ABSTRACT
Nonunion is caused by various factors related to fracture characteristics, patient characteristics, treatment, and infection. Aseptic nonunion, is divided into three categories in accordance with the biological activity of the fracture: atrophic nonunion, oligotrophic nonunion, and hypertrophic nonunion. Treatment of nonunion depends on the cause and classification. Here, we report our experiences and review the various causes of nonunion and treatment methods available.
Subject(s)
Humans , ClassificationABSTRACT
[Objective]To probe the probability of autologous platelet-rich glue(PRG) combined with particulate of cancellous bone in treating the aseptic tibial nonunion.[Method]Sixty patients with tibial nonunion in distal 1/3 fragment were randomly divided into 2 groups.Each group had thirty patients.PRG combined with particulate of autogenous cancellous bone was transplanted in the experimental group while particulate of cancellous bone was applied in the control group.The mean time to the operation was 10.5 months(7-36 months) and the average age were 38 years old.The postoperative systemic and local reaction,and X-ray finings of tibial nonunion were observed.The average follow-up was 22 months.According to the Johner-Wruh scoring system the results were statistically analyzed.[Result]At 8 months bony union was all achieved.There was a remarkable difference between those of experimental and control groups.[Conclusion]PRG had an important role in speeding bone healing,and the combination of PRG and particulate of autogenous cancellous bone is an ideal alternative of bone transplantation.
ABSTRACT
[Objective]To analyze the causes for aseptic shaft nonunion of the lower extremities after intramedullary nailing and to observe the therapeutic effects on bone nonunion by the combined technique of internal bone grafting with blocking screws.[Method]In 12 patients suffering from shaft aseptic nonunion of the low extremities(femur:5 cases;tibia:7 cases;hypertrophic nonunion: 8 cases;atrophic nonunion:4 cases),the therapeutic effects of the method of stabilizing the bone segments(exchanging larger nailing plus blocking screws technique),correcting bone deformity(blocking screws technique plus reduction finger) and reinforcing the bone healing capacity(internal bone grafting technique) were observed respectively.[Result]All patients were followed up for 1-2 years(mean 1.5 years) and all nonunions healed.The union rate was 100% and the period required to achieve union was 4.7-13.5 months(mean 7.8 months).All patients felt no pain at last and no complication occured.[Conclusion]Internal bone grafting combined with blocking screws is an effective treatment for aseptic nonunion of the lower extremities after intramedullary nailing.