The first published example of internal fixation of a fracture was in 1963 by what would be later known as the Swiss AO group.
Interestingly, the US version of the publication left out pictures of fresh tibia fractures being treated because it was felt that including them would risk the reputation of the AO group in America. The treatment was that controversial. By 1969 when the first edition of the Manual of Internal Fixation was published, this treatment by the Swiss AO Group was well on its way to becoming the standard of care for fracture treatment. That being said, there are pros and cons to this course of treatment. Every surgeon, and their patient needs to consider these before choosing a treatment.
Pros of Using a Plate and Screws
- Improved stability of the fracture
- Better control and alignment of the bone fragments
- Restores normal function of affected limb
- Allows for earlier weight-bearing
Cons of Plate and Screws
- Increased risk of infection at the surgical site
- Risk of nonunion or delayed union
- Risk of hardware failure
- Potential for nerve/blood vessel damage during surgery
- Increased pain and discomfort during recovery
There are many factors that contribute to the decision to plate a femur fracture. The location and severity of the fracture is one. Next is the age and overall health of the patient and their lifestyle and occupation. This is a major operation and carries with it the possibility for increase in blood loss compared to other options. All surgeries carry the risk of anesthesia, bleeding and infection, as well as the possibility of blood clots or other complications associated with prolonged immobilization after surgery. Some of the other options to treat a femur fracture include external fixation, which can be done quickly with minimal blood loss, Intramedullary nailing and prosthetic replacement. It is important to consider the pros and cons of any surgery and to obtain medical advice from a qualified orthopedic surgeon to be able to make an informed decision about the best treatment option.