Risks

Orthopedic surgery is obviously not without its risks, and this risk is increased by the possibility of bone infections as well as soft tissue infections. In addition to general surgical risks there are more specific risks associated with fracture repair, these include...

Implant Infections

With external fixators, the exterior frame has to connected to the bone, and it is not uncommon in these circumstances for the pin entry sites to become infected. Although rarely fatal, this can lead to complications with other parts of the procedure (if the infection spreads) and extreme discomfort and distress for the patient.

Generally this risk is reduced my teaching the patient the methods and importance of good wound care, and administration of antibiotics to treat infections.

Reduced Soft Tissue Regeneration

Tissue often has trouble regrowing over implanted metal-work, and this can lead to incorrectly fitted or innappropriate fixators working their way out of the body. This can lead to unsightly complications, as the implant becomes visible on the surface.

Regeneration is being increased using combinations of dressings and drugs to try and counter this, but the invention of "key-hole" and other less invasive procedures has been a major advance, reducing this from the major problem it once was.

Increased Bleeding

Orthopeadic surgery often involves working around, or through, large muscle groups and their associated blood supplies. This can increase patient bleeding during surgery and negatively impacts patient mortality.

Bleeding is countered by performing some operations (such as cruciform ligament replacement) under tournicet and cauterisation of non-essential or damaged vessels.

Bone Infections

The interior of bones are not exposed in general surgery, and as such are of little risk of infection, they are however very susceptible to infection. Trauma sufficent to break a bone generally doesn't leave the wound site clean, leading to a further hightened risk.

The infection rate can be reduced using positive-pressure operating theatres, and by ensuring the wound is free of dead tissue and foreign bodies. Correct bone irrigation early in the treatment is thought to greatly reduce the infection rate.

Image courtesy of Flickr and are under creative commons license. Original image can be found at https://www.flickr.com/photos/c12/451392369/sizes/l/