What is osteosynthesis?
Osteosynthesis is a reconstructive surgery that aims to stabilize and unite the ends of a broken bone following a fracture, osteotomy or nonunion in cases of previous fracture. The fragments are stabilized using mechanical devices, allowing complete or partial healing of the muscles, as well as regaining joint function. When the bone fragments are stabilized, the mechanical device can be removed or left in place, if the process was done by internal fixation.
Why is it performed?
Osteosynthesis is mainly applied after a bone fracture. One of the most commonly treated fractures with an osteosynthesis is, for example, the femur fracture. In other cases, such as lateral fractures like an ankle fracture, this type of surgery can quickly heal the bone. It is a type of operation highly recommended in young people.
Osteosynthesis can also be used to treat a bony nonunion. This occurs when a broken bone does not heal after a fracture. There are several factors that can increase the risk of this occurring, such as a diet poor in calcium and protein, advanced age, smoking, diabetes or anemia, or taking corticosteroids and/or painkillers.
What does it consist of?
There are two types of osteosynthesis:
- External osteosynthesis. An external fixator is used to fix the injury. It is a procedure that can be used if it is a compound fracture, with a high risk of infection.
- Internal osteosynthesis. There are two types: Open Reduction Internal Fixation (ORIF) and Closed Reduction Internal Fixation (CRIF). The first consists of open surgery to fix the bones while the second (CRIF) involves reduction without open surgery to achieve the same objective. Once any of the above procedures have been applied, mechanical devices (plates, pins or screws) are used to fix the bones.
Another procedure involves intramedullary osteosynthesis, which allows for better adhesion and faster healing, as the mechanical device passes through the medullary cavity.
Preparation for osteosynthesis
Normally no specific preparation is necessary to undergo osteosynthesis. However, a physical assessment, a functional assessment and a psychological assessment of the patient will be performed prior to any intervention.
The type of surgery to be performed and the type and time of anesthesia required will also be explained, which will depend on the type of injury, the patient’s age and the expected aggressiveness of the intervention.
On the other hand, some previous scans of the injured bones may be necessary, such as:
- X-rays
- CT SCAN
- Magnetic resonance imaging
Care after the operation
It is essential that the patient performs rehabilitation and physiotherapy exercises after the operation, which will depend on the degree of the injury and the operation performed. However, they may include muscle strengthening exercises, stretching and functional recovery exercises, with the aim of restoring the function of the joint or operated area.
Alternatives to this treatment
Osteosynthesis currently takes into account, in addition to the reduction and stable fixation of the fracture, biomechanical variables and the importance of soft tissues. Hence, minimally invasive osteosynthesis techniques are being carried out, which allows a faster recovery of patients.