Failure of treatment of ununited fractures of the carpal scaphoid.
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Of 147 patients with fractures of the tibia, femur and humerus, in whom an average of 3.3 operations had failed to produce union, all were treated with external skeletal fixation in situ and pulsed electromagnetic fields (PEMFs). Of the 147, 107 patients united for an overall success rate of 73%. Union of the femur occurred in 81% and the tibia in 75%. Only five of 13 humeri united. Failure to achieve union with PEMFs was most closely associated with very wide fracture gaps and insecure skeletal fixation devices.
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Osteosynthesis with compressing plates was performed in 112 patients with fractures (51) and non-united fractures (61) of forearm bones. In 6 of 10 patients operated upon within 7 days after trauma the fracture failed to unite. Operations made later than 7 days after trauma gave consolidation of the fractures in 39 of 41 patients. The treatment of non-healing fractures was effective in 57 of 61 operated patients. With the help of metallic plates with 6--8 screws the complete stabilisation of bone fragments was achieved following any kind of diaphyseal fracture.
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In the present communication the author reports his experience with operative treatment of 237 patients having unhealing fractures and pseudarthrosis of the femoral bone, using modern methods of osteosynthesis, osteoplasty and sanatorium-spa treatment. The results of treatment were studied in 230 patients. Good and satisfactory issues were observed in 202 patients (87.8%), poor--in 28 (12.2%).
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