Internal fixation

Internal fixation is an operation in orthopedics that involves the surgical application of implants for repair of a bone, a concept from the mid-19th century. An internal fixator can be made of stainless steel or titanium.

The types of internal fixation are bone screws and metal plates, pins, rods, Kirschner wires and intramedullary devices such as the Küntschernagel and the locking nail.

Open reduction and internal fixation ( ORIF )

Open reduction and internal fixation (English open reduction internal fixation, ORIF ) involves the use of implants to control the healing process of the bone and open reduction or arrest of the bone itself. Open reduction refers to open surgery to set the bone, as for some fractures required. Internal fixation refers to fixation by means of screws and / or plates, in order to enable or facilitate healing. Rigid fixation prevents micro- motion breaking lines to facilitate healing and to prevent infection, which can (for example, dynamic compression plate), occurring during the use of implants, such as plates. Open reduction and internal fixation is often used in cases of serious fractures such as comminuted fractures or dislocated fractures. Internal fixation devices for the spine to either prevent injury to the spinal cord or allow for already traumatic paraplegia, rapid mobilization and rehabilitation of the patient.

The risks and complications include bacterial colonization of the bone, infection, stiffness and loss of motion, nonunion, malunion, damage to the muscles, nerve damage and paralysis, arthritis, tendonitis, chronic pain due to the implanted plates, screws and pins, compartment syndrome, deformity, audible popping and snapping, and possible future operations for the removal of the osteosynthesis material.

Closed reduction and internal fixation

Closed reduction and internal fixation (English closed reduction internal fixation, CRIF ), the reduction is without open surgery followed by internal fixation. There appears to be an acceptable alternative in unstable displaced lateral condylar fractures of the humerus in children. If the dislocation after closed reduction is, however, more than 2 mm, open reduction and internal fixation is recommended.