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At least 379 records · Page 21Linked to original sources
PubMed1981

Pseudarthrosis of the forearm bones. (Clinical and radiographic survey of 112 operated cases).

There are two aims in the surgery of pseudarthrosis in the forearm; consolidation of the fracture, and restoration of function as nearly normal as possible in a part of the musculo-skeletal system which is mechanically controlled by extremely delicate, interdependent, structural units. These aims are, of course, the same as those in the treatment of fresh fractures. The following conclusions emerge from a clinical and radiographic study of 112 operated cases: (a) Sherman's plate has been shown to be an ideal means of synthesis, because of its metallurgical and physical qualities, which enable it to adapt excellently to an irregular bone surface. (b) Plate fixation is supplemented by an appositional cortical transplant. This also plays a definite mechanical role, both because of the firm grip that it affords to the screws when the bone stumps are atrophic, which they often are, and because it is isoelastic with the recipient's tissue. Two cortical grafts are sometimes used instead of a plate and graft. (c) The best functional results are obtained when the leverage of the forearm has been anatomically restored.

Adolescent↗
PubMed1995

Congenital pseudarthrosis of the tibia. Long-term followup of 29 cases treated by microvascular bone transfer.

The authors show that vascularized fibular transplantation is the safest technique to treat congenital pseudarthrosis of the tibia. Results of transplantation in 29 patients reveal that the rate and speed of healing were superior to those of any other published method, and the final outcome at maturity was generally acceptable. In addition, the technique allows secondary lengthening procedures to be done. Various factors, such as age at first fracture, age at operation, gender, and type of fixation, did not appear to influence the outcome significantly.

Adolescent↗
PubMed1995

[Changes in the wrist joint in spontaneous course of scaphoid pseudarthrosis].

Scaphoid non-union always leads to carpal arthrosis. What is the natural history and course and sequence of development of arthrosis in scaphoid bone pseudarthrosis and what factors play a role in this? Forty-nine patients with scaphoid non-union were followed up; the period of observation was between three and 39 years. For comparison, 55 patients in whom a Matti-Russe reconstruction had been carried out successfully in the same period were followed up. Both the clinical and the radiological appearance seemed to be better in the operated patients than in the unoperated patients. The time factor, the position and form of the fracture appeared to be crucial for the development of arthrosis. No patient was free of arthrosis after ten years. The arthrosis begins in the radial part of the radiocarpal joint and progresses to the mediocarpal joint. The development of mediocarpal arthrosis takes about 20 years. Unstable and displaced fractures accelerate the development of arthrosis. Proximally located non-unions are unfavorable because of the danger of osteonecrosis of the proximal fragment. These non-unions should be treated surgically as soon as possible.

Adolescent↗
PubMed1995

[Congenital pseudarthrosis of the clavicle and thoracic outlet syndrome. Report of a case and review of the literature].

The association pseudarthrosis of the clavicle and the thoracic outlet syndrome is rare. The author describe a case in a 64 years old man, found before embolic complications. Shoulder X-ray and artériography démonstrate the lesion. The etiopathogenic hypothesis are called up. In case of complication, the surgical treatment is made of osteo synthesis or partial or total resection of the clavicle, associated to a vascular repair in case of need. At long term the result is excellent.

Clavicle↗
PubMed1994

Congenital pseudarthrosis of the tibia: treatment with free vascularized fibular graft.

Five children with congenital pseudarthrosis of the tibia were treated by resection of the lesion and reconstruction of the extremity with a free vascularized fibular graft (FVFG). Two of five cases had had multiple surgical procedures before FVFG. These two cases were complicated with the non-union of the proximal grafthost junction. Of these, one case achieved bone union after further resection of the non-union and adding allogenic bone graft and another case denied further operation and was lost to follow-up 6 months postoperatively. Three cases, two of which underwent FVFG as a primary treatment and another one after failure from the Sofield procedure respectively, were initially treated successfully and solid union of the grafthost junctions was within four months postoperatively. Problems including: anterior bowing, refracture, valgus deformity of the ankle and leg length discrepancy occurred in all four followed cases.

Adolescent↗
PubMed1994

[Natural course in pseudarthrosis of the scaphoid].

Knowledge of the natural history of scaphoid nonunion is important for establishing the indication for surgery. The late results after the Matti-Russe operation reveal carpal arthrosis in a relatively high percentage of cases. On the other hand, we see patients who have engaged in sports and have continued working without symptoms for years despite scaphoid nonunion. We now address the question as to the nature and time of the development of arthrosis and the factors affecting it. Forty-one patients with pseudarthrosis were followed up over a period of 3-39 years. For comparison, 55 patients in whom a Matti-Russe operation had been successfully performed were followed up for the same period. Both the clinical and radiological appearance seem to be better in patients operated on than in those who were not operated on. The time factor, the location and the form of the fracture determine the development of arthrosis. No patient was free of arthrosis after 10 years. Arthrosis begins in the scaphostyloid joint and progresses to the scaphotrapezoid, scaphocapital and scapholunar joint. Development of midcarpal arthrosis takes place over about 20 years. Unstable and displaced fractures accelerate the development of arthrosis. Proximally located pseudarthroses are unfavorable because of the danger of osteonecrosis of the proximal fragment. These pseudarthroses should be eliminated as soon as possible by surgery.

Adult↗
PubMed1993

[Free transfer of the vascularized fibula in pseudarthrosis and femoral bone loss].

The authors report their experience of femoral reconstruction by free fibular graft transfer. Twenty eight patients were operated on between 1977 and 1988. The average follow-up was 7 years and 3 months. The etiology of most of the cases was a post traumatic lesion (70 per cent). Loss of substance was found in 19 cases. 60 per cent of these were septic. The approach was usually posterior and vessels from the sciatic nerve were used. Union was obtained in 89 per cent of the cases. In 65 per cent of the cases union occurred in less than 1 year. In 1 out of 4 cases graft thickening was necessary and achieved by secondary bone grafts. The comparison of this technique with standard treatments evidenced a definite superiority of vascularized bone grafts in cases of septic pseudarthrosis and significant losses of bone.

Adolescent↗
PubMed1993

Congenital pseudarthrosis of the tibia--treatment with free vascularised fibular grafts.

Congenital pseudarthrosis is uncommon. We report on a series of 4 patients treated by means of free vascularised fibular grafts. Complications encountered were graft fracture, delayed union and angulation deformities. Modifications in the surgical technique improved later results. We recommend wide excision of pathological bone, bridging of the defect by free vascularised fibular grafts and rigid fixation.

Bone Transplantation↗
PubMed1993

[A Cloward-type bone-harvesting technic in the management of pseudarthrosis of the navicular bone].

Authors present an apparatus resembling the Cloward instrument, that can be however used more simply and safely for gaining a good quality cortico-spongious cylinder from the iliac wing. The functioning of the bone gaining instrument and the process of bone gaining is described. The apparatus was used in more than 100 cases for filling up with spongious bone chips the cavity arising after the cleaning of the pseudarthrosis of the navicular bone. Three different cases are presented to demonstrate the alternative applications of the apparatus. It is supported by literary data that the autologous bone gained from the iliac wing is the most suitable for transplantation.

Adult↗
PubMed1993

[Management of 2 cases of pseudarthrosis].

Authors describe their standpoint concerning the choice of therapeutic methods in the solution of two cases of the lower leg's pseudarthrosis. On the basis of two cases treated successfully they strive after osteogenetic induction and adequate stability and in the formation of principles after the equilibrium of modernity and rationality.

Adolescent↗
PubMed1995

[Surgical and conservative therapy of scaphoid pseudarthrosis].

Should an asymptomatic scaphoid pseudarthrosis be eliminated by surgery? Two patient populations were followed up in order to be able to answer this central question. The first group comprised 49 unoperated patients and the second group 55 patients in whom Matti Russe reconstructive surgery had led to healing of the bone and in whom the operation had been carried out at least three years previously. The period of observation was up to 25 years. The study yielded the following findings: 1. The spontaneous course automatically terminates in radiocarpal arthrosis. It begins after five to ten years in the radiocarpal joint and also affects the intracarpal joint after a further ten years. Besides an increasing shortening of the scaphoid bone, an exacerbating carpus collapse can also be observed. 2. Neither the position of the fracture, left- or righthandedness nor the patient's occupation affect the course. Only necrosis of the proximal fragment favors the development of arthrosis. 3. The operated patients have much better results both clinically and radiologically. The development of arthrosis is slowed down (but not stopped) by the operation. 4. A DISI deformity left behind after the operation does not affect the development of arthrosis. 5. The earlier the operation is carried out, the more favorable the course. 6. We attribute the relatively high rate of arthrosis in Matti-Russi reconstructive operation (69%) to an excessively long immobilization. For this reason, we prefer internal fixation with a Herbert screw.

Adolescent↗
PubMed1996

[Treatment of pseudarthrosis of the clavicle by bone plate with screw fixation and autologous spongiosa graft].

PURPOSE OF THE STUDY: The authors review and evaluate the operative treatment of mid-shaft clavicular non-union by compression plate osteosynthesis and most frequently by decortication and autogenous bone grafting. MATERIAL AND METHODS: From 1979 to 1990, 11 consecutive patients, 9 males and 2 females, mean age 33.5 years, with symptomatic non-union of mid-shaft clavicular fracture were operated and followed-up for an average of 4 years. The pseudarthrosis was atrophic in 10 and hypertrophic in 1 patient. The initial treatment of the fracture was always conservative. RESULTS: All patients achieved bone union by 3-7 months post operatively. The functional results were excellent in 9 patients. The remaining two patients had mild symptoms such as occasional pain related to weather, soreness of the muscles with overhead lifting and discomfort of the shoulder. Minor complications were noted such as 1 delayed wound healing, 3 cheloid scars and 1 transient partial paresis of the brachial plexus. DISCUSSION: Symptomatic non-union of the mid-shaft clavicular is a rare complication, mainly after non-operative treatment (11 cases in 12 years in our series). Factors responsible for non-union are the initial high velocity injury, the cominution, the overlapping and great displacement, the paucity of cancellous bone at this site and the trapezius interposition. Internal fixation by compression plating, decortication and bone grafting in atrophic non-union often encountered is a safe reliable method allowing uncomplicated healing and acceptable functional results.

Adolescent↗
PubMed1977

[Postoperative staphylococcal infection as a late complication following treatment of pseudarthrosis (author's transl)].

The study describes a case of postoperative infection following surgery of a humeral pseudarthrosis in a dog. The infection was manifested by fistulas which healed after treatment with different antibacterial drugs, but recurred on six different occasions during a period of twenty months after the operation. Staphylococcus aureus or epidermidis was isolated after aerobic incubation while no microbes were detected after anaerobic incubation. The infection appeared to be localized to a suture of polypropylene. The infection regressed and no more fistulas appeared after this suture had been removed.

Animals↗
PubMedDate not supplied

The effects of cigarette smoke on the progression of septic pseudarthrosis of the tibia treated by Ilizarov external fixator.

The authors conducted a study to evaluate the effects of cigarette smoke on the healing of septic pseudarthrosis of the tibia treated by ilizarov external fixator. A total of 31 patients of both sexes were chosen, and the healing time in relation to the habit of smoking was examined. The results have shown that the healing time in non-smokers as compared to smokers was shorter by 33%. The difference is highly significant. This shows that abstention from smoking during treatment should be given maximum importance in prevention.

Adult↗
PubMed1997

[Pseudarthrosis of the capitate bone. Report of 2 cases].

Well protected by its central position and richly vascularized, the capitate bone is rarely involved in posttraumatic pseudarthrosis. Drawing on two cases, the present study will describe anatomy, aetiology, pathogenesis, diagnosis, and therapy of pseudarthroses of the capitate. Restoration of the physiological capitate height was achieved in both cases with a corticocancellous bone graft from the iliac crest which led on to bony union within three months.

Adult↗
PubMed1990

Simultaneous presentation of upper lobe fibrobullous disease and spinal pseudarthrosis in a patient with ankylosing spondylitis.

A 51 year old man with a 20 year history of ankylosing spondylitis and pronounced thoracic gibbus presented with two simultaneous complications of longstanding ankylosing spondylitis, upper lobe fibrobullous disease, and spinal pseudarthrosis. No neurological sequelae developed and treatment was conservative. Both these lesions mimic tuberculosis, and so it is important to determine them accurately to avoid unnecessary antituberculosis treatment. Both of these complications are reported to occur in longstanding ankylosing spondylitis and their simultaneous presentation may be more common than is realised. This case is believed to be the first such report of their association.

Bone Resorption↗
PubMed1997

Pseudarthrosis of the Lumbar Spine.

Pseudarthrosis can be a costly and disabling complication of lumbar spinal fusion. This review focuses on the incidence, causation, diagnosis, and nonoperative management of this condition, as well as surgical approaches that can be effective in treating carefully selected patients. Judicious initial selection of patients for fusion and the use of meticulous surgical technique in the first operation continue to be the best means of prevention.

Journal Article↗