Skip to main content
SpringerLink
Log in

Non-Operative Treatment of Long Bone Fractures in Adults

  • Reference work entry
  • First Online:
European Surgical Orthopaedics and Traumatology

  • 385 Accesses

Abstract

This chapter describes the possibilities of no-touch fracture healing by closed manipulation in aldult long shaft bones. The clinical part is – out of necessity – precided by pointing out the biology of fracture healing. Furthermore, we will draw attention to the fracture anatomy and its deforming forces. The main goal of this text is to provide the reader with a basic guidline for his personal practice. Hence, throughout the second and clinical part of the text, we will try to make a clear distinction between suitable and non-suitable fracture types for closed treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 649.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 949.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Schmitz MA, Finnegan M, Natarajan R, Champine J. Effect of smoking on tibial shaft fracture healing. Clin Orthop Relat Res. 1999;365:184–200.

    Article  PubMed  Google Scholar 

  2. Chen F, Osterman AL, Mahony K. Smoking and bony union after ulna shortening osteotomy. Am J Orthop. 2002;31:518–21.

    CAS  Google Scholar 

  3. Burd TA, et al. Heterotopic ossification prophylaxis with indomethacin increases the risk of long bone non union. J Bone Joint Surg Br. 2003;85:700–5.

    CAS  PubMed  Google Scholar 

  4. Augat P, Simon U, Liedert A, Claes L. Mechanics and mechano-biology of fracture healing in normal and osteoporotic bone. Osteoporos Int. 2005;16:36–43.

    Article  Google Scholar 

  5. Thomas TL, Meggitt BF. A comparative study of methods for treating fractures of de distal half of the femur. J Bone Joint Surg Br. 1981;63(1):3–6.

    PubMed  Google Scholar 

  6. Trueta J. Blood supply and the rate of healing of tibial fractures. Clin Orthop Relat Res. 1974;105:11–26.

    Article  PubMed  Google Scholar 

  7. Nelson Jr GE, Kelly PJ, Peterson LFA, Janes JM. Blood Supply of the Human Tibia. J Bone Joint Surg Am. 1960;42:625–36.

    PubMed  Google Scholar 

  8. Whiteside LA, Lesker PA. The effects of extraperiosteal and subperiosteal dissection. I. On blood flow in muscle. J Bone Joint Surg Am. 1978;60:23–6.

    CAS  PubMed  Google Scholar 

  9. Strachan RK, McCarthy I, Fleury R, Hughes SPF. The role of the tibial nutrient artery. J Bone Joint Surg Br. 1990;72:391–4.

    CAS  PubMed  Google Scholar 

  10. Nicoll EA. Fractures of the tibial shaft- a survey of 705 cases. J Bone Joint Surg Br. 1964;46:373–87.

    CAS  PubMed  Google Scholar 

  11. Court Brown CM. External casting of diaphyseal fractures of the tibia and fibula. Curr Orthop. 1998;12:262–72.

    Article  Google Scholar 

  12. Schatzker J, Tile M. The rationale of operative fracture care. 2nd ed. Berlin/Heidelberg/New York: Springer; 1996.

    Book  Google Scholar 

  13. Gregson T. Tibial cast wedging A simple and effective Method. J Bone Joint Surg Br. 1994;76(3):496–7.

    CAS  PubMed  Google Scholar 

  14. Millner SA. A More accurate method of measurement of angulation after fractures of the tibia. J Bone Joint Surg Br. 1997;79:972–4.

    Article  Google Scholar 

  15. Kristensen KD, Kiaer T, Blicher J. No arthrosis of the ankle 20 years after malalignedtibial shaft fracture. Acta OrthopScand. 1989;60(2):208–9.

    Article  CAS  Google Scholar 

  16. Ellis H. Disabilities after tibial shaft fractures. J Bone Joint Surg Br. 1958;40(2):190–7.

    PubMed  Google Scholar 

  17. Van Der Schoot DKE, Den Outer AJ, Bode PJ, Obermann WR, Vught AB. Degenerative schnages at the knee and ankle related to malunion of tibial fractures: 15-year follow-up of 88 patients. J Bone Joint Surg Br. 1996;78:722–5.

    PubMed  Google Scholar 

  18. Bostman OM. Spiral fractures of the shaft of the tibia: initial displacement displacement and stability of reduction. J Bone Joint Surg Br. 1986;68(3):462–6.

    CAS  PubMed  Google Scholar 

  19. Phieffer LS, Goulet JA. Insructional course lecture. Delayed union of the tibia. J Bone Joint Surg Am. 2006;88(1):205–16.

    Google Scholar 

  20. Noordeen MH, Lavy CB, Shergill NS, Tuite JD, Jackson AM. Cyclical micromovement and fracture healing. J Bone Joint Surg Br. 1995;77(4):645–8.

    CAS  PubMed  Google Scholar 

  21. Sarmiento A. Cast Treatment of Tibial Fractures. J Bone Joint Surg Am. 1967;49:855–75.

    CAS  PubMed  Google Scholar 

  22. Sarmiento A, Gersten LM, Sobol PA, Shankwiler JA, Vangsness CT. Tibial Shaft Fractures treated with Functional Braces. Experience with 780 fractures. J Bone Joint Surg Br. 1989;71:602–9.

    CAS  PubMed  Google Scholar 

  23. Sarmiento A, Sharpe FE, Ebramzadeh E, et al. Factors influencing the outcome of closed tibial fractures treated with functional bracing. Clin Orthop Relat Res. 1995;315:8–24.

    PubMed  Google Scholar 

  24. Ekholm R, Adami J, Tidermark J, Hansson K, Tornkvist H, Ponzer S. Fractures of the shaft of the humerus. An epidemiological study of 401 fractures. J Bone Joint Surg Br. 2006;88(11):1469–73.

    Article  CAS  PubMed  Google Scholar 

  25. Brennan S, Murphy D. Fractures of the human diaphysis- degree of distraction in hanging cast and high rate of non union. J Bone Joint Surg Br. 2010;92(suppl II):349–50.

    Google Scholar 

  26. Laing PG. Arterial blood supply of the adult humerus. J Bone Joint Surg Am. 1959;38:1105–16.

    Google Scholar 

  27. Healy WL, et al. Retrospective review of records of 26 patients with non-union of the humeral shaft. Clin Orthop. 1987;219:206–13.

    PubMed  Google Scholar 

  28. Pehlivan O, Ilyas BC. Functional treatment of the distal third humeral shaft fractures. Arch Orthop Trauma Surg. 2002;122(7):390–5.

    PubMed  Google Scholar 

  29. Sarmiento A, Horowitch A, Aboulafia A, Vangsness Jr CT. Functional bracing for comminuted extra-articular fractures of the distal third of the humerus. J Bone Joint Surg Br. 1990;72(2):283–7.

    CAS  PubMed  Google Scholar 

  30. Sarmiento A, Kinman PB, et al. Functional bracing of the fractures of the shaft of the humerus. J Bone Joint Surg Am. 1977;59:596–601.

    CAS  PubMed  Google Scholar 

  31. Balfour GW, Mooney V, Ashby ME. Diaphyseal fractures of the humerus treated with a ready made fracture brace. J Bone Joint Surg Am. 1982;64:11–3.

    CAS  PubMed  Google Scholar 

  32. Hunter SG. The closed treatment of fractures of the humeral shaft. Clin Orthop. 1982;164:192–8.

    PubMed  Google Scholar 

  33. Sarmiento A, Zagorsky JB, Zych GA, Latta LL, Capps CA. Functional bracing for the treatment of fractures of the humeral diaphysis. J Bone Joint Surg Am. 2000;82:478–86.

    Article  CAS  PubMed  Google Scholar 

  34. Koch PP, Gross PF, Gerber C. The results of functional (Sarmiento) bracing. J Shoulder Elbow Surg. 2002;11:143–50.

    Article  PubMed  Google Scholar 

  35. Ekholm R, Ponzer S, Tornkvist H, Adami J, Tidermark J. The Holstein-Lewis humeral shaft fracture: aspects of radial nerve injury, primary treatment and outcome. J Orthop Trauma. 2008;22(10):693–7.

    Article  PubMed  Google Scholar 

  36. Larsen LB, Bargfred T. Radial nerve palsy after simple fracture of the humerus. Acta Orthopscand. 1991;62(2):148–53.

    Article  Google Scholar 

  37. Schatzker J, Tile M. Fractures of the humerus. Rationale of operative fracture care. 3rd ed. Berlin/Heidelberg/New York: Springer; 2005.

    Google Scholar 

  38. Shah JJ, Bhatti NA. Radial nerve paralysis associated with fractures of the humerus. A review of 62 cases. Clin Orthop. 1983;172:171–6.

    PubMed  Google Scholar 

  39. Holstein A, Gwilym B. Fractures of the humerus with radial-nerve paralysis. J Bone Joint Surg Am. 1963;45:1382–8.

    CAS  PubMed  Google Scholar 

  40. Strycker WS, Fussel ME, West HD. Comparison of the results of operative and non-operative treatment of diaphysial fracture of the femur at the navel hospital, San Diego, over a five year period. In Proceedings of the American academy of orthopaedic surgeons. J Bone Joint Surg Am. 1970;52:815.

    Google Scholar 

  41. Rothwell AG. Closed kuentschner nailing for comminuted femoral shaft fractures. J Bone Joint Surg Am. 1970;52:815.

    Google Scholar 

  42. Dencker H. Shaft fractures of the femur a comparative study of the results of the various methods of treatment in 1003 cases. Acta Chir Scand. 1965;130:173–84.

    Google Scholar 

  43. Kooistra G, Femoral shaft fractures in adults. A study of 329 consecutive cases with a statistical analysis of different methods of treatment. Assen, The Netherlands. Van Gorcum & Comp. 1973.

    Google Scholar 

  44. Iqbal QM. An appraisal of the treatment of femoral shaft fracture: open versus closed. Med J Aust. 1976;1(11):392–5.

    CAS  PubMed  Google Scholar 

  45. Crotwell WH. The thigh-lacer: ambulatory non-operative treatment of femoral shaft fractures. J Bone Joint Surg Am. 1987;60:112–7.

    Google Scholar 

  46. Wardlaw D. The cast brace treatment of femoral shaft fractures. J Bone Joint Surg Br. 1977;59(4):411–6.

    PubMed  Google Scholar 

  47. Tudor LT, Meggitt BF. A comparative study of methods for treating fractures of the distal half of the femur. J Bone Joint Surg Br. 1981;53(1):3–5.

    Google Scholar 

  48. Schweigel JF, Gropper PT. A comparison of ambulatory versus non-ambulatory care of femoral shaft fractures. J Trauma Infect Crit Care. 1974;14(6):474–81.

    Article  CAS  Google Scholar 

  49. Rothwell A. Closed Kuentschner nailing for comminuted femoral shaft fractures. J Bone Joint Surg Br. 1982;64(1):12–6.

    CAS  PubMed  Google Scholar 

  50. Hughston JC. Fracture of the distal radial shaft: mistakes is management. J Bone Joint Surg Am. 1957;39:249–64.

    PubMed  Google Scholar 

  51. Tare RR, Garfunkel AI, Sarmiento A. The effect of angular and rotational deformities of both bones of the forearm. J Bone Joint Surg. 1984;66(1):65–70.

    Google Scholar 

  52. Ring D, et al. Monteggia fractures in children and adults. J Am Acad Orthop Surg. 1998;6:215–24.

    CAS  PubMed  Google Scholar 

  53. Rettig ME, Raskin KB. Galeazzi fracture dislocation: a new treatment oriented classification. J Hand Surg Am. 2001;26(2):228–35.

    Article  CAS  PubMed  Google Scholar 

  54. De Boeck H, Haentjens P, Handelberg F, Casteleyn PP, Opdecam P. Treatment of isolated ulnar fractures with below elbow plaster cast. A prospective study. Arch Orthop Trauma Surg. 1996;115:316–20.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, University Hospital, Brussels, Belgium

    J. Fabry & Pierre-Paul Casteleyn

Authors
  1. J. Fabry
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pierre-Paul Casteleyn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Fabry .

Editor information

Editors and Affiliations

  1. Royal National Orthopaedic Hospital, Stanmore, United Kingdom

    George Bentley

Rights and permissions

Reprints and permissions

Copyright information

© 2014 EFORT

About this entry

Cite this entry

Fabry, J., Casteleyn, PP. (2014). Non-Operative Treatment of Long Bone Fractures in Adults. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34746-7_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-34746-7_7

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-34745-0

  • Online ISBN: 978-3-642-34746-7

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation