Air Instrument Surgery

Air Instrument Surgery, Volume 2: Orthopedics has been compiled to aid in the se lection and use of air instruments in orthopedic surgical techniques. In each instance it attempts to demonstrate the classic approach, leaving it to the individual surgeon to develop further his expertise and ingenuity with air-driven instruments. Possible applications and adaptations are as unlimited as the surgeon's skill and imagination. Detailed illustrations and text treat the use of each air instrument in various proce dures, but the surgical application is given only for that portion of each procedure in which manual operation can be advantageously replaced by the use of air instru ments. This book, therefore, does not depict complete surgical procedures, nor does it include all the procedures in orthopedic surgery for which air instruments are now employed. Use of air-driven instruments does not imply any change in basic surgical techniques. It does enhance the surgeon's dexterity, increase his speed and, in some situations, makes a surgical approach possible for the first time. A technical guide has been needed since air instruments were introduced. Air In strument Surgery, Volume 2: Orthopedics is the second publication to fill that need. Its function is to clarify problems and difficulties and to suggest solutions by means of air instrument surgery. It is also intended to remove any apprehension about the use of air instruments. To ensure this, the technical procedures are supplemented with detailed instructions for assembling, using and maintaining the instruments.

The use of the compressed air-driven turbine for the activation of surgical burs and saws as developed by Dr. Robert M. Hall has been a boon for the plastic, max illofacial, and oral surgeon. The development of air instrument surgery coincided with the opening of new vistas in surgery in the area of craniofacial surgery. Cranio facial osteotomies for orbital (ocular) hypertelorism, for the deformities of cranio stenosis (Cronzon's disease, Apert's syndrome) and subcranial osteotomies at various levels of the facial skeleton have brought about dramatic improvements in the form of the facial substructure in patients with gross deformities. In many of these maxillofacial deformities the facial skeleton and dento-alveolar processes must be advanced, recessed or expanded in the lateral dimension. In such cases maloc clusion of the tceth is usual; this is corrected by intermaxillary fixation of the mo bilized bony structures which also reestablishes adequate relationships between the dento-alveolar processes of the upper and lower jaws. This brings us to the subject of surgical orthodontics, a field that is just beginning to expand; its development should bring about closer collaboration between surgeon and orthodontist, resulting in rapid and efficient improvement of malocclusion. The absence of vibration characteristic of the air-driven turbine, in contrast to the mechanically driven drill, allows the surgeon to carry out delicate and precise surgical procedures with less fatigue to himself.

This chapter deals with so me surgical uses of an air-powered bone-biter, Ronjair®. The to01 has been developed in response to the need to prevent hand cramping, blisters, fatigue, and consequent cIumsiness after extensive bone removal. The Instru ment, which has been in operative use since April 1971, has also proved to be more precisely controllable by the surgeon than comparable hand-powered instruments. The instrument is a new Air Instrument conceived with considerable attention, to full contral of the biting tips, to versatility and ease of use. Still, a little directed learning is essential for comfortable bone-cutting. Some hints are included in "How to use the Ronjair®, Air-Powered Rongeur" and "Technique suggestions", but it is ad visable to practice outside the operating room to get the feel of it. In aseries of presentations to so me 3,000 neurosurgeons and orthopedists in the past two years at large national meetings, it was cIear that nearly all could become adept in the use of the instrument after some 5 -10 minutes. The Ronjair® Air-Powered Rongeur was developed by Hall International Inc. with the suggestions and effort of N. Edalatpour, M.D. N. Edalatpour, M.D., F.A.C.S.

First published in 1954, Farquharson's Textbook of Operative General Surgery has become firmly established as a classic textbook for trainee surgeons throughout the world. Basic surgical techniques, including the reasons for their application, are discussed. General surgical operations are described and the indications for them are covered. Techniq