Internal Fixation

Treatments used for various types of fractures are cast immobilization, traction, and internal fixation. A plaster or fiber glass cast is the most commonly used device for fracture treatment. Most broken bones heal successfiiUy once properly repositioned, ie, fixed in place via a cast. This type of cast or brace is known as an orthosis. It allows limited or controlled movement of nearby joints. This treatment is desirable for certain fractures. 

Biocompatible aromatic poly(ester-amide), (1 ), were prepared by Gomurashvili et al. (3) and used as stents in internal fixation devices. 

Daniels, A. U. Chang, M. K. O. Andriano, K. P., Mechanical properties of biodegradable polymers and composites proposed for internal fixation of bone../. Appl. Biomat. 1990, 1, 57-78... 

Total joint replacement, internal fixation of fractures... 

Schildhauer TA, Bauer TW, Josten C, Muhr G (2000) Open reduction and augmentation of internal fixation with an injectable skeletal cement for the treatment of complex calcaneal fractnres. J Orthop Tranma 14 309-317... 

A 10-year-old child sustained a compound fracture of the left forearm and has returned to the unit after an open reduction and internal fixation (ORIF). Which interventions should the nurse implement ... 

A PRN narcotic to a client with an open reduction and internal fixation of the left tibia. 

Bostman, O. and PMajamaki, H. Clinical biocompatibUity of biodegradable orthopaedic implants for internal fixation a review. Biomater 2000,21(24), 2615-2621. 

Jacob, E., et al., 1993. Evaluation of biodegradable cefazolin sodium microspheres for the prevention of infection in rabbits with experimental open tibial fractures stabilized with internal-fixation. Journal of Orthopaedic Research 11 (3), 404—411. 

Bradley, J.S., Hastings, G.W., and Johnson-Hurse, C. 1980. Carbon hber reinforced epoxy as a high strength, low modulus material for internal fixation plates, Biomaterials 1,38-40. 

Bostman, O., Hirvensalo, E., Vainionpaa, S. et al, 1990. Degradable polyglycolide rods for the internal fixation of displaced bimalleolar fractures. Intern. Orthop. (Germany), 14 1-8. 

TABLE 45.2 Failure Modes of Internal Fixation Devices... 

Claes, L. 1989. The mechanical and morphological properties of bone beneath internal fixation plates of differing rigidity. /. Orthop. Res. 7 170. 

Hutzschenreuter, P. and Briimmer, H. 1980. Screw design and stability. In Current concepts of Internal Fixation, H. Uhthoff (Ed.), pp. 244—250, Springer-Verlag, Berlin. 

Perren, S.M., 1989. The biomechnics and biology of internal fixation using plates and nails. Orthopaedics 12 21. 

Perren, S.M. 1991. Basic aspects of internal fixation. In Manual of Internal Fixation, 3rd ed., M. Muller, M. Allgower, R. Schneider, and H. Willenegger (Eds.), pp. 1-112, Springer-Verlag, Berlin. 

PMMA is also injected into vertebral bodies for fixation of fragility fractures of the spine, injected into screw holes to augment internal fixation in osteopenic bone, and injected into stmctural voids following resection of benign tumors to control dead space and support the surrounding bone. In many of these applications antimicrobial powder can be added to the PMMA for drug delivery when local delivery of antimicrobials is needed. 

Keating, J.F., Hajducka, C.L., Harper, J. 2003. Minimal internal fixation and calcium-phosphate cement in the treatment of fractures of the tihial plateau. A pilot study. J Bone Joint Surg Br 85(1), 68-73. 

Kennady, M.C., Tncker, M.R., Lester, G.E., Bnckley, M.J. Stress shielding effect of rigid internal fixation plates on mandibular bone grafts. A photon absorption densitometry and quantitative computerized tomographic evaluation. Int. J. Oral Maxillofac. Surg. 18, 307-310 (1989)... 

W. S. Pietrzak, Principles of development and use of absorbable internal fixation, Tissue Engineering 6 425-433 (2000). 

Furukawa, T., Matsusue, Y., Yasunaga, T., Nakagawa, Y., Shikinami, Y., Okuno, M., and Nakamura, T. (2000), Bone bonding ability of a new biodegradable composite for internal fixation of bone fractures, Clin. Orthop. 16(379) 247-258. 

Tormala R, Vasenius J., Vainionpaa S., Laiho J., Pohjonen T., Rokkanen R, Ultra-high-strength absorbable self-reinforced polyglycolide (SR-RGA) composite rods for internal fixation of bone fractures In vitro and in vivo study, J. Biomed. Mater. Res., 25, 1991, 1-22. 

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