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At least 919 records · Page 51Linked to original sources
PubMed1990

[Reconstructive surgical procedures in scaphoid pseudarthrosis].

Operative procedures for application in scaphoid nonunion are limited by secondary changes of wrist and carpus. The choice of treatment is determined by the degree of vascularization of the fragments. Bony union can be achieved by means of an autogenous free bone graft if there is adequate vascularization of at least one fragment. In the case of extensive impairment of the blood supply, a bone graft on a vascular pedicle is recommended. The postoperative stability of the fragments is of decisive importance for consolidation of the nonunion. The localization and orientation of the nonunion and the extent to which the blood supply is impaired determine the choice of treatment. The standard methods of operation are demonstrated. Our results and experience with the techniques of Matti-Russe I (86 cases), Russe II (18 cases), the Pechlaner-Hussl vascular pedicle bone transplant (35 cases) and the Herbert screw (18 cases) are reported.

Bone Transplantation↗
PubMed1990

[Value of Illizarov's method in the treatment of long bone pseudarthrosis. Apropos of a A.S.A.M.I.F series of 87 cases].

This study is the outcome of multicenter endeavour compiling 87 cases of pseudoarthrosis managed according to principles set forth by G.A. Ilizarov. All clinical forms are described: simple pseudoarthrosis (non-infected and without loss of substance); septic pseudoarthrosis; pseudoarthrosis with loss of bone substance, both septic and aseptic. This method is used in the majority of cases. This method is used in the majority of cases after several consecutive unavailing attempts with conventional therapeutical procedures. Considering all situations, the lesions heal in over 90% of cases and the infection subsides with an equal rate of success. Such results are achieved within a period of 5 months. Sequelae or complications imputable to the method are few. Indications are specified, which depend upon the clinical form of the treated pseudoarthrosis, as well as upon the surgeon's personal skill.

Adolescent↗
PubMed1990

[Delayed consolidation and pseudarthrosis in posttraumatic pathology of the carpal scaphoid. A magnetic resonance study].

Delayed unions and fibrous or sclerotic non-unions of the carpal scaphoid are frequent sequelae of non-diagnosed or not properly treated fractures. The most important cause of abnormal unions is ischemic necrosis, due to the terminal vascularity of the carpal scaphoid. Conventional X-rays, scintigraphy, and CT do not yield sufficient information for a complete diagnosis; at present, MR imaging represents a valuable alternative, for it is a noninvasive technique able to provide a "biological imaging" of bone. Fourteen patients underwent surgical/nonsurgical treatment, based on the findings supplied by MR imaging. MR reliability was evaluated in relation to the therapeutic results obtained. The study proved MR imaging to provide important information as to therapy planning; in case of surgical treatment, MR imaging helped in choosing the most appropriate location for the insertion of bone graft or screw.

Adolescent↗
PubMed1986

[Pseudarthrosis of the scaphoid].

For the treatment of scaphoid non-unions, innumerable curative and palliative operations have been recommended. Of the curative operations, the various methods of bone grafting give the best results, whereas screw fixation is not satisfactory. Bone pegs with a cortical graft are no longer used because of technical difficulties. Corticocancellous grafts (Matti-Russe) yield bony union in almost 90% of cases. The combination of corticocancellous grafts with plate stabilization gives the highest rate of bony union (99%). A cure should therefore always be attempted in all non-union cases, with the exception of cases already involving severe, generalized osteoarthritis or extensive necrosis of the scaphoid. Of the different palliative methods, the early results of prosthetic partial or total replacement of the scaphoid are satisfactory. Late results are less satisfactory, with a high rate of complications and carpal collapse. With severe osteoarthrosis, proximal carpectomy, especially the transscaphoideo-lunate resection, gives good results. Intercarpal arthrodeses have been disappointing. Radiocarpal arthrodesis results in a pain-free, strong wrist; however, there is complete loss of motion, whereas denervation gives satisfactory results in 57% and preserved mobility of the wrist.

Bone Plates↗
PubMed1989

[The treatment of infected pseudarthrosis of the tibia using Umiarov's technic (epiderm-fascio-osteoplasty)].

Infected tibial nonunions, with bone loss and extensive soft tissue damage, often require long multistage treatment. Epidermo-fascial osteoplasty according to Umiarov allows the removal of important bone loss without previous sterilization of purulent foci or coverage of the soft tissues. The results obtained in 5 cases treated by Umiarov technique are very satisfactory and allow to consider this method as a valid alternative to the traditional treatments.

Humans↗
PubMed1989

[Surgical treatment of invalids with pseudarthrosis of the humerus].

Complex rehabilitation of 132 invalids with unhealed fractures and false joints of the humerus is analysed. Modern methods of surgical treatment were applied: extrafocal distraction-compression osteosynthesis in 45.5% of cases, bone autoplasty in 41.7%, other operations in 2.8% of cases. The differentiated use of the methods of treatment with consideration for the changes developing in the soft tissues and bone structure made it possible to achieve union of the humeral bone fragments and restore the function of the limb and the working capacity of the patients in 96.6% of cases.

Adult↗
PubMed1989

[Septic diaphyseal pseudarthrosis. Practice during war and peace time. Apropos of 130 cases].

130 septic diaphyseal pseudoarthroses (SDP) were treated over a period of 10 years, 58 in the context of a war situation and 72 in civilian practice. The two etiologies differed in that the size of the initial associated cutaneous lesion was much greater in battle injuries. A staged treatment procedure was applied in 110 cases: treatment of the infection, followed by osteogenic grafts and depending on the case, stabilisation of the assembly or replacement of internal by external fixation materials. More recently, the use of muscular or musculocutaneous pedicle flaps has enabled, in a single procedure, the eradication of osteitis and the implantation of cortico-trabecular bone in 20 SDP producing 19 consolidations and 2 cases of residual osteitis.

Adult↗