By Redento Mora, Luisella Pedrotti, Gabriella Tuvo (auth.), Redento Mora (eds.)
In 2%-7% of all bone fractures, union is behind schedule or fails. Nonunions of the bones signify a problem for orthopedic surgeons and will have a critical mental effect on those sufferers. furthermore, the social price of dealing with those lesions, frequently requiring a number of approaches, could be very excessive, and issues on the topic of wrong remedy usually are not infrequent. this article relies at the improvement over decades of the units and operative ideas of monofocal, bifocal, and multifocal compression-distraction osteosynthesis, in cooperation with the CITO Institute of Moscow and the LNIITO Institute of Riga, and on 1000's of operative methods on noninfected and contaminated nonunions individually played by way of the authors either within the former Soviet Union, Russia and Italy. the first objective of this booklet is to debate at the moment on hand instruments for diagnosing lengthy bone nonunions, to demonstrate the technique of prevention, and to specify the indicators for administration utilizing compression-distraction techniques.
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Additional info for Nonunion of the Long Bones: Diagnosis and treatment with compression-distraction techniques
Fig. 3. Histologic feature of a hypertrophic nonunion. In the fibrocartilaginous tissue some osteoid trabeculae are seen (Hematoxylin and Eosin, original magnification: x 125) Fig. 4. Hypertrophic nonunion: microscopic feature. Capillary vessels are clearly empty (Hematoxylin and Eosin, original magnification: x 125) Failure of Union 33 On electron microscopy chondroblasts in mineralized areas show a large cytoplasm with abundant mitochondria and endoplasmic reticulum. Within the matrix numerous dense vesicles, partially containing hydroxyapatite crystals, are seen .
Within the matrix numerous dense vesicles, partially containing hydroxyapatite crystals, are seen . Synovial pseudoarthroses may be a late manifestation of more mobile nonunions that progressively tear apart, although in some cases pseudoarthroses may exist from the start. Microscopic examination shows cleft-like spaces filled with synovial fluid within the soft tissues of the nonunion. True synovial lining cells are absent, but fronds similar to synovial villi are sometimes observed [2, 25].
J Bone Joint Surg Br 77[Suppl. 1]:92 Rhinelander FW (1974) Tibial blood supply in relation to fracture healing. Clin Orthop Relat Res 105:34–81 Caterini R, Farsetti P, Tudisco C, Bellocci M (1996) Studio istologico ed ultrastrutturale della pseudoartrosi nell’uomo. Giorn Ital Ortop Traumatol 22:109–117 Dell’Orbo C, Quacci D, Bartolozzi P et al (1988) Aspetti morfologici del tessuto di pseudoartrosi. Atti SOTIMI 51:93–97 Mora R (2000) Tecniche di compressione-distrazione. Amplimedical, Milano Esterhai JL, Brighton CT, Heppenstall RB et al (1981) Detection of synovial pseu- Failure of Union 26.
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