The Use of the SFS for Reconstructive Bone Surgery
There are many indications for secondary operations on the peripheral skeleton. Most peripheral fractures are less conspicuous and, therefore, either primarily overlooked or their functional significance underestimated. The approved methods of conservative treatment, especially in the hand, seem to have met with too little recognition. Malpositions of rotation, angulation and shortening call more frequently for operation than do pseudarthroses. Painful post-traumatic arthrosis as well as congenital or rheumatic affections of joints can be either corrected or at least relieved from pain by arthrodesis. Here fixation with small plates has proved to be very useful, and has largely replaced the application of Kirschner wires. The stability achieved is good enough to make external fixation by plaster almost always unnecessary. Intensive mobilization of neighbouring joints and immediate full weight bearing achieves surprisingly good functional results. In our experience the combination of autogenous bone grafting with metal fixation is the safest procedure. In many cases, however, reliable arthrodesis can be carried out without any bone grafting. The requirements, therefore, are good vascularity, broad contact surfaces and faultless compression. Six different operations are available from which the one most suitable for the specific situation can be selected.
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