osteosyntes

Osteosyntese (also called osteosynthesis) is the surgical fixation of bone fractures or bone segments using implants such as plates, screws, nails, wires, or external devices to achieve stable alignment and facilitate healing. The goal is to provide mechanical stability while preserving as much biology of healing as possible, and to allow early mobilization when appropriate.

The technique developed during the 20th century and has evolved with advances in implant design and surgical approaches. Modern methods include open reduction with internal fixation (ORIF), closed reduction with internal fixation, and minimally invasive plate osteosynthesis (MIPO). Intramedullary nailing and external fixation are alternative fixation strategies, chosen based on fracture type, location, and soft tissue condition.

Implants used in osteosynthesis are selected to provide either absolute stability, which promotes primary bone healing, or relative stability, which allows secondary healing with callus formation. Plates and screws can compress fracture fragments or bridge a defect; locking plates improve stability in osteoporotic bone; intramedullary nails align long bones with limited soft tissue disruption. External fixators may be used for temporary stabilization or when soft tissue injury complicates internal fixation.

Postoperative care varies with fracture location and fixation method, but early controlled mobilization is often encouraged, with weight-bearing tailored to stability and healing. Complications can include infection, nonunion or malunion, hardware failure or irritation, and injury to surrounding tissues. Overall outcomes are favorable when patient selection, surgical technique, and rehabilitation are well coordinated.