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Electrical stimulation in the treatment of ununited fractures.

Sixteen patients with nonunion were treated with direct-current stimulation by placement of percutaneous electrodes. The median age of nonunion was two years. All patients had previous surgical intervention to induce healing, and the fractures had been immobilized for long periods before electrical stimulation was considered. Eleven of ther 16 fractures united and the patients returned to full activity, free of external support. Complications included one late deep infection and one recurrence of osteomyelitis; with treatment, both patients healed both nonunions and infection. There were no refractures. The semi-invasive technique is simple, relatively painless, and the electrical apparatus is portable. Contraindications to its use are excessive motion at the fracture site or active infection.

Adult↗
PubMed1988

Treatment of ununited fractures of the scaphoid by iliac bone grafts and Kirschner-wire fixation.

Of 151 ununited fractures of the scaphoid that were treated with iliac bone grafts and Kirschner-wire fixation through a volar approach, all but four (97 per cent) healed in an average of seventeen weeks, Three of the four failures resulted from obvious technical errors. Neither the preoperative existence of necrosis of the proximal fragment nor the location of the fracture affected the results. When there was mild radiocarpal arthritis preoperatively, it did not progress postoperatively; if there was moderate radiocarpal arthritis preoperatively, progression seldom was seen if a radial styloidectomy was done. Displaced and unstable ununited fractures healed even if the deformity was not corrected completely. The principal benefit of the procedure was relief of pain rather than an increase either in motion of the wrist or in strength of grip.

Adolescent↗