Abstract
Non-union occurs when bone healing ceases and does not continue without some type of intervention. Classification of non-union is traditionally based on the amount of callus or bone healing at the fracture site. Successful treatment of non-union often depends on appropriate reduction and realignment of the fracture, bone grafting if necessary, and stabilization. This may not be possible in some neglected and complicated non-unions. Under these circumstances, modification of the standard techniques or a limited surgical interference, that might not be anatomical, may succeed in improving function. We present four cases of non-anatomical salvage solutions for difficult long bone non-unions with satisfactory functional outcome.
Highlights
Non-union is defined chronologically as a fracture that does not unite in six months, or biologically when the healing process is lingering behind the expected rate [1]
Classification of nonunion is traditionally based on the amount of callus or bone healing at the fracture site
Successful treatment of a non-union often depends on appropriate reduction and stabilization of the fracture, in addition to bone grafting if necessary [5]
Summary
Non-union is defined chronologically as a fracture that does not unite in six months, or biologically when the healing process is lingering behind the expected rate [1]. Classification of nonunion is traditionally based on the amount of callus or bone healing at the fracture site. The environment is vascular and the healing potential is excellent, so inadequate immobilization or stabilization usually creates the non-union [3]. Atrophic non-unions are characterized by absence of callus formation. The fracture will not heal without changes to promote vascularity, such as introduction of living cells (autograft and/or free or rotational tissue transfer), removal of infection, and/or resection of nonviable bone [4]. Successful treatment of a non-union often depends on appropriate reduction and stabilization of the fracture, in addition to bone grafting if necessary [5]. In some neglected and complicated nonunions, anatomical open reduction and internal fixation
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