FRACTURE FIXATION

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Bone fractures can be complete or incomplete, simple or comminuted, closed, or open. Comminuted fractures comprise more than two bone fragments, and open fractures are associated with an open skin wound.

Many fractures are treated nonoperatively. Still, a large number of fractures require operative treatment. If a fracture that requires operative treatment is not treated, nature tries to stabilize the loose fragments by pain-induced contraction of the surrounding muscles, which may lead to bone shortening. The result of this process frequently is the lack of proper bone alignment and impaired function.

The fundamental goal of fracture fixation is to stabilize the fractured bone, to enable fast healing of the injured bone, and to return early mobility and full function of the injured extremity. For lower extremity fractures, stability for weight-bearing is the primary goal. In the upper extremity, restoration of functional hand and arm motion is most important.

There are two main types of fracture fixation: internal and external. All internal and external fixation methods that allow appreciable interfragmentary movement under functional weight-bearing are considered flexible fixation. Techniques that use compression are regarded as rigid fixation.

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