Repositionstechniken der konservativen Frakturbehandlung

While modern orthopedic surgery views open reduction and fixation of fractures as the best treatment strategy, the conservative therapeutic approach with the core principles «closed reduction - external casting - delayed mobilization», poses a currently underestimated and scarcely implemented alternative. Given the correct indication and application of the appropriate reduction techniques adapted for the fracture's morphology and providing stable external casting, the functional outcome is comparable to operative treatment. Children's fractures and fractures of the upper extremities, in particular, represent eligible indications for conservative management. Fractures of the lower extremities, on the other hand, are not as apt to this approach since body weight bearing causes susceptibility to secondary dislocation. Key factor in conservative management of fractures is a functional reduction in length, translation and rotation using the principles of ligamentotaxis. Furthermore, continuous clinical and radiological controls are essential, since secondary dislocation needs to be detected early in order to prevent negative outcome.