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Percutaneous skeletal fixation is the surgical procedure of treating fractures by inserting surgical implants through the skin. It is applicable in the treatment of fractures in the pelvis and other bones in the body, including the spine. It is also known as percutaneous pinning.
A fracture refers to a break in a bone commonly resulting from accidents, falls, or contact injury during sports. In some cases, the presence of osteoporosis and low bone density makes a person at high risk of developing fractures, which cause intense pain, swelling, and tenderness in the injured part.
There are generally two types of orthopaedic procedures to fix implants for bone repair and these are open and closed reduction internal fixation techniques. The former involves open surgery while the latter is the minimally invasive alternative to the procedure.
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Those with fractures in different parts of their bodies are offered percutaneous skeletal fixation. These include:
- Fracture of the humerus or the long bone in the arm, which is quite common among children below ten years old
- Fractured fingers
- Fractured pelvic ring, which typically results from vehicle accidents, falling from great heights or being crushed by a heavy object
- Sacral fractures
- Fractured vertebrae
This procedure is considered a safe and effective method of treating fractures in several parts of the body. In most paediatric patients, the fractures heal completely with no adverse impact on bone growth later on. This procedure also avoids complications associated with open fixation technique, which includes bleeding and disruption of nearby body parts.
When necessary, the affected body part is placed on a sling to minimise movements and patients are required not to engage in strenuous activities for several weeks. Most are also required to undergo physical rehabilitation to encourage healing and resume functionality.
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The techniques used for percutaneous skeletal fixation are varied, depending on the location and type of fracture. Regardless of the technique used, the procedure is typically performed under local anaesthesia and with the use of imaging technology, which allows visualisation of the bones and assists in guiding the implants to the desired location. Some procedures are done with fluoroscopy while others are performed with the help of computed tomography (CT scan). For fractures near joints, the surgeon will also restore alignment using specialised orthopaedic tools to ensure that the fracture will heal properly.
For the procedure, the surgeon makes a small stab incision where the implants are inserted to keep the bones in place and fix the fractured parts. Depending on the need, threaded pins and cannulated screws are placed. Specialised tools are then used to manipulate the pins into position to provide optimal support to the fractured bone. The placement of implants is then assessed using imaging technology before the tools are withdrawn.
المخاطر والمضاعفات المحتملة
Percutaneous skeletal fixation reduces the risk of excessive bleeding and infection that are typically associated with open surgery. However, there is the possibility of injuring nearby or adjacent body parts such as blood vessels and nerves, which could lead to compromised functioning of the affected part and in severe cases, partial paralysis.
Though rare, there are still reports of pin site infection, which is typically resolved with antibiotic medication. Some patients also report stiffness in the affected part of the body, especially if it involves the joints.
- Fernandez, Diego L.; Jesse B. Jupiter (2002). Fractures of the Distal Radius: A Practical Approach to Management (Second ed.).
What is Percutaneous Skeletal Fixation: Overview, Benefits, and Expected Results
Fractures and broken bones can be challenging to manage, often requiring surgical intervention to ensure proper healing and restoration of function. Traditionally, open surgery has been the go-to option for treating fractures. However, an alternative technique called percutaneous skeletal fixation has gained popularity due to its minimally invasive nature and potential benefits. In this article, we will provide an overview of percutaneous skeletal fixation, explore its benefits, and discuss the expected results for patients.
Percutaneous skeletal fixation, also known as minimally invasive surgery or percutaneous pinning, is a technique used to treat fractures by stabilizing fractured bones using metal pins or wires. This procedure involves making small incisions near the fracture site rather than creating a large open incision. The surgeon then guides the pins or wires through the skin and into the fractured bone, securing it in place.
This minimally invasive approach offers several advantages over traditional open surgery. It reduces tissue trauma and disruption, resulting in less pain, smaller scars, and a faster recovery time. Additionally, percutaneous skeletal fixation can be performed under local anesthesia, eliminating the need for general anesthesia in many cases.
Benefits of Percutaneous Skeletal Fixation
1. Minimally Invasive: The use of small incisions and the avoidance of larger open incisions result in reduced tissue damage, lower risk of infection, and faster healing compared to open surgery.
2. Faster Recovery: Due to the smaller incisions and reduced tissue trauma, patients often experience a shorter hospital stay and quicker return to their daily activities. This can significantly improve their overall quality of life and reduce healthcare costs.
3. Lower Risk of Complications: Percutaneous skeletal fixation minimizes the risk of complications such as wound infections, excessive bleeding, and nerve damage that are more common in open surgery.
4. Reduced Scarring: The small incisions used in percutaneous skeletal fixation result in smaller scars, which are less noticeable and can boost self-confidence.
5. Local Anesthesia: Unlike open surgery, percutaneous skeletal fixation can be performed under local anesthesia, minimizing the risks associated with general anesthesia. This makes it a safer option, especially for patients with underlying health conditions.
The expected results of percutaneous skeletal fixation are favorable, with patients often experiencing improved fracture stability and faster healing compared to traditional open surgery. The procedure aims to align and stabilize the fractured bone, allowing it to heal properly.
Additionally, patients can expect the following benefits:
- Reduced pain and discomfort
- Improved mobility and function
- Shorter recovery time
- Minimal scarring
- Less postoperative medication requirements
It’s important to note that individual results may vary depending on the type and severity of the fracture, as well as the patient’s overall health and adherence to postoperative care instructions.
Percutaneous skeletal fixation offers a minimally invasive alternative to traditional open surgery for the treatment of fractures. This technique provides numerous benefits, including shorter recovery time, reduced scarring, and lower risk of complications. With its expected results of improved fracture stability and faster healing, percutaneous skeletal fixation is an effective option for patients seeking optimal outcomes and a quicker return to their normal daily activities.