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Results for “PSEUDARTHROSIS”

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At least 667 records · Page 37Linked to original sources
PubMed1999

[Surgical treatment of chronic post-traumatic osteomyelitis of the femur in pseudarthrosis, ununited fractures and defects].

The authors have analyzed the results of treatment for chronic posttraumatic osteomyelitis of the femoral bone in 69 cases of ununited fractures, false joints ad femoral bone defects. The treatment included surgical sanation of the osteomyelitic nidus together with aspiration lavage drainage and extranidal osteosynthesis by external fixation as well as local and general antibacterial therapy. In 13 cases free bone autoplasty of the osteomyelitic cavities or defects was used together with spongious structures of iliac bone (crest and wing), in 2 of these patients it was applied for replacement of the large defects of the diaphysis of the femoral bone (8 and 12 cm). In 57 patients surgical treatment was carried out in one stage, a major requisite for this was the opportunity for joining bone fragments inside the open wound after sequestrectomy as well as stable external fixation by the apparatus. This treatment gave successful results in 97% of patients.

Adolescent↗
PubMed1999

[Treatment of ununited fractures and pseudarthrosis of long bones of the lower limbs complicated by osteomyelitis].

123 patients with ununited diaphyseal fractures and false joints of the shin bones (93) and the hip (30), complicated by purulent infection, were treated in the clinic for pyogenic complications and consequences of locomotor traumas of the CITO from 1988 to 1994 years. Most patients were men (110 patients). The posttraumatic period varied from several months to 12 years. Many patients before their admittance to the clinic were not once unsuccessfully operated 69 (56.1%) patients had osseous defects of the thigh and the shin, all patients contractures of joints of the lower extremities as well as substantial trophic disturbances and atrophy of the muscles. 12 patients underwent closed transosseous osteosynthesis by the apparatus of an external fixation. One stage surgery was carried out in 111 patients, which included radical fistulosequestrenecretomy (and when indicated--extended segmental sequestrectomy) and transosseous osteosynthesis by the apparatus of external fixation with the use of the needles, rods, or their combination. The feature of the osteosynthesis depended on the extent of bone defect, which has been developed after sequestrectomy, in the defect up to 4 cm monolocal osteosynthesis was used, in the defect from 5 to 8 cm--bilocal and if it were over 8 cm--multilocal osteosynthesis was preferable. One stage treatment resulted in favourable outcomes in 95.9% of patients: the osteomyelitis was eliminated, the integrity of the bone was restored and in a great majority of cases--the length of the extremity was preserved. The treatment duration was 1.5-2 times less than in commonly used methods.

Adolescent↗
PubMed1999

[Results of the treatment of pseudarthrosis of the tibia by subsurface and extrafocal osteosynthesis].

The results of treatment of 417 patients with pseudoarthroses of the tibia (aged from 17 to 71 years) with the use of various methods: by internal fixation with auto- and allografts, metal plates as well as in the use of extranidal (extralocal) osteosynthesis were analysed. The number of consolidation failures was minimal after autoplasty by Khakhutov and bone autoplasty. The rate of healing after osteosynthesis was substantially lower in internal fixation, than in extranidal (extralocal) osteosynthesis. Inflammatory complications occur less frequently when osteoplasty by Khakhutov was used. The highest rate of complications was observed in tibialization and in bilocal osteosynthesis.

Adolescent↗
PubMed2000

[Pseudarthrosis and non-union of disjunctive talar fractures].

PURPOSE OF THE STUDY: Neck fractures of the talus are rare. Necrosis is the complication most often observed. Mal union or non union are rarely reported: 11 cases of such complications have been treated and are presented with results of surgical treatment. MATERIAL: Seven non unions and 4 mal unions after separation fracture of the talus, presenting with pain and deformity of the hindfoot were treated. The treatment included removal of the fibrous tissue, heel reaxation, bone grafting, peritalar joints arthrodesis. RESULTS: Bone healing was observed in 5 of 7 non unions, and the correction of the hindfoot deformity in 9 of the 11 cases. DISCUSSION: Non union or mal union after separation fracture of the neck of the talus are poorly tolerated, the patients walking with the foot in internal rotation, bearing most of the weight on the lateral border of the foot. Such poor course results from: the less mechanical stiffness of the medial part of the talus, the severity and the comminution of the fracture, insufficienct reduction and fixation, too early weight bearing, and is associated with degenerative changes of peritalar joints. Functional and antomical good results can be obtained with bone healing, hindfoot reaxation and peritalar arthrodesis. We emphasize the interest of X Rays in the examination and the adequacy of a good initial treatment.

Adult↗
PubMed2000

[Intramedullary osteosynthesis for treatment of pseudarthrosis].

The main causes of long bone fractures healing complications are: insufficient vascularisation of the bone fragments and excessive movement in the fracture site. Intramedullary osteosynthesis preceded by intramedullary reaming (internal decortication) ensure refreshing of the bone ends and a good mechanical stabilisation in cases with pseudoarthroses. Long bone fractures healing complications occurring during either conservative or operative treatment can be treated using this method. Intramedullary nailing with reaming usually suffices in the treatment of pseudoarthroses of the lower extremity. Weight bearing stimulates metaplasia of connective tissue into bone. Lack of dynamic compression in the upper extremity requires intramedullary nailing to be supplemented by interlocking of the nail and open external decortication of the fracture site. Several cases of pseudoarthoses treated with intramedullary osteosynthesis are presented.

Fracture Fixation, Intramedullary↗
PubMed2000

[Failure of locked centro-medullary nailing in pseudarthrosis of the humeral diaphysis].

PURPOSE OF THE STUDY: The aim of this work was to assess results after treatment by nailing of nonunion of the humeral shaft. In particular, we focused on consolidation and factors predictive of failure. MATERIAL AND METHOD: A prospective study was conducted in 13 consecutive patients presenting aseptic nonunion of the humeral diaphysis. There were five cases after orthopedic treatment and eight cases after internal fixation. Two patients had iterative nonunions. Locked nailing was performed with three successive types of nails: the Seidel nail in four cases, the Russel Taylor nail in seven, and the ACE nail in two. Anterograde nailing was used for the first three cases and retrograde nailing for the others. All patients were followed regularly in our department. Last follow-up was one to seven years after nailing. RESULTS: Five nonunions (38%) did not consolidate after locked nailing. Consolidation was achieved in the other patients after four to 18 months. The anatomic result was good in these patients. Between the success and failure groups, there was no significant difference in age, gender, type of fracture, first intention treatment, delay from fracture to nailing, type or diameter of the nail, surgical access or not to the fracture site during nailing, or duration of complementary fixation. Anterograde nail insertion, used in our first three patients in this series, appeared to affect shoulder function. The retrograde route was used in other patients and did not appear to have any impact on the elbow itself or the elbow region. DISCUSSION: This clinical study was unable to identify clinical factors explaining failures but did provide several arguments suggesting that defective primary stability of the initial fixation could be incriminated in the failures. CONCLUSION: Centromedullary locked nailing is a simple technique with potential for resolving difficult problems of nonunion. Good functional outcome can be obtained when consolidation is achieved. Rather than abandoning this technique, it would be advisable to conduct further research to determine what factors are determinant in its failures.

Adult↗