Nonunion of the Long Bones: Diagnosis and treatment with - download pdf or read online


By Redento Mora, Luisella Pedrotti, Gabriella Tuvo (auth.), Redento Mora (eds.)

In 2%-7% of all bone fractures, union is not on time or fails. Nonunions of the bones symbolize a problem for orthopedic surgeons and will have a critical mental influence on those sufferers. in addition, the social expense of handling those lesions, frequently requiring a number of strategies, can be quite excessive, and problems on the topic of unsuitable remedy will not be infrequent. this article is predicated at the improvement over a long time of the units and operative innovations of monofocal, bifocal, and multifocal compression-distraction osteosynthesis, in cooperation with the CITO Institute of Moscow and the LNIITO Institute of Riga, and on hundreds and hundreds of operative approaches on noninfected and contaminated nonunions in my view played by means of the authors either within the former Soviet Union, Russia and Italy. the first objective of this publication is to debate at the moment on hand instruments for diagnosing lengthy bone nonunions, to demonstrate the technique of prevention, and to specify the indicators for administration utilizing compression-distraction techniques.

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Same case as in Fig. 1. 4% in Gustilo type IIIA and to 15% in Gustilo type IIIB [4]. In another series, the reported infection rate after operative treatment in open tibial fractures “up to grade IIIA” was 7% [5]. Cordero [6] reported that the incidence of infection in tibial intramedullary nailing is different, depending on the soft tissue damage: 2% in closed fractures, 4% in Gustilo II fractures, 6% in Gustilo IIIA fractures, and up to 18% in Gustilo IIIB type fractures. Open and Closed Fractures The difference between closed and open fractures is sometimes blurred and it is important to try and elucidate the real differences between them.

In: Brighton CT, Friedlander GE, Lane JM (eds) Bone formation and repair. AAOS, Rosemont (Illinois), pp 505–527 Simpson AH, Wood MK, Athanasou NA (2002) Histological assessment of the presence or absence of infection in fracture non-union. Injury 33:151–155 Diagnosis of Infection ANNA MACCABRUNI, REDENTO MORA “Awareness of the infection and knowledge of the event of bone compromised by it are important to the surgeon weighing treatment alternatives and forms of actives intervention” [1]. However, infection developing in fractures is often difficult to diagnose and all the useful diagnostic means must be employed.

In the deep area the reverberation artifacts reappear parallel to the cortical bone which is the scanning object. a b Fig. 5a, b. Ultrasonographic evaluation of bone callus. a Fourth phase: progressive callus formation. b Sixth phase: the cortex is rebuilt Assessment of Fracture Healing - 21 The sixth phase (90–140 days): the bone callus image is clearly outlined and appears reduced in volume (Fig. 5b). Extensimetric Monitoring The echographic controls described provide information on the morphologic aspects and on the biological state of the bone tissue but they allow only an indirect evaluation of its mechanical strength.

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