Imaging and understanding fracture fixation

Abstract

In this chapter, the radiological aspects of surgical fracture management are discussed in detail. History of fracture fixation and the work of the pioneers of the field in the early and mid-twentieth century are introduced. Biology of bone healing is discussed in detail, with emphasis on the new understanding of the effect of mechanical environment and the concept of direct and indirect. Techniques of absolute stability that result in direct bone healing, such as lag screw fixation and compression plating, are described. Generations of compression plates from the round hole plate of Müller to dynamic compression plate (DCP), limited-contact dynamic compression plate (LC-DCP), and the more recent locking compression plate (LCP) are discussed at length. Tension band principle and its application to fracture fixation is introduced. Techniques of relative stability resulting in indirect or callus healing are discussed, including a discussion of intramedullary nailing and its various modes, bridge plating, and external fixation. Different types of external fixators and the pioneering work of Gavriil Ilizarov are introduced. The new concepts of internal fixator and less invasive stabilization system (LISS) are also described. © 2010 Humana Press.