Nonunion of the Diaphysis of Long Bones

Pande, Ketan C; Babhulkar, Sudhir

doi:10.1097/01.blo.0000152369.99312.c5

Cited by 111 publications

(63 citation statements)

References 19 publications

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“…These elements are associated with the following: age and osteoporosis, smoking, high energy trauma and comminuted fractures, open fractures with periosteal stripping and inadequate osteosynthesis. Those factors are confirmed by many authors (17)(18)(19)(20). Technical errors were found in the management of the forearm fractures which explains nonunion that was found in our series, namely: a plate of which the most proximal of the three distal screws appeared in the fracture site, the use of a single pin in the ulna pinning (K-Wire) , little filling and consisting of very fine pins, open fractures treated with external fixation.…”

Section: Discussionsupporting

confidence: 85%

Treatment Results Of Diaphyseal Forearm Fractures With Dynamique Compression Plate A Retrospective study of 156 Cases.

Boussakri

Ouaritini

Shimi

et al. 2015

IJMS

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This retrospective study addresses a series of 156 cases of forearm fractures. These 156 cases were managed in the traumaorthopedic department (B4) of Fez University Hospital, Morocco, from May 2008 till January 2013. The purpose of this study is to analyze epidemiological and clinical factors of diaphyseal forearm fractures and the results of their treatment with dynamic compression plate (DCP), as well as the complications and therapeutic errors of this surgical technique. The frequency of hospitalization in the trauma-orthopedic department was 3,96%. Ages ranged between 16 and 83, the average age was 32. 132 patients were male (85%). 90% were managed at the day of trauma. Traffic accidents were the most frequent cause in 52% patients. The fracture was in the left forearm in 65% of patients. 53% of fracture lines were in the middle third of the forearm. 38 fractures were open, and 30 were admitted for polytrauma. Osteosynthesis was performed with dynamic compression plate for all patients. In comparison with the literature, our series shows the predominance of young male patients, with traffic accidents being the cause. Osteosynthesis with dynamic compression plate remains the treatment of choice that provides satisfactory results if the accuracy in this technique was respected.

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Section: Discussionsupporting

confidence: 85%

Treatment Results Of Diaphyseal Forearm Fractures With Dynamique Compression Plate A Retrospective study of 156 Cases.

Boussakri

Ouaritini

Shimi

et al. 2015

IJMS

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“…Approximately 5% to 10% of the 6.2 million fractures occurring annually in the United States develop delayed unions or nonunions [35,45]. Conventionally, nonunions are subdivided into hypertrophic or atrophic and septic or aseptic according to their clinical presentation and specific characteristics [3,7].…”

Section: Introductionmentioning

confidence: 99%

“…Several authors have reported healing rates in over 80% of the cases, mostly with enhancement of the biologic substrate at the fracture site [11,17,29]. Autologous bone graft (ABG) is regarded as the gold standard among the many available alternatives of biologic augmentation with reported efficacy of 87% to 100% [3,4,34,41]. Nevertheless, it is also associated with limited availability, longer operative time, and donor site morbidity [2].…”

Section: Introductionmentioning

confidence: 99%

The Synergistic Effect of Autograft and BMP-7 in the Treatment of Atrophic Nonunions

Giannoudis

Kanakaris

Dimitriou

et al. 2009

Clin Orthop Relat Res

116

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Combining autologous bone graft and recombinant human bone morphogenetic protein-7 (BMP-7) to treat long-bone fracture aseptic atrophic nonunions theoretically could promote bone healing at higher rates than each of these grafting agents separately. We retrospectively reviewed prospectively collected data on patient general characteristics, clinical outcomes, and complications over 3 years to determine the healing rates and the incidence of complications and adverse events of this ''graft expansion rationale.'' There were 45 patients (32 male) with a median age of 43 years (range, 19-76 years). Minimum followup was 12 months (mean, 24.5 months; range, 12-65 months). There were seven humeral, 19 femoral, and 19 tibial nonunions. The median number of prior operations was two (range, 1-7). All fractures united. Clinical and radiographic union occurred within a median of 5 months (range, 3-14 months) and 6 months (range, 4-16 months), respectively. Thirty-nine (87%) patients returned to their preinjury occupation at a mean of 4.2 months (range, 3-6 months). The median visual analog scale pain score was 0.9 (range, 0-2.8; maximum 10), and the median functional score was 86 (range, 67-95; maximum 100) at the final followup. BMP-7 as a bone-stimulating agent combined with conventional autograft resulted in a nonunion healing rate of 100% in these 45 patients.

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“…However, the reported rate of bony union after reamed exchange nailing varies from as high as 100% by Klemm [8], to 78.3% by Hak et al [6], and as low as 53% by Weresh et al [15]. A better understanding of the mechanics of fracture stabilization and of the biological requirements for fracture healing has improved the outcome in these difficult cases [1].…”

Section: Introductionmentioning

confidence: 99%

Plate augmentation leaving the nail in situ and bone grafting for non-union of femoral shaft fractures

Kim

2005

International Orthopaedics (SICOT)

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We reviewed 15 patients with femoral nonunion after interlocking intramedullary nailing treated with plate augmentation and bone grafting with the nail in situ. The mean time from primary nailing to plate augmentation and bone grafting was 10 months. At the time of presentation, the patients had undergone an average of 1.6 operations from the time of their original injury. To achieve stability of the fracture, we applied an AO plate on the lateral aspect of the femur. The retained nail maintained alignment of the fracture, and plating did not require an extensive surgical approach. In all patients, there was visible motion at the fracture site; however, the motion disappeared after plate augmentation. All patients achieved radiological solid union at an average of 7.2 months.

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Nonunion of the Diaphysis of Long Bones

Cited by 111 publications

References 19 publications

Treatment Results Of Diaphyseal Forearm Fractures With Dynamique Compression Plate A Retrospective study of 156 Cases.

Treatment Results Of Diaphyseal Forearm Fractures With Dynamique Compression Plate A Retrospective study of 156 Cases.

The Synergistic Effect of Autograft and BMP-7 in the Treatment of Atrophic Nonunions

Plate augmentation leaving the nail in situ and bone grafting for non-union of femoral shaft fractures

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