Dr Wang Shuang said that patients with severe comminuted fractures can choose "minimally invasive surgery" to reduce the chance of wound infection. (Photo courtesy/Children's General Hospital) Wang Shuang, an attending orthopedic doctor at Children's General Hospital, said that the main factors affecting fracture healing depend on two factors: "the degree of fixation of the fracture site" and "the integrity of the soft tissue around the fracture site". "Fracture fixation" is like a "sticker". At first, you can't move it Just fix it by hand for about five minutes, and the paper will stick firmly. But if you start to stick, move it left and right manually, and the paper won't stick well. The principle of fracture fixation is the same. The firmer the fixation, the easier it is to grow new bone, otherwise the fracture may not heal. The methods of fixing fracture strength in medical treatment include plaster, external fixator, steel nail, steel plate and intramedullary nail. Among them, gypsum fixation strength is the worst, and intramedullary nail is the strongest. However, it does not mean that the strongest fixation method is the best treatment method, and the treatment method must be decided according to the age of the patient, the type of fracture and the experience of the doctor.
The factor of "wrapping the integrity of the soft tissue at the fracture" is because the integrity of the soft tissue represents the integrity of the blood supply at the fracture. The more blood supply to the fracture site, the greater the chance of fracture healing. The principle of "minimally invasive surgery" is to keep the integrity of the soft tissue at the fracture as much as possible.
Dr. Wang Shuang said, but in some special fractures, the fracture site is not suitable for using self-locking intramedullary nail, but what should I do when I need to fix it with steel plate? In recent years, minimally invasive bone plate surgery has become more and more mature. For example, a 40-year-old male patient surnamed Wu suffered a comminuted fracture of the right tibia, from the knee joint to the lower shaft. This kind of fracture is not suitable for self-locking intramedullary nail, and plaster fixation can not cover the fracture. And fixed with plaster, the fracture is easy to move. Minimally invasive plate fixation was used in the treatment. This method of operation does not require plastering. On the third day after operation, the patient can get out of bed with crutches.
Minimally invasive surgery can make cartilage tissue less damaged and has many advantages. It can not only solve many complicated fractures, but also shorten the hospital stay and the operation time13 compared with traditional surgery, which also means that patients can shorten the time of taking anesthetic and reduce the amount of bleeding. Therefore, minimally invasive surgery is a great blessing for fracture patients.
Fan Tuan, listen to the famous doctor!