First, the principle of treatment
The principle of fracture treatment currently used internationally is the principle of fracture treatment of AO tissue:
1. Reconstruct the anatomical relationship by fracture reduction and fixation. Repositioning is the basis for fixed and functional exercise, and stress should be prompt and correct after fracture. Fixing is to maintain the position after the reset in various ways, prevent it from being displaced again, and create conditions for fracture healing;
2. According to the "personality" of the fracture and the need of injury, use a fixed or splint to reconstruct stability;
3. Use careful operation and gentle reduction method to protect the blood supply of soft tissue and bone;
4. Early and safe activity training for the whole body and affected parts. On the basis of maintaining a correct reduction of the fracture, the reasonable movement of the injured limb is performed as soon as possible to restore the function of the limb.
Second, the fixation method of fractures mainly includes two types of external fixation and internal fixation.
1. External fixation: It is mainly used for maintenance and reset after fracture reduction. If the internal fixation is not strong enough after open reduction, it can be supplemented with external fixation. Commonly used external fixation methods include plaster bandages, small splints, traction, external fixators, and brace fixation.
2. Internal fixation: refers to a fixation method in which an open reduction fracture is fixed in place by an internal fixation device of metal or degradable material. Clinically, according to the actual needs of fracture fixation, different types of internal fixation equipment can be used. Commonly used, including various bone plates, screws, intramedullary nails, round needles (Ske's needle, Kirschner wire, etc.), stainless steel wire, Degradable material products, etc. The main purpose of internal fixation is to achieve full recovery of the affected limb function as quickly as possible. Internal fixation does not permanently replace broken bones, but only as a temporary support. Currently, the internationally recognized principle of biological internal fixation (BO) is:
(1) Relocate away from the fracture site to protect the local soft tissue from the fracture;
(2) Do not sacrifice the blood supply of the fracture to force the anatomical reduction of the fractured fracture block, such as the larger fracture block that must be reset, and try to preserve the soft tissue pedicle of the blood supply;
(3) using internal fixation equipment with low elastic modulus and good biocompatibility;
(4) reducing the contact area between the internal fixation and the bone;
(5) Minimize surgical exposure time.
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