Percutaneous bone grafting in the treatment of the delayed union and non-union of tibial fractures

Injury ◽  
2002 ◽  
Vol 33 (3) ◽  
pp. 239-245 ◽  
Author(s):  
J. Kettunen ◽  
E.A. Mäkelä ◽  
V. Turunen ◽  
O. Suomalainen ◽  
K. Partanen
Keyword(s):  
Bone Grafting ◽  
Delayed Union ◽  
Tibial Fractures ◽  
Non Union

scholarly journals Titanium Elastic Nailing System (TENS) for Tibia Fractures in Children: Functional Outcomes and Complications

2016 ◽  
Vol 55 (204) ◽  
pp. 55-60 ◽  
Author(s):  
Kapil Mani KC ◽  
Parimal Acharya ◽  
Arun Sigdel
Keyword(s):  
Functional Outcomes ◽  
Skin Irritation ◽  
Limb Lengthening ◽  
Delayed Union ◽  
Tibial Fractures ◽  
Entry Site ◽  
Superficial Infection ◽  
Non Union ◽  
Fractures In Children ◽  
Tibia Fractures

Introduction: Closed reduction and cast application is still regarded as first line treatment for pediatric tibial fractures. Over the past few decades, management of pediatric tibial fractures has shifted more towards operative intervention because of quicker recovery, shorter rehabilitation period, less immobilization, lack of stiffness of adjoining joints, and less psychological impact to the children. Flexible intramedullary nails not only fulfill the above advantage but also maintain alignment and rotation.Methods: This was a retrospective study of pediatric tibial fractures fixed with two titanium elastic nails through proximal ends of bones. Alignment of fracture, any infection, delayed union, non union, limb length discrepancy, motion of knee joint, and fracture union time were measured during follow-up examination.Results: Forty-five patients were enrolled into the study out of which 28 (62.2%) were male and 17 (37.8%) were female. Average age of patient was 9.48±2.17 years and average time taken to heal the fractures (both clinical and radiological) was 11.17±2.81 weeks. There were 2 (4.4%) of malunion, 4 (8.8%) of delayed union, 3 (6.6%) of limb shortening, 2 (4.4%) of limb lengthening, 6 (13.6%) of nail prominence and skin irritation, 2 (4.4%) of superficial infection at nail entry site and one case of re-fracture.Conclusions: Titanium elastic nail fixation is a simple, easy, rapid, reliable and effective method for management of pediatric tibial fractures in patients with operative indications. There may be the chances of complication following the TENS in tibia but these are avoidable as well as manageable with careful precautions. Keywords: complications; functional outcomes; tibia fractures. | PubMed

scholarly journals Platelet-Rich Plasma Combined With Autologous Grafting in the Treatment of Long Bone Delayed Union or Non-union: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Weijun An ◽  
Peng Ye ◽  
Tao Zhu ◽  
Zhizhong Li ◽  
Jianbin Sun
Keyword(s):  
Subgroup Analysis ◽  
Bone Grafting ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Combined Treatment ◽  
Delayed Union ◽  
Long Bone ◽  
Non Union ◽  
Autologous Bone Grafting ◽  
Autologous Bone

Background: Platelet-rich plasma (PRP) has been suggested as an emerging treatment for bone defects. However, whether PRP could enhance the therapeutic efficacy of autologous bone grafting for long bone delayed union or non-union remains unknown. A meta-analysis of randomized and non-randomized controlled trials (RCT and NRCT) was performed to summarize current evidence.Methods: Relevant RCTs and NRCTs comparing the influences of autologous bone grafting on healing of long bone delayed union or non-union with and without PRP were obtained by searching PubMed, Embase, Cochrane's Library, China National Knowledge Infrastructure, and WanFang databases from inception to September 10, 2020. A random-effect model was applied to pool the results with the incorporation of the potential heterogeneity. Subgroup analysis according to study design was also performed.Results: Six RCTs and two NRCTs with 420 patients were included. Compared to patients allocated to autologous bone grafting alone, those allocated to combined treatment with PRP and autologous bone grafting were not associated with higher rates of radiographic bone healing [risk ratio (RR): 1.06, 95% confidence interval (CI): 0.99–1.13, P = 0.09; I2 = 24%] or excellent/good posttreatment limb function (RR: 1.14, 95% CI: 0.95–1.37, P = 0.37; I2 = 0%) but was associated with a shorter healing time (mean difference: −1.35 months, 95% CI: −1.86 to −0.84, P < 0.001; I2 = 58%). Subgroup analysis according to study design showed similar results for the above outcomes (P-values for subgroup difference all >0.10).Conclusions: Combined treatment with PRP and autologous bone grafting may be effective to accelerate the healing of long bone delayed union or non-union compared to autologous bone grafting alone.

scholarly journals Operative fixation for complex tibial fractures

2012 ◽  
Vol 94 (1) ◽  
pp. 34-38 ◽  
Author(s):  
AJP Hutchinson ◽  
AE Frampton ◽  
R Bhattacharya
Keyword(s):  
English Literature ◽  
Surgical Techniques ◽  
Delayed Union ◽  
Tibial Fractures ◽  
Fixation Technique ◽  
Non Union ◽  
Fixation Techniques ◽  
Secondary Procedures ◽  
Operative Fixation ◽  
Tibial Shaft Fractures

INTRODUCTION The management of open tibial shaft fractures remains challenging. Intramedullary nailing and external fixation are the most commonly used fixation techniques although the optimal fixation technique remains unresolved. In this article the outcomes of these two surgical techniques are compared. METHODS A comprehensive literature search was conducted through MEDLINE® using Ovid® and MeSH (Medical Subject Heading) terms for articles published in the English literature between 1999 and 2009. The outcome measures compared were time to fracture union, infection rates and complications. RESULTS Forty-one studies were identified, of which only three met the inclusion criteria. The average time to union was variable. Delayed union and non-union appeared to be more prevalent in the external fixator group although this was not statistically significant. Both techniques were associated with secondary procedures as well as infection. CONCLUSIONS The current literature indicates little evidence to suggest the superiority of one fixation technique over another for open tibial fractures.

Failure of Surgery for Scaphoid Non-Union is Associated with Smoking

2006 ◽  
Vol 31 (3) ◽  
pp. 252-255 ◽  
Author(s):  
C. P. LITTLE ◽  
B. J. BURSTON ◽  
J. HOPKINSON-WOOLLEY ◽  
P. BURGE
Keyword(s):  
Bone Grafting ◽  
Smoking Prevalence ◽  
Screw Fixation ◽  
Delayed Union ◽  
Proximal Pole ◽  
Non Union ◽  
Scaphoid Fractures ◽  
The Uk ◽  
Vascularized Bone

Scaphoid fractures predominantly affect young men, in whom the UK smoking prevalence approaches 40%. We examined the association between smoking and failure of non-vascularized bone grafting and screw fixation for scaphoid non-union and delayed union in a retrospective cohort study. Adequate follow-up was obtained in 64 of 87 patients treated (74%). Union was defined as the presence of trabecular continuity on at least two films from a four-view radiographic series. Union was achieved in 47 of 64 cases. Seventeen were smokers. Thirteen of the 17 patients with non-union were smokers (relative risk 3.7; 95% CI: 1.3–10.1, p = 0.005). Proximal pole fractures, long injury-grafting interval and non-compliance were not more frequent in smokers than non-smokers. Smoking is strongly associated with failure of union after screw fixation and non-vascularized bone grafting of the scaphoid. Smokers should be advised to avoid smoking pre-operatively and during the healing period.

scholarly journals A Rare Presentation with Segmental Gap Non-union in Proximal Phalanx Fracture of Thumb in Child: A Case Report

2021 ◽  
Vol 11 (9) ◽  
Author(s):  
Pankaj K. Sharma ◽  
Vinit K. Verma ◽  
Raj S. Potalia
Keyword(s):  
Bone Grafting ◽  
Functional Outcomes ◽  
Pediatric Population ◽  
English Literature ◽  
Proximal Phalanx ◽  
Delayed Union ◽  
Delayed Presentation ◽  
Rare Presentation ◽  
Non Union ◽  
Sporadic Cases

Introduction:Traumatic injuries of to hand are not uncommon in the pediatric population and most of them are managed by conservative means and rarely surgical intervention required. There is a very rare incidence of delayed union or non-union in these fractures and found a very few numbers of sporadic cases documented in English literature. Case Report:We described delayed presentation of post-traumatic gap non-union of proximal phalanx of thumb in a child who presented with severe disability of hand especially writing and grasping. He was managed as open reduction, tibial strut bone grafting, and internal fixation with crossed Kirchner wire and followed for a period of minimum of 2 years. The fracture united radiologically and healed well clinically, whereas functional outcomes were excellent. There was no difficulty in writing and activity of daily living with operated hand while having comparative cosmetic appearance to other hand. Conclusion:Non-union of phalanx fractures are very rare in the pediatric population whereas excellent clinical and functional outcomes can be achieved with adequate stable fixation and autologous bone grafting. Keywords:Gap non-union, proximal phalanx, fracture, skeletally immature, tibial strut graft

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