Skip to main content

Advertisement

SpringerLink
Log in

Delayed union of multifragmentary diaphyseal fractures after bridge-plate fixation

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

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.

Résumé

Malgré le développement des différents traitements, un certain nombre de pseudarthroses sont encore rencontré dans les fractures des os longs des membres. Le but de ce travail est d’évaluer la prise en charge de ces retards de consolidation après fixation par plaque de fractures diaphysaires multi fragmentaires. 19 patients ont été inclus pour ce travail. Ils ont bénéficié d’une reprise chirurgicale pour retard de consolidation après fixation par plaque. Le temps moyen entre l’intervention primaire et la révision a été de 12 à 20 semaines. Dans tous les cas il a été nécessaire d’augmenter la stabilité par l’addition de vis complémentaires. La compression inter fragmentaire a été réalisée chez 16 patients, une compression axiale chez 2 patients et un changement de plaque chez un patient. Une greffe a été nécessaire chez 9 patients. La consolidation a été totale chez tous les patients à 16 semaines après la réintervention. Ce travail a pour but de donner une information concernant l’algorithme chirurgical lorsqu’il existe un défaut de consolidation après ostéosynthèse par plaque.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig 2

Similar content being viewed by others

References

  1. Babhulkar S, Pande K, Babhulkar S (2005) Nonunion of the diaphysis of long bones. Clin Orthop Relat Res 431:50–56

    Article  PubMed  Google Scholar 

  2. Baumgaertel F, Gotzen L (1994) The “biological” plate osteosynthesis in multi-fragment fractures of the para-articular femur. A prospective study. Unfallchirurg 97(2):78–84

    PubMed  CAS  Google Scholar 

  3. Blatter G, Gasser B, Weber BG (1986) Die Wellenplatte. AO Bull 1:3–5

    Google Scholar 

  4. Farouk O, Krettek C, Miclau T, Schandelmaier P, Guy P, Tscherne H (1999) Minimally invasive plate osteosynthesis: does percutaneous plating disrupt femoral blood supply less than the traditional technique? J Orthop Trauma 13(6):401–406

    Article  PubMed  CAS  Google Scholar 

  5. Farouk O, Krettek C, Schandelmaier P, Said GZ, Tscherne H (1999) Anatomic basis of minimally invasive plate osteosynthesis in the femur. Tech Orthop 14(3):158–169

    Article  Google Scholar 

  6. Gautier E, Ganz R (1994) The biological plate osteosynthesis. Zentralbl Chir 119(8):564–572

    PubMed  CAS  Google Scholar 

  7. Müller ME, Allgöwer M, Schneider R, Willenegger H (1991) Manual of internal fixation: techniques recommended by the AO-ASIF group, 3rd edn. Springer, Berlin Heidelberg New York

    Google Scholar 

  8. Pai V, Coulter C, Pai V (2007) Minimally invasive plate fixation of the tibia. Int Orthop 31(4):491–496

    Article  PubMed  Google Scholar 

  9. Richter J, Schulze W, Muhr G (2000) Diaphyseal femur pseudarthroses—only a technical problem? Chirurg 71:1098–1106

    Article  PubMed  CAS  Google Scholar 

  10. Riemer B (2004) Plating diaphyseal fractures. Tech Orthop 18(4):360–367

    Article  Google Scholar 

  11. Ring D, Barrick WT, Jupiter JB (1997) Recalcitrant nonunion. Clin Orthop Relat Res 340:181–189

    Article  PubMed  Google Scholar 

  12. Ring D, Kloen P, Kadzielski J, Helfet D, Jupiter JB (2004) Locking compression plates for osteoporotic nonunions of the diaphyseal humerus. Clin Orthop Relat Res 425:50–54

    Article  PubMed  Google Scholar 

  13. Smith WR, Morgan SJ (2002) Failure of internal fixation of the femoral shaft. Tech Orthop 17(4):448–457

    Article  Google Scholar 

  14. Wenda K, Runkel M, Rudig L (1995) The “inserted” condylar plate. Unfallchirurgie 21(2):77–82

    Article  PubMed  CAS  Google Scholar 

  15. Wenda K, Runkel M, Degreif J, Rudig L (1997) Minimally invasive plate fixation in femoral shaft fractures. Injury 28(Suppl 1):A13–A19

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Assiut University Hospitals, 71516, Assiut, Egypt

    Galal Z. Said, Osama Farouk & Hatem G. Z. Said

Authors
  1. Galal Z. Said
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Osama Farouk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hatem G. Z. Said
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Osama Farouk.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Said, G.Z., Farouk, O. & Said, H.G.Z. Delayed union of multifragmentary diaphyseal fractures after bridge-plate fixation. International Orthopaedics (SICOT) 33, 549–553 (2009). https://doi.org/10.1007/s00264-008-0528-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-008-0528-9

Keywords

Search

Navigation