Biological osteosynthesis

It has been stated that effective fracture treatment requires both the cons truction skills of a carpenter and the nurturing abilities of a gardener.(4 , 18). The carpenter strives for adequate mechanical stability of the recon structed bony column, and the gardener nurtures the tissue bed to make it c apable of fostering the growth of new bone. Because the efforts of the carp enter to reconstruct the bony column may conflict with the goals of the gar dener to preserve soft tissue viability, these two roles of the orthopedist must be balanced against one another. This has been referred to as the "co ncept of balance in fracture treatment."(2) Treatment of highly comminuted diaphyseal fractures requires the balance shift away from anatomical recons truction and toward preservation of the biological potential for bone heali ng. This concept in fracture treatment is called biological osteosynthesis. (14) Other terms used more or less synonymously include bridging osteosynth esis and indirect reduction.(14, 21) Bridge plating and biological plating are terms that denote the concept of biological osteosynthesis applied in c onjunction with the use of bone plating systems.(16, 21)