Outcome of Fixation for Nonunion of Extremities

Purpose. To review the outcomes of 102 consecutive patients who underwent fixation for nonunion of extremities. Methods. Medical records of 71 men and 31 women aged 16 to 82 (mean, 45; standard deviation [SD], 19) years who underwent fixation for nonunion of the upper (n=31) and lower (n=71) extremi...

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Main Authors: Takahiro Niikura, Sang Yang Lee, Yoshitada Sakai, Kotaro Nishida, Ryosuke Kuroda, Masahiro Kurosaka
Format: Article
Language:English
Published: SAGE Publishing 2014-12-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/230949901402200308
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author Takahiro Niikura
Sang Yang Lee
Yoshitada Sakai
Kotaro Nishida
Ryosuke Kuroda
Masahiro Kurosaka
author_facet Takahiro Niikura
Sang Yang Lee
Yoshitada Sakai
Kotaro Nishida
Ryosuke Kuroda
Masahiro Kurosaka
author_sort Takahiro Niikura
collection DOAJ
description Purpose. To review the outcomes of 102 consecutive patients who underwent fixation for nonunion of extremities. Methods. Medical records of 71 men and 31 women aged 16 to 82 (mean, 45; standard deviation [SD], 19) years who underwent fixation for nonunion of the upper (n=31) and lower (n=71) extremities were reviewed. The nonunion types included oligotrophic (n=47), hypertrophic (n=22), atrophic (n=17), defect (n=12), and comminuted (n=4). 13 of the nonunions were infected. 10 patients had concomitant injuries of the brain (n=2), abdomen (n=5), chest (n=1), and spine (n=2). 43 patients were smokers, and 19 had diabetes mellitus. 80 patients had had previous surgery, and 3 had undergone previous radiotherapy. The mean time from injury to nonunion surgery was 19 (SD, 25.6; range, 6–180) months. Outcome measures included bone union, ability to return to original work, pain, gait, and loss of range of motion. Results. The mean follow-up period was 26.6 (SD, 19.9; range, 8–121) months. 100 patients achieved bone union. 83 of them achieved bone union after a single surgery in a mean of 5.6 (SD, 2.9) months. The remaining 17 patients underwent multiple surgeries, 13 of whom had infected nonunions. Two patients did not achieve bone union. Of 64 patients who had work, 47 returned to their original work and 17 did not. Outcome was unsatisfactory in 5 patients who had persistent pain and/or no improvement in gait. Conclusion. Bone union is not necessarily associated with adequate recovery of function.
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spelling doaj.art-fb19e359246142db92e7517cb33e7cbf2022-12-21T17:34:03ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902014-12-012210.1177/230949901402200308Outcome of Fixation for Nonunion of ExtremitiesTakahiro Niikura0Sang Yang Lee1Yoshitada Sakai2Kotaro Nishida3Ryosuke Kuroda4Masahiro Kurosaka5 Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, JapanPurpose. To review the outcomes of 102 consecutive patients who underwent fixation for nonunion of extremities. Methods. Medical records of 71 men and 31 women aged 16 to 82 (mean, 45; standard deviation [SD], 19) years who underwent fixation for nonunion of the upper (n=31) and lower (n=71) extremities were reviewed. The nonunion types included oligotrophic (n=47), hypertrophic (n=22), atrophic (n=17), defect (n=12), and comminuted (n=4). 13 of the nonunions were infected. 10 patients had concomitant injuries of the brain (n=2), abdomen (n=5), chest (n=1), and spine (n=2). 43 patients were smokers, and 19 had diabetes mellitus. 80 patients had had previous surgery, and 3 had undergone previous radiotherapy. The mean time from injury to nonunion surgery was 19 (SD, 25.6; range, 6–180) months. Outcome measures included bone union, ability to return to original work, pain, gait, and loss of range of motion. Results. The mean follow-up period was 26.6 (SD, 19.9; range, 8–121) months. 100 patients achieved bone union. 83 of them achieved bone union after a single surgery in a mean of 5.6 (SD, 2.9) months. The remaining 17 patients underwent multiple surgeries, 13 of whom had infected nonunions. Two patients did not achieve bone union. Of 64 patients who had work, 47 returned to their original work and 17 did not. Outcome was unsatisfactory in 5 patients who had persistent pain and/or no improvement in gait. Conclusion. Bone union is not necessarily associated with adequate recovery of function.https://doi.org/10.1177/230949901402200308
spellingShingle Takahiro Niikura
Sang Yang Lee
Yoshitada Sakai
Kotaro Nishida
Ryosuke Kuroda
Masahiro Kurosaka
Outcome of Fixation for Nonunion of Extremities
Journal of Orthopaedic Surgery
title Outcome of Fixation for Nonunion of Extremities
title_full Outcome of Fixation for Nonunion of Extremities
title_fullStr Outcome of Fixation for Nonunion of Extremities
title_full_unstemmed Outcome of Fixation for Nonunion of Extremities
title_short Outcome of Fixation for Nonunion of Extremities
title_sort outcome of fixation for nonunion of extremities
url https://doi.org/10.1177/230949901402200308
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