Riassunto:
Operation on fractures of shafts and joints is chiefly indicated in the upper arm, forearm, femur and tibia. Injuries in these areas can almost always be successfully treated by the techniques described in the "AS IF Manual of Internal Fixation," followed by early exercises. The fixation of small fragments which are of such biomechanical importance, has hitherto given indifferent results, especially when the distal parts of the hand and foot are involved. The implants and instruments developed by Dr. Heim and tried out by AS IF members during recent years have now been assembled into a "small fragment set," which is now available. These implants have significantly expanded the scope of AS IF instrumentation for internal fixation. Pannike first compared the application of the small fragment set with the conventional methods used in hand surgery. Heim and Pfeiffer in cooperation with Meuli, illustrate in this Volume the small fragment set, elucidating in a didactic manner the composition of the set, the indications for its use, and its method of application to all suitable fractures. Enough good results have been secured to establish the usefulness of this development. The following volume may therefore be regarded as an important supplement to the ASIF Manual. It makes it clear again that every internal fixation requires a high level of technical skill, a sense of responsibility, and very gentle handling of the soft tissues.
Contenuti:
I. Introduction and Objectives.- General Section.- II. Implants and Instruments of the SFS.- 1. The SFS Screws.- 2. The SFS Plates.- 3. The Instruments of SFS.- III. General Techniques of Internal Fixation Using the SFS.- 1. Fundamental Principles.- 2. Interfragmentary Compression by Means of the SFS.- 3. Axial Compression by Means of SFS.- 4. Combined Internal Fixation with Small and Large Implants.- 5. Multiple Fractures.- IV. Pre-Operative, Operative, and Post-Operative Guide Lines.- V. Autogenous Bone Graft Combined with the Use of SFS.- VI. The Use of the SFS for Reconstructive Bone Surgery.- 1. Bone Pegging Combined with a Plate.- 2. Graft Interposition Combined with a Plate.- 3. Compressed Bridging Graft Combined with a Plate.- 4. Bone Pegging with Screw Fixation.- 5. Excision of Joint and Subsequent Fixation with a Tension-Band Plate.- 6. Excision of the Joint Followed by Screw Fixation.- Special Section.- VII. Introduction and Summary.- VIII. The Elbow.- 1. Lower End of Humerus.- 2. Radial Head.- 3. Olecranon.- 4. Secondary Operations on the Elbow.- 5. Clinical X-Ray Examples.- IX. The Wrist Joint.- 1. Lower End of Radius.- 2. Lower End of the Ulna.- 3. Scaphoid Bone.- 4. Other Parts of the Carpus.- 5. Clinical X-Ray Examples.- X. The Hand.- A. Introduction.- B. Injuries to and Internal Fixation of the First Ray.- 1. Fractures of the Base of the First Metacarpal.- 2. Peripheral Fractures of the First Ray.- 3. Secondary Operation on the First Ray.- 4. Statistics Referring to the First Ray.- 5. Clinical X-Ray Examples.- C. Injuries to, and Internal Fixation of the II–V Rays.- 1. Approaches.- 2. Fractures of the Second to Fifth Metacarpals.- 3. Articular Fractures.- 4. Shaft Fractures of the Proximal and Middle Phalanges.- 5. Secondary Operations of the Second to Fifth Rays.- 6. Statistics about the Second to Fifth Rays.- 7. Clinical X-Ray Examples.- XI. The Ankle Joint.- A. Lower Tibia.- 1. Comminuted Fractures of the Lower Tibial Epiphysis.- 2. Depressed Comminuted Fracture.- 3. Secondary Surgery.- B. Malleolar Fractures.- 1. Introduction and Indications.- 2. Lateral Internal Fixations.- 3. Medial Malleolar Fixation.- 4. Secondary Intervention after Malleolar Fractures.- C. Fractures of the Talus.- D. Clinical X-Ray Examples.- XII. The Forefoot.- 1. Tarsal Bones.- 2. Metatarsus and Toes.- 3. Secondary Operation on the Forefoot.- 4. Clinical X-Ray Examples.- XIII. Special Locations.- A. Upper Limb.- 1. Clavicle.- 2. Scapula.- 3. Humerus.- B. Lower Limb.- 1. Knee.- 2. Tibial Shaft.- C. Mandible.- D. Clinical X-Ray Examples.- XIV. Special Indications.- 1. Internal Fixation in Children.- 2. The Use of the SFS in Open Fractures.- 3. Special Orthopaedic Indications.- 4. The Use of the SFS in the Surgery of Rheumatoid Deformities.- 5. Clinical X-Ray Examples.- References.
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