:
Small-mouthed rongeur
Category:
Cutting and Dissecting
Description:
Large handle with double-action mechanism and thin, sharp jaws.
Use(s):
Used for removing pieces of bone and the soft tissue surrounding the bone.
Instrument insight:
The double-action mechanism gives the rongeur more torque at the tip for better
biting action. Always have a moistened sponge ready when handing the surgeon a
rongeur. As the surgeon works to remove tissue and/or bone, the rongeur has to be
cleaned between uses. While focusing on the wound, the surgeon will point the tip
of the rongeur toward the surgical technologist. Using a moistened sponge, the
surgical technologist will clean the tissue from the jaws.
Caution:
When setting up, always check the screw to ensure it is tightened down and can not
fall out into the wound when in use.
427
Instrument:
CUSHING RONGEUR
Category:
Cutting and Dissecting
Description:
Medium-sized handle with a single hinge and short, oval, cup-shaped jaws.
Use(s):
Used for removing pieces of bone and the soft tissue surrounding the bone.
Instrument insight:
Always have a moistened sponge ready when handing the surgeon a rongeur. As
the surgeon works to remove tissue and/or bone, the rongeur has to be cleaned
between uses. While focusing on the wound, the surgeon will point the tip of the
rongeur toward the surgical technologist. Using a moistened sponge, the surgical
technologist will clean the tissue from the jaws.
428
Instrument:
DUCKBILL RIGHT AND LEFT BITER
Category:
Cutting and Dissecting
Description:
A thick handle with thumb lever that opens and closes the jaws. Has a square-
shaped cutting tool on the right or left side of the instrument.
Use(s):
Cuts and dissects tissue during arthroscopy procedures.
Instrument insight:
Before handing to the surgeon, hold this instrument by the handle with the cutting
end away from you so that you may visualize what side the cutter is facing.
429
Instrument:
DUCKBILL STRAIGHT BITER
Category:
Cutting and Dissecting
Description:
Ringed handles with a thin rod that has a rectangular-shaped cutter attached
distally.
Use(s):
Cuts and dissects tissue facing the surgeon.
430
Instrument:
SHAVER
Category:
Cutting and Dissecting
Description:
Motorized handpiece (pictured in blue) is an attachment for various burrs and
blades that move at various speeds and directions. Suction tubing is connected to the
adaptor next to the cord attachment. The black cord end is handed off the field and
connected to the control panel. The shaver is activated by stepping on the foot pedal
or with buttons on the handpiece.
Use(s):
Houses various shaver attachments to remove, trim, or burr tissue and bone.
Instrument insight:
Shaver often gets clogged with debris. Remove shaver attachment, separate it into its
two parts, and remove tissue. HINT: Strike the two parts together to remove tissue.
Instrument:
MARTIN CARTILAGE CLAMP
Other names:
Meniscus clamp
431
Category:
Grasping and Holding
Description:
Ringed handles with large serrations placed in opposition.
Use(s):
Used for grasping heavy tissues and cartilage. The Martin clamp is often used to
grasp the meniscus for dissection during total knee arthroplasty.
Instrument:
PLATE FORCEPS
Other names:
Plate-holding forceps, plate holders, plate clamp
Category:
Grasping and Holding
Description:
These come in various sizes and designs depending on the type of plating system
that is being used and the size and type of bone that is being fixated. The foot of the
forceps fits into the counter of the plate, ensuring a firm grip of the plate and the
back side of the bone. The foot often has the ability to swivel for precise positioning
of the forceps onto the plate.
432
Use(s):
During an open reduction internal fixation, these are used to hold the plate in
alignment while drilling and screw placement take place.
Instrument:
KERN BONE HOLDING FORCEPS
Category:
Grasping and Holding
Description:
Long, thin handles with a bar ratchet device between them to lock jaws in place. The
inner jaws have four heavy teeth and heavy serrations that allow for secure grasping
of the bone.
Use(s):
Used for manipulating bone fractures into place and for holding the fracture in
alignment while plates and screws are placed. Also used during total joint
procedures to grasp bone segments.
Instrument insight:
Hands and instruments should be kept away from the ratchet bar during the
procedure to prevent inadvertently releasing it.
433
Instrument:
LOWMAN BONE CLAMP
Category:
Grasping and Holding
Description:
Three curved, grasping, blunt claws at the working end that are tightened into
position by turning the screw mechanism at the proximal end.
Use(s):
Used for holding the fractured bone in alignment while plates and screws are placed.
Instrument insight:
Inspect the screw mechanism before surgery to ensure that it is working properly.
434
Instrument:
LEWIN BONE HOLDING FORCEPS
Other names:
Joplin forceps
Category:
Grasping and Holding
Description:
Ringed handles with very sharp double-curved graspers.
Use(s):
Used for manipulating bone fractures into place and for holding the fracture in
alignment while plates and screws are placed. The Lewin forceps can also be used
during a hip arthroplasty to punch holes in bone for passage of sutures when closing
the joint.
Instrument insight:
Because of sharp ends, use extreme caution when handling.
435
Instrument:
NEEDLENOSE PLIERS
Category:
Grasping and Holding
Description:
Thin, single-action handles with serrated jaws that narrow to a point.
Use(s):
Remove pins and hardware and twist wires.
Instrument:
436
PLIERS
Other names:
Channel locks
Category:
Grasping and Holding
Description:
Thin, single-action handles with thin and thick serrations and rounded-end jaws.
Hinge provides two opening sizes of the jaws.
Use(s):
Used to place or remove hardware and to grasp pointed trocar during drain
insertion of deep wounds.
Instrument:
ARTHROSCOPY PROBE
Other names:
Blunt probe, blunt hook, knee scope probe
Category:
Probing and Dilating
Description:
437
Right-angled blunt hook with a flattened handle.
Use(s):
Used to examine and move tissues around inside the knee joint.
Instrument insight:
Should be placed on the Mayo stand for every arthroscopy.
Instrument:
BENNETT RETRACTOR
Category:
Retracting and Exposing
Description:
A smooth, solid grip type handle with a downward-curved, rounded, flared blade
and a smaller upward-curved round lip.
Use(s):
Used for retracting tissues during procedures involving large bones (e.g., the
proximal or mid-shaft of the femur).
Instrument insight:
The lip of the Bennett is slid behind and around the bone shaft for leverage when
retracting tissues. There is no pulling needed when holding this retractor; once it is
placed, simply hold the handle down or back.
438
Instrument:
HIBBS RETRACTOR
Category:
Retracting and Exposing
Description:
This is a flattened, double-ended retractor that has a laterally bent blade and slightly
bent lip with V-shaped teeth on one end and a small, crescent-shaped blade on the
other.
Use(s):
This is a tissue retractor for either deep or superficial areas. The Hibbs retractor is
often used in large bone cases.
439
Instrument:
BECKMAN RETRACTOR
Category:
Retracting and Exposing
Description:
Self-retaining, finger-ringed instrument with a ratcheted release device on the
shanks. Two hinged arms extend from the shank to three outward-curved prongs on
one side and four on the other. These prongs can be sharp or dull.
Use(s):
Used for retraction in procedures involving deep tissue, such as the spine, and in
proximal femur fractures.
Instrument insight:
Always hand this retractor to the surgeon with the prongs pointing downward.
Caution:
The prongs may be very sharp. Exercise care when handling sharp instruments to
avoid puncture to gloves and/or skin.
Instrument:
MURPHY-LANE BONE SKID
Category:
440
Retracting and Exposing
Description:
Double ended with large or small curved spoons at each end.
Use(s):
Used for removing the femoral head from the joint during total hip arthroplasty.
Instrument insight:
The size of the femoral head and the acetabulum will determine which end of the
bone skid to use.
Instrument:
BONE HOOK
Category:
Retracting and Exposing
Description:
Thick handle with an extremely sharp curved hook at the working end.
Use(s):
Used for retracting bone or heavy tissue.
Instrument insight:
441
Always hand the bone hook to the surgeon with the prongs pointing downward.
Caution:
The prongs are very sharp. Exercise care when handling sharp instruments to avoid
puncture to gloves and/or skin.
Instrument:
CHANDLER RETRACTOR
Other names:
Chandler elevator
Category:
Retracting and Exposing
Description:
Thick handle with medium-curved, blunt blade.
Use(s):
Used for retracting bone and tissue.
Instrument insight:
This instrument is used to hold soft tissue away from bone, like a lever, when the
surgeon is performing fixation.
442
Instrument:
MINI HOHMANN RETRACTOR
Category:
Retracting and Exposing
Description:
A flattened, smooth handle with thin, slightly curved blades and with a small,
upward-curved, pointed tip.
Use(s):
Used for retracting tissue or bone in tight, small areas. The mini Hohmann retractor
is often used during open reduction internal fixation (ORIF) of the ankle.
Instrument insight:
The tip of the Hohmann retractor is slid behind and around the bone for leverage
when retracting tissues. There is no pulling needed when holding this retractor; after
it is placed, simply hold the handle down or back.
443
Instrument:
SHARP HOHMANN RETRACTOR
Other name:
Hohmann retractor
Category:
Retracting and Exposing
Description:
Flat handle with two holes placed distally to aid in grasping the handle. The blade is
shaped in a square with an upward, slightly curved prong at the end.
Use(s):
Used for retracting a large area of tissue, usually close to bone.
Instrument insight:
The prong of the Hohmann retractor is slid behind and around the bone for leverage
when retracting tissues. There is no pulling needed when holding this retractor; after
it is placed, simply hold the handle down or back.
444
Instrument:
BLUNT HOHMANN RETRACTOR
Category:
Retracting and Exposing
Description:
Flat handle with two holes placed distally. The blade is blunt, very thin, and slightly
curved. There is no pulling needed when holding this retractor; after it is placed,
simply hold the handle down or back.
Use(s):
Used for retracting a small amount of tissue in a very tight area.
445
Instrument:
CHARNLEY RETRACTOR
Other names:
Ortho Balfour retractor
Category:
Retracting and Exposing
Description:
A square-shaped frame with attachable blades.
Use(s):
Self-retaining retractor often used during hip surgeries to hold the wound open.
Instrument insight:
Comes with a cylinder weight with a chain that can be hooked to the frame to pull
the retractor downward and out of the way.
Instrument:
RAGNELL RETRACTOR
Category:
Retracting and Exposing
446
Description:
Double ended with right-angle blunt blades that are available in different sizes.
Use(s):
Used for retracting varying amounts of tissue at different depths.
Instrument:
ISRAEL RAKE RETRACTOR
Category:
Retracting and Exposing
Description:
The handle has a teardrop opening with two prongs on each side. Has four large
claws that may be blunt or sharp.
Use(s):
Used for retracting large amounts of tissue that usually does not involve bone.
Instrument insight:
This instrument is also available with sharp prongs.
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Instrument:
COBRA RETRACTOR
Category:
Retracting and Exposing
Description:
This is a smooth, solid grip type handle with a downward-curved, flared blade and
with a smaller upward-curved, round tip.
Use(s):
Used for retraction of large areas of tissue. The large bend in the blade allows tissue
to be retracted far away from the field, allowing for better visualization.
Instrument insight:
There is no pulling needed when holding this retractor; after it is placed, simply hold
the handle down or back.
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Instrument:
BLOUNT KNEE RETRACTOR
Category:
Retracting and Exposing
Description:
Thin, flat handle with a blunt blade at a right angle and slightly curved.
Use(s):
Used for retracting tissue at a right angle.
Instrument insight:
Often used as a lever to retract. There is no pulling needed when holding this
retractor; after it is placed, simply hold the handle down or back.
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Instrument:
TAYLOR HIP RETRACTOR
Category:
Retracting and Exposing
Description:
Thin handle with a curved, rounded end and blade at a right angle with a sharp tip.
Use(s):
Used for retracting tissue for exposure in total hip arthroplasties.
Instrument insight:
The sharp tip is placed next to or on the bone for leverage. There is no pulling
needed when holding this retractor; after it is placed, simply hold the handle down
or back.
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Instrument:
ALM RETRACTOR
Category:
Retracting and Exposing
Description:
A self-retaining retractor. Thumb screw with flaring wings to open the arms of the
retractor. Four sharp prongs on each side.
Use(s):
Used for retracting in small areas.
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Instrument:
HUMERAL HEAD RETRACTOR
Category:
Retracting and Exposing
Description:
An angled two-prong blade with a straight flat handle.
Use(s):
Placed between the glenoid and the humeral head to obtain exposure.
Instrument:
FUKUDA HUMERAL HEAD RETRACTOR
Other names:
Humeral head retractor, Fukuda retractor
Category:
Retracting and Exposing
Description:
The Fukuda retractor is available in small and large sizes; it has a T-bar style handle
with an angled blade and oval fenestration at the working end.
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Use(s):
Used to retract the humeral shaft posteriorly and helping to expose the entire
glenoid surface.
Instrument:
LEVER SKID HUMERAL HEAD RETRACTOR
Other names:
Bone skid, shoulder skid
Category:
Retracting and Exposing
Description:
Double ended with large and small curved spoons at each end.
Use(s):
Removal of the humeral head from the joint during a total shoulder arthroplasty.
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Instrument:
CAPSULE RETRACTOR
Other names:
Fork retractor
Category:
Retracting and Exposing
Description:
A curved ribbon of steel with three angled sharp prongs at the working end. These
come with one, two, or three prongs, which are designed to retract in different areas.
Use(s):
The two- and three-prong retractors are designed to be placed medially along the
scapular neck to retract the anterior capsule and labrum. The single-prong retractor
is commonly used when retracting on the inferior rim of the glenoid.
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Instrument:
BROWNE DELTOID RETRACTOR
Category:
Retracting and Exposing
Description:
The blade is concave and angled with a cup-like indentation at the working end. The
handle is flat with a round opening and two curved prongs at each side of the distal
end.
Use(s):
Placed to contour the humeral head for deltoid retraction to allow for exposure.
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Instrument:
KOLBEL SELF-RETAINING GLENOID RETRACTOR
Category:
Retracting and Exposing
Description:
A finger-ring, ratcheted self-retaining retractor that has exchangeable shallow to
deep blades.
Use(s):
For retracting the capsule open during shoulder procedures.
Instrument:
PULSAVAC
Other names:
Pulse lavage
Category:
Suctioning and Aspirating
Description:
A battery pack provides power. The irrigation spike and the suction connection are
handed off the sterile field. The pulsavac gun has two speeds with controls on the
handle. A barrel is attached to the gun with a funnel at the distal end of the gun.
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Use(s):
Used for irrigation and debridement of tissues. The Pulsavac is commonly used for
high-pressure irrigation during total joint arthroplasties.
Instrument:
25-DEGREE, 4-MM LENS
Other names:
Arthroscope
Category:
Viewing
Description:
A rigid, stainless-steel tube containing an optical chain of precisely aligned glass
lenses and spacers. The objective lens is located at the distal tip of the scope. This
determines the viewing angle. The stainless-steel cylinder is called the optical
element or the telescope, providing both images and light. The light connector
allows attachment of the light cord to the telescope. At the proximal end is the
eyepiece or ocular lens; this attaches to the camera coupler, or the surgeon may view
the surgical field directly.
Use(s):
Used for viewing the inside of a joint.
Instrument insight:
25 degrees is the angle at which the objective lens views. 25-degree endoscopes are
very expensive and fragile. Care should be exercised when handling an endoscope;
it should never be picked up by the distal telescope end, placed under heavy objects,
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or dropped.
Instrument:
ENDOSCOPIC CAMERA
Category:
Viewing
Description:
At the distal end of the camera is the coupler, which attaches the camera to the
eyepiece of the rigid scope. The coupler is attached to the camera head, which
provides the image quality. Attached to the camera head is the cord, which relays
the images back to the video system.
Use(s):
Used for the transmission of images from the rigid or flexible endoscope to the video
monitor.
Instrument insight:
Most camera failures are related to a damaged cord. Care should be exercised when
handling the camera and cord. They should never be placed under a heavy object,
dropped, twisted, or kinked. Also keep the distal end covered until it is ready to be
plugged into the unit.
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Instrument:
FIBEROPTIC LIGHT CORD
Other names:
Light cord
Category:
Viewing
Description:
A 10-foot-long fiberoptic cable with an endoscope adaptor at the proximal end and a
light source adaptor at the distal end.
Use(s):
Used for delivering high-intensity light to the endoscope for illumination during
endoscopic procedures.
Instrument insight:
Exercise care when handling a fiberoptic cord; it should never be placed under a
heavy object, dropped, twisted, or kinked because the tiny fibers inside can be easily
damaged.
Caution:
When not in use, the light source must be placed on standby or turned off. The
intense heat from the beam can cause the patient’s drapes or any flammable vapors
around the patient to ignite.
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Instrument sets
Instrument:
LARGE FRAGMENT SET
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Other names:
Large frag set
Category:
Sets
Description:
First tray (instruments): Different types of screwdrivers, depth gauge, variety of drill
bits, taps, chuck, drill guides, and plate holders.
Second tray (implants): Narrow plates, broad plates, T-plates, and bending
templates.
Third tray (screws): Variety of screws, locking screws, other implants, and screw
forceps.
Use(s):
These instruments, plates, and screws are used to secure fractures in large bones.
Instrument insight:
Check surgeon’s preference card for type of screws, implants, drill bit sizes, and drill
guides. Check each tray before use to determine that all instruments and sizes are in
each tray. This is especially needed for screws because they are placed in the patient
and not reused.
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Instrument:
SMALL FRAGMENT SET
Other names:
Small frag
Description:
First tray (instruments): variety of screwdrivers, drill bits, depth gauge, bone holding
clamps, and screw retriever.
Second tray (implants and screws): implants—locking compression plates (LCP
)plates, T-plates, one-third tubular, proximal humerus, straight reconstruction plates,
curved reconstruction plates, and oblique and right angle plates; screws—cortex,
cancellous, shaft, and self-tapping; Kirschner wires and washers also in this tray.
Use(s):
These instruments, implants, and screws are used to secure fractures in small bones.
Instrument insight:
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Check surgeon’s preference card for type of screws, implants, drill bit sizes, and drill
guides. Check each tray before use to determine that all instruments and sizes are in
each tray. This is especially needed for screws because they are placed in the patient
and not reused.
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Instrument:
TOTAL KNEE INSTRUMENTS
Other names:
Knee arthroplasty set
Description:
Several pans are opened to perform the arthroplasty. Shown here:
• Medullar pan
• Femoral trials
• Patella
• Posterior stabilization (PS) trials
• Tibial base plate trials
• Tibial femoral general instrument kit
• Tibial femoral general instrument kit II
Use(s):
These are used to perform a total knee replacement (arthroplasty).
Instrument insight:
There are many different systems and companies that have their own systems. Total
knee instrument pans are often set by the company sales representative for a specific
surgeon or group of surgeons according to their preference; these systems will differ
accordingly. These pictures were set up by a Zimmer representative for a specific
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surgeon. Sets can vary by facility.
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Instrument:
TOTAL HIP INSTRUMENTS
Other names:
Total hip arthroplasty set
Description:
Several pans are opened to perform the arthroplasty. Shown here:
• Acetabular instrument tray
• Acetabular instrument tray II
• Acetabular reamer set
• Provisional acetabular shell
• Provisional acetabular liners
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• Medial lateral cone collars and rasp handles
• Femoral stem instruments
• Femoral head trials
Use(s):
These are used to perform a total hip replacement (arthroplasty).
Instrument insight:
There are many different systems and companies that have their own systems. Total
hip instrument pans are often set by the company sales representative for a specific
surgeon or group of surgeons according to their preference; these systems will differ
accordingly. These pictures were set up by a Zimmer representative for a specific
surgeon. Sets can vary by facility.
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