Internal wire fixation

The disadvantage of steel wire is that the fixing effect is small and the application range is correspondingly small. The stainless steel wire is used to circumscribe the oblique or spiral fold of the long bone, which is not only easy to break, but also causes bone absorption outside the pressure. Periosteal blood flow is impaired, thereby losing the fixation and affecting fracture healing. However, the steel wire has the characteristics of fine diameter and bendability, and can be circumcised or fixed through the artificial intra-bone tunnel, which can effectively maintain the reset of some fractures, which is its advantage. Stainless steel wire internal fixation is often used in the following cases [Fig. 1]. 1. Transverse fracture of the humerus; 2. Transverse fracture of the ulnar olecranon; 3. Avulsion fracture of the distal phalanx; 4. As an auxiliary fixation for other internal fixation, to fix the free bone piece (such as intramedullary nail and fixed small bone with wire) ; 5. unstable cervical spine fracture, dislocation. Treatment of diseases: phalangeal fractures of the humerus Indication The disadvantage of steel wire is that the fixing effect is small and the application range is correspondingly small. The stainless steel wire is used to circumscribe the oblique or spiral fold of the long bone, which is not only easy to break, but also causes bone absorption outside the pressure. Periosteal blood flow is impaired, thereby losing the fixation and affecting fracture healing. However, the steel wire has the characteristics of fine diameter and bendability, and can be circumcised or fixed through the artificial intra-bone tunnel, which can effectively maintain the reset of some fractures, which is its advantage. Stainless steel wire internal fixation is often used in the following cases [Fig. 1]. 1. Transverse fracture of the humerus; 2. Ulnar fracture of the olecranon; 3. Avulsion fracture of the distal phalanx; 4. As an additional fixation for internal fixation, to fix the free bone fragments (such as intramedullary needle fixation and fixation of small bone pieces with steel wire); 5. Unstable fracture and dislocation of the cervical spine. Preoperative preparation 1. According to the size of the fracture block and the strength of the local contraction force, the stainless steel wire with the corresponding diameter, softness, easy bending and strong pulling force is selected. 2. Prepare a steel needle, wire cutter, wire-wound hemostat (or wire cutter), and a hand drill for drilling. Surgical procedure 1. Perforated steel wire: The method of threading the wire is different depending on the location of the fracture. Generally, the ring fixing method and the 8-shaped fixing method are commonly used. Ring fixation: more for tibiofibular fractures. Use a thick round needle to wear a steel wire, close to the edge of the bone, and suture it in the ankle. Or first drill a tunnel with a small drill bit on both sides of the fracture, and then use a steel wire to loop through the tunnel. 8-shaped fixation: commonly used for olecranon fractures. First, a tunnel is drilled at each end of the fracture, and then the wire 8 is passed through, and the wire crosses the bone. 2. Tightening the wire: first use a towel and other instruments to reset the fracture and keep the position, then slowly tighten the wire to avoid cutting off the bone and soft tissue, or to break the wire. After the tension is fully tightened until the fracture ends are tightly connected, the ends of the wire can be twisted into a rope. The tightness should be appropriate. There will be cracks left between the broken ends of the loose fractures, which will affect the healing. If it is too tight, it will easily break the steel wire. 3. Disposal of the stump: Cut off the excess wire, leave a stump of 3 to 5 mm, bend it to the bone surface or bury it in the soft tissue of the depression, causing pain without puncturing the skin.