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Internal fixation is an
Closed Reduction Internal Fixation (CRIF) is reduction without any open surgery, followed by internal fixation. It appears to be an acceptable alternative in unstable distressed lateral
operation
Operation or Operations may refer to:
Arts, entertainment and media
* ''Operation'' (game), a battery-operated board game that challenges dexterity
* Operation (music), a term used in musical set theory
* ''Operations'' (magazine), Multi-Ma ...
in orthopedics
Orthopedic surgery or orthopedics ( alternatively spelt orthopaedics), is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal ...
that involves the surgical implementation of implants for the purpose of repairing a bone
A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...
, a concept that dates to the mid-nineteenth century and was made applicable for routine treatment in the mid-twentieth century. An internal fixator may be made of stainless steel, titanium alloy
Titanium alloys are alloys that contain a mixture of titanium and other chemical elements. Such alloys have very high tensile strength and toughness (even at extreme temperatures). They are light in weight, have extraordinary corrosion resista ...
, or cobalt-chrome
Cobalt-chrome or cobalt-chromium (CoCr) is a metal alloy of cobalt and chromium. Cobalt-chrome has a very high specific strength and is commonly used in gas turbines, dental implants, and orthopedic implants.
alloy. or plastics.
Types of internal fixators include:
* Plate and screws
* Kirschner wire
Kirschner wires or K-wires or pins are sterilized, sharpened, smooth stainless steel pins. Introduced in 1909 by Martin Kirschner, the wires are now widely used in orthopedics and other types of medical and veterinary surgery. They come in differ ...
s
* Intramedullary nails
Open reduction
Open Reduction Internal Fixation (ORIF) involves the implementation of implants to guide the healing process of a bone, as well as the open reduction, or setting, of the bone. ''Open reduction'' refers toopen surgery
Minimally invasive procedures (also known as minimally invasive surgeries) encompass surgical techniques that limit the size of incisions needed, thereby reducing wound healing time, associated pain, and risk of infection. Surgery by definiti ...
to set bone
A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...
s, as is necessary for some fractures. ''Internal fixation'' refers to fixation of screws and/or plates, intramedullary rods and other devices to enable or facilitate healing
With physical trauma or disease suffered by an organism, healing involves the repairing of damaged tissue(s), organs and the biological system as a whole and resumption of (normal) functioning. Medicine includes the process by which the cells ...
. Rigid fixation prevents micro-motion across lines of fracture to enable healing and prevent infection, which happens when implants such as plates (e.g. dynamic compression plate
A dynamic compression plate (DCP) is a metallic plate used in orthopedics for internal fixation of bone, typically after fractures. As the name implies, it is designed to exert dynamic pressure between the bone fragments to be transfixed. Dynamic ...
) are used. ORIF techniques often are used in cases involving serious fractures such as comminuted or displaced fractures or, in cases where the bone otherwise would not heal correctly with casting or splinting alone.
Risks and complications may include bacterial colonization of the bone, infection
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dis ...
, stiffness and loss of range of motion, non-union, mal-union, damage to the muscles, nerve damage and palsy, arthritis, tendonitis
Tendinopathy, a type of tendon disorder that results in pain, swelling, and impaired function. The pain is typically worse with movement. It most commonly occurs around the shoulder ( rotator cuff tendinitis, biceps tendinitis), elbow ( tennis e ...
, chronic pain associated with plates, screws, and pins, compartment syndrome
Compartment syndrome is a condition in which increased pressure within one of the body's anatomical compartments results in insufficient blood supply to tissue within that space. There are two main types: acute and chronic. Compartments of the ...
, deformity
A deformity, dysmorphism, or dysmorphic feature is a major abnormality of an organism that makes a part of the body appear or function differently than how it is supposed to.
Causes
Deformity can be caused by a variety of factors:
* Arthritis a ...
, audible popping and snapping, and possible future surgeries to remove the hardware.
Closed reduction
Closed Reduction Internal Fixation (CRIF) is reduction without any open surgery, followed by internal fixation. It appears to be an acceptable alternative in unstable distressed lateral condylar fracture
A condyle (;Entry "condyle"
in
humerus in children, but if fracture displacement after closed reduction exceeds 2 mm, open reduction and internal fixation is recommended. Various techniques of minimally invasive surgery for internal fixation of bones have been reported. The treatment of fractures of the distal third of the tibia has evolved with the development of improved imaging and surgical techniques. Internal fixation implants for intracapsular hip fractures in older adults The latest evidence suggests that there may be little or no difference between screws and fixed angle plates as internal fixation implants for intracapsular hip fractures in older adults. The findings are based on low quality evidence that cannot firmly conclude major difference in hip function, quality of life, and additional surgery.
Basic Principles And Techniques Of Internal Fixation Of Fractures (28MB PPT)
{{DEFAULTSORT:Internal Fixation Orthopedic surgical procedures
in
humerus in children, but if fracture displacement after closed reduction exceeds 2 mm, open reduction and internal fixation is recommended. Various techniques of minimally invasive surgery for internal fixation of bones have been reported. The treatment of fractures of the distal third of the tibia has evolved with the development of improved imaging and surgical techniques. Internal fixation implants for intracapsular hip fractures in older adults The latest evidence suggests that there may be little or no difference between screws and fixed angle plates as internal fixation implants for intracapsular hip fractures in older adults. The findings are based on low quality evidence that cannot firmly conclude major difference in hip function, quality of life, and additional surgery.
Additional images
See also
* ''Arbeitsgemeinschaft für Osteosynthesefragen
The AO Foundation is a nonprofit organization dedicated to improving the care of patients with musculoskeletal injuries or pathologies and their sequelae through research, development, and education of surgeons and operating room personnel. The AO ...
''
* CNT Network Bio-stress Sensors
* External fixation
External fixation is a surgical treatment wherein rods are screwed into bone and exit the body to be attached to a stabilizing structure on the outside of the body. It is an alternative to internal fixation, where the components used to provide ...
* List of orthopedic implants An orthopedic implant is a medical device manufactured to replace a missing joint or bone or to support a damaged bone. The medical implant is mainly fabricated using stainless steel and titanium alloys for strength and the plastic coating that is ...
* Osseoincorporation
* Osseointegration
Osseointegration (from Latin ''osseus'' " bony" and ''integrare'' "to make whole") is the direct structural and functional connection between living bone and the surface of a load-bearing artificial implant ("load-bearing" as defined by Albrekt ...
References
External links
Basic Principles And Techniques Of Internal Fixation Of Fractures (28MB PPT)
{{DEFAULTSORT:Internal Fixation Orthopedic surgical procedures