DR. ONG KEE LEONG
Surgical Fixation of Knee Fractures
Surgical fixation of knee fractures is a procedure that involves the alignment and stabilisation of broken bones in the knee joint using hardware such as screws, plates, rods, or wires. This treatment restores the structural integrity of the knee, allowing for healing and rehabilitation. The procedure addresses fractures in the distal femur (thigh bone), proximal tibia (shin bone), or patella (kneecap) that form the knee joint complex.
Book AppointmentPotential Risks and Complications
Surgical fixation of knee fractures may involve several potential complications. These include infection, blood clots, hardware problems such as loosening or irritation, nonunion or malunion of the fracture, knee stiffness, and post-traumatic arthritis. Additional risks relate to anaesthesia, bleeding, and damage to surrounding structures. The orthopaedic knee specialist evaluates each patient’s specific risk factors and implements preventive measures accordingly.
Indications for Surgical Fixation
The following conditions typically warrant consideration of surgical fixation for knee fractures based on clinical assessment and imaging results.
- Displaced Fractures: Fractures where bone fragments have moved out of normal alignment require surgical intervention to restore anatomical position and facilitate healing.
- Intra-articular Fractures: Fractures extending into the knee joint surface need surgical repair to restore joint congruity and reduce the risk of post-traumatic arthritis.
- Unstable Fractures: Fractures that cannot maintain alignment with non-surgical methods benefit from internal fixation to prevent movement during the healing process.
- Open Fractures: Fractures where bone has penetrated the skin require surgical debridement and fixation to reduce infection risk and promote healing.
- Comminuted Fractures: Multiple bone fragments resulting from high-energy trauma often need surgical reconstruction to restore knee anatomy and function.
Benefits of Surgical Fixation
- Anatomical Restoration: Surgery allows for realignment of bone fragments, particularly when dealing with complex fractures involving the joint surface.
- Early Mobilisation: Internal fixation provides stability that often permits earlier range of motion exercises and weight-bearing, reducing complications associated with prolonged immobilisation.
- Improved Functional Outcomes: Proper alignment and fixation of knee fractures generally lead to better long-term knee function and reduced risk of post-traumatic arthritis.
- Reduced Healing Time: Surgical stabilisation creates a favourable environment for bone healing by maintaining fragment position and allowing compression across fracture lines.
Surgical Techniques
Open Reduction Internal Fixation (ORIF)
This common technique involves making an incision to directly visualise the fracture, manually restoring alignment, and securing the bones with hardware such as plates and screws. ORIF is suitable for complex intra-articular fractures requiring reconstruction of the joint surface.
Intramedullary Nailing
This method utilises a metal rod inserted into the medullary canal (hollow centre) of the bone to stabilise fractures, particularly in the distal femur. The nail is secured with screws above and below the fracture site, providing stability while being less invasive than traditional plating techniques.
External Fixation
In this approach, pins or wires are inserted through the skin and into bone fragments, then connected to an external frame. External fixation may be used as a temporary measure for severely comminuted or open fractures, or as a definitive treatment in specific situations.
Medisave & Insurance Shield Plan Approved
For Singaporeans & Singapore Permanent Residents
Preparing for the Procedure
- Medical Evaluation: A comprehensive assessment includes physical examination, medical history review, and various tests to evaluate surgical fitness. This evaluation identifies conditions that may affect anaesthesia or recovery and allows for management planning.
- Medication Adjustments: Certain medications, particularly blood thinners, may need to be temporarily discontinued before surgery. The surgeon will provide instructions on which medications to stop and when, as well as which medications should be continued.
- Pre-operative Imaging: Detailed X-rays, CT scans or MRI studies are obtained to assess fracture patterns and plan the surgical approach. These images help the surgeon determine the appropriate fixation method and hardware requirements for the specific fracture configuration.
- Fasting Instructions: Patients must follow guidelines regarding food and fluid intake before surgery. Typically, nothing should be consumed by mouth for 6-8 hours before the scheduled procedure to reduce anaesthesia-related risks.
Post-Surgical Care and Recovery
- Hospital Stay: Patients typically remain in hospital for 1-3 days after surgery, during which pain management, wound care, and initial mobilisation are addressed. The length of stay varies based on the complexity of the fracture, overall health, and progress with initial physical therapy.
- Pain Management: A multimodal approach to pain control typically includes oral medications and, occasionally, patient-controlled analgesia in the early post-operative period. Pain management strategies are adjusted as recovery progresses to balance comfort with avoiding long-term medication dependence.
- Rehabilitation: Physical therapy begins shortly after surgery with gentle exercises and gradually progresses to more challenging activities. The rehabilitation protocol follows a structured timeline that balances protection of the surgical repair with restoring motion, weight-bearing status, strength, and function.
- Follow-up: Regular check-ups with the orthopaedic surgeon allow monitoring of fracture healing, hardware position, and functional progress. These visits include radiographic studies and clinical examinations to guide adjustments to the rehabilitation programme as needed.
Step-by-Step Procedure
Anaesthesia Administration
The procedure begins with the administration of either general anaesthesia, which renders the patient unconscious, or regional anaesthesia, which numbs the lower body. The anaesthesiologist monitors vital signs throughout the procedure.
Surgical Approach
The surgeon makes an incision in the appropriate location around the knee, with the size and position determined by the fracture site and planned fixation method. The incision provides access to the fractured bone while protecting surrounding nerves, blood vessels, and soft tissues.
Fracture Reduction
The bone fragments are manipulated into their correct anatomical positions using instruments. This step requires careful attention, particularly for fractures involving the joint surface, where irregularities can lead to post-traumatic arthritis.
Internal Fixation Application
Hardware such as plates, screws, wires, or nails are applied to hold the reduced fracture in position. The hardware configuration depends on the fracture pattern, bone quality, and biomechanical considerations to provide stability during healing.
Wound Closure
After confirming fracture reduction and hardware placement with intraoperative imaging, the surgical site is irrigated and closed in layers. The skin may be closed with sutures, staples, or adhesive strips, and a sterile dressing is applied.
Why Do Patients Choose Dr Ong Kee Leong?
- Dr. Ong Is Passionate In Sports, Giving Him A Deep Understanding Of Sports-Related Injuries And How They Can Be Treated
- Personalised And Professional Approach To Deliver High-Quality Orthopaedic Care Based On The Most Up-To-Date Literature
- Detailed Aftercare Plan To Ensure Smooth, Long-Term Recovery
- Fellowship Trained Surgeon With 15 Years Of Experience In Orthopaedic Conditions
- Problem-Oriented, Well-Organised and Individualized Treatment Plans Catered To Your Specific Needs
- Specialist In The Management Of Sports Injuries And Degenerative Conditions Of The Shoulder And Knee Joints
- Knowledgeable And Pleasant Clinical Staff To Assist You With Your Every Need Detailed Aftercare Plan To Ensure
- Our Care Is Conveniently Accessible At Mount Elizabeth Novena and Farrer Park Hospital
- Minimal Waiting Time For Initial Consultation
- Assistance With Medical Claims (e.g. Medisave & Integrated Shield Plans)
About Dr. Ong Kee Leong
Senior Consultant, MBBS (Singapore), MMed (Ortho), FRCSEd (Ortho)
Dr Ong Kee Leong is a senior consultant orthopaedic surgeon with subspecialty training in shoulder, knee, and arthroscopic sports surgery.
- Completed a fellowship in Germany, gaining focused, hands-on exposure to complex joint conditions beyond the scope of general orthopaedic practice.
- Served as Director of Sports Service at Changi General Hospital, managing a wide range of sports-related injuries in both recreational athletes and national-level competitors before entering private practice.
- Subspecialty focus on shoulder and knee conditions, including arthroscopic (keyhole) surgery.
Hospital & Clinic Affiliations
Dr Ong practises at a clinic in Singapore with access to accredited hospital facilities for surgical procedures. Patients have access to diagnostic imaging (X-ray, MRI, and ultrasound), day surgery facilities for arthroscopic procedures, and structured rehabilitation services.
Please contact the clinic directly for the current practice address, nearest MRT station, and details of affiliated surgical facilities.
Patient Care Philosophy
Dr Ong’s clinical approach is grounded in a single principle: exercise and sports are highly beneficial for long-term health. This reflects a genuine belief that physical activity is central to long-term health, and that the goal of orthopaedic care is to return you to the activities that matter to you, not simply to resolve your imaging findings.
In practice, this means prioritising joint preservation wherever possible. Rather than moving quickly to joint replacement or highly invasive procedures, the focus is on treatments that protect and restore the body’s natural structures.
Every plan is shaped by what you want to do with your body, whether that is returning to competitive sport, running at weekends, or simply walking without pain.
Beyond acute treatment, Dr Ong incorporates injury prevention and load management guidance into his consultations. Understanding why an injury occurred, and how to modify training to reduce the risk of recurrence, is part of the long-term care approach.
Frequently Asked Questions
How long does the surgical procedure take?
The duration varies from 1-4 hours depending on fracture complexity, fixation method, and any additional procedures required. Your surgeon can provide a time estimate based on your particular case.
Will the hardware be removed after healing?
Hardware removal is not routine and is only considered if the implants cause symptoms or problems. Most patients retain their implants permanently without issues, avoiding a second surgery.
What level of function can I expect after recovery?
Most patients achieve good function, but outcomes depend on fracture severity, joint involvement, quality of reduction, and rehabilitation participation. Some residual symptoms or limitations may persist with complex injuries.
How soon can I return to work after surgery?
Return to work timing varies based on occupation demands, with sedentary jobs possible within 2-6 weeks, while physically demanding work may require 3-6 months. Modifications may be needed during the transition period.
Have an enquiry about your condition or a certain treatment?
Fill up the form and we will get back to you soon!
Make An Enquiry
Prefer to talk? Call our clinic directly to make an enquiry at (65) 6884 6788
(Please ask for Dr Ong Kee Leong)
our clinics
Visit Us Today
Mt Elizabeth Novena
- 38 Irrawaddy Road #06-59/60/61 Mt Elizabeth Novena Specialist Centre Singapore 329563
- klong@sog.sg
- (65) 6884 6788
- (Ask for Dr Ong)
- (65) 9652 5022
-
Mon – Fri : 9:00 am – 5:00 pm
Sat : 9:00 am – 1:00 pm
other practice locations
Farrer Park Hospital
- 1 Farrer Park Station Road #14-06 Connexion Singapore 217562
- klong@sog.sg
- (65) 6884 6788
- (Ask for Dr Ong)
- (65) 9652 5022
-
Mon – Fri : 9:00 am – 5:00 pm
Sat : 9:00 am – 1:00 pm
Mt Alvernia Medical Centre
- 820 Thomson Road #07-53 Mt Alvernia Medical Centre D Singapore 574623
- klong@sog.sg
- (65) 6884 6788
- (Ask for Dr Ong)
- (65) 9652 5022
-
Mon – Fri : 9:00 am – 5:00 pm
Sat : 9:00 am – 1:00 pm
"Moving your body the way nature intended is a freedom not well appreciated until it is lost. We are passionate about getting you back in the game, and staying in the game. Our team is fully committed to returning you to the life and activities you love."
Billing & Payment
Consultation fees are charged based on length of consultation, and start from SGD$200 (within 30 minutes).
Modes of Payment
We accept the following modes of payment:
- Cash
- PayNow & PayLah
- All major Credit Cards
If you are insured and would like to use a Letter of Guarantee (LOG) from the major insurers in Singapore, please contact us and our friendly clinic staff will assist you and provide more information if required.
Can I Claim Through My Medisave Account? (For Singaporeans and PR)
Yes, you can. Our Clinic is an accredited day surgery clinic by the Ministry of Health. Singaporeans and Permanent Residents may use their Medisave for eligible orthopaedic inpatient procedures and hospitalizations.
The exact amount would depend on the complexity of the procedure. If you have any enquiries, feel free to speak to our friendly clinic staff about using your Medisave account.
Integrated Shield Plans (Singaporeans and PRs)
Yes, patients who have purchased Integrated Shield plans with riders for co-insurance and deductibles will be able to use them in our clinic for eligible procedures. For more information, contact us to find out if your procedure is claimable.
The 5 Approved Integrated Shield Insurers are:
- NTUC Income’s IncomeShield and Enhanced IncomeShield
- American International Assurance International Co’s (AIA) HealthShield Gold
- Great Eastern Life Assurance Co’s SupremeHealth and SupremeHealth Plus
- Prudential Assurance Co’s PRUShield
- AXA Shield