Cases reported "Fractures, Ununited"

Filter by keywords:



Filtering documents. Please wait...

1/10. Extra-corporeal shock-wave therapy in the treatment of non-unions.

    It has been at least a decade since the introduction of extra-corporeal shock-wave treatment (ESWT) for the treatment of non-unions. Despite conflicting opinions in the literature, it is recently experiencing a revival. This paper reports our experience with Ossa Tron, which produces shock-waves electro-hydraulically, on 5 patients. The two successful cases experienced remarkable results of union at an average of 22 weeks after ESWT. The remaining three had disappointing results. A description of the study and a note on the essential issues are presented.
- - - - - - - - - -
ranking = 1
keywords = wave
(Clic here for more details about this article)

2/10. Non-invasive treatment of long-bone pseudarthrosis by shock waves (ESWL).

    Non-invasive treatment of non-union of diaphyses by application of the shock waves known from lithotripsy has proved successful in three out of four cases. Two thousand shock waves with a single-wave energy of 18 kV were applied by the MFL 5000 and HM3 Lithotripters of the Dornier Medizintechnik Company with manual detection of the lesion. The shock waves induced a kind of callus formation in the non-union soft tissue within about 6 weeks, which was successfully maintained and transformed into bony union in all cases but one by dynamic fixation less rigid than a plaster cast. Four cases are documented and the effects of the shock waves and principles of bony union discussed.
- - - - - - - - - -
ranking = 1.5
keywords = wave
(Clic here for more details about this article)

3/10. Electrical bone stimulation: an overview and its use in high risk and Charcot foot and ankle reconstructions.

    Since early work done in the 1950s on the "piezoelectricity of bone," a growing body of basic science and clinical evidence suggests the use of electrical bone stimulation as an adjunct in the treatment of foot and ankle nonunions, fusions, and Charcot arthropathy. Both implantable designs (that allow for direct constant stimulation of bone) and nonimplantable (such as pulsed and combined electromagnetic fields) devices have been studied. Ongoing research continues to support the potential usefulness of these modalities.
- - - - - - - - - -
ranking = 27471.971068557
keywords = electromagnetic
(Clic here for more details about this article)

4/10. The treatment of a phalangeal delayed union using electrical stimulation.

    The use of electrical stimulation to heal ununited fractures or nonunions of phalanges has not been previously reported. A case is reported using pulsed electromagnetic fields (PEMF) in the treatment of a phalangeal delayed union.
- - - - - - - - - -
ranking = 27471.971068557
keywords = electromagnetic
(Clic here for more details about this article)

5/10. Nonunions of stress fractures of the tibia.

    Stress fractures of the tibia commonly occur in the proximal metaphysis and heal readily with rest. Fractures of the middle third of the tibia, on the other hand, are uncommon. We encountered six stress fractures of the middle third of the tibia over a 5 year period. None of these fractures healed with simple immobilization. One was treated with electromagnetic stimulation and failed to unite 2 years after presentation. One patient underwent a biopsy of the lesion without bone grafting and it had not healed when he was last seen. One patient sustained two acute complete fractures, and the stress fracture finally healed after the second acute fracture was openly reduced and internally fixed. The other three lesions were excised and grafted because of failure to unite. They all healed promptly. Stress fractures of the middle third of the tibia are unusual lesions. However, care must be taken in treating them. The patient must protect the extremity until the fracture has completely healed. Surgical excision and bone grafting of the lesion may be required if the fracture does not heal with plaster immobilization.
- - - - - - - - - -
ranking = 27471.971068557
keywords = electromagnetic
(Clic here for more details about this article)

6/10. Bioelectric repair of metatarsal nonunions.

    An exciting new development in the field of bone physiology has been the discovery of electrical potentials in stressed bone and the relation of this knowledge to Wolff's law. The application of these discoveries for the treatment of nonunions by exogenous bioelectric potentials via direct current and pulsed electromagnetic fields has been a major development in orthopedic surgery. To date, the literature reports the use of this new treatment modality in the large long bones of the extremities. The authors have utilized these techniques to repair nonunions of the metatarsals and, in the process, have adapted some of the principles for the small bones of the foot.
- - - - - - - - - -
ranking = 27471.971068557
keywords = electromagnetic
(Clic here for more details about this article)

7/10. The development and application of pulsed electromagnetic fields (PEMFs) for ununited fractures and arthrodeses.

    This article deals with the rational and practical use of surgically noninvasive pulsed electromagnetic fields (PEMFs) in treating ununited fractures, failed arthrodeses, and congenital pseudarthroses (infantile nonunions). The method is highly effective (more than 90 per cent success) in adult patients when used in conjunction with good management techniques that are founded on biomechanical principles. When union fails to occur with PEMFs alone after approximately four months, their proper use in conjunction with fresh bone grafts insures a maximum failure rate of 1 to 1.5 per cent. Union occurs because the weak electric currents induced in tissues by the time-varying fields effect calcification of the fibrocartilage in the fracture gap, thereby setting the stage for the final phases of fracture healing by endochondral ossification. The efficacy, safety, and simplicity of the method has prompted its use by the majority of orthopedic surgeons in this country. In patients with delayed union three to four months postfracture, PEMFs appear to be more successful and healing, generally, is more rapid than in patients managed by other conservative methods. For more challenging problems such as actively infected nonunions, multiple surgical failures, long-standing (for example, more than two years postfracture) atrophic lesions, failed knee arthrodeses after removal of infected prostheses, and congenital pseudarthroses, success can be expected in a large majority of patients in whom PEMFs are used. Finally, as laboratory studies have expanded knowledge of the mechanisms of PEMF action, it is clear that different pulses affect different biologic processes in different ways. Selection of the proper pulse for a given pathologic entity has begun to be governed by rational processes similar, in certain respects, to those applied to pharmacologic agents.
- - - - - - - - - -
ranking = 137359.85534278
keywords = electromagnetic
(Clic here for more details about this article)

8/10. Treatment of delayed union and pseudarthrosis by low frequency pulsing electromagnetic stimulation. Study of 35 cases.

    This is a study of 35 cases of delayed union or established fibrous union ("pseudarthrosis") treated by pulsing electromagnetic stimulation. The treatment, applied up to 12 hours per day, can be carried out at home, with clinical and radiological control every 60 days. The average time of healing was 6 months. Consolidation occurred in 88.5% of cases, usually without the production of excessive periosteal callus. The method was particularly useful and effective in infected fractures, failed bone grafts, revascularisation of fragments showing signs of necrosis, and fractures with associated skin lesions.
- - - - - - - - - -
ranking = 137359.85534278
keywords = electromagnetic
(Clic here for more details about this article)

9/10. Selection, evaluation and indications for electrical stimulation of ununited fractures.

    Management of nonunions requires careful and critical assessment of the true biologic status of the fracture. The mere radiographic persistence of a fracture line does not invariably indicate nonunion. Ten percent of fractures considered initially to be ununited in this series healed spontaneously without further treatment. The patient who has no pain with weight-bearing and no demonstrable motion on careful stress studies does not usually require further treatment, except for protection against reinjury. Intraosseous venography may be useful to distinguish the delayed from the nonunion in order to institute appropriate and early treatment. Percutaneous direct-current electrostimulation is proving to be a reliable and effective method of managing the most common nonunion of the tibia or distal femur. It appears less satisfactory for the more proximal femoral fractures and for fractures of the humerus. Electrical stimulation does not eliminate the need to stabilize the nonunion of either the femur or the upper limb. Electrical stimulation also does not eliminate the need for bone grafting in approximately 15% to 20% of nonunions. The fractures' biologic inability to respond may be identifiable by 99MTc diphosphonate bone scan. The implantable direct-current electrical stimulatory device proved ineffective in this series. Hopefully, further development of this technology may produce more consistent results in the future. The electromagnetic noninvasive stimulator appears to be a useful alternative method to the semi-invasive system. This, of course, should depend on the individual needs of the patient and the nature and location of the fracture. Continued technologic improvement in all electrical stimulatory methods should broaden their usefulness and applicability. However, the healing status of the fracture and the processes by which each fracture responds must be carefully assessed to appreciate what is being effected by electrical stimulation. Critical evaluation and clarification of indications are essential if the patient is to be offered the most effective therapy available.
- - - - - - - - - -
ranking = 27471.971068557
keywords = electromagnetic
(Clic here for more details about this article)

10/10. Non-union of a midshaft anterior tibial stress fracture: a frequent complication.

    We report a case of non-union of a midshaft anterior cortex tibial stress fracture and review the literature concerning this pathological entity. This is a relatively rare clinical form of tibial stress fracture which often results in delayed union, non-union or complete fracture. Initial management is as for a conventional stress fracture, associated in some cases, according to certain authors, with pulsing electromagnetic field physiotherapy. If after 4-6 months no sign of union is present, surgical management is indicated, in the form of excision of the fracture site with or without bone graft.
- - - - - - - - - -
ranking = 27471.971068557
keywords = electromagnetic
(Clic here for more details about this article)
| Next ->


Leave a message about 'Fractures, Ununited'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.