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SurgSpace / Specialties / Orthopedic Surgery

Orthopedic Surgery

Bones, joints and the injured limb: fracture fixation from plates to nails, the hip fracture pathway that defines care of the older patient, arthroplasty that trades a worn joint for a working one, and the emergencies, open fractures, compartments, septic joints, where limbs are saved or lost.

4 operations in depth5 interactive cases

Backdrop: Anteroposterior X-ray of a total hip arthroplasty · Mikael Häggström, M.D · CC0

Inside the OR

OR & Periop

Shared operative foundations, the room, the instruments, the anaesthetic.

Shared operative foundations taught once, the room they happen in, the instruments on the tray, and the anaesthetic that makes it possible.

  • Fracture healing & the stability spectrum

    Every fixation choice in the specialty is the same decision: how much movement will this fracture see, and which healing biology does that invite. Taught once here; the fixation operations assume it.

    1. 01Two healing modes. Absolute stability (rigid compression, no movement at the fracture) heals bone directly, without callus; relative stability (controlled micro-movement) heals by callus. Both work; mixing their hardware philosophies is what fails.
    2. 02The implant menu. Compression plates and lag screws buy absolute stability for articular surfaces that need perfection; nails, bridging plates and external fixators buy relative stability for shafts that want callus.
    3. 03Blood supply is the currency. Bone heals at the speed of its blood supply: periosteal stripping, high-energy injury and smoking all tax it, and the femoral head's retinacular vessels are the anatomy behind the whole hip fracture algorithm.
    4. 04When healing fails. Non-union is a diagnosis with causes: instability, dead bone, infection, or a starved envelope. The workup asks which, because the fix (more stability, more biology, or both) follows the cause.
    5. 05Reading the plan. Weight-bearing orders are the fixation's biography: what the construct can carry today tells you what stability the surgeon bought and what healing they are waiting for.
    Used byDebridement and fixation of an open tibial fractureHip fracture fixation (dynamic hip screw)

  • Implants, biofilm & the infected metalwork problem

    Arthroplasty and fixation both leave foreign surfaces in the body, and infection on an implant follows different rules from infection in tissue: biofilm changes the diagnosis, the drugs and the surgery.

    1. 01Biofilm biology. On any implant, bacteria can switch to a sessile, glued-down state inside a polymer matrix: metabolically quiet, shielded from antibiotics and immunity, and essentially incurable without addressing the surface they live on.
    2. 02Diagnostic discipline. Sample before treating: aspiration and deep cultures before antibiotics, because biofilm organisms are hard enough to grow without a head start of empirical therapy.
    3. 03The strategy grid. Early infection on a fixed implant: debride and retain. Chronic infection: the metal comes out, in one or two stages. Infected fracture fixation adds a twist: stability itself fights infection, so hardware may stay until the bone unites.
    4. 04Prevention's weight. Prophylactic antibiotics, laminar discipline and skin preparation matter more here than almost anywhere: an infection rate difference of one percent is a lifetime difference for the patients inside it.
    Used byTotal hip arthroplastyArthroscopic washout of septic arthritisDebridement and fixation of an open tibial fracture

On the tray

No instruments are tagged to this specialty’s operations yet.

Anaesthesia

The airway, the depth, the haemodynamics and the analgesia: the head of the bed has its own rooms.

Enter anaesthesia

Watch and learn

When an operation is best understood in motion

Watch for

Debridement and fixation of an open tibial fracture

  • Wound extension and debridement
  • Lavage
  • Skeletal stabilisation
  • Soft-tissue cover plan
Find candidates on YouTube

Watch for

Hip fracture fixation (dynamic hip screw)

  • Reduction on the traction table
  • Lateral approach
  • Guidewire and lag screw
  • Plate, compression and closure
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Watch for

Total hip arthroplasty

  • Approach and dislocation
  • Neck cut and acetabular preparation
  • Femoral preparation and implants
  • Closure and first steps
Find candidates on YouTube

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Hub shaped by the Surgical Specialties Lead with the Orthopaedic surgery reviewer (open seat). Images and videos carry their source; educational use for supervised learning, not clinical guidance.