Management of pelvic pseudarthroses and pelvic malunion

Der Orthopäde
D C Mears

Abstract

Nonunion with or without a late pelvic deformity remains a formidable reconstructive problem [1, 2]. For the present discussion, a nonunion is defined as a failure to achieve a union of a pelvic fracture, within six months after the time of injury, as documented by clinical and radiographic assessment. Most of the cases follow conservative management or the initial application of external fixation of a displaced and unstable injury pattern. While most of the nonunions represent a combination of a significant traumatic event, a smaller subgroup constitute pathological fractures or so-called "insufficiency fractures" of osteopenic bone [3]. By definition, the latter group represents a variety of pathological conditions including senile, post-menopausal and post-irradiation osteopenia or after the harvesting of massive autologous bone graft from the posterior ilium. Active malignancy as a factor is wholly excluded from these cases. The present report is based upon our clinical experience of two hundred cases that were managed during the past twenty year period [4]. The results constitute a summary of the observations whereupon certain recommendations for a therapeutic protocol have evolved. With the unusual nature of this clinical...Continue Reading

Citations

Sep 28, 2010·Journal of Orthopaedic Trauma·Berton R Moed, Daniel R Whiting
Nov 20, 2014·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Florian GrasIvan Marintschev
Apr 28, 1999·The Journal of the American Academy of Orthopaedic Surgeons·D C Mears
Nov 18, 2000·Journal of Orthopaedic Trauma·C BellabarbaB R Bolhofner
Feb 3, 2009·Clinical Orthopaedics and Related Research·Nikolaos K KanakarisPeter V Giannoudis
May 5, 2016·Journal of Orthopaedic Trauma·Sami W Mardam-BeyMichael J Gardner

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