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High friction compression in the treatment of complicated fractures of the lower extremity.

Charnley's compression clamps have hastened the union of cancellous bones but not much success has been obtained in the slender shafts of cortical bones. The principles of biophysics show that a fracture site under compression acts as a hinge joint. If friction is increased in such "joints" along indicated axes, immobility of the fracture fragments can be obtained and lead to bone union. We have developed a modified device based on Charnley's compression clamps to create high friction compression. We successfully applied it in the treatment of eight fractures of the shafts of the femur or tibia which would not unite because of infection, soft tissue interposition or gross incongruity of fragments. The mechanical aspects of creating friction with the device are discussed.