This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Surgical Interventions  • Orthopedic Surgery  • Alert me on articles by topic

Joseph J. Gugenheim, Jr, MD

JAMA. 2004;291:2122-2124.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

In the presence of adequate stability and vascularity, bone fractures heal with histologically normal tissue, unlike injuries to most tissues, which typically develop fibrous scar tissue. Historically, physicians have sought methods to treat extremity fractures to achieve stability, including casts and internal fixation. Rigid casts made from plaster of Paris or synthetic plastics are noninvasive and inexpensive and can be used for the treatment of most stable fractures. However, casts do not provide adequate immobilization for grossly unstable fractures, and inadequate immobilization may result in nonunion, delayed union, or displacement of fracture segments. Also, casts immobilize muscles and joints adjacent to the fracture, which can result in weakness and fibrosis of muscles, stiffness of joints, and contractures. Because of these potential problems, surgical treatment with internal and external fixation is often indicated for unstable fractures.

Intramedullary nails and plate and screw combinations are . . . [Full Text of this Article]

Types of External Fixators

Indications in Acute Trauma

Indications in Reconstructive Orthopedics

Challenges for the Future

Author Affiliation: Fondren Orthopedic Group, LLP, Texas Orthopedic Hospital, Houston.

RELATED ARTICLE

Bone Fractures
Sharon Parmet, Cassio Lynm, and Richard M. Glass
JAMA. 2004;291(17):2160.
EXTRACT | FULL TEXT