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Conversion of Thermal to Electrical Energy patent by G.N.Hatsopoulos

By G.N.Hatsopoulos

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Individual screws may therefore be left in place as they do not produce irritation of the soft tissues. This is also true for deeply inserted implants, especially if their removal is expensive or risky. In older patients, especially if they have a short life expectancy, implants may be left in place without hesitation. In 54 younger patients, plates should normally be removed if at all possible, but cosmetic implications must always be considered. When removing an implant it is not always necessary to re-open the whole of the original incision, but this may be better in difficult parts of the anatomy to ensure that the structures are properly identified.

By closing the tension device with the wrench , precise reduction and axial compression is achieved b Lag screw through a plate: In an oblique fracture, interfragmentary compression may be produced by a lag screw through the plate, if the near cortex is provided with a gliding hole. By this screw the posterior fragment is pulled up to the plate, or the anterior fragment is compressed 34 between the plate and the posterior fragment (see Manual o/Internal Fixation, 1971 , Fig. 38) c Neutralization plate in a fracture with a butterfly fragment : Interfragmentary compression between the two main fragments and the butterfly fragment is achieved by two individual lag screws.

It is also applicable in some segmental fractures. A good example is the oblique fracture of the lower fibula in combination with a spiral fracture of the lower tibia (Fig. 28). Treatment should be concentrated on the dominant fracture, as all stresses must be eliminated in treating multiple fractures. The time factor is important in this type of internal fixation to minimize interruption of blood supply, development of infection and damage to soft tissues, and the technical performance may often be rather difficult.

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