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What is it about ?
Sometimes it is necessary to use plates, screws or pins to put the fragments of a fractured bone back into the correct position and reattach them to each other. This technique is called osteosynthesis and has the advantage of allowing better consolidation of the different fragments and faster reuse of the fractured body part. The material used is chosen in such a way as not to cause undesirable reactions, such as rejection. It is often made from a titanium alloy.
The osteosynthesis material can, in principle, remain in place and does not necessarily have to be removed. On the other hand, you can decide to remove the material in question, for example if it causes discomfort, if it reduces the mobility of the person or if the screws come off.
This patient guide covers the most common fractures that are treated by osteosynthesis.
Ankle fracture
A fracture of the tibia and / or fibula, at the level of the peg, is usually treated by the placement of plates and screws. If the junction between the two bones is also broken, an additional screw will be provided. A cast should then be worn for 6 weeks, possibly replaced by a walking cast during the last 3 weeks. If the screws and plates do not get in the way after the operation, they are usually not removed. Otherwise, they can be removed after 8 to 12 months.
Nailing the femur and / or tibia
In the case of a femur fracture or tibia, a long nail can be inserted in the center of the bone and fixed with screws. This intervention allows a rapid return to load of the leg. The nails used are generally made of titanium. They are withdrawn at the earliest after 1 year and, if it is a femur fracture, preferably not before 2 years. Intensive exercises (excessive walking, jumping, running) should be avoided during the month following nail removal. You can also choose to have only the screws removed and leave the nail in place.
Dynamic hip screw
For a femoral neck fracture a dynamic hip screw can be used. It is a system composed of a screw and a plate in which the screw can slide. This system facilitates and improves the future mobilization of the leg. In young people (under 50) this screw can be removed 1 year after the fracture has fully healed. In most cases, this corresponds to 2 years after the initial injury. In older people, the screw is left in place.
Plates on the radius and ulna
Forearm fractures can pose special problems because of the many tendons and nerves in this part of the body. The risk of a new fracture is also higher there than in other places. Because of this, it is sometimes not possible to remove the plaque. If the plaque forms a lump under the skin and causes discomfort, it is removed after 8 to 12 months.
Fractures of the collarbone and fractures in the joint between the shoulder and the collarbone
A broken collarbone can be treated by placing an elastic nail in the body of the bone or a system of plates and screws. This intervention makes it possible to restore the position of the bone fragments as well as possible. Screws and pins can be removed after 5-6 weeks; plaques, after 8 to 12 weeks. After the operation, the arm should be worn in a sling for 3 weeks. Often, fractures without displacement of bone fragments do not require an operation. It is enough to wear, for 1 to 6 weeks, a special splint which slightly pulls the shoulder backwards.
Kirschner pins in the fingers
To treat a displaced fracture of the fingers, Kirschner wires are sometimes used. These are small pins that are inserted into the bone, through the skin, before locking them with external fixation. In most cases, they can be removed after 3 to 4 weeks.
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