Internal fixation

Surgery that uses metal screws, steel plates, intramedullary needles, steel wires, or bone plates to directly fix broken bones inside or outside the broken bone is called internal fixation. This kind of surgery is mostly used for fracture reduction and osteotomy to maintain the reduction of the folded end. The main advantage of internal fixation is that it can better maintain the anatomical reduction of the fracture, which is more direct and effective than simple external fixation, and it is more effective in preventing scissors-type or rotational activities at the fracture end. In addition, some internal fixations have a strong support effect. Postoperative can be used with little or no external fixation, which can reduce the scope and time of external fixation. Strong internal fixation is conducive to the functional training of injured limbs and early wake-ups, reducing long-term bed rest. Complications (such as fallout pneumonia, venous thrombosis, bladder stones, etc.). However, there should be sufficient understanding of the disadvantages of internal fixation. No matter what kind of metal internal fixation is, it is always a foreign body to the human body. In clinical practice, osteoporosis or loosening of internal fixation occurs frequently under and around the internal fixation. Once an infection occurs, metal foreign bodies can severely impede wound and fracture healing. At the same time, the placement of internal fixation requires extensive stripping of soft tissue and periosteum, which inevitably affects blood flow and delays fracture healing. Due to the development of aseptic technology, surgical techniques are constantly proficient, and the metal quality of internal fixation is gradually improved. Proper selection of internal fixation can indeed improve the treatment of certain fractures. However, it must be pointed out that one-sided pursuit of anatomical reduction of fractures and abuse of internal fixation is extremely wrong, and the indications must be strictly controlled. At the same time, it should be recognized that internal fixation is only a temporary measure to maintain reduction. Although it has a certain supporting effect, it cannot replace fracture healing. Different protective measures must be taken after surgery until the fracture heals. Otherwise, internal fixation fatigue, bending or breaking will occur. According to the concept that a strong internal fixation with a certain pressure between the ends of the fracture can form a primary healing of the fracture (that is, the fracture end is directly connected to the end of the bone by new bone without passing through the epiphysis), various compression internal fixations (such as In addition to pressure plates, compression screws, etc.), in addition to promoting fracture healing, external fixation can be used with little or no use for early movement and even weight bearing. Compression internal fixation also has the inherent disadvantages of general internal fixation. At the same time, strong internal fixation can still cause bone atrophy at the fracture site, and even re-fracture occurs after removal of the internal fixation.

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