Non-Operative Treatment of Nonunion

Oog Jin Shon; Man-Ho Lee; Hyo Sae Ahn

doi:10.12671/jkfs.2014.27.4.338

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Shon, Lee, and Ahn: Non-Operative Treatment of Nonunion

Review Article

Journal of the Korean Fracture Society 2014; 27(4): 338-347.

Published online: 20 October 2014

DOI: https://doi.org/10.12671/jkfs.2014.27.4.338

Non-Operative Treatment of Nonunion

Oog Jin Shon, M.D., Man-Ho Lee, M.D., Hyo Sae Ahn, M.D.

Department of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu, Korea.

Address reprint requests to: Oog Jin Shon, M.D. Department of Orthopedic Surgery, Yeungnam University Medical Center, 170 Hyeonchung-ro, Nam-gu, Daegu 705-703, Korea. Tel: 82-53-620-3640, Fax: 82-53-628-4020, maestro-jin@hanmail.net

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figures and Tables

Fig. 1

Hypervascular nonunions. (A) Elephant foot. (B) Horse hoof. (C) Oligotrophic.

Fig. 2

Avascular nonunions. (A) Torsion wedge. (B) Comminuted. (C) Defect. (D) Atrophic.

Fig. 3

Classification of nonunions by Paley et al. (A) Type A nonunion. (B) Type B nonunion.

Fig. 4

EXOGEN® Smith & Nephew, Inc. USA.

Fig. 5

(A) A 64-year-old man with a right tibio-fibular shaft fracture. (B) OR/IF with tibia nail was performed. (C) Five months after the operation, nonunion had developed (arrow). (D) Dynamization was performed. (E) Eight months after the operation (arrow). (F) Computed tomography (CT) image at 13 months after the operation, nonunion was still seen. (G) After use of EXOGEN® for three months, union had progressed on the CT image. (H) Twenty months after the first operation, union was achieved.

Fig. 6

FORTEO® Lilly USA.

Fig. 7

(A) An 84-year-old woman with a left femur shaft insufficiency fracture. (B) OR/IF with femoral nail was performed. (C) With use of FORTEO®, union had progressed at two months after the operation.

Fig. 8

(A) A 25-year-old man with a left femur shaft fracture. (B) OR/IF with femoral nail was performed. (C) Seven months after the operation, nonunion was seen. (D) Dynamization was performed. (E) Two months after dynamization, callus formation was seen. (F) Finally, union was achieved.

Notes

Financial support: None.

Conflict of interest: None.

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