External fixation of fracture

igor kisselev, www.close-up.biz / Getty Images The most common type of fracture management is with immobilization. There are different types of immobilization including splint, braces, casts, slings, and others. Cast immobilization is the most common method where a material (typically plaster or fiberglass) is wrapped around an injured extremity and allowed to harden.Casts come in an endless number of shapes and sizes and require Fractures treated with immobilization must be adequately aligned to allow for healing with good results. If the alignment of the fracture is not sufficient, further treatment may be needed. Xavier Bonghi / Getty Images Traction involves gentle pulling of the extremity to align the bones. Often a metal pin is placed in the bone away from the fracture, this is called skeletal traction. Ropes and weights are attached to the pin to gently pull and hold the bone fragments into alignment. Skin traction is a similar concept, but instead of a pin being inserted into the bone, the traction is placed by pulling externally on the extremity. Skin traction cannot pull with as much force as skeletal traction, so if traction is being used for more than a short time, usually skeletal traction is favored. MIRIAM MASLO/SPL / Getty Images Pins can be used to stabilize bones when a closed reduction is used to improve alignment, but a cast is insufficient to hold the bones in place. Pins are typically placed through the skin in a procedure called a closed reduction wi...

From the Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY (Dr. Tejwani), the Department of Orthopaedic Surgery, Jersey Shore University Medical Center, Neptune, NJ (Dr. Polonet), and the Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA (Dr. Wolinsky). Dr. Tejwani or an immediate family member has received royalties from Biomet; is a member of a speakers' bureau or has made paid presentations on behalf of and serves as a paid consultant to Zimmer and Stryker; and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons, the Orthopaedic Trauma Association, and the Foundation of Orthopaedic Trauma. Dr. Polonet or an immediate family member serves as a paid consultant to Biomet. Dr. Wolinsky or an immediate family member is a member of a speakers' bureau or has made paid presentations on behalf of Zimmer; serves as a paid consultant to Biomet and Zimmer; has received research or institutional support from Synthes; and serves as a board member, owner, officer, or committee member of the Orthopaedic Trauma Association, the American Academy of Orthopaedic Surgeons, the American Orthopaedic Association, and the American College of Surgeons. This article, as well as other lectures presented at the Academy’s 2014 Annual Meeting, will be available in March 2015 in Instructional Course Lectures, volume 64. External fixation for definitive or initial management of tibia...

How Broken Bones Heal video With modern treatment methods, most broken bones (fractures) heal without any problems. After a broken bone is treated, new bone tissue begins to form and connect the broken pieces. Some broken bones do not heal even when they get the best surgical or nonsurgical treatment. In some cases, certain risk factors make it more likely that a bone will fail to heal. When a broken bone fails to heal it is called a "nonunion." A "delayed union" is when a fracture takes longer than usual to heal. Bone Healing For bone healing to happen, the bone needs adequate stability and blood supply. Good nutrition also plays a role in bone healing. • Stability. All treatment of broken bones follows one basic rule: the broken pieces must be put back into position and prevented from moving out of place until they heal. Some fractures can be held in position with a cast. Some fractures require surgical fixation with devices like screws, plates, rods and frames. • Blood supply. Blood delivers the components required for healing to the fracture site. These include oxygen, healing cells, and the body's own chemicals necessary for healing (growth factors). The blood supply to the injured bone usually comes back on its own during the healing period. A broken bone stabilized with a plate and screws. • Nutrition. A broken bone also needs adequate nutrition to heal. Eating a healthy and well-balanced diet that includes protein, calcium, vitamin C, and vitamin D is the best way ...

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