Treatment of non-unions with bone defects: which option and why?
Bone defects associated with non-unions occur as a result of the initial insult or as a consequence of bone excision following non-union development. Historically management of this clinical scenario consisted mainly of amputation, which provided a short recovery period but a significant loss of limb function. Today treatment has evolved and multiple options are available for reconstruction of the bone defect. Broadly these are: bone shortening with lengthening later or bone transport and 'docking' (distraction osteogenesis based techniques); the use of vascularised and non-vascularised bone grafts; bone substitutes; stem cells; growth factors; scaffolds and gene therapy.
King's College Hospital, Denmark Hill, London, UK.
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Ashman
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Phillips
D000671:Amputation, Surgical; D001847:Bone Diseases / Q000503:physiopathology / Q000628:therapy*; D001852:Bone Lengthening / Q000379:methods*; D001861:Bone Regeneration; D016025:Bone Transplantation / Q000379:methods*; D005599:Fractures, Ununited / Q000503:physiopathology / Q000628:therapy*; D015316:Genetic Therapy / Q000379:methods*; D006801:Humans; D019857:Osteogenesis, Distraction / Q000379:methods*; D018579:Patient Selection; D023822:Tissue Engineering / Q000379:methods*; D016896:Treatment Outcome