Surgical Illustration: Distal Femur ORIF with LISS Plating

The goal of this project was to illustrate a surgical procedure through an effective sequential narrative for novice surgeons. Through direct observation of a distal femur open reduction and internal fixation (ORIF) procedure at Mount Sinai Hospital’s Surgical Skills Centre, the key anatomical and procedural elements were illustrated digitally in the style of traditional pen and ink.

 

Client: Prof. Dave Mazierski & Dr. Shelley Wall
Media: Procreate, Adobe InDesign
Format: 8.5X11” pages in a surgical atlas
Audience: Surgeons
Date: June 2021

 

Process work

Direct Observation + Research

I directly observed the surgical procedure, doing quick sketches and taking notes. Further research was conducted to fill in areas with gaps to develop a complete narrative.

 
ORIF sketch 1
ORIF sketch 2
 


Thumbnail Sketches

I created rough thumbnail sketches to accompany each figure description, highlighting the most important steps of the procedure.

 

Thumbnail sketches PDF

Revised Sketches

Based on preliminary feedback from instructors and colleagues, changes to the illustrations were made (red) to remove extraneous information and create a better view of the fracture.

 
 

Revised sketches PDF

Second Revised Sketch

I continually revised the sketches and figure descriptions based on instructor and colleague feedback to improve clarity.

 
 
 

Final

 
 

References

LISS plate fixation of distal femoral fracture. (2017, September 11). [Video]. YouTube. https://www.youtube.com/watch?v=MN3Mbaqdxgw 

Md, F. N. H. (2014). Atlas of Human Anatomy: Including Student Consult Interactive Ancillaries and Guides (Netter Basic Science) (6th ed.). Saunders. 

Md, H. M. (2018). Harborview Illustrated Tips and Tricks in Fracture Surgery (2nd ed.). LWW. 

MIO - less invasive stabilization system (LISS). (2020). Surgery Reference. https://surgeryreference.aofoundation.org/orthopedic-trauma/adult-trauma/distal-femur/basic-technique/mio-liss-less-invasive-stabilization-system 

MIPO approach to the distal femur from lateral/anterolateral. (2020). Surgery Reference. https://surgeryreference.aofoundation.org/orthopedic-trauma/adult-trauma/distal-femur/approach/mipo-approach-to-the-distal-femur-from-lateral-anterolateral#distal-approach 

Surgical Exposures in Orthopaedics: The Anatomic Approach (Hoppenfeld, Surgical Exposures in Orthopaedics) by Stanley Hoppenfeld MD (2009–05-29). (2021). LWW. 

Synthes. (2000). Less invasive stabilization system (LISS). http://synthes.vo.llnwd.net/o16/LLNWMB8/US%20Mobile/Synthes%20North%20America/Product%20Support%20Materials/Technique%20Guides/SUTGLISSDistFemurJ2892H.pdf 

Weaver, M. (2020, November 1). Less Invasive Stabilization System (LISS) for Distal Femur Fracture Repair. Journal of Medical Insight. https://jomi.com/article/17/Less-Invasive-Stabilization-System-(LISS)-for-Distal-Femur-Fracture-Repair?t=4s 

 

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