During their 20 years of activity members of the Associa tion for the Study of Internal Fixation (AO - ASIF) have made authoritative contributions to the development of internal and external fixation. The close collaboration of surgeons, basic researchers, metallurgists, engineers and the establishment of clinical documentation has made it possible to achieve a solid scientific basis for internal fixa tion. Clear definitions for the standardization of different types of osteosynthesis were possible: interfragmentary compression, splintage and buttressing as well as combina tions of these…mehr
During their 20 years of activity members of the Associa tion for the Study of Internal Fixation (AO - ASIF) have made authoritative contributions to the development of internal and external fixation. The close collaboration of surgeons, basic researchers, metallurgists, engineers and the establishment of clinical documentation has made it possible to achieve a solid scientific basis for internal fixa tion. Clear definitions for the standardization of different types of osteosynthesis were possible: interfragmentary compression, splintage and buttressing as well as combina tions of these three techniques. At the same time a scienti fic and workmanlike instrumentation was developed. The idea was to keep diversification within limits but, however, to assemble a comprehensive collection of implants and in struments to answer all the problems presented by the com plexity of bone operations. Osteosynthesis is a difficult and demanding operative method. Its. claims on the surgeon and the theatre staff are high. Therefore plans have existed for a long time to supplement the "Manual of Internal Fixation" with a de tailed description of the AO Instrumentation, its use and maintenance. Our collaborator FRIDOLIN SEQUIN, graduate engineer, has accomplished this task with expert knowledge. He has organized over many years courses for theatre nurses and has been able from the resulting experience to provide helpful suggestions. When RIGMOR TEXHAMMAR R. N. joined AO-International four years ago, it was natural to include her as a co-author.
I Medical and Scientific Directives.- 1 The Origin and the Goals of the AO.- 2 Bone Heahng.- 3 Successful Internal Fixation.- 4 Failures Following Internal Fixation.- 5 Indications and Goals of Internal Fixation.- 6 Documentation.- II Principles of the AO (ASIF)-Technique and Basic Mechanical Principles.- The Principles of the AO (ASIF) Technique.- 1 Interfragmental Compression.- 1.1 Static Interfragmental Compression.- 1.1.1 Static Compression with External Fixators.- 1.1.2 Static Compression with Lag Screw.- 1.1.3 Static Compression with Plates.- 1.2 Dynamic Compression with the Tension Band.- 2 Splinting.- 2.1 Splints with Load-Bearing Function.- 2.2 Splints without Load-Bearing Function.- 3 Combinations.- 3.1 Lag Screw and Neutralization Plate.- 3.2 Lag Screw and Buttress Plate.- 3.3 Lag Screw and Tension Band Plate.- 3.4 Kirschner Wires and Tension Band Wire.- III Practical Part.- A Instrumentation of the AO/ASIF.- 1 Classification of AO Instruments.- 1.1 Standard Instrument Sets.- 1.2 Additional Necessary Instruments.- 1.3 Special Supplementary Instruments.- 2 Materials Used in AO Instruments and Implants.- 2.1 Metal for Implants.- 2.2 Metal for Instruments.- 3 Instruments for the Screw and Plate Fixation of Large Bones.- 3.1 Basic Instrument Set.- 3.1.1 Standard Instruments.- 3.1.2 Additional Necessary Instruments.- 3.1.3 Special Supplementary Instruments.- 3.2 Screw Set.- 3.2.1 Large AO Screws.- 3.2.2 Use of Screws as Lag Screws (static interfragmental compression).- 3.2.3 Screws for Plate Fixation.- 3.3 The Plate Set.- 3.3.1 Classification of Plates.- 3.3.2 Design Principles of Various Plates.- 3.3.3 Applications of the Plates.- 3.3.4 Use of the Dynamic Compression Plate.- 3.3.5 Use of the Round-Hole Plates.- 3.3.6 Use of the Semitubular Plates.- 3.3.7 Use of the Special Plates (Contoured Plates).- 3.3.8 Bending Instruments.- 3.3.9 Bending and Twisting of Plates.- 4 Instrument Set for Angled Blade Plates.- 4.1 Instruments for Angled Blade Plates.- 4.1.1 Standard Instruments.- 4.1.2 Additional Necessary AO/ASIF Instruments.- 4.1.3 Special Supplementary Instruments.- 4.2 Angled Blade Plates.- 4.2.1 Design.- 4.2.2 Four Main Types of Angled Blade Plates.- 4.3 Use ofthe Angled Blade Plates.- 4.3.1 130° Angled Blade Plates on the Proximal Femur.- 4.3.2 Condylar Plates on the Proximal Femur.- 4.3.3 Condylar Plates on the Distal Femur.- 4.3.4 Osteotomy Plates.- 5 Small Fragment Set.- 5.1 Size Ranges of Small Fragment Instruments and Implants.- 5.2 Instruments for Small Screws and Plates (4.0-3.5-2.7 mm dia.).- 5.2.1 Standard Instruments for Small Screws and Corresponding Plates.- 5.2.2 General Instruments of the Small Fragment Set.- 5.2.3 Additional Necessary Instruments.- 5.2.4 Special Supplementary Instruments.- 5.3 Implants of the "3.5"-Group.- 5.3.1 Small AO/ASIF Screws.- 5.3.2 Small Plates.- 5.3.3 Use of 4.0- and 3.5-mm Screws as Lag Screws.- 5.3.4 Use of the Plates with 3.5-mm (and 4.0-mm) Screws.- 5.4 Implants of the "2.7"-Group.- 5.4.1 Screws.- 5.4.2 Plates for the 2.7-mm Cortex Screws.- 5.4.3 2.7-mm Cortex Screw as Lag Screw.- 5.4.4 Use of the Plates with 2.7-mm Screws.- 5.4.5 Screw-Drill Bit-Tap.- 5.5 Mini Instruments.- 5.5.1 Mini Instruments for 2.0- and 1.5-mm Cortex Screws and Corresponding Plates.- 5.5.2 Special Supplementary Instruments.- 5.6 Mini Implants.- 5.6.1 Mini Screws (2.0 and 1.5 mm dia.).- 5.6.2 Use of 2.0- and 1.5-mm Mini Cortex Screws as Lag Screws.- 5.6.3 Mini Plates for 2.0-mm Cortex Screws.- 5.7 Use of Mini Implants on Bones of the Hand and Foot.- 5.8 Number of Engaged Cortices in Small Bones (During Plating).- 6 Instrument Set for Removal of Broken Screws.- 6.1 Instruments.- 6.2 Use of the Instruments.- 6.2.1 Demaged Hexagonal Screw Socket.- 6.2.2 Broken Screw Head.- 6.2.3 Broken Cancellous Bone Screw or Malleolar Screw.- 7 Medullary Instrument Set.- 7.1 Medullary Instruments.- 7.1.1 Instruments for Medullary Reaming.- 7.1.2 Instruments for the Insertion and Extraction of Medullary Nails.- 7
I Medical and Scientific Directives.- 1 The Origin and the Goals of the AO.- 2 Bone Heahng.- 3 Successful Internal Fixation.- 4 Failures Following Internal Fixation.- 5 Indications and Goals of Internal Fixation.- 6 Documentation.- II Principles of the AO (ASIF)-Technique and Basic Mechanical Principles.- The Principles of the AO (ASIF) Technique.- 1 Interfragmental Compression.- 1.1 Static Interfragmental Compression.- 1.1.1 Static Compression with External Fixators.- 1.1.2 Static Compression with Lag Screw.- 1.1.3 Static Compression with Plates.- 1.2 Dynamic Compression with the Tension Band.- 2 Splinting.- 2.1 Splints with Load-Bearing Function.- 2.2 Splints without Load-Bearing Function.- 3 Combinations.- 3.1 Lag Screw and Neutralization Plate.- 3.2 Lag Screw and Buttress Plate.- 3.3 Lag Screw and Tension Band Plate.- 3.4 Kirschner Wires and Tension Band Wire.- III Practical Part.- A Instrumentation of the AO/ASIF.- 1 Classification of AO Instruments.- 1.1 Standard Instrument Sets.- 1.2 Additional Necessary Instruments.- 1.3 Special Supplementary Instruments.- 2 Materials Used in AO Instruments and Implants.- 2.1 Metal for Implants.- 2.2 Metal for Instruments.- 3 Instruments for the Screw and Plate Fixation of Large Bones.- 3.1 Basic Instrument Set.- 3.1.1 Standard Instruments.- 3.1.2 Additional Necessary Instruments.- 3.1.3 Special Supplementary Instruments.- 3.2 Screw Set.- 3.2.1 Large AO Screws.- 3.2.2 Use of Screws as Lag Screws (static interfragmental compression).- 3.2.3 Screws for Plate Fixation.- 3.3 The Plate Set.- 3.3.1 Classification of Plates.- 3.3.2 Design Principles of Various Plates.- 3.3.3 Applications of the Plates.- 3.3.4 Use of the Dynamic Compression Plate.- 3.3.5 Use of the Round-Hole Plates.- 3.3.6 Use of the Semitubular Plates.- 3.3.7 Use of the Special Plates (Contoured Plates).- 3.3.8 Bending Instruments.- 3.3.9 Bending and Twisting of Plates.- 4 Instrument Set for Angled Blade Plates.- 4.1 Instruments for Angled Blade Plates.- 4.1.1 Standard Instruments.- 4.1.2 Additional Necessary AO/ASIF Instruments.- 4.1.3 Special Supplementary Instruments.- 4.2 Angled Blade Plates.- 4.2.1 Design.- 4.2.2 Four Main Types of Angled Blade Plates.- 4.3 Use ofthe Angled Blade Plates.- 4.3.1 130° Angled Blade Plates on the Proximal Femur.- 4.3.2 Condylar Plates on the Proximal Femur.- 4.3.3 Condylar Plates on the Distal Femur.- 4.3.4 Osteotomy Plates.- 5 Small Fragment Set.- 5.1 Size Ranges of Small Fragment Instruments and Implants.- 5.2 Instruments for Small Screws and Plates (4.0-3.5-2.7 mm dia.).- 5.2.1 Standard Instruments for Small Screws and Corresponding Plates.- 5.2.2 General Instruments of the Small Fragment Set.- 5.2.3 Additional Necessary Instruments.- 5.2.4 Special Supplementary Instruments.- 5.3 Implants of the "3.5"-Group.- 5.3.1 Small AO/ASIF Screws.- 5.3.2 Small Plates.- 5.3.3 Use of 4.0- and 3.5-mm Screws as Lag Screws.- 5.3.4 Use of the Plates with 3.5-mm (and 4.0-mm) Screws.- 5.4 Implants of the "2.7"-Group.- 5.4.1 Screws.- 5.4.2 Plates for the 2.7-mm Cortex Screws.- 5.4.3 2.7-mm Cortex Screw as Lag Screw.- 5.4.4 Use of the Plates with 2.7-mm Screws.- 5.4.5 Screw-Drill Bit-Tap.- 5.5 Mini Instruments.- 5.5.1 Mini Instruments for 2.0- and 1.5-mm Cortex Screws and Corresponding Plates.- 5.5.2 Special Supplementary Instruments.- 5.6 Mini Implants.- 5.6.1 Mini Screws (2.0 and 1.5 mm dia.).- 5.6.2 Use of 2.0- and 1.5-mm Mini Cortex Screws as Lag Screws.- 5.6.3 Mini Plates for 2.0-mm Cortex Screws.- 5.7 Use of Mini Implants on Bones of the Hand and Foot.- 5.8 Number of Engaged Cortices in Small Bones (During Plating).- 6 Instrument Set for Removal of Broken Screws.- 6.1 Instruments.- 6.2 Use of the Instruments.- 6.2.1 Demaged Hexagonal Screw Socket.- 6.2.2 Broken Screw Head.- 6.2.3 Broken Cancellous Bone Screw or Malleolar Screw.- 7 Medullary Instrument Set.- 7.1 Medullary Instruments.- 7.1.1 Instruments for Medullary Reaming.- 7.1.2 Instruments for the Insertion and Extraction of Medullary Nails.- 7
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