Edinburgh Research Explorer

Non-union: Indications for external fixation

Research output: Contribution to journalArticle

Related Edinburgh Organisations

Open Access permissions

Open

Documents

https://www.sciencedirect.com/science/article/pii/S0020138319301718
Original languageEnglish
Pages (from-to)S73-S78
JournalInjury
Volume50
Issue numberS1
Early online date29 Mar 2019
DOIs
Publication statusPublished - 1 Jun 2019

Abstract

External fixation is currently used as the definitive mode of fracture stabilisation in the management of ˜50% of long-bone non-unions. Distinction between non-union and delayed union is a diagnostic dilemma especially in fractures healing by primary bone repair. This distinction is important, as non-unions are not necessarily part of the same spectrum as delayed unions. The aetiology of a fracture non-union is usually multifactorial and the factors can be broadly categorized into mechanical factors, biological (local and systemic) factors, and infection. Infection is present in ˜40% of fracture non-unions, often after open fractures or impaired wound healing, but in 5% of all non-unions infection is present without any clinical or serological suspicion.

General indications for external fixation include clinical scenarios where; 1) percutaneous correction of alignment, or mechanical stimulation of the non-union site is required; 2) fixation of juxta-articular or ‘emmental’ bone fragments is necessary; and 3) staged bone or soft tissue reconstruction is anticipated. Specific anatomical indications include infected non-unions of the tibia, humerus, and juxta-articular bone.

External fixation is an essential tool in the management of fracture non-unions. However, with greater understanding of the outcomes associated with both external and internal fixation the relative indications are now being refined.

Download statistics

No data available

ID: 81926503