Internal fixation

Internal fixation
Internal fixation
Intervention

Orthopedic implants to repair fractures to the radius and ulna. Note the visible break in the ulna. (right forearm)
ICD-9-CM 78.5
MeSH D005593
US Navy doctors perform an open reduction internal fixation operation on the femur.
Implant that has been used for fixation of a broken wrist (length in cm)

Internal fixation is an operation in orthopedics that involves the surgical implementation of implants for the purpose of repairing a bone, a concept that dates to the mid-19th century.[1] An internal fixator may be made of stainless steel or titanium.

Types of internal fixators include bone screws and metal plates, pins, rods,[2] Kirschner wires and intramedullary devices such as the Kuntscher nail and interlocking nail.[3]

Contents

Open Reduction Internal Fixation (ORIF)

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 itself. Open reduction refers to open surgery to set bones, as is necessary for some fractures. Internal fixation refers to fixation of screwsand/or plates , Intramedulary bone nails (Femur, Tibia, Humerus) to enable or facilitate healing. Rigid fixation prevents micromotion across lines of fracture to enable healing and prevent infection, which happens when implants such as plates (e.g. Dynamic Compression Plate) are used, Open Reduction Internal Fixation techniques are often used in cases involving serious fractures such as comminuted or displaced fractures, Intramedulary bone nails (Femur, Tibia, Humerus)

Risks and complications can include bacterial colonization of the bone, infection, stiffness and loss of range of motion, non-union, malunion, damage to the muscles, nerve damage and palsy, arthritis, tendonitis, chronic pain associated with plates, screws, and pins, compartment syndrome, deformity, audible popping and snapping, and possible future surgeries to remove the hardware.

Closed Reduction Internal Fixation

Closed Reduction Internal Fixation (CRIF) is reduction without any open surgery, followed by internal fixation. It appears to be an acceptable alternative in unstable displaced lateral condylar fractures of the humerus in children, but if fracture displacement after closed reduction exceeds 2 mm, open reduction and internal fixation is recommended.[4]

See also

Notes

  1. ^ General Principles of Internal Fixation. URL: http://emedicine.medscape.com/article/1269987-overview Accessed 9 January 2010
  2. ^ MedicineNet.com URL: http://www.medterms.com/script/main/art.asp?articlekey=13714 Accessed 9 January 2010
  3. ^ The Original Interlocking Nail System Accessed 10 February 2011
  4. ^ Song, K. S.; Kang, C. H.; Min, B. W.; Bae, K. C.; Cho, C. H.; Lee, J. H. (2008). "Closed Reduction and Internal Fixation of Displaced Unstable Lateral Condylar Fractures of the Humerus in Children". The Journal of Bone and Joint Surgery 90 (12): 2673–2681. doi:10.2106/JBJS.G.01227. PMID 19047713.  edit

External links

v · d · eOrthopedic surgery, operations/surgeries and other procedures on bones and joints (ICD-9-CM V3 76-81, ICD-10-PCS 0P-S)
Bones
Facial
Spine
Coccygectomy · Laminotomy · Laminectomy · Laminoplasty · Corpectomy · Facetectomy · Foraminotomy · Vertebral fixation · Percutaneous vertebroplasty
Upper extremity
Lower extremity
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Upper extremity

Shoulder surgery (Shoulder replacement, Bankart repair, Weaver-Dunn procedure) · Ulnar collateral ligament reconstruction · Hand surgery (Brunelli procedure)

exam: Shoulder examination (Jobe's test, Adson's sign) · Elbow examination (Elbow extension test) · Wrist examination (Tinel sign/Phalen maneuver, Finkelstein's test)
General

M: BON/CAR

anat(c/f/k/f, u, t/p, l)/phys/devp/cell

noco/cong/tumr, sysi/epon, injr

proc, drug(M5)

M: JNT

anat(h/c, u, t, l)/phys

noco(arth/defr/back/soft)/cong, sysi/epon, injr

proc, drug(M01C, M4)

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  • Oral fixation (disambiguation) — Oral fixation may refer to: In psychology: Oral stage, a term used by Sigmund Freud to describe the child s development during the first 0 to 18 months of life, in which an infant s pleasure centers are in the mouth. In music: Oral Fixation, an… …   Wikipedia

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