Bone transport technique versus induced membrane technique for treatment of infected bone nonunion / 中华创伤骨科杂志

Objective To compare the clinical outcomes of bone transport technique versus induced membrane technique for treatment of infected bone nonunion.Methods A retrospective study was made on 46 cases of infected bone nonunion admitted from April 2011 to December 2014.They were 33 males and 13 females,aged from 12 to 68 years (mean,45.3 years),involving 40 tibial and 6 femoral fractures.Bone transport technique was used in 37 cases while 9 cases were treated with induced membrane technique.Fracture union and complications were recorded.The function of the affected limb was evaluated at the final follow-up using Johner-Wruhs criteria.Results The 46 cases were followed up for 9 to 18 months (mean,14 months).In the bone transport group,bone union was achieved after a mean duration of 6.5 months (range,from 4 to 11 months) without complications like wound infection or neurovascular lesions.In the induced membrane group,bone union was achieved after a mean duration of 5.8 months (range,from 4 to 11 months) and there was one case of re-infection.According to the Johner-Wruhs score system,34 cases were rated as excellent,9 as good and 3 as fair,with a total excellent and good rate of 93.5％.Bone transport technique led to 28 excellent,4 good and one fair cases in the patients with tibial nonunion,and one excellent,2 good and one fair cases in the patients with femoral nonunion.Induced membrane technique led to 3 excellent,3 good and one fair cases in the patients with tibial nonunion,and 2 excellent cases in the patients with femoral nonunion.Conclusions Both bone transport technique and induced membrane technique are effective for infected bone nonunion.Bone transport technique may be preferred for tibial infected nonunion while induced membrane technique preferred for femoral infected nonunion.

Treatment of Scaphoid Nonunion with Matti / 대한정형외과학회잡지

The scaphoid is the most commonly fractured carpal bone and the nonunion of the scaphoid has continued to represent a challenge to the surgeon who treats hand injuries. The are many treatment modalities and the technique of bone grafting described by Otto Russe in 1960, which is quite appropriately called the Matti-Russe procedure, has become a well-accepted method of treating nonunion of the scaphoid. And the results of this method has been presented by several authors. At the Department of Orthopedic Surgery, Seoul National University Hospital, From May 1985 to September 1988, ten cases of the scaphoid nonunion had been treated by Matti-Russe procedure and followed up more than 1 year. Fracture healing was observed in all ten cases. Seven patients were totally free of pain both at rest and at excercise and three patients noted moderate pain at excercise. All patient were satisfied with the results of operation and none felt worse.