Delayed unions and non-unions in fractures of the shaft of long bones are by a very large majority man-made, as an analysis reveals that the attending surgeon in such cases has failed to observe the basic principles of fracture treatment. The various ways in which the three fracture commandments are daily being broken both by conservative skeletal traction and by operative methods have been described. When the A, B, C's of fracture therapy (A, reduction; B, immobilization; and C, preservation of blood supply) are employed, over 90 per cent. of slow unions are circumvented.
Prevention of non-unions can be achieved by a simple and practical fracture system which calls for direct skeletal control over both proximal and distal fragments. With the use of the dual-transfixation technique, the care of fractures of the extremities is simplified, standardized, and made available to all surgeons, regardless of location, who either by preference or necessity are faced with fracture problems.