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Related Experiment Videos

Refractures: a consequence of impaired local bone viability.

S B Kessler1, S Deiler, M Schiffl-Deiler

  • 1Chirurgische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, Klinikum Innenstadt, Federal Republic of Germany.

Archives of Orthopaedic and Trauma Surgery
|January 1, 1992
PubMed
Summary

Avascular necrosis of bone can lead to refractures by delaying healing and creating stress risers. Sufficient immobilization is crucial to allow bone repair and prevent refracture, especially before implant removal.

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Area of Science:

  • Orthopedic Surgery
  • Bone Biology
  • Traumatology

Background:

  • Avascular necrosis (AVN) complicates fracture healing and can cause refractures.
  • The role of AVN in refracture pathogenesis is under-recognized.
  • Surgical trauma and periosteal stripping exacerbate bone necrosis.

Purpose of the Study:

  • To investigate the role of avascular necrosis in the pathogenesis of bone refractures.
  • To determine optimal fracture immobilization duration for healing in cases of AVN.
  • To highlight the importance of radiographic assessment before implant removal.

Main Methods:

  • Retrospective evaluation of 28 refractures in 25 patients.
  • Biopsies were performed in 14 patients to assess bone viability and healing.

Related Experiment Videos

  • Analysis of fracture healing, vascular invasion, and bone substitution in necrotic areas.

    • Main Results:

    • Cortical necrosis delays fracture gap bridging, creating stress risers that predispose to refracture.
    • Inadequate immobilization duration can lead to refracture, particularly after resuming activity or implant removal.
    • Sufficient immobilization allows vascular invasion and new bone formation in necrotic segments.

    Conclusions:

    • Avascular necrosis is a significant factor in refracture development.
    • Extended fracture immobilization is necessary to ensure complete healing of necrotic bone.
    • Radiographic monitoring for fracture gap healing is essential prior to implant removal to prevent refracture.