Bone Surgery

Robert Kerrison described his rongeur in 1907 for mastoid work. Frank Cobb’s elevator arrived decades later out of scoliosis surgery. Neither instrument was designed for the operation that now defines them. That accident of history explains something practical about laminectomy trays: they are assemblies of borrowed instruments, adapted from ENT, general orthopaedics and early neurosurgery, […]

An ACL reconstruction is a sequence of four mechanical problems: harvest a graft, put a tunnel in the tibia, put a tunnel in the femur, and fix the graft at both ends under tension. Every instrument on the tray exists to solve one of them. Organising the set that way — by stage rather than

Everything about an arthroscopy tray is dictated by one constraint: the portal is about 5 mm across, and the working space behind it is a joint under fluid pressure with no room to manoeuvre. Instruments have to reach 130 mm or more through that hole, work at an angle the surgeon cannot fully see, and

A lacerated flexor digitorum profundus in zone II is one of the least forgiving repairs in the hand. The tendon retracts into its sheath, the working corridor is a few millimetres wide, and every pass of the needle competes with the pulley system for space. The outcome hinges as much on the tray in front

Cerclage — from the French for “to girdle” — is one of the oldest ideas in fracture surgery: encircle the bone with a wire loop, tension it, and hold the fragments together. The concept is simple. Doing it cleanly, without stripping the periosteum or leaving a loose loop that migrates, depends entirely on the instruments.

The sternum is split, the retractor is in, and cancellous bone edges are weeping steadily from the marrow. Suction clears it; it comes straight back. This is the moment bone wax earns its place on the tray — a pea of soft wax smeared firmly into the bleeding cut surface, and the ooze stops mechanically