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Minimally invasive plate augmentation in the treatment of long-bone non-unions

Title
Minimally invasive plate augmentation in the treatment of long-bone non-unions
Author
박기철
Keywords
Hypertrophic non-union; Minimally invasive plate augmentation; Bone graft; Exchange nailing
Issue Date
2017-11
Publisher
SPRINGER
Citation
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, v. 137, no. 11, page. 1523-1528
Abstract
Exchange nailing is most acceptable for treating hypertrophic non-union of the long bones, requiring the removal of previously fixed implant. However, its main effect of mechanical stabilization is controversial in non-isthmal area. We hypothesized that minimally invasive plate augmentation over the non-union site may have a better option, without the need of bone grafting or removing pre-existing implants.Seventeen patients with hypertrophic non-union of the long bones between 2010 and 2014 on radiography who previously underwent intramedullary (IM) nailing or plate osteosynthesis for long-bone fractures were included. A locking compression plate was inserted with at least three mono- or bicortical screws at each proximal and distal segment. Broken or loosened interlocking screws of IM nail were simultaneously re-fixed. Fracture site exposure, pre-fixed implant removal, and bone grafting were not performed. We investigated whether union occurred and analyzed functional outcomes and complications.Eleven femoral and six tibial non-unions were prospectively included. In the pre-existing implants, 13 nails and 4 plates were found. All cases achieved union at a mean 22.7 weeks. One case of superficial infection was managed with oral antibiotics. Deep infection or implant failure did not occur.Minimally invasive plate augmentation can achieve additional stability and promote healing of hypertrophic non-union of the long bones. When indicated, this technique is the least invasive alternative to exchange nailing and reduces surgical risks in the treatment of diaphyseal non-union.
URI
https://link.springer.com/article/10.1007%2Fs00402-017-2773-0https://repository.hanyang.ac.kr/handle/20.500.11754/116204
ISSN
0936-8051; 1434-3916
DOI
10.1007/s00402-017-2773-0
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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