Non Union
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OrthoMedia ◽  
2021 ◽  

Kanvar Panesar ◽  
Srinivas M. Susarla

AbstractAccurate evaluation, diagnosis, and management of mandibular fractures is essential to effectively restore an individual's facial esthetics and function. Understanding of surgical anatomy, fracture fixation principles, and the nuances of specific fractures with respect to various patient populations can aid in adequately avoiding complications such as malocclusion, non-union, paresthesia, and revision procedures. This article reviews comprehensive mandibular fracture assessment, mandibular surgical anatomy, fracture fixation principles, management considerations, and commonly encountered complications. In addition, this article reviews emerging literature examining 3-dimensional printing and intraoperative imaging.

2021 ◽  
pp. 175857322110444
Guilherme G Mouraria ◽  
José A S Santos Júnior ◽  
Fernando K Kikuta ◽  
Daniel R Zogbi ◽  
Rafael M Brigatto ◽  

Introduction Fractures of the humeral shaft account for about 3% to 5% of all fractures. Although conservative treatment remains the first choice, there are a number of surgical indications. Minimally invasive plate osteosynthesis shows good functional results. However, complications have been reported, such as non-union. Objective To assess the prevalence and risk factors for non-union after treatment of humeral shaft fractures using minimally invasive plate osteosynthesis. Materials and methods This retrospective study was carried out in patients treated by minimally invasive plate osteosynthesis between 2009 and 2019. Demographic data and variables related to the fracture that could influence bone healing were analysed. The unpaired t-test and Mann–Whitney test were used for the statistical analyses. Categorical variables were analysed using the chi-square test or Fisher's exact test Results The study population showed a male predominance (53 of 75, 70.7%). The average time for fracture healing was 19.8 ± 15.3 weeks. Seven patients developed non-union. Only the presence of an open fracture increased the likelihood of non-union. Conclusions The prevalence of non-union in patients treated by minimally invasive plate osteosynthesis was 9.3%. Patients with open fractures were six times more likely to progress to non-union. Fracture characteristics (Arbeitsgemeinschaft für Osteosynthesefragen classification, fracture location and plate working length) did not influence progression to non-union.

2021 ◽  
pp. 74-75
Yogesh Sharma ◽  
Yogesh Malik ◽  
Dhritobroto Bhattacherjee ◽  
Rijuta De ◽  
Dhruv Gautam ◽  

Introduction: Trochanteric fractures are among the most common injuries which are usually resulting from minimal to moderate physical trauma to areas of bone signicantly weakened by osteoporosis. The greatest problems for the orthopaedic surgeon to treating the unstable trochanteric fracture and the complications (implant failure, varus collapse, non-union) occur from xation that result of instability. The implants have evolved from extramedullary implants like dynamic hip screw to the intramedullary types of PFNA2 nail. 50 patients were included in our study from July 2019 to July 2021. 25 patient Material And Methods : s were treated with PFNA2 (Group I) and 25 patients with PFN (Group II) Nails. Mean blood loss during surgery was 153.8±10.92 Results : & 201.6±38.48 in group I & group II respectively and the mean duration of surgery in group I and group II was 65.24+6.57 min and 85.44 + 11.08 min respectively. Conclusion : We concluded that use of helical blade PFN is certainly better in 31A2.2 and 31A3.3 type of fracture than screw PFN.

2021 ◽  
Vol Publish Ahead of Print ◽  
Donald A Wiss ◽  
John Garlich ◽  
Sohaib Hasmi ◽  
Adam Neustein

2021 ◽  
Vol 11 (10) ◽  
pp. 959
Yen-Chun Huang ◽  
Kuan-Jung Chen ◽  
Kuan-Yu Lin ◽  
Oscar Kuang-Sheng Lee ◽  
Jesse Chieh-Szu Yang

The risk of non-union and prolonged periods of protected weight-bearing still remain unsolved issues after distal femur osteotomy (DFO). To improve the stability, we developed the double chevron-cut technique, which is a modified medial closing-wedge DFO guided by a patient-specific instrument. The purpose of this study was to investigate the feasibility and outcome of this operative approach. Twenty-five knees in twenty-three consecutive patients with genu valgum and lateral compartment osteoarthritis that received double chevron-cut DFO were included. The target of correction was 50% on the weight-bearing line (WBL) ratio. Patient-reported outcomes included the Oxford Knee Score (OKS) and the 2011 Knee Society Score (KSS). The mean of the WBL ratio was corrected from 78.7% ± 12.0% to 48.7% ± 2.9% postoperatively. The mean time to full weight bearing was 3.7 ± 1.4 weeks. Union of the osteotomy was achieved at 11.3 ± 2.8 weeks. At a mean follow-up of 17 months, the OKS improved from a mean of 27.6 ± 11.7 to 39.1 ± 7.5 (p = 0.03), and the KSS from a mean of 92.1 ± 13.0 to 143.9 ± 10.2 (p < 0.001). Three patients developed complications, including one case of peri-implant fracture, one of loss of fixation, and one of non-union. The double chevron-cut DFO followed by immediate weight-bearing as tolerated is effective in treating genu valgum deformity and associated lateral compartment osteoarthritis.

2021 ◽  
Vol 22 (4) ◽  
pp. 23-29
S.O. Khmyzov ◽  
E.S. Katsalap ◽  
M.Yu. Karpinsky ◽  
O.V. Yaresko

Background. Congenital pseudarthrosis of the lower leg bones belongs to the group of orphan diseases and manifests itself in non-union (pseudarthrosis) of the lower leg bones, which leads to the formation of deformity and shortening of the limb, and, as a result, is accompanied by a persistent violation of the limb’s supportability. To date, the question of choosing a surgical technique and optimal fixation in the surgical treatment of congenital pseudarthrosis of the lower leg bones remains unresolved. The purpose was to investigate the stress-strain state of the shin model with pseudarthrosis of its bones in the lower third during their osteosynthesis using a titanium mesh. Materials and methods. Osteosynthesis was simulated with an intramedullary nail, wires, and a block of bone grafts on both shin bones with the imposition of a titanium mesh over the grafts under the influence of two types of compression and torsion loads. Results. Studies have shown that additional fixation of the bone graft block with a titanium mesh allows reducing the stress level at almost all control points of the model of osteosynthesis of the lower leg bones in their congenital pseudarthrosis, both under compression and torsion. As the most positive changes, we can note a decrease in the stress values on the tibia around the nonunion line. This can be explained by the fact that the bone graft block reinforced with a titanium mesh takes on a great load. The same fact contributes to the increase in the level of stress at the lower border of the graft block and tibia. The negative factors include an increase in the level of stress along the line of non-union of the fibula. This is also explained by an increase in the modulus of elasticity of the bone graft block, which further loads the fibula. Conclusions. The use of a titanium mesh for additional fixation of the shin bones in the treatment of their congenital pseudarthrosis has a positive effect on the stress-strain state of the model, which is confirmed by a decrease in the stress level at almost all control points of the model, both under compression and torsion loads. The most positive changes are observed along the line of non-union of the tibia.

Naiara Fernandez-Arroyabe ◽  
Gaspar García-Meléndez ◽  
Ana Raquel De Castro-Almeida ◽  
Francisca Escalona-Perez ◽  
Almudena Pérez-Lara ◽  

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