Why internal fixation?
First, some fractures may be seriously damaged, such as comminuted fractures. At this time, if conservative treatment and external fixation are adopted, it is easy to cause fracture displacement, which will lead to delayed healing or even non-healing.
Secondly, although some fractures are relatively simple, they are very easy to shift after reduction, and internal fixation is also needed at this time.
Thirdly, some fractures have complications of soft tissue injury or vascular nerve injury, or some fractures may be open fractures. At this time, surgical open reduction and internal fixation should be adopted.
Fourthly, if surgical reduction and internal fixation are used, reduction can be performed under direct vision, indicating that the reduction effect is better. If steel plate is used for fixation, the fixation strength is higher, which is more conducive to fracture healing. In addition, early functional exercise can be carried out after operation to promote the functional recovery of the affected limb.
Why do you want to take out the internally fixed steel plates and nails?
Theoretically, internal fixation can be omitted if there is no pain and discomfort such as limited limb movement after fracture fixation, but in practice, many patients do not take internal fixation.
What I said above is all theoretical. From the biomechanical point of view, it is best to take out the internal fixator if conditions permit. Because the fixtures in the body remain in the body as inanimate objects, after all, they are still not completely compatible with human tissues and are equivalent to foreign bodies. Secondly, internal fixation will change the normal biomechanical mechanism of human bones.
Under normal circumstances, when we are subjected to external forces, bones have to bear these forces. However, if there is an internal fixture in the body, part of the external force will be transmitted through the internal fixture, and some bone tissues below and around it will not be able to withstand normal stress stimulation. After a long time, bones will have adverse reactions such as disuse osteoporosis and bone resorption due to long-term lack of stress stimulation. Although, with the continuous improvement of internal fixation design, related complications are gradually decreasing. But as I said above, it is better to take it out if conditions permit. This is only good for the health, not bad.
Moreover, the implementation of internal fixation removal is very simple. Generally, an orthopedic surgeon with a little foundation can do it independently, and the cost of surgery is not very high. Even in a big third-class hospital, if the charge is reasonable, it may be 4 to 5 thousand yuan.
Under what circumstances does the doctor not recommend taking out the implanted steel nails and plates?
First, the patient is older, inconvenient to walk and in poor health. Taking steel plates is of little significance and may be more risky.
Second, the patient suffered spinal cord injury due to trauma, and there was no obvious effect after internal fixation. The patient became paraplegic. Removing the implanted plates and nails will only increase the cost of surgery and will not help the patient's recovery. Internal fixation with steel plate can also play a positive role in future rehabilitation.