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    Open Reduction Internal Fixation Rif

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    Nurul Hidayah
    Open reduction and internal fixation is a surgical procedure used to realign bone fractures and repair joints. It involves surgically repositioning fractured bone fragments to their normal alignment through an open incision (open reduction) and securing them in place with internal fixation devices like plates, screws, rods or wires. Internal fixation holds fractures securely to allow early movement and prevent re-displacement during healing. While it speeds recovery, risks include infection, non-union of the bone, implant failure, and re-fracture if the implant is removed too early. Careful surgical technique, equipment, and operating conditions are important to minimize these risks.

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    Open Reduction Internal Fixation Rif

    Uploaded by

    Nurul Hidayah
    771 views16 pages
    Open reduction and internal fixation is a surgical procedure used to realign bone fractures and repair joints. It involves surgically repositioning fractured bone fragments to their normal alignment through an open incision (open reduction) and securing them in place with internal fixation devices like plates, screws, rods or wires. Internal fixation holds fractures securely to allow early movement and prevent re-displacement during healing. While it speeds recovery, risks include infection, non-union of the bone, implant failure, and re-fracture if the implant is removed too early. Careful surgical technique, equipment, and operating conditions are important to minimize these risks.

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    Open Reduction INternal Fixation

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    Open reduction and internal fixation is a surgical procedure used to realign bone fractures and repair joints. It involves surgically repositioning fractured bone fragments to their normal alignment through an open incision (open reduction) and securing them in place with internal fixation devices like plates, screws, rods or wires. Internal fixation holds fractures securely to allow early movement and prevent re-displacement during healing. While it speeds recovery, risks include infection, non-union of the bone, implant failure, and re-fracture if the implant is removed too early. Careful surgical technique, equipment, and operating conditions are important to minimize these risks.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    771 views16 pages

    Open Reduction Internal Fixation Rif

    Uploaded by

    Nurul Hidayah
    Open reduction and internal fixation is a surgical procedure used to realign bone fractures and repair joints. It involves surgically repositioning fractured bone fragments to their normal alignment through an open incision (open reduction) and securing them in place with internal fixation devices like plates, screws, rods or wires. Internal fixation holds fractures securely to allow early movement and prevent re-displacement during healing. While it speeds recovery, risks include infection, non-union of the bone, implant failure, and re-fracture if the implant is removed too early. Careful surgical technique, equipment, and operating conditions are important to minimize these risks.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 16

    OPEN REDUCTION &

    INTERNAL FIXATION OF
    FRACTURES

    Presented By Siti Nur Rifhan Kamaruddin


    OVERVIEW
    DEFINITION: Surgical procedure to fix a severe bone
    fracture or to repair a joint.
    Open Reduction means surgery is needed to
    realign the bone fracture into the normal position
    Indication for Open reduction
    - When close reduction fails
    - Large articular fragment needs accurate
    positioning
    - Avulsion fractures
    Generally, Open Reduction is the first step to
    internal fixation
    Internal fixation refers to the steel rods, screws or
    plates used to keep the bone fracture stable in order to
    heal the right way.
    If properly applied, internal fixation
    holds a fracture securely so that
    movements can begin at once- with
    early movement, the fracture
    disease (edema, stiffness) is
    abolished
    Speed is not an issue. Pt can leave
    hospital as soon as the wound is
    healed.
    Weight bearing should be avoided
    even though the bone moves in one
    piece, the fracture is not united.
    Infection is the main concern.
    Risk of infection:
    - The Patient: Devitalized tissues, a
    dirty wound and unfit patient are
    all dangerous
    - The Surgeon: Thorough training, a
    high degree of surgical dexterity,
    adequate assistance are essential
    - The Facilities: A guaranteed
    septic routine, a full range of
    implants.
    INIDICATIONS FOR INTERNAL
    FIXATION
    Fractures that cannot be reduced
    Fractures that are unstable and prone to re-
    displacement after reduction(e.g midshaft
    fractures of forearm and some ankle fractures)
    Fractures that unite poorly and slowly
    (fractures of the femoral neck)
    Pathological fractures bone disease may
    prevent healing
    Multiple fractures, where early fixation
    reduced risk of general complication
    Fractures in patients who present severe
    nursing difficulties.
    TYPES OF INTERNAL
    SCREWS
    FIXATION
    Interfragmentary screws (lag
    screws) are useful for fixing
    small segments onto main
    bone
    WIRES
    Stiff, Kirschner wires can hold
    bone fragments together.
    Often insert percutaneously
    without exposing the fracture
    Used in situations where
    fracture healing is predictably
    quick.
    PLATES & SCREWS
    Useful for treating both tubular & flat
    bones.
    When used on tubular bones, firm
    coaption of fragments can be achieved
    by compression device before tightening
    the screws.
    Plates can be shaped. e.g Buttress
    plates are often used to prop up
    the overhang of an expanded
    metaphysis- as in fixing fractures
    of proximal tibial plateau.
    In tension-band plating, the
    plate is applied on the tension
    side of the bone so that
    tension forces on the plate
    side of bone are converted to
    the more advantageous side.

    Anti-glide plates: By fixing


    the plate over the tip of a
    spiral or oblique fracture and
    then using the plate as a
    reduction aid, the anatomy
    can be restored with minimal
    stripping of soft tissues.
    INTERMEDULLARY NAILS
    Suitable for long bones.
    A nail (or long rod) is inserted into the
    medullary canal to splint fracture,
    rotational forces are resisted by
    introducing locking screws which
    transfix the bone cortices and the nails.
    Nails can be used with or without prior
    remaining if the medullary canal
    reaming achieves an interference fit
    which further improves facture stability.
    Though at the expense of some
    damage to the intermedullary supply.
    COMPLICATIONS OF INTERNAL FIXATION

    Most complications are due to


    poor technique, poor
    equipment
    or poor operating condition.
    Infection
    - Iatrogenic Infection :
    - Most common cause of chronic Osteomyelitis
    - Quality of Patent's tissues and open
    operation are the predisposing factor. Not
    the metal implant.
    - If infection not rapidly controlled with IV
    antibiotic, the implants should be replaced
    with external fixation.
    Non-union
    - Cause : Excessive stripping of soft tissues,
    unnecessary damage to blood supply and rigid
    fixation with a gap between the fragments.
    Implant failure
    - Metal is subject to fatigue and undue stresses
    should be avoided until fractures has united.
    - Pt with femoral or tibial fractures should still
    use crutches until fracture is healing (at least
    6 weeks)
    - Pain at the fracture site is a danger signal!
    Re-fracture
    - Important not to remove metal implant too
    soon
    - A year is minimum and 18-24 months safer.
    - For several weeks after implant removal, the bone
    is weak so weight bearing should be avoided.
    REFERENCES
    Apley and Solomons Concise System
    of Orthopedics and Trauma 4th
    Edition. CRC Press
    THANK
    YOU..

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