By Priv. Doz. Dr. Urs Heim, Prof. Dr. Karl M. Pfeiffer (auth.)
The moment English-language variation of the Small Fragment Set handbook was once enthusiastically acquired and speedy went right into a moment printing. In getting ready a 3rd variation, we discovered it essential to revise the textual content greatly and partially restructure it. the explanations for this are quite a few. adventure of contemporary years has introduced technical refinements within the operative therapy of many sorts of small fracture. lots of those alterations stem from the small-fragment-set education courses carried out in Switzerland due to the fact that 1980, and likewise from classes and symposia which were held in different eu international locations and the us. those occasions have been events for a fruitful ex switch of expertise with surgeons who have been severe of our tools. because of this trade, we perceived a necessity either to revise our symptoms and to provide better awareness to substitute ideas. We additionally felt it essential to reply to criticisms of the 1st variations about the catalog-like software lists and illustrations, and the eye given to primary concepts. Many surgeons who paintings or want to paintings with small implants, particularly these practising in another country, are green in operations at the better bones. it really is vital that those colleagues take delivery of a uncomplicated creation to the "biomechanical considering" of the Swiss organization for the learn of inner Fixation (ASIF).
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Additional info for Internal Fixation of Small Fractures: Technique Recommended by the AO-ASIF Group
S-mm hole is drilled through an adjacent plate hole using the green (neutral) end of the DCP drill guide. S-mm cortex tap, and the first screw is inserted An eccentric drill hole is made in the opposite fragment using the yellow end of the DCP drill guide, making sure the arrow points to the fracture. Correct placement of the bit can be checked by looking at the lower part of the drill guide. The hole is tapped and the screw inserted. ~ =::-:="'" b Twice as much compressive displacement can be obtained by inserting a second screw by the same technique.
5-mm DCP can also function as a neutralization plate. In this case all the screw holes are drilled centrally through the green, neutral drill guide. The oval holes of the DCP permits screws to be inserted at an angle if required. This may be necessary to avoid a fracture line or a previously placed lag screw (Fig. 32d). Oblique fracture lines should be compressed with a plate screw whenever possible, as this significantly augments the stability of the fixation (Fig. 32c). 0-mm DCP, the technique is the same, using correspondingly smaller instruments and a smaller compressive displacement.
It is virtually impossible to correct malalignment by drilling new holes. This technique is designed to avoid the two most common errors in this type of internal fixation: - Axial malalignment with use of the T plate. This results from eccentric tensile forces that arise when the fracture is compressed before both screws have been -inserted in the T piece of the plate (Fig. 38 b). - Rotational mal alignment with the oblique L plate. This occurs when the delayed insertion of a screw off the long axis of the plate alters the rotational alignment of the bone (Fig.