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When a bone fractures, the fragments lose their alignment in the form of displacement or angulation. For the fractured bone to heal without any deformity the bony fragments must be re-aligned to their normal anatomical position. Orthopedic surgery attempts to recreate the normal anatomy of the fractured bone by reduction of the displacement.
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 lateral condylar fractures of the humerus in children, but if fracture displacement after closed reduction exceeds 2 mm, open reduction and internal fixation ...
Monteggia fractures may be managed conservatively in children with closed reduction (resetting and casting), but due to high risk of displacement causing malunion, open reduction internal fixation is typically performed. [4] Osteosynthesis (open reduction and internal fixation) of the ulnar shaft is considered the standard of care in adults.
Percutaneous pinning is considered to be less invasive, faster, and requires less skill compared to open surgery (plate fixation). [ 1 ] Disadvantages of this technique include that the stabilized fracture is less stable compared to a surgical plate, the person may require extensive limits to their motion at the early stages, and there is a ...
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]
An undisplaced fracture may be treated with a cast alone. A fracture with mild angulation and displacement may require closed reduction (putting into place without surgery). Significant angulation and deformity may require an open reduction and internal fixation. An open fracture will always require surgical intervention. [citation needed]
In cases where closed reduction is not successful, open (surgical) reduction may be needed. [2] X-rays are often used to confirm success and absence of associated fractures. The arm should be kept in a sling or immobilizer for several days, prior to supervised recovery of motion and strength. Various non-operative reduction techniques are employed.
These fractures, although less common, often require surgery in active, healthy patients to address displacement of both the joint and the metaphysis. The two mainstays of treatment are bridging external fixation or ORIF. If reduction can be achieved by closed/percutaneous reduction, then open reduction can generally be avoided.