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Gãy xương chày, xương cánh tay và xương trụ

Chức năng phương thức điều trị là An giằng hiệu quả trong việc quản lý lựa chọn của gãy xương chày, xương cánh tay và xương trụ, đặc biệt là năng lượng thấp chấn thương. Trong trường hợp gãy xương chày, đó là giảm chỉ áp dụng cho gãy ngang và trục gãy xương không ổn định với mức độ chấp nhận | Functional Fracture Bracing Augusto Sarmiento MD and Loren L. Latta PhD Abstract Functional bracing is an effective therapeutic modality in the management of selected fractures of the tibia humerus and ulna particularly low-energy injuries. In the case of tibial fractures it is applicable only to reduced transverse fractures and to axially unstable fractures with an acceptable degree of shortening. The rate of union of tibial fractures after functional bracing is approximately 97 . The initial shortening noted with closed tibial fractures rarely increases with weight bearing. Shortening has been reported to be as little as 12 mm in 95 of patients with angulation of 8 degrees in 90 . Such minimal shortening and angulation do not affect functional results. In closed and type I open diaphyseal humeral fractures treated with functional braces the nonunion rate is approximately 3 . Most of the reported residual angular deformities have been functionally and cosmetically acceptable. For isolated ulnar fractures the nonunion rate is approximately 2 . Functional fracture bracing is predicated on the premise that motion at the fracture site encourages osteogenesis. The method is applicable only to selected fractures and it is necessary to have a clear understanding of its rationale indications and technique. J Am Acad Orthop Surg 1999 7 66-75 The belief that immobilization of a fracture with the joints above and below it is essential for fracture healing has been ingrained in the minds of the orthopaedic community for many generations. The popularization of compressionplate fixation by the AO in the 1960s reinforced the belief that rigid immobilization and interfrag-mentary compression constitute the ideal environment for fracture repair. The introduction of functional fracture bracing also in the 1960s constituted a radical departure from such traditional practices and beliefs. It freed joints adjacent to the fracture and demonstrated that motion at the fracture site .