what is internal fixation?!
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usually refers to a metal plate inserted to stabilize a fracture
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"Fixation" means keeping objects in place, i.e. bone fragments, etc.
"Internal" means that the fixation process is performed underneath the skin and soft tissues.
An "internal fixator" would typically be a bone plate that is placed directly against the bone and is fastened to either side of a fracture by short screws that are screwed through the plate and into the bone fragments. You might be surprised to know that there are such things as "external fixators", which typically consist of long screws that are screwed into the bone fragments and protrude a good inch through the skin, and are connected by an external rod or hard material of some sort.
Keep in mind, though, that fractures sometimes need to be "reduced", i.e. the ends brought together. Reduction can be "open" or "closed". Open reduction means actually touching the bone to bring the fragments together, which obviously involves making an incision to access the bone fragments (or using an existing access). Closed reduction, in contrast, means bringing the fragments together without actually touching the bone.
Generally, when a bone fracture is treated, "reduction" and "fixation" may or may not be done. If you break your arm and the bone fragments are in their proper places, reduction need not be performed. I'm not sure, however, if placing a cast over a broken arm would be considered "external fixation".
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