Treatment of Atrophic Nonunion - A Report of Two Cases
AbstractOBJECTIVE: To underscores the importance of compression in the management of atrophic nonunion.
METHOD: We report a series of two cases of atrophic nonunions of long bones resulting from long periods of limb immobilization in traditional splints successfully treated by Ilizarov compression technique
RESULT: Long periods of limb immobilization in traditional fracture treatment often result to regional osteoporosis and non-union that does not unite without surgical intervention.2 Simple freshening of bone ends, local splinting or plaster or external fixator support and internal fixation with plates, screws or nail do not give rigid fixation due to bone softening and often result to serial nonunion. Compression of fragment ends is necessary to achieve bone union. Closed distraction technique, a bloodless transformation of bone callus which avoids exposure of fracture site and soft tissue stripping is best suited for treating infected nonunions, limb shortening and axial mal-alignments10. Open compression is indicated where fragment ends are
CONCLUSION: We conclude that the small diameter wires are best suited for compression of osteoporotic bones. Compression osteosynthesis appears superior to open reduction and internal fixation with higher rates of union and lower rates of postoperative complications.
Nig Jnl Orthopaedics & Trauma Vol.2(2) 2003: 124-126