Internal fixation is an operation in orthopedics that involves the surgical implementation of

implants Implant can refer to: Medicine *Implant (medicine), or specifically: **Brain implant **Breast implant **Buttock implant **Cochlear implant **Contraceptive implant **Dental implant **Fetal tissue implant **Implantable cardioverter-defibrillator ** ...

for the purpose of repairing a bone, 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 Stainless steel is an alloy of iron that is resistant to rusting and corrosion. It contains at least 11% chromium and may contain elements such as carbon, other nonmetals and metals to obtain other desired properties. Stainless steel's corros ...

, titanium alloy, or cobalt-chrome alloy. or plastics. Types of internal fixators include: * Plate and screws * Kirschner wires * 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 to open surgery to set bones, as is necessary for some

fracture Fracture is the separation of an object or material into two or more pieces under the action of stress. The fracture of a solid usually occurs due to the development of certain displacement discontinuity surfaces within the solid. If a displa ...

s. ''Internal fixation'' refers to fixation of screws and/or plates,

intramedullary rod An intramedullary rod, also known as an intramedullary nail (IM nail) or inter-locking nail or Küntscher nail (without proximal or distal fixation), is a metal rod forced into the medullary cavity of a bone. IM nails have long been used to treat ...

s and other devices to enable or facilitate healing. 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) are used. ORIF techniques often are used in cases involving serious fractures such as

comminuted Comminuted may refer to: *Comminution, the process in which solid materials are reduced in size, by crushing, grinding and other processes *Bone fracture, as in a crushed or splintered bone *Comminuted skull fracture A skull fracture is a break ...

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, stiffness and loss of range of motion, non-union, mal-union, damage to the muscles, nerve damage and palsy,

arthritis Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In som ...

, tendonitis, chronic

pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...

associated with plates, screws, and pins, compartment syndrome, deformity, 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 fractures of the

humerus The humerus (; ) is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a roun ...

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

$X ray internal fixation leg fracture$

References

External links

Basic Principles And Techniques Of Internal Fixation Of Fractures (28MB PPT)
{{DEFAULTSORT:Internal Fixation Orthopedic surgical procedures

Open reduction

Closed reduction

Additional images

See also

References

External links