title: Delayed union of multifragmentary diaphyseal fractures after bridge-plate fixation.
abstract: Despite recent developments in fracture treatment, cases of non-union after long bone fractures are still encountered. This work aims at evaluating the active management of delayed union after the bridge-plate fixation of multifragmentary diaphyseal fractures by a limited surgical interference. Nineteen patients were included. All had revision surgery for delayed union of multifragmentary diaphyseal fractures after bridge-plate fixation. The period between primary and revision surgery was 12-20 weeks. Increasing stability was performed by adding more screws in all cases. Interfragmentary compression was performed in 16 patients. Axial compression of the fracture was applied in two patients, while one patient had the plate exchanged for a longer one. Bone grafting was added in nine patients. Union was achieved in all patients 8-16 weeks after re-operation. This work is a message for timely surgical interference in delayed union after bridge-plate fixation by a limited surgical procedure, before complete failure of the fracture stabilisation or non-union.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Assiut University Hospitals, Assiut, Egypt.
authors.forename: Galal Z
authors.initials: GZ
authors.lastname: Said
authors.forename: Osama
authors.initials: O
authors.lastname: Farouk
authors.forename: Hatem G Z
authors.initials: HG
authors.lastname: Said
mesh_terms: D000328:Adult; D001860:Bone Plates / Q000009:adverse effects*; D015331:Cohort Studies; D018483:Diaphyses / Q000293:injuries / Q000601:surgery; D004868:Equipment Failure; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D016268:Internal Fixators / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult