The wrist is the articulation of the two forearm bones, the ulna and the radius, with the double row of eight carpal bones. There is an articular disc between the dished surface of the radius and the proximal carpal row of bones. Digit joints are classified as:
– DIP Distal interphalangeal joint
– PIP Proximal interphalangeal joint
– MCP Metacarpophalangeal joint
An external fixator acts as a stabilizing frame to hold the broken bones in proper position. In an external fixator, metal pins or screws are placed into the bone through small incisions into the skin and muscle. The pins and screws are attached to a bar outside the skin. Because pins are inserted into bone, external fixators differ from casts and splints which rely solely on external support.
The elbow naturally operates as a hinge joint, with the majority of the natural range of motion occurring on one plane, although it also includes a rotational component. The joint involves the articulation of three bones: the humerus, the radius and the ulna. The articulation of the head of the radius on the ulna allows for forearm pronation and supination, resulting in the ability to rotate the wrist.
The labrum is a ring of cartilage that circles the end of the shoulder blade (the glenoid). This stabilizes the shoulder joint and allows for a wide range of movement. A common type of labral tear is the SLAP lesion, which is an acronym for superior labral anterior to posterior.
The rotator cuff is a combination of four muscles and their tendons that cover the head of the humerus. These include the supraspinatus, the infraspinatus, the teres minor and subscapularis muscles. These muscles stabilize the ball of the shoulder within the joint and enable the arm to lift and rotate. The shoulder joint allows for a great range of motion, but at the expense of stability, as it is not directly attached to the axial skeleton in the way that the lower limbs are.
The meniscus is a crescent-shaped pad of fibrocartilage located between the femur and the tibia. It acts as a shock absorber and prevents friction between the two bones. It also helps stabilize the knee along with the ligaments and protects the articular cartilage of the knee, aiding in the prevention of degenerative arthritis.
Tendons have been traditionally repaired with the surgical use of suture anchoring technology to rejoin a torn tendon directly. One issue with traditional tendon repair is the incidence of re-tearing previously operated injuries. This predominantly occurs following procedures involving the repair of the shoulders rotator cuff tendons and the ankles Achilles tendon.
The hip arthroscopy market can be segmented by device type, yielding five segments: radiofrequency (RF) probes, banana blades, hip access kits, suture anchors and disposable suture passers. RF probes can be further segmented by product type, yielding two sub-segments: articulating RF probes and static RF probes.
The ACL/PCL fixation device market can be segmented into tibial fixation and femoral fixation devices. Tibial fixation includes interference screws, intratunnel fixation devices and washer and post devices. Femoral fixation devices include interference screws, cross-pins, intratunnel fixation devices and cortical fixation devices.
The ACL/PCL reconstruction market can be segmented into the BTB allografts and soft tissue allografts. Growth of the market will be driven by changes in surgical techniques and newer technology. There is a trend towards soft tissue allografts as technological advances make them easier to use.
The total plate and screw market includes both anatomical and generic plates. Anatomical plates are shaped to fit specific bones by having contoured shapes and are typically lower profile than a generic plate. In contrast, generic plates are straight and vary in length to conform to different bone sizes. Anatomical and generic plates are both offered in stainless steel and titanium varieties.
Intramedullary (IM) hip screws are hybrid devices, incorporating aspects of intramedullary nails and conventional hip screw design. They are inserted into the femur at an angle similar to that of hip screws, but instead of being anchored by a plate external to the shaft of the bone, IM hip screws are anchored inside the medullary cavity. The screws are designed for intertrochanteric or subtrochanteric fractures of the hip. IM hip screws are also known as dynamic hip screws (DHS).
IM nails are inserted into the length of long bones and are held in place by cortical screws. These screws pass through the outer cortex layer of bone and into the nail, either at one or both ends of the device. The devices are also known as either rods or pins. IM nails are less invasive than plates and screws and have been growing in popularity to replace plate fixation. The advantage of intramedullary constructions is that they support body weight along with the bone and thus allow for faster recovery.
Cannulated screws are hollowed screws used in the fixation of a wide variety of fractures, in particular hip fracture fixation. The hollowed cavity within the screw allows for precise placement by way of a guidewire into the desired location.
As opposed to internal fixation, external fixation involves the stabilization of fractures by rods and pins that attach from outside the body. The rods and pins are anchored to rigid frames. Unilateral fixators are located externally on only one side of the limb. Circular fixators are ring-shaped and surround the fractured limb. While circular fixators are more cumbersome, they offer more versatility and are stronger and more stable when weight is applied.
Bone is naturally piezoelectric, which means that mechanical stress applied to bone alters its natural electric field. Conversely, an applied electric or ultrasound field will alter the mechanical stress within the bone, thereby stimulating bone growth. It is by this principle that bone growth stimulators work, artificially inducing stress to stimulate bone growth as an adaptive response. All bone stimulation devices, except those offered by Bioventus, are indicated for non-union fractures, which include difficult-to-heal or slowly healing fractures. All external devices can be worn over a cast.