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Types of Orthopedic Punches

The orthopedic punch, as the name implies, provides a source of force or power during a range of orthopedic surgical procedures. The shape of each type of punch varies according to its function, but the basic premise, of using pressure to pierce, cut or stabilize bone, categorizes a punch as a strong and durable instrument with which to operate on bone.

  1. Removing Bone Tissue

    • An orthopedic punch, sometimes known as punch forceps, has handles and a sliding jaw and looks a little like a large pair of pliers. It bites into bone to take a section for sample, to remove diseased bone tissue, to create a cavity of a specific shape for the insertion of a prosthesis, or to cut bone without taking bone tissue. Punches can be upward-, downward- or oblique-cutting, depending on the procedure.

    Pinning Bone

    • Pinning involves reaming out the shaft of the bone and inserting a pin to stabilize it during healing. A surgeon uses a mallet to insert the pin into the bone. Before the end of the pin is driven down into the shaft, the flat end of a bone punch is placed on the head of the pin. Depending on the diameter of the pin the surgeon bangs or taps the head of the punch with the mallet, to drive the remainder of the pin home down into the shaft without damaging the bone.

    Wiring Bone

    • A bone wire punch looks similar to a pin punch, but is thinner at the operative end and is used in procedures in which a surgeon uses Kirschner wires, or K-wires, to stabilize small bones. Rather than leave the K-wires protruding from the insertion site and providing a focus for infection, the surgeon turns the K-wires back on themselves to feed them under the skin and against the bone. Skin closure is then completed with no possible site for bacterial growth.

    Manufacture and Durability

    • Depending on individual function, bone punches are made of hardened high or low carbon steel and can be hot or cold forged. They are then ground, polished and sharpened by hand to ensure precision, strength and longevity. They need to withstand autoclave sterilization conditions of 15 lbs per square inch of barometric pressure at a temperature of 121 degrees Celsius for up to an hour, as well as power washing and daily handling.

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