By Dr. med. Ch. F. Brunner, Professor Dr. med. B. G. Weber (auth.)
and refinement that exists in the inevitably strict ideas of the inner fixation procedure. during this method we search to give a contribution to as weIl as to stimulate the quest for rational options to surgical difficulties. it truly is assumed all through that the reader is fa miliar with the technical basics of inner fixation, and so those information are passed over. as a substitute, particular symptoms and technical refinements are awarded at the foundation of case examples. simply because an never-ending number of occasions can come up in orthopedic surgical procedure (a situation that's attracting increasingly more surgeons to the field), we've got taken ca re that our examples can effortlessly be utilized to novel occasions. We now credits, in alphabetic order, those that contributed so much to the innovations offered: R. BLATTER, A. BOITZY, C. BRUNNER, O. CECH, A. DEBRUNNER, F. MAGERL, G. SEGMÜLLER, G. STÜHMER, and B.G. WEBER. We therefore exhibit due to these colleagues in our medical institution who agreed to having their rules released. yet we're additionally thankful to our illustrators, H. and okay. SCHUMACHER, our photographer, M. SCHAFFNER, and our leader secretary, U. OETLIKER, who contributed quite a bit to the training of the manuscript. ultimately, we thank Springer-Verlag for his or her endurance with us and especiaUy for his or her effective paintings in bringing the publication to press. St. GaU, Fall 1981 CH.F. BRUNNER B.G. WEBER Contents Lag Screws ............. .
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Extra resources for Special Techniques in Internal Fixation
Tension band loop in a transverse metacarpal fracture. , Ö', age 32, No. 176315. a Metacarpal shaft fracture: Typical angulation due to traction from the palmar muscles. b Wire tension band system: Dorsal traction from the palmar muscles is neutralized by the wire-Ioop tension band, and the fracture is compressed. c Postoperative roentgenogram: Dorsal figure-of-eight wire loop. d Thirteen months after injury: Complete recovery "Tension Band" Wire on the Diaphysis a c, d 41 42 Wire Loop Example 2: Neglected Monteggia fracture in a child.
154287. a Fraeture-disloeation with avulsion of the tubercles. b Scheme of operation: The shaft is impaeted into the head fragment, the tubercles are redueed against the shaft, and a wire-loop tension band is applied whieh engages the rota tor euff. c Postoperative status. 29) The problem: A faulty osteotomy performed for recurrent dislocation of the shoulder has resulted in pseudarthrosis with dislocation of the humeral head. The rota tor cuff is lax, and the bone is porotic. The solution: After rem oval of the old implants, the humeral head is reduced on the shaft in valgus.
This greatly enhances stability, ensuring asolid interspinous, interlaminar, and intertransverse fusion despite early mobilization. The problem: In the lumbar region the articular surfaces are inclined in such a way that direct screw fixation is not always possible. The solution: With cross-screw fixation, optimum compression can be exerted perpendicular to the articular surfaces. In this way stability is vastly improved. The screw holes are drilled through the spinous process, and correspondingly long screws are used.
Special Techniques in Internal Fixation by Dr. med. Ch. F. Brunner, Professor Dr. med. B. G. Weber (auth.)