title: [Long Bone Nonunion].
abstract: The percentage of delayed or non-unions after fractures of long bones depends on the individual risk profile at approximately 10 %. The current definition states that a non-union is a fracture that will not consolidate without any further intervention - independent from the treatment time. At the early stage of a non-union a conservative treatment is possible in case of an adequately stable situation. The operative treatment depends on the type of the non-union. There are one-step or two-step procedures, all according to the principles of the "diamond concept". This means improvement of the mechanical situation - in most cases by means of a reosteosynthesis - and vascularization, local application of osteoconductive carriers e.g. tricalciumphosphate, vital cells from autologous bone and osteoinductive substances like bone morphogenetic proteins (BMP-2 or BMP-7). Hypertrophic and atrophic non-unions without large defect gaps or signs of infection can be treated with a one-step procedure. For treating infected non-unions or non-unions with large defect gaps the Masquelet technique is recommended.
authors.affiliation: Unfall- und Wiederherstellungschirurgie, Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinik Heidelberg.
authors.forename: G
authors.initials: G
authors.lastname: Schmidmaier
authors.affiliation: Unfall- und Wiederherstellungschirurgie, Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinik Heidelberg.
authors.forename: A
authors.initials: A
authors.lastname: Moghaddam
mesh_terms: D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D019485:Bone Morphogenetic Proteins / Q000008:administration & dosage*; D016025:Bone Transplantation / Q000295:instrumentation / Q000379:methods*; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D019317:Evidence-Based Medicine; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D011542:Pseudarthrosis / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D019485:Bone Morphogenetic Proteins