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Numerous pinning techniques have been proposed, however there is not enough evidence to determine which is more effective. [1] Pinning involves the manipulation, with X-ray guidance, of the fracture into an acceptable position, and the immediate insertion of metal pins, called Kirschner wires, through the skin, into one bone fragment and across the fracture line into the other bone fragment.
Intraoperative X-ray of a humerus fixated by Kirschner wires. Kirschner wires or K-wires or pins are sterilized, sharpened, smooth stainless steel pins. Introduced in 1909 by Martin Kirschner, the wires are now widely used in orthopedics and other types of medical and veterinary surgery.
External fixation is a surgical treatment wherein Kirschner pins and wires are inserted and affixed into bone and then exit the body to be attached to an external apparatus composed of rings and threaded rods — the Ilizarov apparatus, the Taylor Spatial Frame, and the Octopod External Fixator — which immobilises the damaged limb to facilitate healing. [1]
In medicine, the Ilizarov apparatus is a type of external fixation apparatus used in orthopedic surgery to lengthen or to reshape the damaged bones of an arm or a leg; used as a limb-sparing technique for treating complex fractures and open bone fractures; and used to treat an infected non-union of bones, which cannot be surgically resolved.
Orthopedic plates are designed based on the bone fracture. While the general design is similar, each plate must be manufactured to not only to reduce the fracture but also fit the contour of the patient's bone. [5] Protection Locking plates can be used either to support a locking head screw, or to force bone together at the fracture.
One potential complication of intramedullary nailing after a fracture is bone malrotation, where the broken bone is fixated out of alignment and heals incorrectly, causing a rotated limb. Lower screws holding intramedullary rods can sometimes cause limited dorsiflexion as a result of damage and subsequent healing and fibrotic developments ...
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Orthopedic surgery attempts to recreate the normal anatomy of the fractured bone by reduction of the displacement. [citation needed] This sense of the term "reduction" does not imply any sort of removal or quantitative decrease but rather implies a restoration: re ("back [to initial position]") + ducere ("lead"/"bring"), i.e., "bringing back to ...