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At least 19 recordsLinked to original sources

Forearm pseudarthrosis--neurofibromatosis: case report.

A 3 1/2-year-old white girl with neurofibromatosis sustained left radius and ulna fractures. The radius was sclerotic with no medullary canal at the fracture site, and the ulna was hypoplastic distal to the fracture. The fractures failed to unite when immobilized in a long arm plaster cast for 5 months and pseudarthrosis developed. Three subsequent operative attempts to obtain union of the pseudarthrosis by means of internal fixation and bone grafting over the next 30 months were also unsuccessful, and the pseudarthrosis persisted. The forearm was supported in a custom molded leather brace until the child was 13 1/2 years old and had reached skeletal maturity. Osseous union was then operatively obtained using dual onlay tibial cortical and cancellous bone grafts. There has been no recurrence of the pseudarthrosis 3 years and 2 months after bone grafting. The author recommends postponing surgical attempts to achieve union of the forearm bone pseudarthrosis associated with neurofibromatosis until the patient reaches skeletal maturity.

Bone Neoplasms

Severe complication of surgical treatment of congenital pseudarthrosis of the clavicle.

Congenital pseudarthrosis of the clavicle, as observed in a review of the literature, is a rare condition of uncertain etiology which usually presents on the right side. Four of 10 cases were treated by surgical repair of the pseudarthrosis with excision of the non-union and internal fixation with a Steinmann pin and cancellous bone graft. A major postoperative complication in one case consisted of an acute massive neuropraxia of the brachial plexus (recognized 6 hours postoperatively), and was successfully treated by immediate removal of the internal fixation. Ten months postoperatively, the patient was experiencing only minimal weakness of the right opponens muscle. Roentgenograms at this time showed that the pseudarthrosis had healed but with angulation of the clavicle.

Child

[Alternatives for the operative treatment of the pseudarthrosis (author's transl)].

The stable osteosynthesis and bone grafting mostly cause the osseous healing of a false joint (pseudarthrosis). There are cases of pseudarthrosis in combination with other adverse failures. For them even an osseous healing would not achieve painlessness and usability of the limb, but the alternative operation might result in a satisfactory effect.

Adolescent

Congenital pseudarthrosis of the radius.

Five children with six congenital pseudarthroses of the long bones of the forearm are described. Four cases were the result of neurofibromatosis, one was related to fibrous dysplasia, and one appears to be idiopathic. Whereas congenital pseudarthrosis of the leg primarily involves the tibia, congenital pseudarthrosis of the forearm primarily involves the radius. Four of the children were treated with bone grafts of the radius, three requiring repeated grafting. The etiology, differential diagnosis, long term prognosis, and treatment correlate with the data of similar lesions in the tibia. Thus the reason for poor fusion is probably unrelated to weight bearing but is rather the result of underlying bone pathology.

Child, Preschool

[Results of screw fixation of the scaphoid pseudarthrosis].

MATTI-RUSSE's cancellous graft is successful in the management of scaphoid pseudarthrosis. The necessity of post-operative immobilization of the wrist, usually previously immobilized, for up to 16 weeks is its disadvantage. Screw fixation including radial styloidectomy and a small cancellous graft is an alternative abbreviating immobilization to only 2 to 6 weeks. the follow-up of 26 patients thus operated revealed osseous union in 19 cases. The failures were due to lack of proper indication or faulty technique. In spite of the correct position of the scaphoid screw one pseudarthrosis did not heal, the clinical result being satisfactory. The procedure described permits early remobilization of the wrist. Failures, also described by other authors, can be avoided by proper indication and technique.

Adult

Congenital pseudarthrosis of the clavicle.

This is a report of 5 cases of congenital pseudarthrosis of the clavicle, a rare disorder of the shoulder girdle. Little more than 100 cases have been reported in the literature; 3 of our 5 cases represent a very rare form of left side involvement with dextrocardia. The pseudarthrosis mass generally protrudes under the skin and may need surgical correction. When unilateral, there is marked and unexplained predominance for the right side. Three cases required no treatment; 2 were successfully treated by excision of the bone ends, bone grafting and internal fixation.

Child

Preventive treatment of congenital pseudarthrosis of tibia.

If an osteotomy is carried out in a child with congenital angulation of the tibia with segmental sclerosis, a pseudarthrosis develops in many cases. This should be prevented by a bone-graft operation along the concave side of the tibia. The results described illustrate this contention.

Bone Transplantation

Congenital pseudarthrosis of the ulna: a case report.

A case of congenital pseudarthrosis of the ulna is described. The inevitability of dislocation of the radial head in the early years of life, is pointed out. Following dislocation of the radial head, creation of a stable single-bone forearm is necessary to prevent loss of hand function due to effective shortening of the long flexors. A method of radioulnar fusion is described. Following such fusion good hand function can be anticipated, as the vital humeroulna radiocarpal joints are intact.

Child

Treatment of posttraumatic clavicular pseudarthrosis.

Six patients with posttraumatic pseudarthrosis of the clavicle were treated during 1973 and 1974 with an operative technique consisting of trimming of the bone ends, placement of a cortical bone transplant posteriorly and metal plate anteriorly, and fixation of the plates with screws. At examination 10-23 months postoperatively complete healing had been achieved in all cases.

Adult

The transarticular graft for infantile pseudarthrosis of the tibia. A new technique.

Fourteen cases of pseudarthrosis of the tibia in childhood presented at a hospital in Burma over a period of eight years. The ages of the patients ranged from one month to seventeen years. Nine were treated by a pointed graft driven into the medullary cavity of the distal tibia, and usually across the ankle joint into the body of the talus, before fixation to the proximal tibia. In six of the nine union was secured, but one case required a second grafting. Transarticular segments of graft showed a marked tendency to undergo absorption. No significant deformity was observed to follow central penetration of the growth plate and epiphysis of the lower tibia.

Adolescent

Treatment of congenital pseudarthrosis of the tibia with direct current.

Bone possesses a bioelectric property that is important in maintaining its structural and architectural integrity. In vivo experiments demonstrate that bone formation can be accelerated by the application of direct current. We hypothesize that bone formation occurs through an electrochemical rather than an electromechanical effect. Two cases of congenital pseudarthrosis of the tibia treated by direct current stimulation are presented. A bone graft may be added to enhance bony union in conjunction with direct current. The implications of this work are that there is need for further fundamental studies including ultrastructural observations.

Adolescent

The treatment of infected pseudarthrosis.

Modern tendencies in the treatment of infected pseudarthrosis are discussed and compared with the methods of the recent past. Seventy four cases are analysed in detail. Fifty three were in the tibia, twenty six of which were treated by a standard modern technique consisting of osteomuscular decortication, excision of infected tissues and necrotic bone, external fixation and if necessary the addition of autoplastic cancellous grafts. The main purpose of this study was to analyse these results and assess the validity of this method.

Abscess

Congenital pseudarthrosis of long bones: a clinical, radiographic, histologic and ultrastructural study.

Sixteen patients with pseudarthrosis of the tibia and one of the radius were evaluated clinically, radiograpically, and microscopically and separated into 3 groups; 8 had neurofibromatosis clinically, 3 had fibrous dysplasia histologically, and 6 had no evidence of either neurofibromatosis or fibrous dysplasia. Prognosis and therapy were determined by correlated clinical, radiographic, and histological observations. Fracture before age 2 years carried a poor prognosis. Electron microscopy allowed neither differentiation among these fibrous lesions, nor any clue to their origin, nor did it support the concept of a neural or vascular derivation.

Adolescent

[A case report: pseudarthrosis of the os lunato-triquetrum?].

The reported case is in its development, diagnostic, course, and legal aspect so extraordinary, that an explicit report is justified. The patient complained of pain in his right wrist region some days following an unusual work with a drilling machine for eight days. The X-rays six months later showed an irregular joint space between the lunate and triquetrum bone, while on his left wrist a synostosis between these bones was found. These changes seemed to be suspicious for a pseudarthrosis of a congenital synostosis, but this diagnosis led to a six years' controversy in several legal procedures. The different interpretations (judgements) by the attending doctors, specialists, and judicial experts, show again the importance of an exact early documentation with sufficient primary X-rays, eventually with comparison of the other hand. During treatment, nothing should be left undone which could support or refute especially an unusual diagnosis.

Adult

[Comments on pseudarthrosis of the cuneonavicular joint (author's transl)].

This paper reports on the result of central bone chip bolting in the treatment of pseudarthrosis of the cuneonavicular joint, using an autologous bone chip according to the method evolved by Wilhelm and Sperling. The surgical procedure and postoperative course are described in detail, as well as the findings of a followup check effected two years later.

Carpal Bones