FRACTURE FIXATION – NAILING
Fractures of the long bones of the lower limb (femur – thigh bone and tibia – leg bone) are serious injuries that may be a threat to life or limb. Management involves resuscitation of the deranged physiology of the body followed by surgical fixation of the broken bone. First aid involves splinting the injured limb, administration of oxygen and adequate pain relief. The purpose of surgery is realignment of the injured bone and early return to function. Union continues over time dictated by the nature of injury and patient personality and is monitored by serial radiographs. This technique cannot be applied for all fractures.
QUICK FACTS ABOUT NAILING
DURATION OF SURGERY: 90 minutes
ANESTHESIA : General anesthesia or Regional (preferred)
LENGTH OF HOSPITAL STAY
Isolated Injury – 4 to 5 days
Polytrauma – 7 to 10 days.
Because of the location within the bone marrow canal walking with an aid is encouraged the day after surgery for toilet privileges. As the bone shows signs of union gait improves. Physiotherapy has a vital role in the first few weeks post injury.
The procedure is minimally invasive and the scars are about 4-5 cm in length
The surgery is generally safe. Surgical fixation involves the placement of a metal nail within the bone. This is associated with a 1% risk of infection (one case in about 100 closed injuries). The requirement for blood transfusion is uncommon. Dispersion of bone marrow in blood affecting lung function and making breathing uneasy is a rare but known risk