[Discontinuous stress compression--therapeutic principles in the treatment of posttraumatic pseudoarthroses]

Post-traumatic infected or noninfected pseudoarthrosis represents one of the therapeutically most resistant problems in contemporary orthopaedics. The incidence of these cases has increased and the problem become even more relevant after mass application of osteosynthetic material was introduced. Without rejecting the classic methods of treatment for infected or noninfected pseudoarthrosis, but with the aim of finding a more functional and more rational therapeutic method, over the past 7 years we have begun to apply a new therapeutic approach in the treatment of pseudoarthrosis, making use of Ilizarov's principle of tensile distraction compression. We have consistently followed the therapeutic schema, applying the method which has been devised at the Kurgan Scientific Research Institute of Experimental and Clinical Orthopedics and Traumatology and making use of the external fixator of the original Ilizarov construction. The basic theoretical postulate on which our entire work has been based is: Dedifferentiation of polyblast cells under the influence of compressive and tensile forces (in rigid fixation conditions) into osteogenic cells. We have treated 168 cases of pseudoarthrosis. After stress compression 59. The average time of fixation was 17,250 days. All patients were ambulatory as early as the second postoperative day with full weight bearing of the affected extremity. Taking into consideration our experiences, we may say that we have been greatly encouraged by our results as they indicated that we were right to continue our work along the same lines.