Objectives and Hazards of Internal Fixation

Abstract

Today’s methods of fracture treatment aim at complete restoration of all functions of the injured limb. This requires on the one hand rapid ossification of the fracture after it has been properly reduced, and, on the other hand the integrity of the surrounding soft parts. Internal fixation is only satisfactory when it can neutralize the fracture and allow early movement of the surrounding soft parts and joints. When an anatomical reduction is obtained in a fracture, in the absence of internal fixation, external methods of splintage must be used. Open reduction by itself without appropriate internal fixation should not be attempted in any case where conservative treatment may be expected to produce union of the fracture in a satisfactory alignment. Here the risk of opening a closed fracture without proceeding to internal fixation would be injustifiable.

No two fractures can be treated alike (Hellner).

The aims and basic principles, however, remain the same.