| Internal fixation | |
|---|---|
| Intervention | |
Orthopedic implants to repair fractures to the radius and ulna. Note the visible break in the ulna. (right forearm) |
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| ICD-9-CM | 78.5 |
| MeSH | D005593 |
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) 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 screws and/or plates, intramedullary bone nails (femur, tibia, humerus) 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. 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, mal-union, 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 (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]