Abandoning functional fixedness: creative solutions in fracture surgery using widely available materials.

Lisette Langenberg & Matthijs Botman

Introduction

Functional fixedness is a well-known phenomenon In psychology and design, which may be described as the perception that a tool is linked to only one function. This article presents a collection of examples of the use of materials and instruments in fracture surgery, abandoning functional fixedness. One of the aims is to raise awareness by demonstrating that several tools may be used out of their “fixed” context. The most important goal is to reach surgeons that operate in remote areas in which there is a lack of surgical instruments and materials, and surgeons are forced to abandon functional fixedness in surgical problem-solving.

Material and methods

A Pubmed search was performed for technical tips and tricks. Thereby a sum of examples of surgical ingenuity that was gathered in a decade of orthopaedic and general surgery training was collected by the authors.

Results

Several surgical tips and tricks that may be used in surgery preparation, exposure, fracture reduction and fixation (use of Kirschner wires, plate and screw fixation and intramedullary fracture fixation) are presented.

Discussion

The surgical tips and tricks that are presented in this article may be useful especially in low-resource settings. As surgeons, it is useful to be aware of the concept of functional fixedness, and to realize the value of abandoning it, if possible. Parallels with non-medical professions like the automotive industry may be inspiring. It is always important to realize that the quality and safety of surgery should not be jeopardized.