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Non-anatomical surgical solutions for difficult non-unions: case series.

Zaki Said G, Farouk OA, Galal Said H, Mohamed El-Sharkawi MM - Trauma Mon (2013)

Bottom Line: This may not be possible in some neglected and complicated non-unions.Under these circumstances, modification of the standard techniques or a limited surgical interference, that might not be anatomical, may succeed in improving function.We present four cases of non-anatomical salvage solutions for difficult long bone non-unions with satisfactory functional outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic and Trauma Surgery, Faculty of Medicine, Assiut University Hospitals, Assiut, Egypt.

ABSTRACT

Abstract: Non-union occurs when bone healing ceases and does not continue without some type of intervention. Classification of non-union is traditionally based on the amount of callus or bone healing at the fracture site. Successful treatment of non-union often depends on appropriate reduction and realignment of the fracture, bone grafting if necessary, and stabilization. This may not be possible in some neglected and complicated non-unions. Under these circumstances, modification of the standard techniques or a limited surgical interference, that might not be anatomical, may succeed in improving function. We present four cases of non-anatomical salvage solutions for difficult long bone non-unions with satisfactory functional outcome.

No MeSH data available.


Related in: MedlinePlus

A, A1: Side Swipe Injury of the Right Elbow Four Years Previously Resulted in Non-union of the Upper Third of the Radius, Ulna. The Olecranon Fracture is nonunited. AP and Lateral Views of the Elbow and Forearm Showing the Upper Segments of the two Bones Fused Together in one Bony Mass. There is a Left-over Screw From Previous Surgery in Front of the Elbow Joint. B, B1: Three and Half Month Follow-up After T-plate Fixation of the Upper Bony Mass and the Distal Ulnar Shaft Showing Union. C, C1: Elbow Flexion Range 0-120°. D, D1: Full Supination, 90° Pronation at Last Follow-up. E: Patient Lifting a Chair.
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fig1716: A, A1: Side Swipe Injury of the Right Elbow Four Years Previously Resulted in Non-union of the Upper Third of the Radius, Ulna. The Olecranon Fracture is nonunited. AP and Lateral Views of the Elbow and Forearm Showing the Upper Segments of the two Bones Fused Together in one Bony Mass. There is a Left-over Screw From Previous Surgery in Front of the Elbow Joint. B, B1: Three and Half Month Follow-up After T-plate Fixation of the Upper Bony Mass and the Distal Ulnar Shaft Showing Union. C, C1: Elbow Flexion Range 0-120°. D, D1: Full Supination, 90° Pronation at Last Follow-up. E: Patient Lifting a Chair.

Mentions: A 55 year-old man travelling in a bus sustained sideswipe injury of his right elbow. This resulted in open comminuted fractures of the upper end of his forearm bones. After having multiple surgeries at the local hospital he presented four years later with a freely mobile non-union of the upper end of the radius and ulna, and was unable to use this limb. He had still useful range of movement at the elbow joint (20-90˚ flexion range). His DASH disability score was 54. (6) Radiological examination revealed that the upper ends of the radius and ulna to be fused together into one bony mass, with non-union between the bony mass and the remaining part of the shafts of the radius and ulna. The olecranon was nonunited, raised and ankylosed to the olecranon fossa (Figure1).


Non-anatomical surgical solutions for difficult non-unions: case series.

Zaki Said G, Farouk OA, Galal Said H, Mohamed El-Sharkawi MM - Trauma Mon (2013)

A, A1: Side Swipe Injury of the Right Elbow Four Years Previously Resulted in Non-union of the Upper Third of the Radius, Ulna. The Olecranon Fracture is nonunited. AP and Lateral Views of the Elbow and Forearm Showing the Upper Segments of the two Bones Fused Together in one Bony Mass. There is a Left-over Screw From Previous Surgery in Front of the Elbow Joint. B, B1: Three and Half Month Follow-up After T-plate Fixation of the Upper Bony Mass and the Distal Ulnar Shaft Showing Union. C, C1: Elbow Flexion Range 0-120°. D, D1: Full Supination, 90° Pronation at Last Follow-up. E: Patient Lifting a Chair.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860664&req=5

fig1716: A, A1: Side Swipe Injury of the Right Elbow Four Years Previously Resulted in Non-union of the Upper Third of the Radius, Ulna. The Olecranon Fracture is nonunited. AP and Lateral Views of the Elbow and Forearm Showing the Upper Segments of the two Bones Fused Together in one Bony Mass. There is a Left-over Screw From Previous Surgery in Front of the Elbow Joint. B, B1: Three and Half Month Follow-up After T-plate Fixation of the Upper Bony Mass and the Distal Ulnar Shaft Showing Union. C, C1: Elbow Flexion Range 0-120°. D, D1: Full Supination, 90° Pronation at Last Follow-up. E: Patient Lifting a Chair.
Mentions: A 55 year-old man travelling in a bus sustained sideswipe injury of his right elbow. This resulted in open comminuted fractures of the upper end of his forearm bones. After having multiple surgeries at the local hospital he presented four years later with a freely mobile non-union of the upper end of the radius and ulna, and was unable to use this limb. He had still useful range of movement at the elbow joint (20-90˚ flexion range). His DASH disability score was 54. (6) Radiological examination revealed that the upper ends of the radius and ulna to be fused together into one bony mass, with non-union between the bony mass and the remaining part of the shafts of the radius and ulna. The olecranon was nonunited, raised and ankylosed to the olecranon fossa (Figure1).

Bottom Line: This may not be possible in some neglected and complicated non-unions.Under these circumstances, modification of the standard techniques or a limited surgical interference, that might not be anatomical, may succeed in improving function.We present four cases of non-anatomical salvage solutions for difficult long bone non-unions with satisfactory functional outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic and Trauma Surgery, Faculty of Medicine, Assiut University Hospitals, Assiut, Egypt.

ABSTRACT

Abstract: Non-union occurs when bone healing ceases and does not continue without some type of intervention. Classification of non-union is traditionally based on the amount of callus or bone healing at the fracture site. Successful treatment of non-union often depends on appropriate reduction and realignment of the fracture, bone grafting if necessary, and stabilization. This may not be possible in some neglected and complicated non-unions. Under these circumstances, modification of the standard techniques or a limited surgical interference, that might not be anatomical, may succeed in improving function. We present four cases of non-anatomical salvage solutions for difficult long bone non-unions with satisfactory functional outcome.

No MeSH data available.


Related in: MedlinePlus