The treatment of fractures and types of ortho surgical implants produced by orthopedic implant manufacturing companies in India; in general, have undergone major changes during the previous few decades. The fear of infection after internal fixation has also reduced dramatically. Internal fixation technique gained such popularity that during the late 70s, it was thought that other techniques of fracture treatments like open reduction and plate fixation of diaphyseal fractures would eventually fade away. The AO principles of fracture and orthopedic implants popularized the concept that ideal callus can be achieved from rigid immobilization of fractures and “compression” of fragments.
However, experimental analysis and studies related to orthopedic implants India have indicated that regular internal fixation of fracture can be the cause of many complications such as infections, delayed unions, nonunion, and failure of the metal implants.
It was also evident that in many instances the surgical procedure did not eliminate the need for postoperative protection of the extremity, a finding which was opposite to expected result. A demonstrative study from the Netherlands based on fractures treated during the last 5 to 7 years indicated that rather than reducing the diseased condition of the patient, the internal fixation method (aka AO method) had increased morbidity, which was quite opposite to conventional long leg cast stabilization of tibia fractures. It was also indicated in the findings that the time that was needed to recover from injury was longer when plate fixation was used.
Over the years, the external fixation technique (a technique which was quite popular among ortho surgical implants experts in the past) has been revived and radically developed. Its finest use has been found in the management of open fractures, particularly those associated with severe soft tissue wounds. More recently, the technique of intramedullary fixation which involves interlocking nails and locking plates has received better acceptance, and the results found are also progressively satisfactory. Yet, its application in Gustilo type III open fractures is still questionable, and perhaps even not preferred at this time. Improved antibiotics and surgical procedures of soft tissue, which are aimed at covering the wound continue to improve the diagnosis of these very complicated fractures.
As a leading orthopedic implants manufacturer in India, we have found that at this time there is not one single treatment that applies to all fractures of the tibia under all situations. To give you a better insight, we have discussed the place and role that functional bracing in the management of tibial fractures in this article.
Tibial fractures are commonly considered to be severe, because in tibial cases delayed union and nonunion, shortening, and angular deformities are likely to occur. It is all our argument. However, there are very large cases of tibial fractures that can be effectively treated by closed functional means without the need for any surgical intervention. This method requires minimal hospitalization or in some cases, none at all prevents the complications of surgery and anesthesia and also decreases the general cost of treatment.
Regardless of how well the treatment of fracture using internal or external rigid fixation appears, it causes a violation of the natural biological process of bone formation and interferes with the normal healing cycle. The mere fact that the practical benefits of such as intervention often outweigh its biological disadvantages does not invalidate the above point. Over the years we have seen and found ample evidence in the medical literature to demonstrate that fracture treatment with plates, interlocking nails, locking plates, or fixates delays the healing process.
The distraction of the normal bone formation process caused by rigid fixation as well as by external fixation is discussed further. Being in the trauma implants and spine implants field for quite a while now, we have done our research after studying various medicals journals. These findings stated that tibial fractures treated using intramedullary fixation do not exhibit faster clinical or radiological healing than comparable fractures treated by closed functional bracing.
Other studies published in leading medical and orthopedic journals have also stated that patients’ ability to perform any movement unassisted and without any problem after intramedullary fixation requires mostly longer periods than others who have similar fractures but treated by nonsurgical functional methods.
External fixation often even delays healing to a much greater extent and therefore extends the period of suffering for a patient.
Orthopedic implants specialists across major research institutions in the world, where tibial fractures are cured by various methods, have clearly stated that the functional fracture bracing method has its best implication in the cure of closed fractures, particularly those resulting from low-impact injuries. Many open diaphyseal fractures like those resulting from low-velocity gunshot wounds are preferred for closed functional treatment. Functional bracing has less implication in the treatment of open fractures, particularly those with major soft tissue pathology, where an intramedullary fixation or external fixation has confirmed to be of greater advantage.
Orthopedic products manufacturers in India have triumphed over the fear of shortening of closed tibial fractures by having accepted the fact that those fractures experience initially the maximum amount of shortening rather than upon completion of healing. Final shortening in many closed tibial fractures is even less than 1 cm which does not produce a limp or walking difficulty and is also not associated with late undesirable consequence.