principles of fracture fixation

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Principles of fracture fixation

+ Absolute stability

No micromotion in the fracture healing by

primary (direct) bone without callus formation

+ Relative stability

There is some motion in the fracture fragments stimulation of callus formation secondary bone healing by callus formation

+ Perren's strain theory

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Fracture Simple fracture

(<2 mm) Multifragmentary (>2 mm)

Relative stability Bone resorption, healing delay, or nonunion

Secondary bone healing (callus)

Absolute stability Primary bone healing, osteonal remodelling

Bone resorption, healing delay, or nonunion

+ Methods of absolute stability

Compression by Lag Screw

+ Compression plate

+Dynamic compression by Tension band

+ Methods of relative stability Bridging plate

+intramedullary nailing

+External fixation

+ Home message

Simple diaphysial fracture anatomical reduction and absolute stabilization

Intraarticular fracture anatomic congruity of the joint surface must be restored and the fragments should be fixed rigidly by interfragmentary compression

Diaphysial multifragmentary fracture god alignment in all planes and relative stabilization.

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References:

AO Principles of Fracture Management: Thomas P. Ruedi , William M. Murphy

Rockwood and Green's Fractures in Adults