Bone is living tissue and when it breaks, it has the ability to heal naturally. When such a fracture occurs, bone fragments are usually repositioned, gently stabilized and supported until the healing bone is strong to support body weight and movement. Until the late 19th century, foot and ankle surgeons relied on casts and splints to support and stabilize broken bones externally. Today, doctors can carry out internal fixation of fractures to optimize the healing process.
Surgical procedures often involve the use of surgical hardware, or implants.
Your podiatric surgeon has a number of different types of hardware to select from depending on the nature of the issue being addressed. The purpose of this hardware is to help patients regain mobility without placing undue stress on the site of injury.
Implants can be made of plastic, metals, and composite materials. Below are some of the more common types of surgical hardware used in podiatry, and their benefits.
- Bones heal faster and more effectively if the fracture fragments are pressed firmly together. Foot and ankle fractures can be compressed to improve stability using screws.
- Screws are one of the most common and routine hardware used in internal fixation. They can be used to provide fixation alone, or in conjunction with other devices.
- Screws come in various dimensions and shapes, allowing for versatility in their use on bones of different sizes. The most frequently implanted types are cortical and cancellous screws.
- Plates are comparable to internal splints that hold broken pieces of bone together. There are different types of plates named according to their function. Examples include neutralization, buttress and compression plates.
- Neutralization plates are designed to protect fracture surfaces from normal bending, rotation, and axial loading forces.
- Buttress plates are designed for use at the knee or ankle joint, and specially contoured to handle larger compression and shear forces at these locations.
- Compression plates are used for fractures that are stable in compression, with screw holes for fixation.
Wires and Pins
Wires are useful when it comes to pinning bones together. They are particularly useful when pieces of bones are too small to be fixed with a screw. Orthopedic surgeons can use different types of wire. A common example is the cerclage wire. It is placed around the circumference of the affected bone to pull fractured fragments together. Wires are used in conjunction with other devices but can also be used alone to treat small fractures in the foot. Wires may be removed later, or left in permanently.
Rods and Nails
In some type of fractures, particularly fractures in the long bones, the best method of holding the bones together (fracture reduction) is by inserting a rod or nail through the intramedullary canals of bones. Screws at the end of the rods are then used to hold the bones in position (preventing shortening or rotating) until the fracture has healed.
Many patients will leave medical implants in place permanently, with few or no side effects. Others may experience occasional ache or inflammation. Athletes in particular may experience pain, stiffness or discomfort related to hardware after the recovery process is complete and they return to high-intensity training. If the implant’s purpose has been fulfilled and healing is complete, these patients may be given the option of undergoing a surgical revision to remove hardware. This type of removal is generally not performed within 12 months of the original implant date, and your foot surgeon will offer recommendations on a case by case basis.
If you are considering foot or ankle surgery, or if you need a second opinion regarding treatment for a chronic condition, call (713) 541-3199 to schedule an appointment with Dr. Gabriel Maislos, DPM, FACFAS. Dr. Maislos is a top Houston podiatric surgeon, skilled in performing different types of corrective procedures involving implants in addition to a full range of podiatry services.
Call (713) 541-3199 if you experience:
- pain or swelling
- fracture, sprain or twist injury
- inability to support body weight due to discomfort