Читать книгу Synopsis of Orthopaedic Trauma Management - Brian H. Mullis - Страница 42

Bone fracture healing is a complex mechanoresponsive process that is biologically regulated by the mechanical conditions at the fracture site over the course of healing. In fracture management, surgeons may stabilize broken bones with plates, intramedullary devices, external fixators, or external splints, casts, or braces. These constructs allow the surgeon to tailor the mechanical environment to suit the individual needs of the patient by selecting the implant length, implant thickness or diameter, screw number, screw type, and screw configuration. Each decision alters the fracture’s biomechanical environment, which in turn determines if the fracture will attempt to heal with callus (relative stability leading to secondary healing) or without callus (absolute stability or interfragmentary compression leading to primary healing). A sound understanding of fracture fixation biomechanics is the foundation upon which a surgeon’s treatment will succeed or fail. This chapter introduced basic definitions and principles of biomechanics as they apply to trauma implants and describe techniques for altering the implant construct mechanics to achieve the desired mode of healing and minimize the risk of premature construct failure.