Restore the patient to optimal functional state
Prevent fracture and soft-tissue complications
Get the fracture to heal, and in a position which will produce optimal functional recovery
Rehabilitate the patient as early as possible
HOW FRACTURES HEAL
Regeneration vs repair
Three phases of healing by callus
Rapid process, rehabilitation slow, low risk
With operative intervention (reduction + compression)
Primary bone healing
Slow process, rehabilitation rapid, high risk
With operative intervention (nailing or external fixation)
Healing by callus
Rapid process, rehabilitation rapid, lesser risk
TREATING THE FRACTURE
Does the fracture require reduction?
Is it displaced?
Does it need to be reduced? (e.g. clavicle, ribs, MT’s)
How accurate a reduction do we need?
alignment without angulation (closed reduction - e.g. wrist)
anatomic (open reduction - e.g. adult forearm )
How are we going to hold the reduction?
Rigid (Internal fixation)
What treatment plan will we follow?
When can the patient load the injured limb?
When can the patient be allowed to move the joints?
How long will we have to immobilise the fracture for?