Traumatologists insist that the treatment of fractures and injuries should be carried out gradually. If the cast is removed too early, the loose ends of the bone can form a nonunion. It causes a lot of trouble, pain, becomes the reason of improper load distribution on the musculoskeletal system and spoils aesthetics.
Can a nonunion knit by itself? Usually patients who have faced such a problem come to Ladisten with this question. Experts working at the clinic are able to them using modern minimally invasive techniques.
A nonunion or pseudoarthrosis is a pathology of a congenital and acquired nature, in case of which the continuity of the tubular bone is disrupted and mobility occurs in parts which are not typical to have it.
The pathology can be localized in different places. The nonunion in case of the ankle fracture usually has congenital nature. The rest of the “false joints” are formed after injury.
According to ICD-10, the nonunion is denoted by such codes:
The pathology does not form immediately. In order to confirm that the bones are not knitted properly, a certain period must pass. The Food and Drug Administration (FDA) describes the diagnosis of non-union if at least 9 months have passed since the fracture and no dynamics of callus formation are visible on X-rays over the past 3 months.
A congenital nonunion is formed because of the following reasons:
Among all cases of pseudoarthrosis, the share of congenital pathologies reaches up to 4%. The remaining 96% are acquired. Their main causes are:
At Ladisten, thorough diagnostics are carried out and the consequences of surgical errors are corrected.
Does the nonunion hurt? Patients who have undergone surgery after a fracture and do not feel relief often ask about it. The answer is obvious: it hurts. But besides the pain, other symptoms are added. The main signs of improper knitting of tubular bones are as follows:
If you suspect something is wrong after treating an injury or fracture, you should consult a doctor to perform timely diagnostics. If the process of formation of a nonunion is detected early, the prognosis is favorable.
In terms of clinical recommendations, X-ray is considered the main method used in order to confirm the diagnosis of nonunion. The images must be taken in frontal and lateral projections.
The main symptom of a nonunion is that there is no callus on the X-ray. The ends of the bone fragments are smoothed and rounded, the cavity at the level of the medullary canal is closed.
During diagnostics, the 1976 Weber-Cech classification is used. A nonunion can be:
If a nonunion is present, treatment is impossible without surgery. The damaged area is fixed again surgically for the formation of callus and ossification.
In order to achieve this, osteosynthesis according to Ilizarov is performed. For the operation, an external fixation device which the patient wears for about 6 months is used.
At Ladisten, surgical manipulations are carried out in a minimally invasive way. The method has proven its effectiveness over 30 years of practice. Veklich’s device, which is the new design being used, has a patent. Dr. Veklich’s device is a reliable unit for bone knitting with low weight and improved ergonomics. It doesn’t include traumatic needles, thereby reducing the risk of infection and the duration of rehabilitation.
Early diagnostics and treatment of fractures is the first step in prevention. The main measures include:
If the doctor’s recommendations are followed, the risk of pathology development is reduced.
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