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WELCOME Introduction to an AO Workshop for Operating Room Personnel

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Presentation on theme: "WELCOME Introduction to an AO Workshop for Operating Room Personnel"— Presentation transcript:

1 WELCOME Introduction to an AO Workshop for Operating Room Personnel
Indications for Internal Fixation

2 WORKSHOP FORMAT Lectures Video demonstrations
Hands-on practical sessions Discussion

3 WORKSHOP MATERIALS Agenda Evaluation Form
Certificates distributed after consultant returns documents to Nursing CE office

4 ACCREDITATION AO North America is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation The activity is approved by the Association of Surgical Technologists, Inc. for continuing education credits in surgical technology See 1st page of agenda for # of contact hours

5 DISCLOSURE The American Nurses Credentialing Center (ANCC) requires speakers to disclose to you any financial interest or relationship with a commercial company that manufactures products that they may discuss in their presentation(s). The purpose of the activity is education and not the promotion or sale of a specific company’s products.

6 SAFETY Be Careful! Power tools Drill bits K-wires Long hair
Long sleeves Loose clothing Your partner!

7 REMINDERS Turn phones to vibrate Restroom location Breaks, lunch, etc.
Fill out evaluation forms

8 WORKSHOP OBJECTIVES Review the history of the AO
Describe bone properties and fracture types Relate how bones heal Identify when fractures are treated surgically (also called “indications”) Discuss specific fractures and the implants used Practice the techniques on artificial bones

9 WHY THE AO STARTED High percentage of disabilities after motor vehicle and skiing accidents Swiss dissatisfied with methods of fracture treatment in the 1940’s

10 AO ASIF Arbeitsgemeinschaft fur Osteosynthesfragen
Association for the Study of Internal Fixation Founded in 1958 by small group of Swiss surgeons Dedicated to improving the care of patients with musculoskeletal injuries AO Logo

11 The guiding principles of fracture care
AO PRINCIPLES The guiding principles of fracture care Anatomic reduction of fractures Stable fixation Preservation of the blood supply Early mobilization to allow full rehabilitation

12 AO ORGANIZATION Four “Pillars” Documentation Research Teaching

13 INSTRUMENTATION Instrumentation is one of the “pillars” & started in early 60’s to manufacture implants and instruments to achieve AO’s principles SYNTHES is the commercial arm of AO Instruments standardized worldwide

14 TEACHING & EDUCATION Another one of the “pillars”
AO Courses: Surgeons Residents Veterinarians Operating Room Personnel Workshops such as this workshop More than an “inservice”

15 AO COURSES Started in 1960 for surgeons & 1963 for O.R. personnel (ORP) Early emphasis on teamwork 1,965 ORP courses 136,000 participants More than 70 countries

16 BONE -- A LIVING TISSUE Supports soft tissues Enables locomotion

17 ANATOMY OF BONE Diaphysis Metaphysis Epiphysis growth area

18 BONE STRUCTURE Cancellous Bone Cortical Bone

19 CANCELLOUS BONE Spongy bone Metaphyseal location
¼ the mass and 10% the strength of cortical bone

20 CORTICAL BONE Shell around all bones Thickest in diaphyseal location
Very strong

21 BLOOD SUPPLY Diaphysis Metaphysis Nutrient artery, 2/3 of blood supply
Periosteal vessels, 1/3 of blood supply Metaphysis Rich blood supply Endosteal vessels, periosteal vessels and soft tissues

22 BONE PROPERTIES Bones contain biomechanical properties of stiffness & strength but break under very little deformation

23 FRACTURES Overload of bone Loss of bony continuity Loss of support
Soft tissue damage Damage to blood supply

24 TYPES OF FRACTURES Amount of force, direction of force, and soft tissue attachments determine fracture patterns: Transverse Oblique & Spiral Impacted Comminuted Each pattern requires an implant with different biomechanical properties to resist body’s forces

25 TYPES OF FRACTURES Transverse Oblique Spiral

26 TYPES OF FRACTURES Impacted Comminuted

27 BONE HEALING How bone heals depends on the stability of the fracture fixation and the motion between the fragments Relative stability – some motion Absolute stability – no motion

28 BONE HEALING 2 Types: Indirect bone healing Direct bone healing

29 INDIRECT BONE HEALING Usual picture of bone healing Callus formation
“Relative” stable fixation (some motion)

30 INDIRECT BONE HEALING Examples of “relative” stable fixation: Casting
External fixation Intramedullary nailing

31 DIRECT BONE HEALING Contact healing between bones No callus
Requires “absolute” stability between fracture fragments (no motion)

32 DIRECT BONE HEALING Absolute stability comes from compression of bone fragments Achieved with lag screws and compression plates

33 Summary Lag screws & compression plates provide absolute stability & direct bone healing Casts, ex fix and IM nails provide relative stability & indirect bone healing Both have their place in internal fixation

34 When Should You Consider Surgery? (Indications)
Internal fixation should be used only if the disadvantages of conservative treatment can be overcome by surgical treatment Requires knowledge of the techniques & adherence to the principles

35 FRACTURES Which MUST be operated on: Open fractures
Intra-articular (in the joint) fractures

36 FRACTURES Which MAY be operated on: Tibia shaft fractures
Humeral shaft fractures

37 FRACTURES Which should NOT be operated on: Simple vertebral fractures
Uncomplicated clavicle fxs Most children’s fractures

Proper operating room environment Trained surgeon Trained personnel Appropriate instruments and implants Adequate aftercare TEAMWORK!

39 GOALS TODAY Learn AO fracture techniques Learn use of instrumentation
Become a more knowledgeable member of the OR Team Have fun!


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