Fracture treatment has evolved from its earlier days and now includes many modalities. This has led to coining of new terms to describe new procedures. While we can continue this discussion endlessly, in this article we would stick to very basic terms that one should know.
Closed Reduction
Closed reduction of the fracture means reducing the fracture fragments into acceptable anatomical position After reduction has been achieved by manipulation and maneuvers, the alignment is generally maintained by plaster cast.
Open Reduction
This means the fracture fragments are surgically opened, accessed and reduced. This opens the fracture hematoma and therefore term open is used for this kind of reduction.
Internal Fixation
It is a type of fracture fixation where the fragments are fixed by a gadget that is buried beneath the soft tissues and is not visible externally. Plating is a type of internal fixation.
External Fixation
In this kind of fixation, the fixing gadget is outside the soft tissue envelope and is visible to the naked eye. A tubular external fixator or Illizarov external fixator is type of external fixator.
Open Reduction and Internal Fixation
This term is used when reduction of the fracture is done by surgically exposing the fracture and then fixing the fracture with the required gadget. A compression plating is a typical example of open reduction and internal fixation.
Closed Reduction and Internal Fixation
This term is easier to understand if we understand the fact that terms Open or Closed Reductions are in relation to exposure of fracture site.
So if a fracture can be reduced by manipulation and a gadget can be introduced and fixed without disturbing the fracture site, it would be called closed reduction and internal fixation.
Closed reduction because fracture site was not opened to reduce the fractur and internal fixation because the gadget is buried under the soft tissue coverage.
This has been made possible by use of image intensifier which allows view of structures during surgery.
A closed interlock nail is an example of closed reduction and internal fixation.
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About Dr Arun Pal Singh
This is to let you know that I appreciate the information as it relates to medical terminology and the coding procedures I am learning in school.
My only comment is for the person who does the proofreading for word spelling to be more observant as there are a lot of spelling errors in the article.
Dr Arun Pal Singh Reply:
August 18th, 2009 at 12:58 am
@Margaret Gariepy,
Thanks for pointing out. The errors have been corrected.