![]() ![]() 1 Egypt was also the site of the earliest examples of active fracture care (e.g., splints) on an unhealed femur fracture, dated around 300 b.c. 1 The earliest documentation of fracture care was in the Egyptian “Edwin Smith” papyrus, circa 1600 b.c. Through the 20th century, the nonsurgical treatment of closed fractures (i.e., when bone is broken, but skin intact) have been the standard of care. This may be of particular benefit to patients with higher surgical risks, minimizing exposure to treatments that are not only more invasive and expensive, but that can impose greater postoperative risks. Nonoperative methods for closed fractures can sometimes be more safely delivered even with more difficult fractures. CONCLUSIONSīased on the results of this literature review, orthopedic providers should consider the preferable outcomes associated with nonoperative fracture management such as lower infection rates, the possibility of rapid functional improvements and lower healthcare costs. In this paper, the authors review the history of closed extremity fracture treatments, outline contemporary studies regarding treatments of non-displaced fractures, and discuss the recent literature that has informed orthopedic surgeon-patient decision-making discussions regarding closed fracture management. More recently, there has been an increased promotion in the medical literature to evaluate the clinical outcomes of nonsurgical treatment of common upper and lower extremity closed fractures. Over the last 150 years, aseptic technique, anesthesia, antibiotics, and internal implants have changed how orthopedic specialists approach fracture care. Fracture treatment has been documented since the times of ancient Egyptian and Greek civilization, with fracture reduction techniques and the apparatus for immobilization developed over three millennia. ![]()
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