AO NORTH AMERICA NEWS

AONA Ad Hoc Commitee:
"Unconventional Use of Standard Implants"

by Mike Miranda, M.D., Chairman

In practice, we encounter fractures that cannot be stabilized by the standard techniques of interfragmentary compression, or bypassed by a rod or bridge plate. At other times, we have fractures where the standard techniques can be used, but stability cannot be achieved due to osteoporosis or comminution. In those circumstances, we often use other methods of stabilization, or the available implants in a manner outside their stated indications. Lastly, there are surgeons who have documented (1, 2) more elegant solutions to internally fix bony disruption.

In the two former situations, most surgeons don't have enough cumulative experience to determine whether an unusual or unconventional technique will yield the desired outcome of stable fixation for early functional movement. And the literature is often lacking in data to aid in decision-making in these situations.

Supported by a grant from AO North America, an ad hoc committee was formed to gather individuals interested or experienced in this area to discuss and study these cases in the hopes of determining underlying principles which could be applied, studied and taught. Committee members include George Babikian, Peter Cole, Phil Kreiger, Jeff Mast, Vin Santoro, Ray White, and myself as chairman.

Ad Hoc Committee Chairman Michael Miranda, M.D.

The first meeting of this group was held after the Orthopedic Trauma Association in San Antonio Texas. Supported again by AO North America, the gathering was held at the Marriott, with admittance limited to maintain a classroom-like atmosphere. Fortunately, this small gathering was "top heavy" regarding experience, with Professors Christian Krettek, Rene Marti, Jeff Mast, Tom RŸedi and Ray White participating. The meeting started with an introduction focusing on the contributions of individuals like Professor B.G. (Hardi) Weber (1) and others. After excellent presentations by Peter Cole and Enes Kanlic, Jeff Mast raised the bar to new heights with his own creative constructs. The feedback on the meeting was excellent as an educational experience, and has prompted us to consider another meeting of this committee sometime during 2001.

We are sincerely grateful to AO North America for their support and encouragement.

1. Brunner, Ch. F., Weber, B.G.: Special Techniques in Internal Fixation, 1982, Springer-Verlag.
2. Mast, JW, Jacob, R., Ganz R.: Planning and Reduction Technique in Fracture Surgery, 1989, Springer-Verlag.