Minimax Fracture Fixation

Spanning more than 25 years' experience, this rich compendium of operative problems and solutions is based on the contributions of one of the world's leading orthopedic surgeons, Dr. Bernard G. Weber. The procedures are drawn from approximately 125,000 operations performed at the Orthopedic Department, County Hospital, St. Gallen, Switzerland, and the cases and x-ray series chosen from a collection of 80,000 slides!

Key features:

• Surgical problems and solutions drawn from more than 25 years' experience and 125,000 operations
• Packed with nearly 800 images - including 118 hand-drawn illustrations - clearly depicting important concepts and techniques X-rays chosen from 80,000 slides to provide optimal representations of each case
• Detailed coverage of asepsis and potential complications, outlining the best possible treatment plans

The author's in-depth examination of each case offers you many alternative solutions to a broad range of surgical problems. The extensive scope of findings supported by authoritative text truly makes this an invaluable reference.

1 Asepsis and the risk of infection

• From conventional asepsis to sterile enclosure
• 1.1 Introduction
• 1.2 How does airborne contamination and infection occur
• 1.3 How to lower the number of microbes in operating rooms
• 1.4 Bacteriological investigations
• 1.4.1 Counting of airborne bacteria
• 1.4.2 Swab tests taken from the incision prior to skin closure
• 1.4.3 Swab tests deep from the wound and infection rate
• 1.4.4 Patch tests
• 1.5 Germ spectrum
• 1.6 Sterile enclosure and antibiotics
• 1.7 Actual infection rate report 1999–2000
• 1.8 30 years of surgical clean-air conduct
• 1.8.1 General
• 1.8.2 The enclosure and the separating-wall system
• 1.8.3 The ritual for ultraclean-air surgery
• 1.9 Our body-exhaust equipment
• 1.10 “Nothing learned and everything forgotten”
• 1.11 Conclusions and Summary
• 1.12 Bibliography

2 The MINIMAX principle for fracture care in adults

• 2.1 History, definition, questions
• 2.2 Ideas behind the MINIMAX principle
• 2.3 The AO principles and the MINIMAX principle
• 2.4 Cases—examples of MINIMAX fixations
• 2.5 Summary
• 2.6 Bibliography

3 Lower leg fractures with and without involvement of the ankle joint

• 3.1 Introduction
• 3.2 General points on lower leg fractures and associated lesions of the ankle joint
• 3.3 Classification of lower leg fractures
• 3.1.1 Discussion
• 3.4 Treatment of lower leg fractures
• 3.5 Bibliography

4 Open fractures of the lower leg

• 4.1 General considerations
• 4.2 Prevention of contamination
• 4.3 Fixation techniques
• 4.4 Cases—open lower leg fractures and their MINIMAX treatment
• 4.4.1 Non-standard plate fixations with standard plates
• 4.4.2 Intramedullary nail fixations with limited indication
• 4.4.3 External fixator to be permanently in place for the entire fracture healing period
• 4.4.4 Minimal local internal fixations that need mechanical protection with an external fixator
• 4.4.5 Plate fixation of the fibula for indirect reduction of the tibial fracture and as a stability augmentation of the external fixator
• 4.4.6 Primary removal of devitalized fragments and secondary autogenous bone defect compensation
• 4.4.7 Secondary change to another fixation type
• 4.4.8 Skin lesion management
• 4.5 Summary
• 4.6 Bibliography

5 Trauma of the ankle joint and of its neighborhood

• 5.1 Introduction
• 5.2 Open reduction and internal fixation (ORIF)
• 5.2.1 Type B fibular fracture
• 5.2.2 Posterior lip fragment of the tibia in the absence of a fracture of the medial malleolus
• 5.2.3 Medial malleolus avulsion fragment
• 5.3 Consequences
• 5.3.1 The short fibula
• 5.3.2 The overlong fibula
• 5.3.3 The fibulotibial synostosis
• 5.3.4 Ankle fusion
• 5.3.5 Secondary clubfoot following Salter III/IV fracture of the medial malleolus (desepiphysiodesis)
• 5.4 Achilles tendon
• 5.4.1 Acute Achilles tendon rupture and repair
• 5.4.2 Achilles tendon defect reconstruction
• 5.4.3 ST Hansen muscle transfer (slightly modified)
• 5.4.4 Foot flexors stretching with external fixator
• 5.5 Acute and recurrent ankle sprain
• 5.5.1 Diagnosis of acute and chronic ankle sprain
• 5.5.2 Treatment of acute ankle sprain
• 5.5.3 Treatment of recurrent ankle sprain
• 5.6 Bibliography

6 Biodynamics, classification, and treatment of nonunions

• 6.1 Introduction
• 6.2 The biodynamic classification of nonunions
• 6.3 The treatment of nonunions based on their bioactivity
• 6.3.1 The treatment of aseptic nonunions
• 6.3.2 The treatment of septic nonunions
• 6.4 Treatment knowledge and treatment results
• 6.4.1 The treatment methods of tibial pseudarthrosis
• 6.4.2 The results
• 6.5 Conclusion
• 6.8 Bibliography

7 Autogenous bone transplantation

• 7.1 Introduction
• 7.2 Purpose of the chapter on autogenous bone
• 7.3 Harvesting sites of autogenous bone
• 7.4 Host site preparation
• 7.5 Clinical examples
• 7.5.1 Spine fusions
• 7.5.2 Humerus and forearm
• 7.5.3 Proximal femur
• 7.5.4 Shaft of the femur
• 7.5.5 Shaft of the tibia
• 7.6 Conclusions and summary