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At least 217 records · Page 12Linked to original sources
PubMed1990

[A combined osteosynthesis method for ununited fractures and pseudarthroses of the femur neck].

A combined method of osteosynthesis consisting of three consecutive steps (reposition and fixation of fragments of the neck with the help of cortical allotransplants, intertrochanteric osteotomy with medialization of the femur, osteosynthesis of the three formed fragments with the Trotsenko-Nuzhdin plate) was used in 28 patients with ununited fractures and false joints of the femoral neck. In 88% of the cases the method resulted in recoveries and returned patients to their professional work.

Adult↗
PubMed1992

Excision of ununited fractures of the posterior process of the talus: a treatment for chronic posterior ankle pain.

The cases of nine patients with ununited fracture of the posterior process of the talus were reviewed. The most common mechanism of injury was forced plantarflexion. All patients had pain in the posterior ankle region. Common physical findings included tenderness between the lateral malleolus and the Achilles tendon and pain on forced plantarflexion. Of the radiographic imaging modalities used, 99Tc bone scan was found to be the most helpful in diagnosis. All nine patients eventually underwent surgical excision at a mean period of 9.4 months post injury. At average follow-up of 27 months after surgery (range 7-69 months), six of nine patients had good or excellent results with respect to pain relief and return to function. There were two complications of sural neuroma formation, one of which resulted in severe persistent pain after surgery. Based on these findings, we believe the differential diagnosis of chronic posttraumatic ankle pain should include fracture of the posterior process of the talus. Furthermore, excision of an ununited fragment through a lateral approach, taking care to preserve and protect the sural nerve, should lead to the return of painless function in the majority of cases.

Adult↗
PubMed1982

The classic. Ununited fractures in children. James Paget, 1891.

James Paget (1814-1899) entered St. Bartholomew's Hospital, London, as a medical student in 1834. He never left. Like Pott, his whole professional life was spent in service to the hospital and its school of medicine. His career began in the preanesthesia, pre-Listerian era, and he lived to see the introduction of X-rays into medical practice. He is best remembered as a teacher and as a surgical pathologist. As a freshman medical student, he observed and described the cysts of Trichina spiralis in the diaphragm of his cadaver. His observations on ununited fractures in children were published in 1891. The years between were filled with an active and distinguished career as a teacher, investigator, and surgeon.

Child↗
PubMedDate not supplied

Selection, evaluation and indications for electrical stimulation of ununited fractures.

Management of nonunions requires careful and critical assessment of the true biologic status of the fracture. The mere radiographic persistence of a fracture line does not invariably indicate nonunion. Ten percent of fractures considered initially to be ununited in this series healed spontaneously without further treatment. The patient who has no pain with weight-bearing and no demonstrable motion on careful stress studies does not usually require further treatment, except for protection against reinjury. Intraosseous venography may be useful to distinguish the delayed from the nonunion in order to institute appropriate and early treatment. Percutaneous direct-current electrostimulation is proving to be a reliable and effective method of managing the most common nonunion of the tibia or distal femur. It appears less satisfactory for the more proximal femoral fractures and for fractures of the humerus. Electrical stimulation does not eliminate the need to stabilize the nonunion of either the femur or the upper limb. Electrical stimulation also does not eliminate the need for bone grafting in approximately 15% to 20% of nonunions. The fractures' biologic inability to respond may be identifiable by 99MTc diphosphonate bone scan. The implantable direct-current electrical stimulatory device proved ineffective in this series. Hopefully, further development of this technology may produce more consistent results in the future. The electromagnetic noninvasive stimulator appears to be a useful alternative method to the semi-invasive system. This, of course, should depend on the individual needs of the patient and the nature and location of the fracture. Continued technologic improvement in all electrical stimulatory methods should broaden their usefulness and applicability. However, the healing status of the fracture and the processes by which each fracture responds must be carefully assessed to appreciate what is being effected by electrical stimulation. Critical evaluation and clarification of indications are essential if the patient is to be offered the most effective therapy available.

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↗
PubMed1984

Treatment of selected patients with an ununited fracture of the proximal part of the scaphoid by excision of the fragment and insertion of a carved silicone-rubber spacer.

An ununited scaphoid fracture whose proximal fragment is small, sclerotic, fragmented, or badly deformed is usually not suitable for bone-grafting. We treated twenty-one such patients by excision of the small proximal fragment through a volar incision and the insertion of a hand-carved silicone-rubber spacer. After surgery, twenty patients (95 per cent) were able to return to work and engage in strenuous activities, including sports. Pain was significantly relieved, although wrist motions and grip were only minimally improved. Preoperative and postoperative comparative measurements of carpal collapse and translation showed only insignificant changes after this procedure.

Adult↗