Treatment of biologically inactive nonunions by a limited en bloc ostectomy and compression plate fixation: a review of 17 cases.
OBJECTIVE
To describe a surgical technique for treatment of biologically inactive nonunions using en bloc ostectomy and compression plate fixation and clinical outcome in 17 dogs.


METHODS
Retrospective clinical study.


METHODS
Seventeen dogs.


METHODS
A transverse ostectomy was performed adjacent and parallel to the nonunion to eliminate nonviable tissue and provide a new, viable fracture surface with a minimum circumferential contact area of 315 degrees. With most of the bony column anatomically reconstructed, compression plate fixation was used to stabilize the fracture. Autogenous cancellous bone grafting was used if a fracture gap was present (<45 degrees of missing circumferential bone contact). Resection of bone was limited so that bone shortening was less than 20% of the overall bone length. Clinical and radiographic follow-up evaluations were obtained whenever possible.


RESULTS
Complete circumferential bone contact and compression plate fixation was achieved after ostectomy in 12 dogs; cancellous bone graft was used in 5 dogs. En bloc ostectomy sites were radiographically healed in a median time of 2.5 months after surgery in 11 dogs that returned for complete in-hospital follow-up, and progressive healing was observed in 3 other dogs, where in-hospital follow-up was obtained up to 2 months after surgery. These dogs had a median follow-up time of 2 months, at which time 6 dogs had no lameness, 4 had minimal lameness, and one had moderate lameness. No complications occurred, and no implants were removed.


CONCLUSIONS
En bloc ostectomy with compression plate fixation was considered successful for the treatment of biologically inactive nonunions. A good to excellent prognosis can be expected with minimal complications.


CONCLUSIONS
Use of an en bloc ostectomy technique for the treatment of biologically inactive nonunions permits easy resection of nonviable tissue. Subsequent fracture stabilization with compression plate fixation resulted in rapid bone healing without complications.
Blaeser
Lauren L
LL
Department of Clinical Sciences, Tufts University School of Veterinary Medicine, North Grafton, MA 01536, USA.
Gallagher
Jack G
JG
Boudrieau
Randy J
RJ
D000818:Animals; D001860:Bone Plates / Q000662:veterinary*; D004285:Dogs; D005260:Female; D005264:Femoral Fractures / Q000601:surgery / Q000662:veterinary; D005593:Fracture Fixation, Internal / Q000379:methods / Q000662:veterinary*; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000601:surgery / Q000662:veterinary*; D006810:Humeral Fractures / Q000601:surgery / Q000662:veterinary; D008297:Male; D011885:Radius Fractures / Q000601:surgery / Q000662:veterinary; D011996:Records / Q000662:veterinary; D012189:Retrospective Studies; D016896:Treatment Outcome