Osteogenic sarcoma associated with internal fracture fixation in two dogs.
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Wiring of the radius marrow in 96 children with fractures of the lower arm or radius always gave adequate stability compared with purely conservative treatment (54 children). Any danger of delayed discovery of secondary dislocation with all its risks can thus be definitely excluded. The method is safe and relatively quick, done in conjunction with any necessary repositioning. Hospitalisation is reduced to a few days,until soft-tissue swelling has gone. Open alignment is indicated only very rarely, in otherwise unresponsive fractures. The small scar at the wrist is acceptable even for girls.
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In the operative treatment of fractures there are special principles for plating by support. Osteosynthesis is indicated for comminnuted fractures and bone defects in the metaphysis. Plating for distance also is established for fractures and pseudarthroses with defects in the diaphysis. This method is especially recommended for fractures of the head of the tibia and for reconstructing the pilon tibial.
The serious complications following fractures in the region of the elbow joint are frequently avoidable by selection of adequate methods of treatment. The advantages of operative in comparison with semi-conservative methods of treatment are presented here in relation to our own patients.
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Seventy-two pathological fractures associated with tumors other than carcinoma of the breast in the long bones of the extremities of sixty patients were treated over a five-year period at Roswell Park Memorial Institute. Pain was relieved in 91 per cent of the patients treated by internal fixation, in 59 per cent of those treated by irradiation, and in 45 per cent of those treated by other means. Among patients with lower-extremity fractures, 61 per cent of those treated by internal fixation became ambulatory, whereas only 23 per cent of those treated by other methods were able to walk. Internal fixation of these pathological fractures appeared to be the best treatment.
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