1. The document discusses the principles of fracture treatment established by the AO study group in the 1950s, including anatomical reduction, stable internal fixation, preservation of blood supply, and early pain-free mobilization.
2. It explains the two modes of fracture healing - direct and indirect - and how the type of stability provided by fixation determines which type of healing occurs.
3. Minimally invasive techniques like MIPO and LISS aim to provide stability while minimizing soft tissue disruption, allowing for indirect reduction and a biological response of callus formation.
3. INTRODUCTION
AO STUDY GROUP 1950 ‘S.
Maurice E. Müller, Hans
Willenegger, Martin Allgöwer,,
Robert Schneider and Walter
Bandi.
Arbeitsgemeinschaft fur
Osteosynthesefragen
KNOW THE REASON FOR FAILURE
AND METHODS TO PREVENT IT .
MSS
4. Ideal management of fracture
The revolution continues -
methods are evolving,
principles remains the same.
Proper understanding of the
personalities of the fracture and
the injury is the prerequisite.
MSS
5. FRACTURE DISEASE.
PAIN AND LACK OF
PHYSIOLOGICAL
CHALLENGE TO BONE &
MUSCLE COMPLEX.
EDEMA.
SOFT TISSUE ATROPHY
OSTEOPOROSIS.
MSS
10. Modes of Fracture
Healing
Based on mechanical environment,
2 ways of bone healing
Direct Indirect
(primary) (secondary)
bone healing bone healing
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18. FOUR FOUNDING
PRINCIPLES
1. Anatomical reduction.
2. Stable internal fixation.
3. Preservation of the
blood supply.
4. Early active pain free
mobilization.
MSS
19. For affective application of the concepts
clear understanding that
Articular and diaphysis fractures have very
different biological requirements.
Type and timing of surgical intervention must be
guided by injury to soft tissue envelope.
Physiological demand of the patient.
MSS
20. ANATOMICAL
REDUCTION
JOINT FRACTURES
– Articular cartilage does not remodel .
Incongruity becomes permanent and can
lead to post traumatic arthritis.
– Perfect anatomical restoration and
freedom of joint motion can only be
obtained by internal fixation –
Sir John Charnley
MSS
24. STABLE INTERNAL
FIXATION
ADEQUATE STABILITY
TO MAINTAIN LENGTH,
ROTATION.
ABSOLUTE STABILITY
‘LAG SCREW, PLATING”
DIRECT HEALING.
CALLUS FREE HEALING
IS NOT THE MAIN AIM.
MSS
25. STABLE INTERNAL
FIXATION
MECHNICAL ERA
(ABSOULTE STABILITY AND
PRIMARY BONE HEALING )
BIOLOGICAL ERA
(RELATIVE STABILITY AND INDIRECT
BONE HEALING)
MSS