In orthopaedics internal fixation is a surgical procedure for holding together the fractured bone for the purpose of repairing a bone. This concept comes in the light in mid- 19th century and after that it is used for the routine treatment of the patients who suffered from the bone fracture. In internal fixation a broken bone must be carefully stabilized and supported to the point of time it is strong enough to handle the weight of the body. During the surgery of broken bones through internal fixation the bone fragments are first reduced into their normal alignment then they are hold together with the help of internal fixators such as plates, screws, nails and wires.
Open Reduction Internal Fixation:
It is a type of surgery used to fix broken bone. There are two parts of the surgery in the first part a broken bone is reduced or put back into place and in the next part internal fixation device is placed on the bone. This can be done with the use of internal fixators such as screws, plates, rods, wires or pins that are used to hold the broken bone together.
Close Reduction Internal Fixation:
In closed reduction internal fixation, without any open surgery fractures can be reduced closed with a very minor incision. In case if fracture is displaced after closed reduction which exceeds 2 mm then open reduction internal fixation is recommended.
Types of Internal Fixators:
These internal fixators may be made of stainless steel or titanium which are durable, strong and long lasting. If a joint is to be replaced rather than fixed these implants can also be made of chrome and cobalt. These fixators rarely cause any allergic reaction and are compatible with the body.
1) Metal plates:
Plates are attached to the bone with screw which holds the broken pieces of bone together. These are like internal splints and may be left in place or removed after healing is complete this depends upon case to case.
2) Pins or wires:
Pins or wires are often used to hold together pieces of bone that are very small to be fixed with screws. Some times in many cases wires are used in conjunction with other form of internal fixators, but they can be used alone to treat fractures of small bones which are found in the hand or foot. Wires are normally removed after a certain amount of time or they may be left in permanently for some fractures.
3) Rods or nails:
The best way to hold the fractures of the long bones pieces together is by implanting a rod or nail through the hollow centre of the bone that normally contains some marrow. Screws are used to keep the fracture from shortening or rotating until the fracture is healed, which are placed at each end of the rod. Majority of fractures are treated through this method in the femur and tibia; nail and rod are left in the bone after healing the healing is complete.
There are various design and size of screw available in the market based on the type of fracture. These screws can be used alone or used to hold the other fixators such as plates, rods and nails. Screws may be either left or removed after healing the bone.
Internal fixation is opposite of external fixation of a fracture which is done by using splint or cast. Orthopaedic surgeons are regularly developing and improving the methods of treating the fractures. These internal fixations are done by the experienced surgeon by using imaging machines like X-ray machines, ultrasound, MRI machines etc. All the procedures have some risks, but problem from this procedure are rare. Infection, bleeding, blood clots and infection to anaesthesia are some potential problems which will be reassess by your doctor.