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Year : 2015  |  Volume : 49  |  Issue : 6  |  Page : 682
The elements of fracture fixation

Former Chairman, Department of Traumatology and Reconstructive Surgery, Klinikum Stuttgart, Stuttgart, Germany

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Date of Web Publication3-Nov-2015

How to cite this article:
Holz U. The elements of fracture fixation. Indian J Orthop 2015;49:682

How to cite this URL:
Holz U. The elements of fracture fixation. Indian J Orthop [serial online] 2015 [cited 2020 Feb 19];49:682. Available from:

Editors: Anand J Thakur

Published: Reed Elsevier India Pvt. Ltd., Gurgaon (Haryana)

2015, ISBN: 978-81-312-4236-0, p. 404

Inspite of several decades of research and experience about fracture fixation as well as continuous innovations in technology and implant designs, we are still facing numerous problems of bone healing, often due to inadequate understanding of mechano-biology in fracture healing.

The third edition of Anand Thakur's "elements of fracture fixation" is a detailed overview of biomechanics, biology, implants and materials relevant to fracture care. To understand the principles of osteosynthesis definitions and the concepts of mechanics are outlined in such a way as to allow easy and accurate perception. Explanatory drawings and diagrams facilitate the comprehension of technical terminololgy which is the basis of discussions about successful or unsuccessful bone healing. Reactions within the specific structures of bone during the healing process are described along mechanical and complex metabolic theories concerning cells, signalling molecules and the extracellular matrix.

Exceptionally good, because rarely elaborated in orthopedic text books, are the remarks concerning implant materials. Clear specifications of objectives are outlined for metals, polymers and bone substitutes.

Most practical and beneficial are the chapters about screws and plates. The designs, the application techniques in various anatomical regions, mechanical effects, hazards and contraindications are described along elucidative graphics. The differences and peculiarities of the locking systems compared to classical plates are worked out intelligible.

The work horse for diaphysial fractures is the intramedullary nail. The effects of splinting the bone with reamed and unreamed nails, locked and unlocked, as well as elastic nails are meticulously described and hints are given how to remove broken implants. A special chapter is dedicated to femoral neck and intertrochanteric fractures. The arguments for simple screw fixation versus dynamic hip screws are highlighted and ideas to the everlasting dispute about intramedullary versus extramedullary devices to stabilize intertrochanteric fractures are stimulating. Furthermore, the concepts of load transfer within the bone using the tension band principle and the principles of external fixation are well drawn.

Finally, the essentials of spinal instrumentation and minimal invasive surgery contribute to an excellent compendium of fracture fixation written by an experienced surgeon for fellows, residents and masters. Reading this book the orthopedic community will benefit in planning, performing and discussing the surgery on a scientific level.

Correspondence Address:
Ulrich Holz
Former Chairman, Department of Traumatology and Reconstructive Surgery, Klinikum Stuttgart, Stuttgart
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-5413.168763

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