Internal fixation

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Internal fixation

Orthopedic implants to repair fractures to the radius and ulna , note the visible break in the ulna (right forearm)
ICD-9-CM 78.5
MeSH D005593
[ edit on Wikidata ]

Internal fixation is an operation in orthopedics that involves the surgical implementation of implants for the purpose of repairing a bone , a concept that dates to the mid-nineteenth century and was made applicable for routine treatment in the mid-twentieth century. [1] An internal fixator may be made of stainless steel or titanium . [2]

Types of internal fixators include:

  • Plate and screws
  • Kirschner wires
  • Intramedullary nails


  • 1 Open Reduction Internal Fixation (ORIF)
  • 2 Closed Reduction Internal Fixation
  • 3 Additional images
  • 4 See also
  • 5 Notes
  • 6 External links

Open Reduction Internal Fixation (ORIF)[ edit ]

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Open Reduction Internal Fixation (ORIF) involves the implementation of implants to guide the healing process of a bone, as well as the open reduction, or setting, of the bone. Open reduction refers to open surgery to set bones , as is necessary for some fractures . Internal fixation refers to fixation of screws and/or plates, intramedullary bone nails ( femur , tibia , humerus ) to enable or facilitate healing . Rigid fixation prevents micro-motion across lines of fracture to enable healing and prevent infection, which happens when implants such as plates (e.g. dynamic compression plate ) are used. Open Reduction Internal Fixation techniques often are used in cases involving serious fractures such as comminuted or displaced fractures or, in cases where the bone otherwise would not heal correctly with casting or splinting alone.

Risks and complications may include bacterial colonization of the bone, infection , stiffness and loss of range of motion , non-union, mal-union, damage to the muscles, nerve damage and palsy, arthritis , tendonitis , chronic pain associated with plates, screws, and pins, compartment syndrome , deformity , audible popping and snapping, and possible future surgeries to remove the hardware.

Closed Reduction Internal Fixation[ edit ]

Implant that has been used for fixation of a broken wrist

Closed Reduction Internal Fixation (CRIF) is reduction without any open surgery, followed by internal fixation. It appears to be an acceptable alternative in unstable distressed or hyperfalotated[ clarification needed ] lateral condylar fractures of the humerus in children, but if fracture displacement after closed reduction exceeds 2 mm, open reduction and internal fixation is recommended. [3]

Various techniques of minimally invasive surgery for internal fixation of bones have been reported. The treatment of fractures of the distal third of the tibia has evolved with the development of improved imaging and surgical techniques. [4]

Additional images[ edit ]

US Navy physicians perform an open reduction internal fixation operation on the femur .

Anterior and lateral view x-rays of fractured left leg with internal fixation

See also[ edit ]

  • Arbeitsgemeinschaft für Osteosynthesefragen
  • CNT Network Bio-stress Sensors
  • External fixation
  • List of orthopedic implants

Notes[ edit ]

  1. ^ T. Schlich (2002) Surgery, Science and Industry. A Revolution in Fracture Care, 1950s-1990s (Houndsmills, Basingstoke: Palgrave)[ page needed ]
  2. ^ General Principles of Internal Fixation at eMedicine
  3. ^ Song, K. S.; Kang, C. H.; Min, B. W.; Bae, K. C.; Cho, C. H.; Lee, J. H. (2008). “Closed Reduction and Internal Fixation of Displaced Unstable Lateral Condylar Fractures of the Humerus in Children”. The Journal of Bone and Joint Surgery. 90 (12): 2673–2681. doi : 10.2106/JBJS.G.01227 . PMID   19047713 .

  4. ^ Krettek, C. (1997). “Foreword: Concepts of minimally invasive plate osteosynthesis”. Injury. 28 Suppl 1: A1–A2. doi : 10.1016/S0020-1383(97)90108-X . PMID   10897280 .

External links[ edit ]

Wikimedia Commons has media related to Internal fixation .
  • AO Surgery Reference
  • Basic Principles And Techniques Of Internal Fixation Of Fractures (28MB PPT)
  • v
  • t
  • e
Orthopedic surgery , operations/ surgeries and other procedures on bones and joints ( ICD-9-CM V3 76–81, ICD-10-PCS 0P–S )
  • Jaw reduction
  • Dentofacial osteotomy
  • Genioplasty / Mentoplasty
    • Chin augmentation
  • Orthognathic surgery
  • Coccygectomy
  • Laminotomy
  • Laminectomy
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  • Corpectomy
  • Facetectomy
  • Foraminotomy
  • Vertebral fixation
  • Percutaneous vertebroplasty
Upper extremity
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Lower extremity
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  • Astragalectomy
  • Distraction osteogenesis
  • Ilizarov apparatus
  • Phemister graft
  • Ostectomy
  • Bone grafting
  • Osteotomy
  • Epiphysiodesis
  • Reduction
  • Internal fixation
  • External fixation
  • Tension band wiring
  • Articular cartilage repair
    • Microfracture surgery
  • Knee cartilage replacement therapy
  • Autologous chondrocyte implantation
  • Arthrodesis
    • Spinal fusion
  • Intervertebral discs
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Upper extremity
  • Shoulder surgery
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Lower extremity
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  • Broström procedure
  • Triple arthrodesis
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  • Replacement joint
  • imaging: Arthrogram
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