Therapeutische Umschau. Revue thérapeutique
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Comparative Study
[Biological internal fixation -- guidelines for the rehabilitation].
The process of fracture healing restores the biological and mechanical state of the bone tissue. In contrast to other tissues, bone has the unique capacity to heal through a real repair process resulting not in a scar but in a regular reconstitution of its original tissue structure. During the last two decades, the understanding of bone biology continuously evolved leading to the new concept that preservation of the viability of the bone fragments is the key to unimpaired fracture healing. ⋯ The mechanical efficiency of this new plate generation is enhanced due to its possibility for angular stability screw insertion; load transfer by friction can be replaced by a load transfer by interlocking (internal fixator), reducing the biological interference of this implant (no contact implant). Functional rehabilitation with painfree mobilization needs to be performed carefully because the loading capacity of the biological plate osteosynthesis is low until radiological signs of bone healing via callus formation is visible. Clinical signs of overload and radiological indicators of potential mechanical failure of the fixation have to be identified by the general practitioners, and the compliance of the patient has to be controlled during the rehabilitation phase to avoid complications after biological internal fixation.