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[Pseudarthrosis of the long bones].
Delayed union affects 5-10% of fractures, with 1-5% developing nonunion (fractures over 6 months old). Management requires classifying nonunions as viable (needing stability) or non-viable (needing biological stimulation) for effective treatment.
Area of Science:
- Orthopedic surgery
- Bone healing research
Context:
- Fractures can lead to delayed union (5-10%) or nonunion (1-5%).
- Nonunion is defined as a fracture lacking healing potential after 6 months.
- Risk factors include patient and fracture characteristics.
Purpose:
- To outline the classification and management of fracture nonunion.
- To differentiate between viable and non-viable nonunions.
- To discuss treatment strategies and alternatives.
Summary:
- Nonunion management involves clinical, radiological, and biological assessment.
- Viable nonunions require enhanced stability (rigid fixation).
- Non-viable nonunions necessitate biological stimulation (bone grafting, decortication).
- Current primary treatment achieves 85-95% bony healing but carries risks.
Impact:
- Provides a framework for classifying and treating challenging fracture nonunions.
- Highlights the importance of tailored treatment based on nonunion type.
- Emphasizes the existence of alternative treatments for nonunion when indicated.
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