Using Different Implant Combinations to Improve Fracture Fixation

This chapter highlights fixation techniques combinations that are commonly used in addition to primary fixation methods for osteosynthesis. Cerclage wiring is still a popular technique, used mostly as an additional fixation method. It is quick, and minimally invasive, and increases the stability of fractures but should be used with caution as it may potentially entrap vital structures. Use of poller screws and Kirschner wires along with intramedullary nailing in order to improve fixation and prevent axial malalignment is also discussed. Poller screws narrow the intramedullary cavity to create an artificial fit and provide 3-point fixation. Kirschner wires act as a palisade wall to guide the intramedullary nail into the correct position. The suture anchor is a relatively new device that can assist in stabilizing joints where ligaments are injured. The suture anchor system provides higher primary stability and better outcomes than plate osteosynthesis alone in these situations. Each technique has its own advantages and limitations, and the correct placement of the tools is essential for desired outcomes.