Internal fixation

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Internal fixation is a surgical procedure used to stabilize and join the ends of fractured bones by mechanical devices such as metal plates, pins, rods, wires, or screws. This technique is commonly employed in the treatment of bone fractures to ensure proper alignment and healing.

History

The concept of internal fixation dates back to the early 20th century. The development of modern internal fixation techniques was significantly advanced by the work of the Swiss Association for the Study of Internal Fixation (AO Foundation) in the 1950s. The AO Foundation established principles and standardized methods for internal fixation, which have been widely adopted in orthopedic surgery.

Types of Internal Fixation Devices

Internal fixation devices come in various forms, each designed for specific types of fractures and bones. Common types include:

• Plates and Screws: Metal plates are attached to the bone with screws to hold the fractured pieces together.
• Intramedullary Rods: These are metal rods inserted into the marrow canal of long bones such as the femur or tibia.
• Pins and Wires: Often used for smaller bones or in pediatric cases, pins and wires can be used to hold bone fragments in place.
• External Fixators: Although primarily an external device, some components are inserted into the bone, making it a hybrid form of fixation.

Procedure

The procedure for internal fixation typically involves the following steps:

1. **Incision**: A surgical incision is made over the fracture site. 2. **Reduction**: The fractured bone fragments are realigned to their normal anatomical position. 3. **Fixation**: The appropriate internal fixation device is applied to stabilize the fracture. 4. **Closure**: The incision is closed with sutures or staples.

Advantages

Internal fixation offers several advantages over other methods of fracture treatment, such as:

• **Stability**: Provides rigid stabilization, allowing for early mobilization and weight-bearing.
• **Healing**: Promotes faster and more reliable bone healing.
• **Alignment**: Ensures precise alignment of bone fragments.

Complications

While internal fixation is generally safe, potential complications can include:

• Infection
• Nonunion or malunion of the fracture
• Hardware failure or irritation
• Nerve damage

Recovery

Recovery from internal fixation surgery varies depending on the type and location of the fracture, as well as the patient's overall health. Physical therapy is often recommended to restore function and strength to the affected area.

See Also

• Orthopedic surgery
• Bone healing
• External fixation
• Fracture reduction
• Osteosynthesis