Advertisement

Pre-, Intra- and Postoperative Guidelines

  • P. Matter

Abstract

In 1958, the AO started an endeavour to improve the then surprisingly poor results of fracture treatment: one-third of all tibia fractures, two-thirds of femur fractures and almost all severe fractures involving major joints ended with a relatively high degree of permanent impairment. At this time, the four basic treatment principles which aimed to improve these results were formulated: early operative anatomic reduction; stable internal fixation; atraumatic surgical technique; and very early active mobilization. To judge from the experience of the Swiss Accident Insurance (SUVA), increasing application of these principles has indeed reduced both the proportion of cases in which compensation is paid after long bone fractures (Table 6.1) and the subsequent degree of permanent impairment.

Keywords

Internal Fixation Active Mobilization Continuous Passive Movement Stable Internal Fixation Medullary Nail 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Allgöwer M (1963) Shock treatment and immediate operative stabilisation of fractures. In : Müller ME, Allgöwer M, Willenegger H (eds) Technik der operativen Frakturbehandlung. Springer, Berlin Göttingen Heidelberg, pp 324, 325Google Scholar
  2. Bone L, Johnston K, Weigelt G, Scheinberg R (1989) Early versus delayed stabilisation of femoral fractures, a prospective randomised study. J Bone Joint Surg [Am] 71: 336–340Google Scholar
  3. Border JR, Hassett J, LaDuca J, Seibel R, Steinbert S, Mills B, Losi I, Border D (1987) The gut origin septic states in blunt multiple trauma (155 = 40) in the ICU. Ann Surg 206: 427–448PubMedCrossRefGoogle Scholar
  4. Cave EF (1958) Fractures and other injuries. Year Book, ChicagoGoogle Scholar
  5. Corrodi E (1962) Nachkontrolle einer konsekutiven Serie von 113 verschraubten Frakturen (Nov. 195759 ). Inaugural dissertation, BaselGoogle Scholar
  6. Danis R (1947) Théorie et pratique de l’ostéosynthèse. Masson, ParisGoogle Scholar
  7. Goris JA, Gimbrère JSF, van Niekerk JLM, Schoots FJ, Booy LHD (1982) Early osteosynthesis and prophylactic mechanical ventilation in the multitrauma patient. J Trauma 22: 895–903PubMedCrossRefGoogle Scholar
  8. Johnson K, Johnston G, Parker B (1984) Comminuted femoral shaft fractures: treatment by roller traction, cerclage wires and intramedullary nail, or an interlocking intermedullary nail. J Bone Joint Surg [Am] 66: 1222–1235Google Scholar
  9. Morscher E (1985) Ist unser Gesundheitswesen wirklich so schlecht. Schweiz Ärztezeitung 66:1708–1714 Müller ME, Allgöwer M, Willenegger H ( 1963 ) Technik der operativen Frakturbehandlung. Springer, Berlin Göttingen HeidelbergGoogle Scholar
  10. Riska E, Myllynen P (1982) Fat embolism in patients with multiple injuries. J Trauma 22: 891–894PubMedCrossRefGoogle Scholar
  11. Riska E, von Bonsdortt H, Hakkinen S (1976) Prevention of fat embolism by early internal fixation of fractures in patients with multiple injuries. Injury 8: 110–116PubMedCrossRefGoogle Scholar
  12. Rittmann W, Perren SM (1974) Cortical bone healing after internal fixation and infection. Springer, New York Berl in HeidelbergCrossRefGoogle Scholar
  13. Rüedi T, Wolff G (1975) Vermeidung posttraumatischer Komplikationen durch frühe definitive Versorgung von Polytraumatisierten mit Frakturen des Bewegungsapparates. Helv Chir Acta 42: 507–512PubMedGoogle Scholar
  14. Schenk R, Willenegger H (1964) Histologie der primären Knochenheilung. Langenbecks Arch Klin Chir 308: 440–452Google Scholar
  15. Seibel R, LaDurca J, Hassett J, Babikian G, Mills B, Border D, Border JR (1985) Blunt multiple trauma (ISS = 36), femur traction and the pulmonary failure septic state. Ann Surg 202: 283–295PubMedCrossRefGoogle Scholar
  16. Wolff G, Dittmann M, Buchmann B, Allgöwer M (1978) Koordination von Chirurgie und Intensivmedizin zur Vermeidung respiratorischer Insuffizienz. Unfallheilkunde 81: 425–442PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • P. Matter

There are no affiliations available

Personalised recommendations