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Bone fracture repair
Definition Surgical procedures to realign and stabilize broken bones ( fractures ) with plates, screws, pins, or bone grafts .
Alternative Names Open reduction internal fixation of bone fracture; ORIF
Description While the patient is pain-free (general or local anesthesia), an incision is made over the fractured bone. The bone is placed in proper position and screws, pins, or plates are attached to or in the bone temporarily or permanently. Any disrupted blood vessels are tied off or burned (cauterized). If examination of the fracture shows that a quantity of bone has been lost as a result of the fracture, especially if there is a gap between the broken bone ends, the surgeon may decide that a bone graft is essential to avoid delayed healing. If bone grafting is not necessary, the fracture can be repaired by the following methods: a) one or more screws inserted across the break to hold it b) a steel plate held by screws drilled into the bone c) a long, thick metal pin (sometimes called a rod or nail) with holes in it, is driven down the shaft of the bone from one end, with screws then passed through the bone and through a hole in the pin. In some cases, after this stabilization, the microsurgical repair of blood vessels and nerves is necessary. The skin incision is then closed. If the broken bone has broken through the skin, the bone ends need to be washed with sterile fluid in the operating room as an emergency to prevent infection.
Indications Open reduction, internal fixation is recommended for complicated fractures not able to be realigned (reduced) by external methods.
Risks Risks for any anesthesia are:
  • reactions to medications
  • problems breathing
  • Risks for any surgery are:
  • bleeding
  • infection
  • Expectations after surgery The advantage of internal fixation is that it often allows early mobility and faster healing. It is by no means necessary or desirable to remove an internal fixation device unless it causes problems. The long-term prognosis is excellent.
    Convalescence The length of the hospital stay depends on factors such as the condition of the bone, the presence of infection, the state of the blood and nerve supply, and presence of other injuries. Children's bones heal rapidly, usually in 6 weeks time.

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