What is internal fixation?
Internal fixation involves setting and stabilizing the fractured bones by cutting open the skin. The bones are realigned to their normal position. Internal fixation uses special implants such as plates, screws, nails, and wires, which hold together the corrected bones.
The advantages of internal fixation are as follows:
- Shorter hospital stay
- Allows the patients to return to the function earlier
- Reduces the chances of improper healing
- Prevents the healing of bone in the improper position
The implants are usually made of stainless steel, titanium, cobalt, or chrome, which are sturdy and strong. Implants are generally compatible with the body and hardly cause any allergic reactions.
What are the general principles of internal fixation?
The general principles of internal fixation are as follows:
- Realignment of the bone fracture to the normal alignment
- Preservation of the blood supply
- Stable internal fixation
- Faster healing for pain-free mobilization of the joints and muscle
- Minimized risk of complications
- Full restoration of function
Stable fixation involves fixation that prevents the movement of the fractured fragments.
Compression on the fractured bone produces friction that prevents the displacement of the fractured fragments and holds it in place. Compression also helps in maintaining a close contact between the fragment surfaces.
The general purposes of implants are
- To provide short-term support
- To maintain alignment during fracture healing
- To allow for rehabilitation
What are the different implants used during internal fixation?
The different implants used for internal fixation include the following:
- Plates: Internal splints used to hold the broken bone, they are fixed to the bone with screws. They may be left in place for healing or may be removed in selective cases.
- Screws: Most commonly used for internal fixation, they are available in different designs and sizes for the bones of different sizes. They can be used alone or with plates, rods, or nails. They may be left inside for healing or removed.
- Rods or nails: For certain fractures of the thighbones or shinbones, rods are inserted through the hollow center of the bone. Screws at the end of the rod prevent the fracture from rotating and keep the rods in place.
- Wires or pins: Fractures that are too small to fix by screws usually require wires to pin them to the bone. They generally treat small fractures of the hands or foot if used alone. Wires can be used in conjunction with other implants.
What are the complications of internal fixation?
The complications of internal fixation are
- implant failure,
- refracture and
- nonunion (arrest in the fracture repair process).