Instrumentation and Technical Equipment

Common Instruments for Hand Surgery

Outside of the specific instrument needs required for a bone or microsurgical procedure, the common instruments are presented, in our practice, according to two distinct types of packaging.

The “common” hand surgery box represents the same minimum instrumentation required for small emergency procedures, such as an exploration of a skin wound or an extensor tendon suture. It contains the following instruments:

• 2 scalpel handles adapted to blades 11, 15 and 23 ( Fig. 3.1a )

  

• 2 needle holders, including a Tubiana needle holder ( Fig. 3.1a )

• 2 Adson forceps; one nontoothed with thin edges, the other toothed, two teeth on one tip and one tooth on the other ( Fig. 3.1b )

• 1 set of Kelly hemostatic forceps ( Fig. 3.1c )

• 2 standard Farabeuf retractors ( Fig. 3.1d )

• 2 Morel-Fatio retractors ( Fig. 3.1d )

• 1 set of skin retractors in the form of single or double Gillies hooks ( Fig. 3.1d )

• 1 pair of Mayo scissors ( Fig. 3.1e )

• 1 pair of thin dissection scissors with curved edges and blunt ends ( Fig. 3.1e )

• 1 pair of thin Stevens dissection scissors ( Fig. 3.1e )

This box is sufficient for most small, common emergency procedures. When a more complex intervention is planned, we use a “hand” box with more complete contents.

In addition to the instruments listed for the common surgery box, the hand box contains the following instruments:

• 1 Terrier flat forceps, useful for the manipulation and tightening of wires and for the shaping of Kirchner wires

• 2 toothed Kocher forceps

• 1 Museux forceps

• 2 additional dissecting forceps (1 toothed Adson forceps, 1 wide tungsten Adson forceps) ( Fig. 3.1b )

• 1 small curette ( Fig. 3.2 )

  

• 1 specific “tendon elevator” instrument used in tenolysis ( Fig. 3.2 )

• 1 Michon forceps, similar to Kelly forceps but straight and without teeth ( Fig. 3.2 )

• 1 dissector ( Fig. 3.2 )

Instruments for Bone Surgery

When a bony procedure needs to be carried out during surgery, the previous instrumentation is supplemented with instruments found in the “bone surgery” box ( Fig. 3.3 ).

The only wires present in this box are Kirchner wires. The other specific elements necessary for osteosynthesis (plate, screws, etc.) are used separately according to the precise needs of the intervention.

This bone surgery box comprises the following instruments:

• 1 square-tip elevator

• 1 set of curved elevators with square tips

• 2 small forceps, serrated

• 1 elevator with round edges or spatula

• 2 double-angled “claw-retractor” or “American” retractors

• 1 set of small curettes

• 1 mallet

• 1 Liston forceps

• 1 gouge forceps with straight edges

• 1 gouge forceps with round edges

• 1 set of Kirchner wires of sizes 4, 6, 8, 10, 12, 14, 18, 22 and 24 tenths of a millimeter.