Nail, Plate and External Fixator Surgery in Delhi
Nail, Plate and External Fixator Surgery in Delhi focuses on selecting the right fixation for your fracture—intramedullary nails, locking plates, or external fixators—based on pattern, bone quality, and soft‑tissue status. Our goals are stable reduction, respect for soft tissues, early safe mobilization, and durable function. We do not provide in‑house physiotherapy; we share written protocols and coordinate with your physiotherapist for a clear, phased recovery.
Intramedullary nails • Locking plates • External fixators • Technique matched to fracture
About Fracture Fixation
Successful fracture surgery balances mechanics and biology. Intramedullary nails are “load‑sharing” devices placed within the bone canal—ideal for many long‑bone shaft fractures. Locking plates provide angular‑stable fixation and are valuable for peri‑articular fractures or osteoporotic bone where screw purchase is limited. External fixators—pin and rod frames or ring/hexapod constructs—stabilize fractures when soft‑tissue conditions are poor or when staged, damage‑control orthopedics is best. We select the method that restores alignment and stability while protecting blood supply and soft tissues.
Every fracture is different. Pattern, location (shaft vs near joint), bone quality, skin/soft‑tissue condition, and associated injuries determine the safest route. Our planning integrates these elements with your goals—return to work, family obligations, and activities you care about.
When Each Method is Used
Intramedullary nails
Femur, tibia, and many humerus shaft fractures; intertrochanteric hip fractures (cephalomedullary nails). Load‑sharing fixation for earlier weight‑bearing in many cases.
Locking plates
Peri‑articular fractures (near joints), metaphyseal comminution, osteoporotic bone, articular reconstruction requiring direct exposure and reduction.
External fixators
Open fractures, severe swelling/skin injury, polytrauma, or infected/non‑union scenarios; also used definitively (ring/hexapod) for deformity correction and bone transport.
Combined strategies
Temporary external fixation followed by nails/plates once soft tissues recover; or nail‑plate combinations in select peri‑articular patterns.
We prioritise safe timing—sometimes “stage 1 external fixator, stage 2 definitive fixation” reduces complications and improves outcomes.
Evaluation & Planning
- Imaging: AP/lateral X‑rays including joints above/below; CT for articular or complex patterns; vascular imaging if pulses abnormal.
- Soft‑tissue review: Swelling, blisters, open wounds, compartment pressures—key to timing and method.
- Classification & strategy: AO/OTA patterning, decision on biological (bridge) vs anatomic (ORIF) fixation, and damage‑control when indicated.
- Patient factors: Bone quality, comorbidities, smoking status, medications (esp. anticoagulants, steroids), and functional demands.
- Rehabilitation plan: Weight‑bearing status, brace/cast needs, and milestones shared with your physiotherapist. We do not provide in‑house physiotherapy.
We’ll show you your X‑rays and explain why a particular method fits your fracture and goals.
Intramedullary Nails
Intramedullary (IM) nails are strong, tubular implants inserted into the bone’s canal. With proximal/distal locking screws, they control rotation and length while sharing load with bone—particularly effective for long‑bone shaft fractures. Reamed nails often provide a stronger construct; unreamed options may be chosen in specific scenarios.
Common indications
Femoral shaft/intertrochanteric fractures, tibial shaft fractures, and selected humeral shaft fractures.
Advantages
Smaller incisions, preserved periosteal blood supply, alignment control with interlocking, and earlier weight‑bearing in many cases.
Considerations
Entry point and alignment are critical. Adjacent joint injuries or articular extensions may need additional measures.
Locking Plates & ORIF/MIPO
Locking plates create fixed‑angle constructs—useful near joints and in osteoporotic bone. We either perform open reduction and internal fixation (ORIF) for precise articular restoration or use minimally invasive plate osteosynthesis (MIPO) to bridge comminution while preserving blood supply. The aim is stable reduction without excessive soft‑tissue disruption.
- Peri‑articular focus: Distal femur, proximal tibia, distal radius, proximal humerus, ankle/pilon.
- Locking technology: Angular‑stable screws improve hold in softer bone and maintain alignment under load.
- MIPO technique: Small incisions, submuscular tunnels, and indirect reduction for better biology in selected patterns.
External Fixators (Damage Control & Definitive)
External fixators stabilize fractures using pins or wires connected outside the skin. They shine when soft tissues are compromised, in open fractures, or in polytrauma where a quick, safe frame buys time until definitive fixation. Ring/hexapod fixators can also be definitive—allowing precise multiplanar corrections or bone transport in complex scenarios.
Damage‑control frames
Rapid stabilization to reduce pain, bleeding, and swelling; facilitates wound care and transfers.
Definitive ring/hexapod
Gradual correction of deformity and length; useful for infected nonunions and complex peri‑articular patterns.
Care & pin sites
Daily cleaning advice and follow‑up to reduce pin‑site irritation or infection.
Soft‑Tissue Management & Timing
Fracture outcomes are tied to soft‑tissue health. Open fractures require early antibiotics and thorough debridement; severe swelling or blisters may warrant staged fixation. We monitor for compartment syndrome and treat urgently if suspected. When needed, plastic‑surgical input (flaps/coverage) is coordinated.
- Open fracture protocol: Antibiotics, debridement, irrigation, and stabilization (often external fixator initially).
- Staged strategy: Frame first, definitive nail/plate when swelling and skin allow.
- DVT prophylaxis: Risk‑based anticoagulation to reduce clot risk.
Protecting soft tissues is as important as fixing bone—it reduces infection, improves healing, and speeds safe mobilization.
Anesthesia & Pain Control
We use multimodal, opioid‑sparing pain strategies. Regional nerve blocks (e.g., femoral/sciatic, popliteal, brachial plexus) reduce systemic side effects and help early movement. Paracetamol and anti‑inflammatories (where appropriate) form the base; short‑course opioids only if required.
- Regional anesthesia: Improves pain control and reduces nausea/sedation.
- Simple schedules: Clear dosing plans to stay ahead of pain and facilitate sleep.
- Delirium awareness: Especially in older adults—avoid over‑sedation; maintain hydration and orientation.
Weight‑Bearing & Protection
Weight‑bearing rules depend on fracture stability, fixation method, and bone quality. IM nails often allow earlier weight‑bearing for diaphyseal fractures; peri‑articular plates usually require a staged increase to protect the joint surface. External fixators may allow early weight transfer while protecting soft tissues.
- Toe‑touch → partial → full: We progress as X‑rays confirm healing and your strength returns.
- Braces & casts: Employed selectively to add protection during early phases.
- Assistive devices: Cane, walker, or crutches matched to balance and environment.
We do not provide in‑house physiotherapy. You’ll receive written protocols and we coordinate progression with your physiotherapist.
Recovery & Rehabilitation
Recovery timelines vary by injury and fixation. As a general guide:
- Week 0–2: Elevation, swelling control, wound care, safe transfers; begin gentle ROM where allowed.
- Week 3–6: Increase ROM, basic strength and gait training; progress weight‑bearing per plan.
- Week 6–12: Progressive strengthening, balance, and endurance; light work for desk jobs.
- Month 3–6+: Return to heavier tasks/sport when strength and X‑rays meet criteria.
We coordinate with your physiotherapist; we do not provide physiotherapy services in‑house. Expect a written plan for exercises and precautions.
Risks & How We Reduce Them
Infection
Antibiotics, meticulous technique, soft‑tissue respect, and careful wound care; pin‑site protocols for external fixators.
Nonunion/malunion
Stable fixation, alignment checks, and staged weight‑bearing; smoking cessation is critical for bone healing.
Implant irritation/failure
Appropriate implant choice and positioning; occasional hardware removal if symptomatic after union.
DVT/PE & stiffness
Risk‑based anticoagulation and early motion; written home plans to prevent stiffness.
Cost & Insurance
Costs depend on fracture type, fixation (nail, plate, or external fixator), implant brand, facility and anesthesia fees, imaging, and length of stay. Many insurers cover medically necessary fracture surgery. We verify benefits and provide a transparent estimate before scheduling your Nail, Plate and External Fixator Surgery in Delhi.
- Insurance pre‑authorization & benefits check
- Clear estimate of out‑of‑pocket costs
- Cashless/financing options where applicable
How to Prepare
Medical optimization
Control diabetes and blood pressure; discuss anticoagulants; stop smoking to improve bone healing.
Imaging & labs
Bring prior films and reports; we’ll order targeted studies if needed to finalize planning.
Home setup
Clear walking paths, add night lights, arrange bathroom support, and plan help in early days.
Physio details
We do not provide in‑house physiotherapy; share your physiotherapist’s contact so we can coordinate written protocols.
Transport & work
Plan safe travel post‑op and discuss timelines for return to work based on your role.
Where to Consult Dr. Neelabh
BLK Hospital
A-4-6, Pusa Rd, Near Rajendra Place Metro Station, New Delhi-110005
🕓 4:00 PM – 6:00 PM
Timings may vary—please call +91‑9810117204 to confirm.
FAQs
Are nails stronger than plates?
When is an external fixator permanent vs temporary?
How soon can I walk?
Will the implant need removal?
Do you provide physiotherapy?
Need fracture fixation with a clear, safe plan?
Book a consultation. We’ll explain your options—intramedullary nail, plate, or external fixator—and build a recovery pathway tailored to your life.