Fixation techniques

Reduction and fixation are two principal components of fracture treatment. Without proper reduction, the correct anatomic form is not restored, and without the proper form, the functional restoration may be incomplete. Fixation is to hold the bony fragments in the desired position until healing can occur. Even properly reduced fragments can undergo secondary displacements, if the forces producing displacements exceed those that resist them. However, once healing has progressed to the point that the bone fragments are sufficiently united and that they now can withstand the average deforming forces, it would be important for the fixation system used to permit the transfer of load-bearing function back to the bone. This chapter will review basic biomechanics pertinent to fracture fixation, the fixation devices and techniques, and important underpinning biological principles. The learning objectives are as follows: