Internal Fixation

Overview
Reviewed by Dr. Jon Warner

The shoulder is made up of three bones: the clavicle, or collarbone; the scapula, or shoulder blade; and the humerus, or upper arm bone. Like all bones, each can be broken, either by direct or indirect force. The clavicle and humerus are two of the most commonly broken bones in the human body. Fractures are most commonly treated by setting the bone into place and wrapping the affected area in a sling or cast. However, some fractures are too complex for this, and require internal fixation, a process that uses metal plates, rods, or screws to pull the fragments of bone together so that they can heal. When a bone is held together with devices affixed internally, it is known as internal fixation, which this report covers. External fixation, where devices are applied external to the skin and arthrodesis, where two bones are fused together, are covered in future reports.

Detailed Description
Specialist
Orthopedic surgeon

Procedure
Before the procedure, the surgeon will take a number of X-Rays to determine the extent of the break and whether internal fixation is necessary. He will also administer a physical examination to see if either a blood vessel, nerve damage or another condition has resulted from the fracture. The doctor will also ask a series of questions to determine how the fracture occurred, if the patient has suffered a previous fracture to the bone in question, and whether any allergies to medication exist.

If internal fixation is necessary, a nerve block, local and/or general anesthetic is applied. The surgeon will then make an incision to gain access to the bone. He or she then aligns the bone fragments and sets them in place using an appropriate medical device. The doctor then orders post-operative X-Rays to ensure the bones are properly fixated.

Recovery

The patient will be instructed to wear a cast or sling while the bone heals. The patient may be guided through a physical therapy program to increase the strength of the muscles around the shoulder joint, as well as activity modifications to prevent further damage to the bone.

Complications/Risks

• Neurovascular injury
  
• Nonunion of bone
  
• Reaction to anesthesia
  
• Frozen Shoulder
  
• Surgical wound infection
  
• Reaction to implant

  Medications
  
  Prescription and non-prescription painkillers, shoulder sling for support.

  Follow up with your doctor if:
  
  Pain, swelling, redness, drainage or bleeding increases around the shoulder joint or symptoms arise suggesting infection, such as fever.

  Last updated: 01-Jan-00