| Abstract: | Workers engaged ih the treatment of fractures now generally agree
that open internal fixation shouId no longer be considered merely as a
procedure supplementary to the long established and well recognized
closed manipulative or instrumental methods of reduction. For frac-
tures of the patella, the oleocranon prcoess, the femoral neck and both
bones of the forearm, as well as for fresh compound fractures and
simple fractures with soft tissue interposition, open internalfixation has
been accepted as the only sure method of securing union with good
alignment and satisfactory function. The success attending open
internal fixation in dealing with the above mentioned fractures led a
number of workers, notabIy Sherman, Darrach and Murray, to advocate
the treatment of simple fractures of the shaft bones in adult patients in
a similar manner. The results secured by these workers during the
past ten years have been sufficiently gratifying to appear to justify their
radicalism and .the continuation of the method (1, 2, 3). However,
many workers still are not willing to accept this method as the treat-
ment of choice for simple fractures of the long bones in the adult.
They contend that, since the closed method of reducing simple fractures
.of the long bones in the adult gives satisfactory results in most
''instances, one shouId not subject the patient to an unnecessary open
.operatjcyn which may be attended by serious complications or even
endanger the patient''s life. But is the closed method of reduction
entirely satisfactory? The fact that so many,techniques of closecl
.reduction have been and still are being devised seems to indicate that, |
