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At least 343 records · Page 19Linked to original sources
PubMed1988

[Fibrin adhesive in the surgical treatment of pseudarthrosis of the scaphoid bone--method and results].

In 50 cases of pseudarthrosis of the scaphoid bone the operative technique of Matti and Russe was applied using fibrin adhesive in addition to a cortico-cancellous bone graft from the iliac crest to secure the fixation of the graft. 48 patients were re-examined. 27% showed bone consolidation after 3 months, 60% after 6 months or more. The total consolidation rate was 87%. It is not quite sure whether the better results are due to fibrin adhesive or not, especially when the consolidation took place after 6 month or more.

Adult↗
PubMed1989

[The femoral neck pseudarthrosis following medial femoral neck fracture. An indication for the vascularized pedicled iliac crest transplant].

Revascularisation surgery was performed in six cases following medial femoral neck fracture with femoral head necrosis and non-union of the femoral neck. A corticospongiosis pelvic graft supplied by the deep circumflex iliac artery was implanted as an autologous heterotopic pedicled transplant. The operative procedure was the same in all cases, since it was possible to lift out the pelvic graft from the same side as the affected hip joint, thus making a microvascular anastomosis unnecessary. Follow-up examination after 15-27 months revealed that, in all cases, osseous consolidation of the pseudarthrosis had been achieved and that further segmental collapse of the contour of the femoral head had been prevented. The angiographic studies performed during the examination demonstrated unimpeded circulation in the pedicle of the transplants in five of the six cases, as long as 3 months after the operation. For the first time it was possible in these five cases, by means of a transplant angiograph, to demonstrate integration of the graft into the biologically weak post-traumatic transplant region.

Bone Transplantation↗
PubMedDate not supplied

Congenital forearm pseudarthrosis: report of six cases and review of the literature.

Congenital forearm pseudarthrosis is a rare clinical entity; only 27 cases have been reported in the English literature. The radius and ulna are affected with nearly equal frequency. Involvement of both bones is extremely rare. Most cases have been associated with neurofibromatosis, which appears to affect adversely the ability to obtain union by conventional corticocancellous grafting. We present a series of six patients treated by various methods. In two of our patients we obtained promising results, as did Allieu et al., by utilizing free vascularized fibular transfer. This may provide an attractive solution to a condition which is historically refractory to conventional operative management.

Child↗
PubMed1989

[Results of the treatment of clavicular pseudarthrosis].

The problems encountered with pseudarthrosis of the clavicle reviewed with reference to 28 patients. Non-union was posttraumatic in 25 cases, due to osteotomy in 2, and postradiation in 1. The preceding treatment had been conservative in 16 cases and surgical in 12. In 26 cases ORIF was performed, with additional bone grafting in 21 cases. Symptoms leading to operation were pain and weakness of the shoulder. In addition, plexus irritation was present in 3 and a thoracic outlet syndrome in 2 cases. At follow-up, bony healing had been achieved in 24 of the 26 cases. No symptoms were present in 23 patients, and these all had a normal ROM of the shoulder. In 1 patient - who had undergone multiple previous operations and local irradiation - slight pain and limited motion were observed despite bony union. In 2 cases non-union is still present, with persistent symptoms.

Clavicle↗
PubMed1989

[The Herbert screw in the treatment of fractures and pseudarthrosis of the carpal scaphoid. Review of 25 cases].

The Authors have reviewed the charts of 25 patients with scaphoid lesions treated with the Herbert screw and this study reports their personal experience. Between September 1983 and December 1986, 4 fresh fractures, 5 delayed unions and 16 pseudarthrosis were treated by means of this osteosynthesis procedure. The mean follow-up was 22 months. Bony union occurred in 21 patients. The series contains 2 failures defined as an absence of bony union after a post-operative delay of more than 6 months. There were 2 other cases considered as doubtful unions on X-rays. Wrist function, nevertheless, was restored in 23 patients. Plaster immobilization did not appear to be essential for every case. The short leave of absence, averaging 2 months only, is also in favour of this technique.

Adolescent↗
PubMed1989

[Congenital pseudarthrosis of the legs and the Ilizarov method. Apropos of 4 cases].

Four cases of congenital pseudarthrosis were treated by the Ilizarov method and consolidation obtained by 3.5 months in three patients who had all undergone several previous surgical procedures. Although the length of follow up is short (maximum 3.5 years) consolidation occurred quicker than by traditional methods. This technique also permitted both simultaneous correction of axial malalignment and leg lengthening. We think that this method has a place as a salvage procedure except where the distal fragment is very thin or dystrophic.

Adolescent↗
PubMed1989

[Intercarpal pseudarthrosis as a complication of Graner's operation].

Since 1978 eighteen patients were treated for Kienböck's disease by the Graner procedure. The satisfactory long-term results can be explained by the preservation of the radiocarpal joint. By restoring fairly congruent joint surfaces, secondary radiocarpal joint arthrosis, which affects long-term results, may be avoided. Employing Graner's procedure, the authors observed two cases with pseudarthrosis within the intercarpal arthrodesis. They interpret this complication to be a result of micro-movements with the new bone block in the former midcarpal joint level. These movements may be avoided by careful removal of all the cartilage from all joint parts which are to be fused.

Adult↗
PubMedDate not supplied

Spinal pseudarthrosis in ankylosing spondylitis.

Spinal pseudarthrosis is an important mechanical complication in longstanding ankylosing spondylitis. Thirty-five patients with 40 lesions were studied. Three lesions through vertebral bodies resulted from complete fractures. The rest occurred at interspaces, more common at the lower thoracic and upper lumbar segments. Double pseudarthrotic lesions were observed in 5 patients. Progressive osteolysis of the anterior elements was prominent, with variable sclerosis, osteophytes, vacuum phenomenon, subluxation and fragmentation. A posterior element weak link, as a bony break or facet joint non-fusion, was an essential component in every lesion, playing an initiating or perpetuating role in its pathogenesis. Mechanical derangement from trauma, severe round kyphosis, spondylodiscitis, hip disease, spinal operation and unusual activities may be contributing factors. Initial treatment is conservative, but 16 patients required operative stabilisation.

Adult↗
PubMed1977

Treatment of congenital pseudarthrosis of the tibia with direct current.

Bone possesses a bioelectric property that is important in maintaining its structural and architectural integrity. In vivo experiments demonstrate that bone formation can be accelerated by the application of direct current. We hypothesize that bone formation occurs through an electrochemical rather than an electromechanical effect. Two cases of congenital pseudarthrosis of the tibia treated by direct current stimulation are presented. A bone graft may be added to enhance bony union in conjunction with direct current. The implications of this work are that there is need for further fundamental studies including ultrastructural observations.

Adolescent↗
PubMed1988

Management of resistant pseudarthrosis of long bones.

A retrospective review was undertaken of 15 patients with long-bone pseudarthrosis with long-standing nonunion. These patients were referred to a tertiary care center after their fractures failed to unite after numerous surgical attempts as well as a course of electrical stimulation. Fourteen patients had nonunion of the tibia, and one had nonunion of a humerus fracture. Twelve were originally Gustillo Grade II or III fractures, and four sustained multiple injuries. The average duration of nonunion before presentation to the clinic was 22.5 months. Five patients presented as infected nonunions. Each nonunion was analyzed with specific reference to injury mechanism, skin and bone conditions, presence of infection, primary treatment protocol, and selection criteria for treatment with electrical stimulation. Review of the data revealed that the most common factor associated with failure of electrical stimulation treatment was inappropriate patient selection, according to criteria previously published for the use of these techniques. Treatment modalities consisted of intramedullary fixation in three, open reduction and internal fixation using Arbeitsgemeinschaft fur Osteosynthesefragen (AO) technique in nine, and external fixation in three. All patients were bone grafted. The mean follow-up duration was 1.5 years. Nonunions were healed in fourteen patients. Twelve were fully weight bearing at six months, and one at 12 months. Success was defined as restoration of a functional extremity, giving a success rate of 87%. A thorough reevaluation of the original treatment regimen and a return to basic principles of operative fracture management and bone grafting can yield excellent results, even in patients with recalcitrant nonunion.

Adult↗
PubMed1987

[Pseudarthrosis of the scaphoid bone. Experiences in 240 cases].

The results after treatment of 197 non-union of scaphoid fractures are reported. The operative technique of Matti-Russe, called also Russe I, has proved successful in cases in which the fracture is located in the middle or distal third of the scaphoid or where there is a viable small proximal fragment. Bone healing depends more on the age of the pseudarthrosis than on the age of the patient. In 86% of 83 cases the technique of Russe I was successful and in this group the period between accident and treatment was no longer than two years. After a period of more than four years after the accident the success rate is only 54%. The combination of the technique of Russe I with styloidectomy of the radius diminishes the number of good results. The operative technique known as Russe II assumes a good blood supply of the distal fragment of the scaphoid. In 15 cases, after resection of the necrotic small proximal fragment of the scaphoid, a fungiform bonegraft from the iliac crest was placed in the cavity and the success rate was 80%. The findings after palliative treatment of 43 non-unions of the scaphoid are based on subjective criticisms by the patients. The denervation of the wrist and the wrist arthrodesis were done in 28 cases. After resection of the necrotic proximal fragment, a tendon interposition arthroplasty was performed in nine cases, and in six cases a prosthesis for the proximal part of the scaphoid was implanted.

Bone Transplantation↗
PubMed1987

Synovial pseudarthrosis: a clinical, roentgenographic-scintigraphic, and pathologic study.

Seventy-six patients with synovial pseudarthrosis were reviewed. This is a distinct pathologic entity which is a different form of nonunion. The humerus, femur, and tibia were the bones most commonly involved. Routine roentgenograms were not beneficial but 99mTc scans were useful for identifying this entity in 93% of cases. Light and electron microscopy revealed normal synovial lining tissue. Motion and infection may lead to the development of this condition. The results of treatment were a 43% success rate in infected cases and 59% for noninfected cases, which is far different from that of regular nonunion.

Diagnosis, Differential↗
PubMed1987

Ligamentotaxis in pseudarthrosis of the scaphoid bone (preliminary report).

Three cases are reported of pseudarthrosis of the scaphoid bone which have been treated by distraction with an external fixator employing ligamentotaxis. The investigations of Ilizarov and collaborators are discussed, pertaining as they do to stimulation of osteogenesis by distraction. Also considered are the possible indications for use of the method in some unfavourable fresh fractures of the scaphoid.

Adult↗
PubMed1986

Preliminary observations on epiphyseal growth rate in congenital pseudarthrosis of tibia after free vascularized fibular graft.

Observations were made on the growth rate of proximal and distal tibial epiphyseal growth plates in three children treated by free vascularized fibular grafts for congenital pseudarthrosis of the tibia. Postoperative measurements show that the distal tibial epiphysis can grow faster than the proximal epiphysis; the successful transfer of vascularized fibula may increase blood supply to the distal tibial epiphyseal plate, thus stimulating its growth.

Child, Preschool↗
PubMed1986

The treatment of noninfected pseudarthrosis of the femur and tibia with locked intramedullary nailing.

Sixty-six cases of noninfected nonunions (27 femoral and 39 tibial) were treated with an interlocking nail. In these cases, 92.6% of the femurs and 94.8% of the tibias healed after the first operation in a mean time of 15.4 and 13.0 weeks, respectively. Deep infection complicated five nailings (7.5%, two femur and three tibia), which included three patients with reactivation of latent osteomyelitis. All cases healed after debridement and use of gentamicin PMMA beads. In one case the nail had to be removed and replaced by an external fixator. Residual angulation between 5 degrees and 10 degrees occurred in three femurs and seven tibias. Shortening occurred in all patients and averaged 0.9 cm in the femur and 0.5 cm in the tibia. Of the patients treated for femoral nonunion, 92.5% achieved full hip flexion and 77.8% full knee flexion on final follow-up examination. In patients with tibial nonunions treated with a locked nail, 92.3% had normal knee flexion and 84.6% obtained normal ankle function. Interlocking nailing offers unique advantages to patients with femoral or tibial shaft pseudarthrosis. The technique allows early weight-bearing, range of motion of adjacent joints, and reliable rates of consolidation of the nonunions.

Adolescent↗
PubMed1985

Congenital pseudarthrosis of the forearm.

Early treatment of congenital pseudarthrosis of the forearm is necessary to prevent permanent angulation and shortening of the forearm with resulting loss of function. Total replacement of defective bone and complete excision of the destructive, abnormal fibrous tissue seem to be essential if an effective treatment is to be accomplished.

Child↗
PubMed1978

The treatment of infected pseudarthrosis.

Modern tendencies in the treatment of infected pseudarthrosis are discussed and compared with the methods of the recent past. Seventy four cases are analysed in detail. Fifty three were in the tibia, twenty six of which were treated by a standard modern technique consisting of osteomuscular decortication, excision of infected tissues and necrotic bone, external fixation and if necessary the addition of autoplastic cancellous grafts. The main purpose of this study was to analyse these results and assess the validity of this method.

Abscess↗
PubMed1985

Surgical treatment of infected pseudarthrosis of the humerus.

The authors report 16 cases of infected lesions of the humerus with delayed consolidation or pseudarthrosis. The treatment consisted of radical surgical debridement, freshening of the bone fragments with removal of all necrotic tissue, and stabilisation with a Hoffmann-Vidal external fixation device. Healing occurred between 3 and 6 months after operation. The one case of failure was attributable to inappropriate technique (inadequate resection of the ends of the fragments).

Debridement↗