Mechanics of trauma meeting

The trauma meeting is an integral part of orthopaedic practice. It focuses on the clinical application of biomechanics in the context of the trauma patient. There is no ‘one size fits all’ approach to fracture management, but biomechanical principles apply whichever treatment modality is used.

The management of a trauma patient depends on a number of factors:

• patient factors, e.g. co-morbidities, lifestyle and functional demands

• the nature of the injury, e.g. the fracture pattern, soft tissue involvement, neurovascular status and other associated injuries

• surgical factors, e.g. local expertise and surgeon's preference of treatment.

It is therefore often said in orthopaedics that the management of a fracture depends on the ‘personality’ of the patient, ‘personality’ of the fracture and ‘personality’ of the surgeon.

The aim of this chapter is to highlight biomechanical aspects of different treatment modalities in relation to specific fractures. It is not intended to focus on fracture classifications, on surgical technique or to provide an extensive clinical review of the outcome of treatments. Instead, the chapter focuses on biomechanical interactions between specific fractures and fixation techniques. It therefore illustrates the approach to comparing and contrasting different techniques used in the management of a family of fractures. In order to keep the discussions simple and manageable, key characteristics of implants and general trends in management are presented, and the finer points and controversies have been left out intentionally.