• Rukmani Birla Hospital,Gopalpura Bypass Road, Near Triveni Bridge,Gopalpura,Jaipur – 302018.

Heal your broken bone adopt the new age fracture fixation

Heal your broken bone adopt the new age fracture fixation

Orthopedics have dramatically evolved over last 2 decades with technological advancement. Gone are the days of time consuming treatment like traction and plasters which restricted patient’s mobility for the maximum amount of time. Though early mobility doesn’t mean instant permission to resume normal activity post-surgery; however, it allows a patient fast recovery. A patient no more needs to lie in the bed for months, instead he/she can sit up, move around with a crutch as per doctor’s advice. Scientific innovation in orthopedics now let easy surgery with implant placement for collarbone fracture or finger fracture which was impossible previously. Though for un-displaced fracture where surgery is not needed, plasters are still in vogue.

With such leap in orthopedic treatment, a lot of myths have come to create confusion. To explain some of the common myths below:

  • The most common misconception that rises in a patient’s mind after a fracture fixation surgery is that post-operation fracture heals instantly. Fracture heals on its own over the time as part of a natural course. The surgery brings the bone back into place, holds them together with an implant be it a plate or a nail till a fracture union occurs.
  • A surgeon is the best guide to recommend a patient on how much mobility is permissible after surgery. If the patient doesn’t follow those rules, many complications may come. Like at times the fracture doesn’t reunite easily if the patient has already started bearing weight on that body part. Then the bone and plate which are supposed to share the load between each other, doesn’t work accordingly.
  • If a patient stands up or walks on his/her fractured limb before it has healed then the entire weight is borne by the unhealed leg, which is very detrimental for the patient. In fact, at times the bending stress leads to break up of plate or nail, breakage of screws or back-out of screws.
  • Once an implant breaks the anatomy of the injured area is different as it has been operated upon previously and the chances of infection increases with it. The fractured bone must be stabilized and supported until it is completely cured.

The risk of infection is always there after operation and it brings more complications with it. Though sterile conditions and developments in surgical techniques reduce that risk, but one must be careful at every step. Why infection occurs?

  • Improper wound care is one major cause. Open wounds and severely damaged soft tissues must be treated with caution. The gauge pieces should be sterile. The dresser must follow the basic dressing norms. Antibiotics are provided immediately for such open wounds.
  • Post-operative infection crops up as early as within 72 hours and as late as in next 3-4 weeks. This infection occurs within the body and not due to any external cause. An orthopedic surgeon usually prescribes antibiotics for short-term recovery, although additional surgery may be necessary to help cleanse the area
  • If the patient’s immunity system is compromised, then there is a big chance of infection. Often underlying causes like UTI, allergy to some metal might cause infection
Usage of plate in fracture fixation:
  • There are two kinds of plates used for internal fracture fixation – Titanium and Steel; and they come in a variety of standardized quality which are approved by the government.
  • One must keep in mind no matter how high quality the plate is; it always has a chance of bending if too much load it put upon it. If any rotational force is working on the plate after surgery, then it also leads to breakage. Many plates/nails break after trauma where another surgery is required.
  • Steel implants are mostly removed as it blocks MRI. Titanium implants have cold-welding which is body friendly, hence many patients prefer to keep them. The cold-welding lets the screw rotate but doesn’t come out of the plate.
  • If it is an inferior extremity fracture, then the implant must be taken out after a period of 3 years. Surgeons prefer to use stainless steel implants if they plan to take it out. For superior extremity fracture the implant should be taken out within 2 years to avoid any bone formation.
  • For children, the implants are taken out early, within 3 – 6 months as bone growth is faster in them. For adult, the minimum time-period for implants are 1-2 years.
  • Every patient should be properly steered about how to take care of bones after the implants are taken out. There have been many documented instances of re-occurrence of fracture as the bone area remains weak after the implant has been taken out.

The five basic guidelines for fracture fixation

  • Listen to your surgeon’s advice on how to use a support device post-surgery without putting too much pressure on the plate. Your plate/nail is not a weight bearing device. It is only there to heal the bones
  • Give yourself maximum rest period and allow your bones to heal naturally. Sit up, dangle your limb (if it is a limb fracture), move your body parts a bit; but don’t walk around much
  • Always keep your dressing material clean, dry, and sterile for avoiding any risk of infection
  • If your doctor has prescribed physical therapy for aiding quick healing, then regularly attend that
  • Don’t forget to take your medicines regularly and visit your doctor as per requirement

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