Internal fixator
Encyclopedia
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. An internal fixator may be made of stainless steel
or titanium
.
Types of internal fixators include bone screws and metal plates, pins, rods, Kirschner wire
s and intramedullary devices such as the Kuntscher nail and interlocking nail
.
refers to open surgery to set bone
s, as is necessary for some fracture
s. 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.
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.
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
in orthopedics
Orthopedics
Orthopedics is the study of the musculoskeletal system. The Greek word 'ortho' means straight or correct and 'pedics' comes from the Greek 'pais' meaning children. For many centuries, orthopedists have been involved in the treatment of crippled children...
that involves the surgical implementation of implants
Implant (medicine)
An implant is a medical device manufactured to replace a missing biological structure, support a damaged biological structure, or enhance an existing biological structure. Medical implants are man-made devices, in contrast to a transplant, which is a transplanted biomedical tissue...
for the purpose of repairing a bone
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...
, a concept that dates to the mid-19th century. An internal fixator may be made of stainless steel
Stainless steel
In metallurgy, stainless steel, also known as inox steel or inox from French "inoxydable", is defined as a steel alloy with a minimum of 10.5 or 11% chromium content by mass....
or titanium
Titanium
Titanium is a chemical element with the symbol Ti and atomic number 22. It has a low density and is a strong, lustrous, corrosion-resistant transition metal with a silver color....
.
Types of internal fixators include bone screws and metal plates, pins, rods, Kirschner wire
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 orthopaedics and other types of medical and veterinary surgery. They come in different sizes and are used to hold bone fragments...
s and intramedullary devices such as the Kuntscher nail and interlocking nail
Innovative interlocking nail
The Innovative interlocking nail is a veterinary surgical system of tools and surgical techniques for using an intramedullary nail, inter-locking nail or Küntscher nail for the repair of fractured bones. The system was developed in 1989 for veterinary use by R. Tass Dueland, DVM., at the...
.
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 reductionReduction (orthopedic surgery)
Reduction is a medical procedure to restore a fracture or dislocation to the correct alignment. When a bone fractures, the fragments lose their alignment in the form of displacement or angulation. For the fractured bone to heal without any deformity the bony fragments must be re-aligned to their...
refers to open surgery to set bone
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...
s, as is necessary for some fracture
Fracture
A fracture is the separation of an object or material into two, or more, pieces under the action of stress.The word fracture is often applied to bones of living creatures , or to crystals or crystalline materials, such as gemstones or metal...
s. Internal fixation refers to fixation of screwsand/or plates , Intramedulary bone nails (Femur, Tibia, Humerus) to enable or facilitate healing
Healing
Physiological healing is the restoration of damaged living tissue, organs and biological system to normal function. It is the process by which the cells in the body regenerate and repair to reduce the size of a damaged or necrotic area....
. 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
Dynamic compression plate
A dynamic compression plate 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 compression is achieved either by attaching a tension...
) 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
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
, stiffness and loss of range of motion
Joint stiffness
Joint stiffness may be either the symptom of pain on moving a joint, the symptom of loss of range of motion or the physical sign of reduced range of motion. Doctors prefer the latter two uses but patients often use the first meaning....
, non-union, malunion, damage to the muscles, nerve damage and palsy, arthritis
Arthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints....
, tendonitis
Tendonitis
Tendinitis , meaning inflammation of a tendon , is a type of tendinopathy often confused with the more common tendinosis, which has similar symptoms but requires different treatment...
, chronic pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
associated with plates, screws, and pins, compartment syndrome
Compartment syndrome
Compartment syndrome is a limb threatening and life threatening condition, defined as the compression of nerves, blood vessels, and muscle inside a closed space within the body . This leads to tissue death from lack of oxygenation due to the blood vessels being compressed by the raised pressure...
, deformity
Deformity
A deformity, dysmorphism, or dysmorphic feature is a major difference in the shape of body part or organ compared to the average shape of that part.Deformity may arise from numerous causes:*A Genetic mutation*Damage to the fetus or uterus...
, audible popping and snapping, and possible future surgeries to remove the hardware.
Closed Reduction Internal Fixation
Closed Reduction Internal Fixation (CRIF) is reductionReduction (orthopedic surgery)
Reduction is a medical procedure to restore a fracture or dislocation to the correct alignment. When a bone fractures, the fragments lose their alignment in the form of displacement or angulation. For the fractured bone to heal without any deformity the bony fragments must be re-aligned to their...
without any open surgery, followed by internal fixation. It appears to be an acceptable alternative in unstable displaced lateral condylar fractures of the humerus
Humerus
The humerus is a long bone in the arm or forelimb that runs from the shoulder to the elbow....
in children, but if fracture displacement after closed reduction exceeds 2 mm, open reduction and internal fixation is recommended.