Biological osteosynthesis.

Methods of fracture treatment must strike a balance between fracture stability and soft tissue integrity. With highly comminuted diaphyseal fractures, exhaustive attempts at anatomical reconstruction often fail to achieve a load-sharing fixation and concurrently traumatize the vascular supply of the already damaged tissue. The lack of balance in this scenario makes failure likely. The strategies of biological osteosynthesis are used when the surgeon determines before surgery that anatomical reconstruction of the multiple cortical fragments is unlikely to result in load sharing. In these highly comminuted fractures, better results can be achieved by applying a set of biological osteosynthesis strategies in which preservation of vascular supply to the damaged bone is balanced with rigid fracture fixation.