PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “FRACTURES, UNUNITED”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 757 records · Page 42Linked to original sources
PubMed1990

Management of fractures of the humerus in patients who have an injury of the ipsilateral brachial plexus.

Twenty-one adults who had a fracture of the middle of the humeral shaft and an injury of the ipsilateral brachial plexus were followed for an average of twenty-eight months. Only two of these patients showed evidence of neurological improvement. Of the eleven patients who had an associated traumatic injury to the brain, eight were treated non-operatively and three, operatively. The presence of a fracture of the humerus in a flail extremity has been found to delay rehabilitation markedly and to result in prolonged hospitalization. Eleven fractures were treated non-operatively with a brace or cast, and there were five non-unions, two delayed unions, and two malunions. Of the ten fractures that were treated operatively, three that were treated by compression-plating all united. Two fractures were treated by external fixation; one had a delayed union and one, a malunion. In the remaining five patients, who were treated with an intramedullary rod, there were two non-unions, one delayed union, and one malunion.

Adolescent↗
PubMed1989

[Maxillo-mandibular fracture outcome. Therapeutic program].

The ill-consolidated outcomes of the maxillo and jaw fractures often show ill-positions of the mandible and/or of the jaw in the three space-levels. In order to program a suitable surgical correction of such pathologic pictures it is necessary to make a cephalometric test and a gnathologic one. The result of these tests will guide the therapeutical choise which will be either the re-opening of the surgical treatment to be effected through the usual osteotomy of the mandible.

Adult↗
PubMed1989

[Residual deformities corrected by combined craniomaxillofacial procedures].

We present a case that have been involved in a severe traffic accident, with the following residual deformities in the Craniomaxillofacial region: Absence of the major part of the frontal bone which had been fractured and its small remained (infected) fragments removed by the neurosurgeons and an open bite, as a result of mal-united jaw fractures, due to inadequate primary treatment because confrontation of more serious and life threatening injuries imposed precedence. The open bite was corrected by bimaxillary orthognathic surgery (Le Fort I and sagittal splitting) and the residual absence of the frontal bone was reconstructed by onlay split rib-grafts. We present the accomplished results.

Accidents, Traffic↗
PubMed1989

[Several indicators of oxidative processes in fractures of the long bones].

The authors have observed 55 patients with fresh fractures, with disturbances in consolidation (delayed consolidation, non-union of fractures, false joints) and with defects of diaphyses of the long bones. In the fracture area the dynamics of oxidation-reduction potential (ORP) was studied and volarographic investigations (determination of the volumetric speed of the local blood flow by hydrogen, a test with oxygen load) were carried out. Certain correlation between the quantity and the dynamics of the values under study and the state of the consolidation process was established. Coincidence of the dynamics of ORP and the local blood flow, presence of the quantity of volumetric speed of the local blood flow of 25-30 ml/min per 100 g of tissue with rather high ORP and a positive test under oxygen load in the polarographic study were prognostically favourable. The applied methods allow to control the course of the process of consolidation of the fragments and to a certain extent prognosticate the results of treatment of the patients with fractures of the long bones.

Femoral Fractures↗
PubMed1989

[Malunion and growth disorders following fractures of the condylus radialis humeri in children].

Basing on the results of 46 fractures of the lateral humeral condyle in children possible mal-unions and disturbances of growth after conservative and operative treatment are shown. Varus-tendency of the elbow axis was observated in 23% after conservative treatment of undisplaced fractures and in 37.5% after open reduction and Kirschner wiring of displaced fractures. Fish-tail deformity was seen both after conservative treatment and fixation with Kirschner wires; only open reduction and osteosynthesis with small-fragment screws could avoid this two disturbances of growth. One non-union was seen after conservative treatment.

Adolescent↗
PubMed1989

Salvage of non-union of supracondylar fracture of the humerus by total elbow arthroplasty.

Fourteen patients in whom open reduction and internal fixation could not be achieved satisfactorily had a total elbow arthroplasty for non-union of a supracondylar humeral fracture. All patients had an established non-union, and ten had had from one to four previous attempts at internal fixation. The average age at the time of operation was sixty-five years. The average duration of follow-up was five years, with a minimum of two years. The average preoperative elbow score was 17 points, with both pain and functional disability present. The average postoperative score was 84 points; there were eight good or excellent results and three failures. The latter three patients had an additional operation: one each for dislocation, loosening of the humeral component, and deep infection. Salvage of supracondylar non-union by means of a total elbow arthroplasty is a technically demanding procedure. Strict indications for selection of patients must be followed. A semiconstrained implant is recommended, with preservation of the epicondyles and their muscular attachments in order to achieve balance of the soft tissues.

Adult↗
PubMed1979

Treatment of the fractured edentulous mandible.

Fifty-three cases of fractures of edentulous mandibles were reviewed and analyzed. Thirty-three cases were sufficiently documented to assess the entire treatment course. Two nonunions were identified. Major factors contributing to the difficulty of repair of fractures include the location of the fracture, the height of the horizontal ramus, and the patient's systemic condition. Closed reduction of fractures of atrophic mandibular bodies is advocated. Although anatomical alignment may not be achieved by this approach, it may preclude nonunion and a prolonged clinical course.

Adult↗
PubMed1988

Nonunion of the humerus.

Under certain circumstances, fractures of the humerus may not heal. Some fractures experience delayed union and some develop nonunion despite improved methods of treatment. This chapter discussed nonunion and fracture fixation methods in the proximal, middle, and distal thirds of the humerus. Special circumstances were discussed, such as infection, nerve palsy, comminution, and electrical stimulation.

Electric Stimulation Therapy↗
PubMed1986

The critical size defect as an experimental model for craniomandibulofacial nonunions.

Little consistency has been manifest among investigators in choosing an appropriate experimental model for maxillofacial bone research. In an effort to develop a protocol for the experimental analysis of maxillofacial nonunions, previous studies using calvarial and mandibular defects as models were reviewed. The creation of nonunions in animals within the calvaria and mandible was size dependent. Defects of a size that will not heal during the lifetime of the animal may be termed critical size defects (CSDs). A rationale was postulated for testing bone repair materials (BRMs) using CSDs in a hierarchy of animal models. This rationale suggests that testing should be initiated in the calvaria of the rat and rabbit, followed by testing in the mandibles of dogs and monkeys. While calvarial CSDs have been established in the rat, rabbit, and dog, further research is necessary to determine the CSD in the calvaria of the monkey, as well as the mandibles of dogs and monkeys.

Animals↗
PubMed1988

Management of resistant pseudarthrosis of long bones.

A retrospective review was undertaken of 15 patients with long-bone pseudarthrosis with long-standing nonunion. These patients were referred to a tertiary care center after their fractures failed to unite after numerous surgical attempts as well as a course of electrical stimulation. Fourteen patients had nonunion of the tibia, and one had nonunion of a humerus fracture. Twelve were originally Gustillo Grade II or III fractures, and four sustained multiple injuries. The average duration of nonunion before presentation to the clinic was 22.5 months. Five patients presented as infected nonunions. Each nonunion was analyzed with specific reference to injury mechanism, skin and bone conditions, presence of infection, primary treatment protocol, and selection criteria for treatment with electrical stimulation. Review of the data revealed that the most common factor associated with failure of electrical stimulation treatment was inappropriate patient selection, according to criteria previously published for the use of these techniques. Treatment modalities consisted of intramedullary fixation in three, open reduction and internal fixation using Arbeitsgemeinschaft fur Osteosynthesefragen (AO) technique in nine, and external fixation in three. All patients were bone grafted. The mean follow-up duration was 1.5 years. Nonunions were healed in fourteen patients. Twelve were fully weight bearing at six months, and one at 12 months. Success was defined as restoration of a functional extremity, giving a success rate of 87%. A thorough reevaluation of the original treatment regimen and a return to basic principles of operative fracture management and bone grafting can yield excellent results, even in patients with recalcitrant nonunion.

Adult↗
PubMed1988

Non-union of fractures of the distal end of the humerus.

The records of twenty patients who had been treated for a non-union of the distal end of the humerus at the Massachusetts General Hospital from 1968 to 1984 were reviewed. Thirteen of the fractures were extra-articular and seven were intra-articular. Seven fractures had been open and nine had been associated with multiple trauma. Eight had been initially treated by open reduction and internal fixation; five, by closed reduction and immobilization; four, by skeletal traction; two, by external fixation; and one, by débridement and immobilization. The average time from the original fracture to the treatment of the non-union was twenty months (range, three to 120 months). All but one patient had pain and instability, and fifteen (75 per cent) had limited motion of the elbow. Radiographically, eleven were considered to have a reactive non-union and nine, a non-reactive non-union. Seventeen (94 per cent) of the eighteen non-unions ultimately united. Two patients underwent excision of the distal end of the humerus and replacement with an allograft. At follow-up (average, 3.6 years), function in one patient was rated as excellent; in six, as good; in seven, as fair; and in six, as poor. The patients who had an extra-articular supracondylar non-union had the best over-all results, while those who had a non-union that was associated with an intra-articular component or severe soft-tissue trauma did less well. It should be emphasized, however, that most of the patients in this study continued to have a major long-term disability, despite the fact that union was successful.

Adult↗
PubMed1987

Closed nailing of the humerus--from down under.

Closed intramedullary nailing of the humerus using a curved clover-leaf nail (Pohl nail) is a relatively minor operative procedure and is associated with few complications. The technique of the operation when performed from below (29 cases) and also from above (7 cases) is that as described initially by Kuntscher and his colleagues. This paper presents the technique and the experience from 1978 to 1985 with 36 cases (20 for metastatic bone deposits, four in multiple injury patients, three in patients with a severe head injury, four in patients with multiple fractures in the same limb and five in other patients particularly elderly women with osteoporotic bones). This review demonstrates the efficacy of closed intramedullary nailing of the humerus particularly when the nail is inserted into the humerus from below just proximal to the olecranon fossa.

Aged↗
PubMed1987

Closed intramedullary fixation of humeral shaft fractures.

During a seven-year prospective study, 158 humeral shaft fractures in 157 patients were treated with closed intramedullary nailing. Only humeral fractures not responsive to closed reduction and immobilization and those in noncomplaint patients were eligible. No immobilization was used postoperatively. Seven patients were lost to follow-up. A total of 148 fractures healed; there were three nonunions. The average time to clinical union was 7.2 weeks. There were no infections or malunions. Eight of 11 preoperative and three postoperative radial nerve palsies were lesions in continuity and healed spontaneously. The remaining three had been severed by missiles and needed further attention. Nail withdrawal occurred in eight patients; five of these needed nail revision. Final range of motion for the elbow averaged 132 degrees and shoulder abduction-external rotation averaged 168 degrees.

Adolescent↗