Abandoning Functional Fixedness: Creative Solutions in Fracture Surgery Using Widely Available Materials


Lisette Charlotte Langenberg
Department of orthopaedic surgery, NoordWest Ziekenhuisgroep Wilhelminalaan 12 1815JD Alkmaar
Mathijs Botman
Department of plastic and reconstructive surgery, Amsterdam University Medical Centers, location VUMC


Purpose – 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. The aim is to demonstrate practical examples on how surgical tools are being used effectively out of their “fixed” purpose. 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.

Design/methodology/approach – A series of examples of surgical ingenuity was gathered by the authors during more than a decade of orthopaedic and general surgery training. Subsequently a Pubmed search was performed to evaluate if these tips and tricks could be substantiated by international literature. 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.

Originality/value – The surgical tips and tricks that are presented in this article may be useful anywhere, especially in resource-limited settings. As surgeons, it is useful to be aware of the concept of functional fixedness, and to realize the value of abandoning it and be creative, if possible. Parallels with non-medical professions like the automotive industry may be inspiring.

December 18, 2023
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