Bone fractures are a major cause of work loss and cost billions of dollars a year to treat. Although most fractures can be treated non-operatively, many will not heal without operative fixation. I have provided some examples of fracture fixation methods on some of my patients.
This is an X-ray of an ankle fracture where both the bone on the outside of the leg (fibula) and the small bone on the inside of the leg (medial malleolus) are fractured. In addition, the tibia has shifted off the ankle, and the major ligaments between the tibia and fibula have been disrupted.
Ankle Fracture repair
This is after surgery. A long plate was placed on the fibula after the bone was put together to hold in place. Long screws were placed into the tibia to allow the ligaments between the bones to heal. Two screws were placed in the medial malleolus to allow it to heal.
This is a CT scan with 3D reconstructions of a humerus fracture. Although most of these fractures heal with non-operative care, the alignment on this fracture was unacceptable.
Humerus Fracture Repair
This is after fixation with a plate and screw construct. This fixation is solid and allows the patient early motion of the elbow and shoulder.
This is a radial shaft fracture. The radius is one of the two bones in the forearm. If these fractures are not fixed they will not heal.
Radius Fracture Repair (AP)
This is fixation with plate and screw construct.
Radius Fracture Repair (Lateral)
This is the side view after repair. Note how the two screws in the middle on either side of the fracture are angled away from the fracture to allow healing to occur.
Hip Fracture 1
Although most hip fractures occur in older patients, this patient was a young marathon runner. This is example of a stress fracture, or a fracture that occurs from over-use. This fracture occurred in the middle of running a marathon.
Hip Fracture Repair
This is after operative fixation with three screws. This was done using minimally invasive techniques with just 3 tiny incisions <5mm. Using live x ray a wire is placed into the femoral head and the screws are placed over the wire.
Hip Fracture 2
Here is another type of hip fracture where the hip is severley shattered.
Hip Fracture 2 Repair
Using three small incisions we are able to fix this fracture with a titanium rod within the middle of the bone, a large screw into the head, and smaller screw at the bottom. This is an advance compared to classic way of making a large incision with dissection to the bone.
These are my standard incisions for this type of fracture. I close the skin from the inside and then place a special glue on the skin to keep it sealed. Thus there are no suture, staples, or dressings necessary.
Hip Fracture 3
This is another type of hip fracture where the head breaks off from the femur. This is called a femoral neck fracture and tend not to heal with fixation. Thus a replacement is necessary.
Hip Fracture 3 Repair
This is after hemiarthroplasty surgery. The head was removed and a new head and stem were placed. Immediate weight bearing is possible.