Clinical Lecture: External fixation of the Lower Limb Flashcards
Basic bone healing steps?
- Bleeding –> haematoma forms in fracture
- Bone healing cells move in
- Transforms into rigid tissue
- This calcifies forming bone
Do bones heal with scar tissue?
No –> new bone almost indistinguishable
Purpose of using metal plates in bone healing?
Plates are like internal splints that hold the broken pieces of bone together. They are attached to the bone with screw.
What is external fixation of the lower limb?
External fixation of the lower leg is a surgical procedure that uses rods or plates to immobilise and fix a bone following a fracture to allow the bone to heal in its correct position.
Location of common peroneal nerve, posterior tibial bundle and deep peroneal nerve
Need to be careful when operating on tibia!
How is the lower limb divided during surgery?
Into segments depending on anatomy
Describe segment 1 of the lower limb
Proximal metaphysis –> the metaphysis is the neck portion of a long bone between the epiphysis and the diaphysis.
Describe segment 2 of the lower limb
Diaphysis
Describe segment 3 of the lower limb
Distal metaphysis
What is the tension stress effect?
Process of new bone and soft tissue formation under gradual distraction:
- Distraction osteogenesis
- Limb lengthening/bone regeneration
What is distraction osteogenesis?
Distraction osteogenesis is a way to make a longer bone out of a shorter one. After a bone is cut during surgery, a device called a distractor pulls the 2 pieces of bone apart slowly.
Advantages of external fixation?
- Essentially percutaneous technique
- Usually no violation of zone of injury or pathology
- Safe and reliable
- Very powerful tool to manipulate healing bone
- Very stable fixation
- Allows early rehabilitation
