[Aseptic pseudarthrosis of the tibial shaft: cause and treatment].
A consecutive series of 23 aseptic pseudarthroses of the tibial shaft is proposed. The aetiology of a pseudarthrosis of the tibia depends on the original fracture form, the associated soft tissue injury, the treatment technique and the surgical procedure. Twelve times the pseudarthrosis developed after a primary treatment with an external fixation device, 6 times after plaster cast immobilization, and 5 times after plate osteosynthesis. Fifteen times, the pseudarthrosis was hypertrophic, and 8 times hypotrophic. Sixteen pseudarthroses were treated with a plate osteosynthesis, 8 times in combination with a decortication and a cancellous bone grafting. Seven times, a closed intramedullary nailing was performed. Healing was achieved after an average time of 5.1 month. After plaster cast immobilization and external fixation treatment, the non-union is caused by a lack of stability in the fracture region; after plate osteosynthesis by a too extensive decortication, resulting in fragment necrosis. Stability and vitality in the fracture site are the principles in the treatment of the pseudarthrosis.
Vanclooster
P
P
Afdeling Algemene Heelkunde-Traumatologie, Katholieke Universiteit Leuven, Belgie.
Rommens
P
P
Broos
P
P
Gruwez
J A
JA
D000328:Adult; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D009984:Orthopedic Fixation Devices; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011859:Radiography; D013978:Tibial Fractures / Q000150:complications*; D014945:Wound Healing
De aseptische pseudarthrose van de tibiaschaft: oorsprong en behandeling.