|| Checking for direct PDF access through Ovid
In recent years, the treatment of fractures has evolved away from the rigid, anatomic internal fixation advocated in the 1960s and 1970s toward stable, “biologically benign” internal fixation, utilizing minimal soft-tissue dissection and retraction. Application of this concept appears to avoid complications that can be produced by additional surgical soft-tissue trauma and bone devascularization. Achieving this goal requires the surgeon to assess the degree of soft-tissue injury so as to be able to optimally time the procedure and plan the surgical dissection. Preoperative planning of the location of the internal fixation enables precise placement of the incisions. The author describes techniques of indirect reduction that enable the surgeon to achieve an adequate reduction without the extensive additional soft-tissue dissection previously required to allow fragment manipulation.