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Fracture Repair Course, By Bone - Coggle Diagram

- - - - 100% Granulation tissue
      - 10% Cartilage
      - 2% Bone
- - - - Oblique
      - transverse
      - Spiral
      - Simple comminuted with large bony segments
    - - Lag screws
      - Cerclage Wires
      - These allow inter fragmentary compression
      - Cannot use these alone
      - Plates
  - - - Small muscle attachments to comminuted fragments will also align
        
        Can be done by hanging leg technique
- - - - less soft tissue impingement but harder to remove
- - - - Apply tension while twisting
      - 3 twists minimum
    - - Exception = minimal soft tissue such as medial tibia, can bend but also twist at the same time
- - - - ~7 degrees side to side
      - ~25 degrees aong the length of the plate
  - - - Still 7 degrees side to side
      - 40 degrees along length
  - - - Compression
      - Neutralization
        
        Spiral fractures
      - Bridging
        
        Span length
    - - Humerus
        
        Lateral surface - get entire length of bone
        
        Medial
        
        from mid to distal area of humerus
        
        Adv: Less movement of bone in this area
      - Radius
        
        Cranially
        
        Medially
        
        Adv: Longer screws and avoiding extensor tendons
      - Lateral or caudal surface
    - - Femur
        
        lateral surface
      - Tibia
        
        Medial surface
        
        Occasionally cranial
  - - - Used to attach plates to bone
      - Also as lag screws for inter fragmentary compression
      - Compress periosteum
    - - More aggressive thread
      - Used in cancellous bone
      - Weaker
    - - With locking plates
      - Stronger as they have wire diameter
      - Preserve blood supply of periosteum
    - - Blunt
      - Self tapping - more common
    - - Green end for neutral screws
        
        Will be neutral/in the middle
        
        No compression caused
      - Gold is for compression
        
        Slightly offset screw
        
        Tightens so there is compression
    - - Used in transverse and very short oblique fractures
      - Use one neutral screw and one compression screw to bring pieces together
      - Drill neutral screw first
      - Reduce fracture
      - Drill compression screw
      - As it slides down the oval entry the plate also solids bringing the pieces together
    - - Used to bring two fragments together
      - Placed perpendicular to Fx line
      - Equidistant to screw edges
      - Drill a larger hole in the proximal cortex
    - - Must be placed perpendicular to fracture line
      - At least 1 screw head away from edge of fracture