Bone fractures are highly traumatic and often very painful injuries. In the past repair and healing often required long periods of forced rest or non weight bearing on the affected bone as we attempted to reconstruct the bone and literally almost glue it together in what we believe was the best way to repair fractures. Unfortunately complications were common and could sometimes lead to non functional bones and require amputation of limbs.
Thankfully our understanding of bone healing and biomechanics has improved dramatically in the last 20 years. We now know that piecing together a shattered bone is not only not effective, the handling of fragments may decrease their ability to heal. The focus of modern fracture repair is now to transfer weight bearing away from the fracture location and to maintain the orientation of joints above and below / either side of the fracture. Fragments are generally left alone for the body to heal with it’s own natural processes and surgical techniques to minimise interference to blood supply are employed.
Fracture Types
Fractures can be broadly classified into:
Fracture repair techniques
It is generally acknowledged that successful complication free healing for fractures requires surgical intervention and the use of implants to support the fractured limb. There are however a variety of implants and implant systems, each with their advantages and disadvantages. The best option is often a combination of a variety of factors and weighing up the pro’s and con’s of each technique.
Bone Plates
Bone plates and screws have been the mainstay of fracture fixation for the last 40 years in both human and veterinary fractures. Recent advances in the development of locking bone plates will in all likelihood mean they continue to be the preferred method of fracture fixation for most fractures. The technique consists of securing a rigid metal plate to the bone with screws. The plate serves two functions, firstly it provides a rigid mechanism to transfer weight from one side of the fracture to the other, and secondly it brings the fragments into alignment to allow healing in an anatomically correct position.
Pros