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September 9, 1961

The Closed Treatment of Common Fractures

JAMA. 1961;177(10):732. doi:10.1001/jama.1961.03040360068034

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Dr. Charnley should be commended for espousing the cause of "closed" or manipulative reductions of fractures. The operative school of fracture surgeons seems to be in the ascendency today, and the trainee is given an overexposure to this procedure. Certainly more attention should be given the closed method of fracture treatment so that each method could be judiciously applied when indicated. There is no question that the closed method requires more ingenuity, patience, and acceptance of occasional imperfections in appearance and function for the over-all benefit of the patient.

There are several criticisms of the book which I would like to make. ( Such difference of opinion is in the best tradition of traumatologists.)

Dr. Charnley states that "if after two weeks a comminuted fracture [of the radial head] has not recovered an acceptable range of pronation and supination, then excision [of the radial head] can seriously be considered." This statement

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