Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Etiology and Management of Nonunion

불유합의 원인과 치료

  • Park, Kyeong-Hyeon (Department of Orthopaedic Surgery, Kyungpook National University School of Medicine) ;
  • Kim, Joon-Woo (Department of Orthopaedic Surgery, Kyungpook National University School of Medicine) ;
  • Oh, Chang-Wug (Department of Orthopaedic Surgery, Kyungpook National University School of Medicine)
  • 박경현 (경북대학교 의학전문대학원 정형외과학교실) ;
  • 김준우 (경북대학교 의학전문대학원 정형외과학교실) ;
  • 오창욱 (경북대학교 의학전문대학원 정형외과학교실)
  • Received : 2017.07.03
  • Accepted : 2017.07.22
  • Published : 2018.02.28
⟨ Previous Next ⟩

Abstract

Nonunion is caused by various factors related to fracture characteristics, patient characteristics, treatment, and infection. Aseptic nonunion, is divided into three categories in accordance with the biological activity of the fracture: atrophic nonunion, oligotrophic nonunion, and hypertrophic nonunion. Treatment of nonunion depends on the cause and classification. Here, we report our experiences and review the various causes of nonunion and treatment methods available.

불유합은 골절의 특성, 환자의 특성 및 치료 등과 관련된 다양한 인자, 그리고 감염 등의 원인으로 발생한다. 감염성을 제외한 비감염성 불유합은 골절부의 생물학적 활동에 따라 위축성, 빈영양형, 그리고 비후형으로 나뉘게 된다. 불유합의 치료는 그 원인 및 분류에 따라 적절한 치료를 하게 된다. 이에 관하여 저자의 경험과 함께 불유합의 원인과 치료 방법에 대해 알아보고자 한다.

Keywords

References

  1. McKee MD, DiPasquale DJ, Wild LM, Stephen DJ, Kreder HJ, Schemitsch EH. The effect of smoking on clinical outcome and complication rates following Ilizarov reconstruction. J Orthop Trauma. 2003;17:663-7. https://doi.org/10.1097/00005131-200311000-00001
  2. Castillo RC, Bosse MJ, MacKenzie EJ, Patterson BM; LEAP Study Group. Impact of smoking on fracture healing and risk of complications in limb-threatening open tibia fractures. J Orthop Trauma. 2005;19:151-7. https://doi.org/10.1097/00005131-200503000-00001
  3. Giannoudis PV, MacDonald DA, Matthews SJ, Smith RM, Furlong AJ, De Boer P. Nonunion of the femoral diaphysis. The influence of reaming and non-steroidal anti-inflammatory drugs. J Bone Joint Surg Br. 2000;82:655-8. https://doi.org/10.1302/0301-620X.82B5.9899
  4. Hak DJ. Management of aseptic tibial nonunion. J Am Acad Orthop Surg. 2011;19:563-73. https://doi.org/10.5435/00124635-201109000-00007
  5. Park J, Kim SG, Yoon HK, Yang KH. The treatment of nonisthmal femoral shaft nonunions with im nail exchange versus augmentation plating. J Orthop Trauma. 2010;24:89-94. https://doi.org/10.1097/BOT.0b013e3181b8dafd
  6. Brinker MR, O'Connor DP. Exchange nailing of ununited fractures. J Bone Joint Surg Am. 2007;89:177-88. https://doi.org/10.2106/JBJS.F.00742
  7. Oh JK, Bae JH, Oh CW, Biswal S, Hur CR. Treatment of femoral and tibial diaphyseal nonunions using reamed intramedullary nailing without bone graft. Injury. 2008;39:952-9. https://doi.org/10.1016/j.injury.2008.02.024
  8. Yang KH, Kim JR, Park J. Nonisthmal femoral shaft nonunion as a risk factor for exchange nailing failure. J Trauma Acute Care Surg. 2012;72:E60-4. https://doi.org/10.1097/TA.0b013e318239caca
  9. Eom TW, Kim JJ, Oh HK, Kim JW. Challenge to treat hypertrophic nonunion of the femoral shaft: the Poller screw augmentation technique. Eur J Orthop Surg Traumatol. 2016;26:559-63. https://doi.org/10.1007/s00590-016-1814-7
  10. Litrenta J, Tornetta P 3rd, Vallier H, et al. Dynamizations and exchanges: success rates and indications. J Orthop Trauma. 2015;29:569-73. https://doi.org/10.1097/BOT.0000000000000311
  11. Oh CW, Apivatthakakul T, Oh JK, et al. Bone transport with an external fixator and a locking plate for segmental tibial defects. Bone Joint J. 2013;95:1667-72. https://doi.org/10.2106/JBJS.L.00238
  12. Oh CW, Song HR, Roh JY, et al. Bone transport over an intramedullary nail for reconstruction of long bone defects in tibia. Arch Orthop Trauma Surg. 2008;128:801-8. https://doi.org/10.1007/s00402-007-0491-8
  13. Ziran BH, Smith WR, Morgan SJ. Use of calcium-based demineralized bone matrix/allograft for nonunions and posttraumatic reconstruction of the appendicular skeleton: preliminary results and complications. J Trauma. 2007;63:1324-8. https://doi.org/10.1097/01.ta.0000240452.64138.b0
  14. Masquelet AC, Fitoussi F, Begue T, Muller GP. Reconstruction of the long bones by the induced membrane and spongy autograft. Ann Chir Plast Esthet. 2000;45:346-53.

Cited by

  1. 다요소 금연 프로그램이 성인골절 환자의 금연 및 골유합에 미치는 효과 분석 vol.27, pp.1, 2018, https://doi.org/10.5953/jmjh.2020.27.1.31