Fracture nonunion in long bones: A literature review of risk factors and surgical management

Nicholson, JA; Makaram, Navnit S; Simpson, A. H. R. W.; Keating, JF

doi:10.1016/j.injury.2020.11.029

Cited by 153 publications

(126 citation statements)

References 116 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is a fracture that shows no substantial sign of healing and reveals radiographic pathological changes with the cessation efforts to repair [11]. The underlying causes for non-union of fracture, in general, are multifactorial and may include elderly patients, diabetes mellitus, obesity, poor nutritional status, alcoholism, chronic liver disease, use of corticosteroids, anticoagulation, radiation therapy, and poor patient compliance [12]. Other factors may be associated with delayed or even nonunion are for example open fractures, transverse fracture pattern especially if treated with a hanging cast which may result in fracture distraction, infections, soft tissue interposition, and insufficient immobilization [13].…”

Section: Discussionmentioning

confidence: 99%

Autogenous Onlay Graft with Compression Plate for Treatment of Persistent Humeral Shaft Aseptic Non-union with Failed Previous Surgery

Hashmi

Al-Shara

Al-Edanni³

2021

Open Access Maced J Med Sci

View full text Add to dashboard Cite

BACKGROUND: The humeral shaft fractures have a good rate of union, despite this fact, still there is a significant rate of nonunion after nonoperative treatment and more often after operative treatment. AIM: The aim of the study is to evaluate the autogenous onlay graft with compression plate for treatment of persistent humeral shaft non-union with failed previous surgery both radiological and functional outcome. MATERIALS AND METHODS: A prospective study on twenty patients having persistent aseptic non-union age between 20 and 60 years old, after failed surgical treatment of fractures humeral shaft in Al-Zahra teaching and Al-Kindy teaching hospitals, while infected nonunion, diabetes mellitus, secondary metastasis, smoking, alcoholism, and patients on long medication with corticosteroid were excluded from the study. All our patients were treated with corticocancellous onlay bone grafting harvesting from the ipsilateral upper tibia and compression plating (graft parallel to plate) and follow-up for at least 18 months post-operative to evaluate both radiology and functional using Mayo elbow performance index. RESULTS: All the patients ended with a solid union without hardware failure, and no one patient needs further surgery, even with significant resorption of the graft, there is a good chance of graft re-calcification and solid union with good to excellent functional outcome. CONCLUSION: Very successful solid union results achieve in those patients with established aseptic nonunion and pseudoarthrosis of the humerus.

show abstract

Section: Discussionmentioning

confidence: 99%

Autogenous Onlay Graft with Compression Plate for Treatment of Persistent Humeral Shaft Aseptic Non-union with Failed Previous Surgery

Hashmi

Al-Shara

Al-Edanni³

2021

Open Access Maced J Med Sci

View full text Add to dashboard Cite

show abstract

“…until clinical as well as radiographic evidence is noted we couldn't conclude as non union and the time frame for non union varies for different fracture sites [5] . Types of non union are hypertrophic nonunion (abundant callus formation), oligotrophic non union (poor callus formation) and atrophic non union with no callus formation [7] . Generally Nonunion can occur due to poor blood supply, improper reduction, instability and interposed soft tissues into the fracture site which is the most common scenario in case of medial malleolus nonunion [9] .…”

Section: Discussionmentioning

confidence: 99%

Non-union of medial malleolar fractures

Abilash¹,

Kumar²

2021

Int. J. Orthop. Sci.

View full text Add to dashboard Cite

To assess the functional and radiological outcome of Nonunion medial mallolar fractures treated surgically with cc screw fixation and bone grafting. Materials and Methods:A prospective type of study conducted in our institute with 23 patients, 15 male and 8 female from august 2019 to September 2021. patients who has no signs of union radoilogically with severe disabling symptoms that affects their day to day activities with history of trauma to the ankle before 3 months were assessed clinically and confirmed radiologically as medial malleolar nonunion and were treated surgically with corticocancellous screw fixation and bone grafting postoperatively patients were regularly assessed clinical as well as radiologically outcome was measured using AOFAS and OMAS scoring. Results: Out of 23 patients who were taken up for final study 18 patients got excellent results, 3 patients with good and 2 patients with fair outcome. AOFAS score of 96.53 and OMAS score of 94.86 Conclusion: We conclude from our study that good functional outcome can be obtained for medial malleolus nonunion treated by open reduction with corticocancellous screw fixation and bone grafting followed by regular postoperative follow up and physical therapy.

show abstract

“…Bone regenerate formation also depends on factors that are independent of the patient's attitude towards the therapeutic process. Comorbidities, such as diabetes mellitus or kidney disease, and certain medications may delay bone healing (37). Our team makes careful, rational judgments when qualifying patients for corrective surgeries and always considers potential obstacles in the treatment process.…”

Section: P R E P R I N Tmentioning

confidence: 99%

Changes in the quality of life of patients with Blount’s disease undergoing simultaneous bilateral varus deformity correction with the use of the Ilizarov method.

et al. 2021

View full text Add to dashboard Cite

IntroductionBlount’s disease is a growth disorder of the proximal tibia, which leads to the varus deformity and internal rotation of this bone. The treatment is mainly surgical and involves proximal tibial osteotomy and deformity correction. The aim of this study was to assess the change in the quality of life of patients with tibia vara deformity who underwent correction via the Ilizarov method.Material and methodsA total of 23 Blount’s disease patients who had undergone bilateral varus deformity correction with the Ilizarov method were included in this study. The following parameters were assessed retrospectively: duration of treatment with Ilizarov frames, baseline and postoperative values of the medial proximal tibial angle (MPTA) and mechanical axis deviation (MAD). The quality of life was assessed with a Short Form (SF)-36 survey.ResultsThe study population comprised 13 females and 10 males (mean age of 28.43), in whom the Ilizarov fixators were kept for an average duration of 106.65 days. MAD values diminished significantly after the surgery. We also observed significant increases in the MPTA values. The SF-36 scores increased across all of the questionnaire’s domains, which indicates a significant improvement in the postoperative quality of life.ConclusionsSimultaneous bilateral correction of the varus deformity with Ilizarov external fixators is a safe and effective treatment method. It helps reduce pain and improve gait, which translates to improving the quality of life in all its aspects. The duration of treatment depends to a large extent on the degree of patient cooperation, their attitude, and self-discipline.

show abstract

Fracture nonunion in long bones: A literature review of risk factors and surgical management

Cited by 153 publications

References 116 publications

Autogenous Onlay Graft with Compression Plate for Treatment of Persistent Humeral Shaft Aseptic Non-union with Failed Previous Surgery

Autogenous Onlay Graft with Compression Plate for Treatment of Persistent Humeral Shaft Aseptic Non-union with Failed Previous Surgery

Non-union of medial malleolar fractures

Changes in the quality of life of patients with Blount’s disease undergoing simultaneous bilateral varus deformity correction with the use of the Ilizarov method.

Contact Info

Product

Resources

About