internal fixation (open reduction internal fixation) a fracture treatment procedure in which pins or a plate are placed directly into the bone to hold the broken pieces in place traction pulling force exerted on a limb in a distal direction in an effort to return the bone or joint to normal alignment immobilization (stabilization)
How do you fix a broken bone with a pin?
Treatment of fractures involves the joining of the broken bones either by immobilizing the area and allowing the bone to heal on its own, or surgically aligning the broken bones and stabilizing it with metal pins, rods or plates. Sometimes, the broken bone fails to re-join and heal even after treatment. This is called non-union.
What are plates in a fracture?
Aug 16, 2018 · Bone fracture repair is a surgery to fix a broken bone using metal screws, pins, rods, or plates to hold the bone in place. It’s also known as …
What is bone fracture repair?
Apr 01, 2022 · Broken bones can be fixed in surgery with metal pins, screws, nails, rods, or plates. These metal pieces hold the bones in place while they heal. Sometimes, the metal pins need to stick out of your skin to hold the broken bone in place. The metal and the skin around the pin must stay clean to prevent infection.
Why should I keep the pin site clean after a fracture?
Screws come in different sizes for use with bones of different sizes. Screws can be used alone to hold a fracture, as well as with plates, rods, or nails. After the bone heals, screws may be either left in place or removed. A broken bone in this patient’s ankle is …
Is a fracture treatment in which a plate or pins are placed directly into the bone to hold the broken pieces in place?
Hip pinning uses pins, screws, or plates to help hold broken bones together so they can heal correctly.
What is a pinned fracture?
Percutaneous pinning is a way to support unstable fractures (breaks). “Percutaneous” means “through the skin.” When the patient is asleep, a surgeon will reduce (set) the fracture. The doctor will insert pins to hold the fracture in position until the bone is healed.
Why are pins used for fractures?
An external fixator acts as a stabilizing frame to hold the broken bones in proper position. In an external fixator, metal pins or screws are placed into the bone through small incisions into the skin and muscle.
Which technique is used in the treatment of fracture?
Traction method is used for the management of fractures and dislocations that cannot be treated by casting. There are two methods of traction namely, skin traction and skeletal traction.
Do pins in bones need to be removed?
Occasionally a screw is positioned across a joint to help hold that joint in place whilst it heals and it should be removed before moving the joint again to prevent breakage of the metalwork. Infected metalwork should always be removed preferably after the fracture has healed.Feb 27, 2015
How are surgical pins removed?
A special tool is used to remove the pins as gently as possible. There may be a tiny bit of blood. The staff will apply a bandage and hold pressure. Once all the pins are removed, the staff will apply a bandage and wrap.
Should pins and plates be removed?
In most cases, implants can stay in your body without any harm. Their removal should never be considered a part of "routine" care. However, there are exceptions. They tend to emerge in a specific context, such as ankle surgery, or because of pain, irritation, or infection.Nov 19, 2021
When are percutaneous pins removed?
The percutaneous pins are usually removed three to four weeks post fixation, once the fracture has united 2. In many centers around the world, this procedure is performed in the clinic setting without the use of analgesia 3.Apr 2, 2014
What do you use for pin care?
Use a squeeze bottle to squirt saline on each pin and surrounding skin. Do not touch the tip of the bottle to the pins or skin. Dry around each pin using sterile gauze or cotton swabs. Use a clean gauze or swab for each pin.
How do you immobilize a fracture?
Immobilise fracture:use broad bandages (where possible) to prevent movement at joints above and below the fracture.support the limb, carefully passing bandages under the natural hollows of the body.place a padded splint along the injured limb.More items...
How do bones heal with plates and screws?
The surgeon may make an incision over the fracture site if a plate and screws are to be utilized. He may make an incision at the end of a long bone and place a rod down the inner aspect of the bone to stabilize and repair a fracture. The fractured bone is then set into place.
What are the 5 R's of fracture management?
Principles of Fracture Management - Reduce - Hold - Rehabilitate - TeachMeSurgery.
What is bone repair?
Bone fracture repair is a surgery to fix a broken bone using metal screws, pins, rods, or plates to hold the bone in place. It’s also known as open reduction and internal fixation (ORIF) surgery.
How to treat a broken limb?
Icing, elevating, and resting the broken limb can help to reduce inflammation. Your doctor will also prescribe painkillers to ease your discomfort. However, if your pain starts to worsen after a few days instead of getting better, call your doctor.
What are the complications of a syringe?
Complications from this surgery are very rare. These complications may include: 1 an allergic reaction to anesthesia 2 bleeding 3 blood clots 4 infection
How long does it take to heal a fractured bone?
According to the Cleveland Clinic, this process will typically take six to eight weeks. However, this time frame can vary based on the fracture type and location. Immediately after the procedure, you will be taken to a recovery room.
What is bone replacement surgery?
This procedure uses bone from a different part of your body or from a donor to replace the portions of bone that were lost. Blood vessels that were damaged during your injury will be repaired during surgery.
What to expect after a surgical incision?
Doctors will often place a surgical bandage over the site that they will remove at a follow-up visit. You can expect some numbness at the incision site, but call your doctor if you begin to experience: swelling. redness.
How to minimize risk of complications?
You can minimize your risk for complications by disclosing all medical conditions and medications you’re taking as well as following your doctor’s post-procedure orders carefully. This can include instructions on keeping your dressing clean and dry.
What is the area where a pin comes out of your skin?
The area where the pin comes out of your skin is called the pin site . This area includes the pin and the skin around it. You must keep the pin site clean to prevent infection. If the site becomes infected, the pin may need to be removed. This could delay bone healing, and the infection could make you very sick.
How to clean a pin site?
Your surgeon may have special instructions for cleaning your pin site. But the basic steps are as follows: 1 Wash and dry your hands. 2 Put on gloves. 3 Pour the cleaning solution into a cup and put half of the swabs in the cup to moisten the cotton ends. 4 Use a clean swab for each pin site. Start at the pin site and clean your skin by moving the swab away from the pin. Move the swab in a circle around the pin, then make the circles around the pin larger as you move away from the pin site. 5 Remove any dried drainage and debris from your skin with the swab. 6 Use a new swab or gauze to clean the pin. Start at the pin site and move up the pin, away from your skin. 7 When you are done cleaning, use a dry swab or gauze in the same way to dry the area.
How long after pin surgery can you shower?
Most people who have pins can take a shower 10 days after surgery. Ask your surgeon how soon and whether you can shower.
How to hold a fractured bone together?
In some fractures of the long bones the best way to hold the bone pieces together is by inserting a rod or nail through the hollow center of the bone that normally contains some marrow. Screws at each end of the rod are used to keep the fracture from shortening or rotating, and also hold the rod in place until the fracture has healed. Rods and screws may be left in the bone after healing is complete. This is the method used to treat the majority of fractures in the femur (thighbone) and tibia (shinbone).
What is a plate in a bone?
Plates. Plates are like internal splints that hold the broken pieces of bone together. They are attached to the bone with screws. Plates may be left in place after healing is complete, or they may be removed (in select cases).
Why do doctors use casts and splints?
Until the last century, physicians relied on casts and splints to support and stabilize the bone from outside the body. The advent of sterile surgical procedures reduced the risk of infection, allowing doctors to internally set and stabilize fractured bones. During a surgical procedure to set a fracture, the bone fragments are first repositioned ...
Why do we need external fixators?
Because they are easily applied, external fixators are often put on when a patient has multiple injuries and is not yet ready for a longer surgery to fix the fracture. An external fixator provides good, temporary stability until the patient is healthy enough for the final surgery.
What are implants made of?
The implants used for internal fixation are made from stainless steel and titanium, which are durable and strong. If a joint is to be replaced, rather than fixed, these implants can also be made of cobalt and chrome. Implants are compatible with the body and rarely cause an allergic reaction.
Can you use screws alone?
Screws can be used alone to hold a fracture, as well as with plates, rods, or nails. After the bone heals, screws may be either left in place or removed. A broken bone in this patient’s ankle is held in position with plates and screws.
What is a hip pin?
A hip pinning is a type of surgery to fix a broken (fractured) hip. Another name for hip pinning is fracture repair and internal fixation. Hip pinning uses pins, screws, or plates to help hold broken bones together so they can heal correctly. Your thighbone (femur) meets with your pelvis at your hip joint. This joint is called a ball-and-socket ...
Why do hip implants break?
Hip fractures often occur because of falls or some other form of blow to the hip. Health problems that raise the risk for falls include: Dementia. Visual problems.
What to do before surgery?
Before your surgery, it is important to give a history of all your health problems. Let your healthcare provider know if you have any medicine allergies. Also let him or her know if you have a more recent problem, like a sudden fever. Tell him or her if you are pregnant or think you might be pregnant.
What is a virtual advisor at Johns Hopkins?
Johns Hopkins Medicine Virtual Advisors (Virtual Advisors) is a group of individuals who share their insights about the Johns Hopkins care experience. One to two times per month, Virtual Advisors receive a link to short, interactive surveys. All responses are confidential.
Why do people need hip replacement?
A hip replacement can prevent problems such as arthritis that may happen because of avascular necrosis. Hip pinning is a treatment choice in younger adults and children. It’s also good for hip fractures that happen between the greater and lesser trochanter (intertrochanteric fractures).
What is the ball and socket joint?
This joint is called a ball-and-socket joint. The socket is a cup-shaped structure on your pelvis called the acetabulum. The ball, or head, is the rounded upper end of your femur.
What is the bump on the side of the hip called?
A smaller bump, called the lesser trochanter, sticks out from the underside of the area where the shaft and neck meet. A hip fracture is a break in the upper part of your thighbone. It may include the top of the shaft, the neck, or the head. During your hip pinning, your surgeon will make a cut ...
Abstract
The differences in the clinical and functional outcomes of closed reduction and percutaneous pin fixation and open reduction with internal fixation (ORIF) using plate and screws have been systematically synthesized by one meta-analysis. With newer studies being published, an effort to update the earlier meta-analysis is necessary.
Background
Emergency departments usually have a high inflow of patients with hand injuries, and metacarpal fractures represent around half (40%) of these hand injuries [ 1, 2 ]. Metacarpal fractures often comprise a large proportion of all hand fractures and fractures below the elbow, particularly in industrialized environments such as the USA [ 2, 3, 4 ].
Methods
A comprehensive search was done systematically through PubMed, Scopus, CENTRAL, and Google scholar databases for papers published up to 15 January 2020. Free-text words and medical subject heading (MeSH) terms were used. Details of the search strategy have been provided in the supplementary document (Supplementary Table 1 ).
Results
A total of 1315 unique citations were obtained upon executing the search strategy in the PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials), and Google scholar databases (Fig. 1 ). Out of these, 1203 were excluded based on title screening. Further, 91 citations were excluded after reading the abstract.
Discussion
The present study was conducted with the intention to perform a systematic literature search and conduct a meta-analysis of studies comparing plate and pin fixation of metacarpal fractures with respect to functional outcomes such as DASH score, percentage range of motion attained, and attained grip strength.
Conclusion
The meta-analysis provides updated pooled evidence on the comparative effectiveness of closed reduction and percutaneous pin fixation and open reduction with internal fixation (ORIF) using plate and screws. The lack of significant long-term differences in the functional outcomes suggests that both these techniques are comparable.
Availability of data and materials
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
