The traditional method of treating fractures is the application of a plaster cast. However, in some cases, with open fractures or displacement of bone fragments, the dressing will be ineffective. In such situations, it is necessary to use osteosynthesis - an operation to connect broken bones, the main purpose of which is a reliable fixation of bone fragments until their full fusion. In this case, special implants are used: plates, rods, screws, and wires for external fixation, which are fixed on bone fragments and restore the unity of the bones. Implants are made from biologically and chemically inert materials - special alloys containing nickel, cobalt, chromium, or titanium, which do not cause the development of metallosis in the tissues of the body.
Types of osteosynthesis
Osteosynthesis of bones can be performed using various methods, depending on the location and nature of the damage.
- External transosseous compression-distraction osteosynthesis is performed using external specialized devices: Ilizarov, Volkov-Oganesyan, Kostyuk, Gudushauri, etc.
- Submersible (internal) osteosynthesis is performed directly in the fracture zone on the bone, intraosseously (intramedullary blocked osteosynthesis), or in the transverse direction through its walls (transosseous osteosynthesis with screws).
The method of osteosynthesis is determined by the attending physician individually, depending on the characteristics of the clinical picture and the data of instrumental examinations.
Indications for metal osteosynthesis are:
- fractures with displacement of bone fragments, when there is no possibility of their reduction in a closed way;
- unstable fractures with a tendency to secondary displacement;
- fractures that do not heal for a long time;
- the presence of intra-articular fractures;
- violation of bone fusion, when a pseudarthrosis is formed;
- fractures in which there is a risk of perforation of the skin by a bone fragment, i.e. transformation of a closed fracture into an open one;
- fractures, which are accompanied by the clamping of soft tissues between the fragments, as well as complicated by damage to the main vessel or nerve.
Contraindications to osteosynthesis are:
- an extensive area of damage with open fractures;
- a strong degree of contamination of soft tissues;
- the presence of a general or local infectious process;
- difficult general situation of the patient with the development of shock or coma;
- tendency to seizures of epilepsy;
- vascular diseases of the extremities;
- pronounced osteoporosis of bones in the area of intervention.
To exclude all possible contraindications to the operation of osteosynthesis, it is necessary to conduct a number of examinations and consult with specialized specialists. Only after doctors is a decision made regarding the volume of surgery and its cost.
How is osteosynthesis performed?
Preparation for the operation consists in carrying out a complex of general clinical laboratory and instrumental examinations. The patient needs to undergo a general blood and urine test, a biochemical blood test, a coagulogram. In addition, as part of the preparation, the patient is assigned an ECG, X-ray, or computed tomography of the damaged area. In some cases, the doctor may order additional tests.
The operation can be performed both under general and local anesthesia. The features of the surgical intervention depending on the fixing structures and the method of their installation. After the procedure, drug treatment is prescribed to reduce painful sensations and prevent infectious complications. The stages of rehabilitation for the prevention of congestive and trophic disorders are also determined. The postoperative recovery course is developed individually by an orthopedic surgeon and a rehabilitation therapist.
Usually, the program includes physiotherapy, massage, physiotherapy exercises. With the responsible implementation of all the recommendations of the attending physician, absolute recovery occurs in 3-6 months.
The Dobrobut network of medical clinics offers to carry out the operation of osteosynthesis in Kyiv. We select the most optimal and effective methods of osteosynthesis, depending on the type of fracture and the patient's condition. Our doctors are the best specialists in Ukraine, they are fluent in the latest techniques, use the most modern equipment, fixation materials, and devices in their work.
To make an appointment for a consultation, as well as clarify all your questions regarding the operation: the cost of the examination, prices, conditions, terms, etc. - call our call center 24/7!
- TiffanyKim, Carmine WangSee, etc - Orthopedic implants and devices for bone fractures and defects: Past, present and perspective. - Volume 1, 2020, Pages 6-18.
- Dagmar I. Vos, Michael H.J. Verhofstad -Indications for Implant Removal after Fracture Healing.
- Karl Stoffel - Osteosynthesis in periprosthetic fractures: Indications, tips, and tricks. Published online, 2019.