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J Orthop Trauma. 2007 Aug;21(7):507-11.

Infected nonunion of the long bones.

Author information

  • 1Department of Orthopaedic Surgery, Academic Medical Centre; Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. p.a.struijs@amc.uva.nl

Erratum in

  • J Orthop Trauma. 2013 Dec;27(12):e274.

Abstract

BACKGROUND:

Although definitions vary, infected nonunion has been defined as a state of failure of union and persistence of infection at the fracture site for 6 to 8 months.>). Infected nonunions of the supracondylar region of the femur are uncommon and are mostly due to a severe open fracture with extensive comminution and segmental bone loss or after internal fixation of a comminuted closed fracture. Associated factors include exposed bone devoid of vascularized periosteal coverage for more than 6 weeks, purulent discharge, a positive bacteriological culture from the depth of the wound, and histologic evidence of necrotic bone containing empty lacunae. Soft-tissue loss with multiple sinuses, osteomyelitis, osteopenia, complex deformities with limb-length inequality, stiffness of the adjacent joint, polybacterial multidrug-resistant infection, and smoking all complicate treatment and recovery. Although uncommon in incidence, infected nonunions of the long bones present a great challenge to the orthopaedic surgeon in providing optimal treatment of this entity. To give direction to the optimal strategy, this systematic review was performed.

OBJECTIVE:

We aimed to review the highest level of available evidence on the operative management of infected nonunions of the long bones.

PMID:
17762489
[PubMed - indexed for MEDLINE]
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