Page 173 - ASOP ROT Study Guide

9. A PRACTICAL GUIDE TO FRACTURE MANAGEMENT

If we bear the factors already outlined in mind, we are now equipped to understand a more
pragmatic approach to treating fractures. Remember that the aim of the orthopaedic management
team is to return the individual to their pre-injury level of function by the safest available means.
9.1 Low Energy Injuries
Fortunately most fractures to the shafts of long bones are caused by a low velocity impact with
relatively little soft tissue damage and correspondingly greater fracture stability. These injuries can
be treated by manipulation and casting (Figures 29A, 29B and 29C), provided that holding is
possible. If holding is a difficulty, such as in the femur for example, then traction may be used.
Other methods of holding include functional bracing and internal fixation. Internal fixation may be
justified if this leads to early mobilization of the injured person. If the risk of operation is low,
such as in young people and the fit middle-aged, or the benefit is high, as in the elderly, then
fixation by an experienced surgeon is generally justified.

FIGURE. A TYPICAL WRIST FRACTURES

www.radiopaedia.org