Mechanical and biological treatment of long bone non-unions

Biasibetti, A.; Aloj, Domenico; Gregorio, Giuseppe Di; Massè, Alessandro; Salomone, C.

doi:10.1016/j.injury.2005.10.013

Cited by 43 publications

(21 citation statements)

References 6 publications

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“…In our study 10 patients of infected nonunion of humerus who were treated with hardware removal, debridement and stabilization in compression with external fixator there was evidence of good bony union in 5 months (range 4 to 6 months), which is comparable to study conducted by Gualdrini et al where the reported union time was 5.5 months after infected nonunion of humerus and 4 months in study done by Biasibetti et al 19,21 Since the nonunion was in the diaphyseal region in all the cases, and because of the co-operative mobilization exercises carried out by the patients there was not much …”

Section: Discussionsupporting

confidence: 88%

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Outcomes of mono-lateral limb reconstruction system in infected non-union of long bones

et al. 2017

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Background: We planned to evaluate functional and radiological outcomes of mono-lateral limb reconstruction system for infected non-union of long bones and to analyse its complications occurring.Methods: It was a prospective study, conducted during period of September 2015 to August 2017 and consisted of 73 cases of these 60 cases were available for final assessment. This infected non-union were classified by AO classification and were treated with mono lateral limb reconstruction system. All the cases were evaluated by ASAMI criteria for bony and functional outcomes. Our mean follow up period was 16.8 months.Results: Among 60 cases of infected non-union with mono-lateral external fixator were followed for mean 16.8 months. According to these ASAMI criteria in our study 26.6% had excellent; 46.6% had good; 16.6% fair; and 10% poor bony outcome. And the functional outcomes were 13.3%, 60%, 16.6%, 10% were excellent, good, fair and poor respectively. Among the cases 50% had pin tract infections and loosening. Two cases pin revision was done. Sinus tract got cleared in all cases except 6 where multiple sinus tracts were present and healing did not occur. There were no infections at the corticotomy site. Delay in the consolidation phase was present in all cases. There was no difficulty in transportation of bone. Post-operatively wound dehiscence in eight cases was managed with split skin graft cover. Limb length discrepancy upto 2.5 cms in lower limb was managed with modified footwear with heel and sole raise. Non-healing fractures united in mean 5.9 months after start of treatment. Non-union site united in 90% cases. Conclusions: Mono-lateral limb reconstruction system is efficient method for treatment of infected non-union of long bones. It has an additional advantage of correcting limb length discrepancies which sometimes occur during the course of treatment.Keywords: Non-union, Infection, Long bones, Limb reconstruction system, External fixator

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Section: Discussionsupporting

confidence: 88%

“…18,19 Functional outcomes were in accordance with bony union we assume it was due to site of non-union's which was in the diaphyseal region in all the cases, and because of the co-operative mobilization exercises carried out by the patients, there was not much of impairment of range of movements.…”

Section: Discussionmentioning

confidence: 65%

Outcomes of mono-lateral limb reconstruction system in infected non-union of long bones

et al. 2017

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“…When envisioning the use of GDFs for treating tendon defects, the use of recombinant proteins seems most relevant. Judging by the successful use of BMP-2 and BMP-7 in orthopedics for bone regeneration (53)(54)(55), it might be possible that recombinant GDFs could be approved for clinical use in the treatment of ruptured tendons with relative ease. It is important to note, though, that the use of megadoses of expensive recombinant proteins might limit this potential use.…”

Section: Figurementioning

confidence: 99%

Molecular targets for tendon neoformation

Aslan¹,

Kimelman-Bleich²,

Pelled³

et al. 2008

J. Clin. Invest.

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Tendons and ligaments are unique forms of connective tissue that are considered an integral part of the musculoskeletal system. The ultimate function of tendon is to connect muscles to bones and to conduct the forces generated by muscle contraction into movements of the joints, whereas ligaments connect bone to bone and provide joint stabilization. Unfortunately, the almost acellular and collagen I-rich structure of tendons and ligaments makes them very poorly regenerating tissues. Injured tendons and ligaments are considered a major clinical challenge in orthopedic and sports medicine. This Review discusses the several factors that might serve as molecular targets that upon activation can enhance or lead to tendon neoformation.

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“…The results of present study is compatible with the study by Gualdrini et al, where the average union time was 5.5 months and in study by Biasibetti. A et al, the union time was 4 months [10,11] . In the present study, among the total cases, superficial pin tract infections was noticed in 48% cases and are responded to oral antibiotics.…”

Section: Discussionmentioning

confidence: 98%

Efficacy external fixator in the management of infected nonunion fractures

Naidu¹

2018

Int. J. Orthop. Sci.

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Management of infected nonunion of fractures is a difficult task for orthopedic surgeons in a manner to create bony stability, in recovery of soft tissue and fracture union. Several surgical treatment modalities have been available like bone grafting, antibiotic treatment, ilizarov methods and free soft tissue transfer. This study was conducted to assess the role of monolateral external fixators in infected nonunion of fractures. A total 40 infected nonunion cases were recruited based on AO classification. Patients with wounds of minimum 3 months were considered as non-draining cases. Blood investigations, microbiological investigation and radiological investigation were done. Special attention was focused on limb length measurements, range of motion of the joints, neuromuscular status and distal vascularity. The final surgical outcome was assessed asper ASAMI'S criteria with grade system. Among the cases, 65% nonunion fractures were observed in femur, 22.5% in tibia and 12.5% in humerus. Superficial pin tract infections was noticed in 48% cases and are responded to oral antibiotics. The final surgical outcome indicates that 90% cases had grade-I & II (excellent and good) recovery from infected nonunion fractures in bony and functional recovery. The monolateral external fixation system is effective and convenient method for the treatment of infected nonunion of long bones and is most reliable to rectify the limb length discrepancies.

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Mechanical and biological treatment of long bone non-unions

Cited by 43 publications

References 6 publications

Outcomes of mono-lateral limb reconstruction system in infected non-union of long bones

Outcomes of mono-lateral limb reconstruction system in infected non-union of long bones

Molecular targets for tendon neoformation

Efficacy external fixator in the management of infected nonunion fractures

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