Open reduction and internal fixation (ORIF) is a type of surgery used to stabilizeĪnd heal a broken bone. Severe cases may require a partial or total shoulder replacement.Clavicle Fracture Open Reduction and Internal Fixation What is clavicle fracture open reduction and internal fixation? In displaced breaks (where the pieces of broken bone are out of alignment), surgical realignment is necessary and may require fixation by metal plates and/or screws. This will be followed by physical therapy to regain range of motion and strengthen the muscles not used during the immobilization. These types of breaks usually heal without surgery by immobilizing the humerus in a sling for two to three weeks. Most breaks in humeral head are nondisplaced, meaning the bone is broken but still properly aligned. Breaks in this area are quite common, especially in older patients who have low bone density due to osteoporosis. It forms the "ball" of the ball-and-socket shoulder joint. The humeral head is located at the upper tip (proximal region) of the humerus (upper arm bone). In some cases, this may include fixation by metal plates and/or screws. Breaks in the knobby upper portions of the bone (the glenoid, scapular neck or acromion) may require surgical realignment. Most breaks in the scapular body heal without surgery by immobilizing it in a sling. A simple X-ray will usually reveal the type of fracture and guide the appropriate treatment, however, a CT scan can be useful to assess more severe or complex breaks. The main symptoms are intense pain while moving the arm and swelling at the back of the shoulder. Less often, breaks occur in the knobby, upper portions of the scapula. Most breaks occur along the scapular body – the large flat section toward the bottom that makes up most of the scapula. Breaks in this bone are usually caused by a high-impact trauma such as a vehicle collision, rather than by a fall or sports injury. ![]() The scapula (shoulder blade) is a strong, triangular-shaped bone that is well-protected by muscle. However, if the break results in an overlapping of the bone ends, or if the bone is broken into multiple pieces, surgery may be necessary to prevent a nonunion of the break or shortening of the bone, either of which can reduce shoulder function. ![]() This bump will gradually get smaller over time. In some cases where this nonsurgical treatment is used, an excess of new bone growth will occur and create a bony prominence or bump at the healing site. Usually, a broken collarbone will heal without surgery by immobilizing it in a sling and treating the patient with ice (to reduce swelling) and pain medication. An X-ray will reveal the type of fracture and guide the appropriate treatment. If the skin is being pushed outward by a sharp bony spike, this is a surgical emergency that requires immediate evaluation by an orthopedic trauma surgeon. There may also be grinding between the broken segments (this is called "crepitus"). Any child who experiences a growth plate injury should receive specialized care by a pediatric orthopedic surgeon to avoid future problems with bone growth and function.Ī doctor's exam of the shoulder will usually show a visible deformity or bump at the site of the fracture. In children, the injury may occur at the growth plate, closer to the end of the bone. ![]() A broken collarbone (clavicular fracture) is a common injury that is often caused by a fall from a bicycle or injury during a contact sport like football.
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