Closed functional treatment of fractures
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Bibliographic Information
Closed functional treatment of fractures
Springer-Verlag, 1981
- : gw
- : us
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Includes bibliographies
Description and Table of Contents
Description
The purpose of this book is to report on my 17 years of experience in the development and implementation of a closed functional method of treatment of certain fractures of long bones of the appendicular skeleton. My personal experiences, clinical results, and the basic concepts underlying the treatment philosophy are reported. Illustrations demonstrating the techniques of application of functional casts and braces are presented in detail as well as a step-by-step description of the management regime and a discussion of the behavior of fractures under this system. Indications and contraindications for the use of this method of treatment are clearly outlined. I consider it important to compile this information for I believe that the system has withstood the test of time and is sufficiently sound to be incorporated in the armamentarium of the orthopaedic surgeon. Also, it may have a favorable socioeconomic impact since it offers a viable alternative in the treatment of frac- tures.
Table of Contents
1 The Rationale of Closed Functional Treatment of Fractures.- 1.1 Immobilization is Unnatural.- 1.2 Function is Natural.- 1.3 Function with Rigid Fixation.- 1.4 Minimizing Interference with the Natural Process.- 1.5 Clinical Management.- 1.6 Indications and Contraindications.- 1.6.1 Shortening and Angulation.- 1.6.2 Bracing as an Adjunct to Internal Fixation.- 1.6.3 Open Fractures.- 1.6.4 Fracture Reduction and Vascular Complications.- Summary.- 2 The Scientific Basis of Closed Functional Management of Fractures.- 2.1 The Role of Vascularity in Fracture Healing.- 2.2 Biochemical Changes Related to Endochondral Ossification.- 2.3 Fracture Callus Architecture.- 2.4 The Effects of Immobilization on Fracture Healing.- 2.5 Stability of Fractures.- 2.6 Anatomic Considerations.- 2.7 Material Considerations.- 3 Fractures of the Tibia.- 3.1 Anatomy and Function.- 3.2 Shortening and Angulation.- 3.3 The Tibial Fracture with an Intact Fibula.- 3.3.1 Angulatory Deformities.- 3.4 The Tibial Fracture with an Associated Fibular Fracture.- 3.5 Management Protocol.- 3.5.1 Stage One.- 3.5.2 Stage Two.- 3.5.3 Stage Three.- 3.6 Application of Casts and Braces.- 3.6.1 The Above-the-Knee Cast.- 3.6.2 The Functional Below-the-Knee Cast.- 3.6.3 The Plaster-of-Paris Below-the-Knee Functional Brace.- 3.6.4 The Plastic Below-the-Knee Functional Brace.- 3.6.5 Prefabricated Braces.- 3.7 Mechanical Function of the Brace.- 3.8 Brace-Soft Tissue Design.- 3.9 Materials and Mechanics.- 3.10 Clinical Experience.- 3.10.1 Fractures of the Proximal Tibia.- 3.10.2 Mid-diaphyseal Tibial Fractures with an Intact Fibula.- 3.10.3 Fractures of the Distal Third of the Tibia with an Intact Fibula.- 3.10.4 Fractures of the Proximal Tibia with Associated Fibular Fracture.- 3.10.5 Diaphyseal Tibial Fractures with Associated Fibular Fractures.- 3.10.6 Short Oblique Fractures of the Tibia.- 3.10.7 Distal Metaphyseal Fractures of the Tibia.- 3.10.8 Segmental Fractures of the Tibia.- 3.10.9 Bilateral Tibial Fractures.- 3.10.10 Open Tibial Fractures.- Clinical Data.- 4 Tibial Condylar Fractures.- 4.1 The Mechanical Role of the Fibula.- 4.2 Clinical Considerations.- 4.3 Clinical Management.- 4.3.1 Application of the Brace.- 4.4 Clinical Experiences.- 4.5 Bicondylar Fractures with Associated Fibular Fracture.- 4.6 Medical Condylar Fractures.- 4.7 Bicondylar Fractures with an Intact Fibula.- 4.8 Lateral Condylar Fractures with an Intact Fibula.- 5 Fractures of the Femur.- 5.1 Femoral Fracture Bracing.- 5.2 Application of the Functional Brace.- 5.3 Clinical Experience.- Clinical Data.- 6 Fractures of the Distal Radius.- 6.1 Management.- 6.2 Application of the Brace.- 6.3 Clinical Experience.- Clinical Data.- 7 Fractures of the Forearm.- 7.1 Fractures of Both Bones of the Forearm.- 7.1.1 Management.- 7.1.2 Application of the Brace.- 7.2 Clinical Experience with Fractures of Both Bones of the Forearm.- Clinical Data.- 7.3 Isolated Radial Fractures.- 7.3.1 Application of the Brace.- 7.4 Isolated Fractures of the Radius: Clinical Material.- Clinical Data.- 7.5 Isolated Ulnar Fractures.- 7.5.1 Management.- 7.6 Application of the Ulnar Sleeve.- 7.6.1 Clinical Material.- 7.7 Bilateral Ulnar Fractures.- 7.8 Segmental Isolated Fractures of the Ulna.- Clinical Data.- 8 Fractures of the Humeral Shaft.- 8.1 Humeral Shaft Fractures.- 8.2 Management.- 8.3 Clinical Experience.- 8.4 Bilateral Humeral Fractures.- Clinical Data.- 9 Delayed Unions and Nonunions of the Tibia.- 9.1 Delayed Unions and Nonunions of the Tibia.- 9.2 Clinical Experience.- 9.3 Infected Nonunions.- Clinical Data.- 10 Fractures in Children.- 10.1 Fractures in Children.- 10.2 Management.- 10.3 Clinical Experience.- 10.3.1 Tibial Fractures.- 10.3.2 Femoral Fractures.- 10.3.3 Forearm Fractures.- Clinical Data.
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