Biological osteosynthesis

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