The Rationale of Operative Fracture Care by Joseph Schatzker

By Joseph Schatzker

The why, the place, whilst and the way of recent fracture therapy, written by way of world-renowned specialists. the 1st version offered over 5,000 copies within the US on my own and shortly grew to become a regular reference. This thoroughly revised and enlarged moment variation takes into consideration the entire very important advances that experience taken position due to the fact that. it truly is richly illustrated with scientific and radiological examples, and describes tips to verify, diagnose and classify fractures, including the proper therapy in every one case. Readers are provided suggestion at the day-by-day perform of facing fractures, together with the surgical technique, number of the simplest implant, keeping off universal pitfalls and the significance of post-operative care. unprecedented in its insurance of the pelvis and acetabulum as well as the higher and decrease extremities.

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In a grade III wound, external fixation is indicated. If the open diaphyseal fracture is severely comminuted, and fixation with screws and plates is not possible or desirable, we favor initial external skeletal fixation. If the wound is small and the fracture an isolated injury and stable after debridement, the limb may be immobilized in plaster or traction or stabilized with an external fixator. Secondary treatment with internal fixation or intramedullary nailing may then be performed at some point between 26 the 1st and 6th week, depending on the condition of the patient and, more specifically, of the soft tissue envelope.

Note the unorthodox position of a buttress plate on the posterolateral aspects of the distal femoral metaphysis. Anatomical reduction and stable fixation led to an excellent recovery of the joint b c 20 Intra-articular Fractures Fig. 2. tO. a 2-year-old nonunion of the lateral femoral condyle in an 18-yea r-old boy. c Note the excellent correction ofthc valgus deformity at 3 years after surgery, with union and an excellent preservation of joint function , despite the intra-articular step clearly evident in b soon after corrective surgery a b c well as that of many other investigators, bears this out.

ER and M. 1 Introduction In spite of the advances made in fracture care and in the prevention of and management of infection, open fractures remain a serious surgical problem. Even now, an open fracture of the tibia with an associated vascular injury results in an amputation in 60% of cases (Lange et al. 1985). In past decades, open fractures often resulted in the loss of life and/or the loss of limb (Billroth 1866). Tscheme (1984) has described the four major eras in the treatment of open fractures; the era of life preservation; the era of limb preservation; the era of avoidance of infection, and the era of the preservation of function.

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