[The value of intramedullary boring and intramedullary splinting in revision of infected pseudarthroses]. 1995

P E Ochsner, and R W Hügli
Orthopädische Klinik, Kantonsspital Liestal.

In the treatment of pseudarthrosis with only a segmental loss of bone elements a reconstruction by the Ilizarov method is too complicated, and simple decortication and plastic surgery with cancellous bone grafting is usually too slow. With reference to three cases, it is shown that simultaneous debridement and bone reaming can improve clearance of the infection. Using decortication and autologous cancellous bone grafting, it is possible to leave the center of the bone free by temporarily inserting a silicon tube. As a result cancellous bone can be saved and the danger of a relapse will be minor. In two cases this technique with the central silicon tube was applied for the first time within the scope of plastic surgery with cancellous bone. If, as in the third case, there is enough bone substance in the region of the pseudarthrosis with swelling of the soft tissue or fistulation, in selected cases reaming of the bone cavity and decortication are all that is necessary. The average length of follow up was 19 months. Only in one of our cases did local inflammation recur 9 months after clearance, which healed rapidly with conservative procedures. The other patients had no episodes of this nature. In our group, the patients achieved full weight-bearing on their leg without external support in an average of 5 months. Compared with another study conducted in Liestal, in which a similar group (infected pseudarthrosis with bone defects of 4-11 cm) was treated by the Ilizarov technique, shortening of the treatment by an average of 4 months was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D008297 Male Males
D008768 Methylmethacrylates The methyl esters of methacrylic acid that polymerize easily and are used as tissue cements, dental materials, and absorbent for biological substances.
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010019 Osteomyelitis INFLAMMATION of the bone as a result of infection. It may be caused by a variety of infectious agents, especially pyogenic (PUS - producing) BACTERIA. Osteomyelitides
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011542 Pseudarthrosis A pathologic entity characterized by deossification of a weight-bearing long bone, followed by bending and pathologic fracture, with inability to form normal BONY CALLUS leading to existence of the "false joint" that gives the condition its name. (Dorland, 27th ed) Pseudoarthrosis,Pseudarthroses,Pseudoarthroses
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D001853 Bone Marrow The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. Marrow,Red Marrow,Yellow Marrow,Marrow, Bone,Marrow, Red,Marrow, Yellow
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D005593 Fracture Fixation, Internal The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment. Osteosynthesis, Fracture,Fixation, Internal Fracture,Fixations, Internal Fracture,Fracture Fixations, Internal,Fracture Osteosyntheses,Fracture Osteosynthesis,Internal Fracture Fixation,Internal Fracture Fixations,Osteosyntheses, Fracture

Related Publications

P E Ochsner, and R W Hügli
August 1947, Medical bulletin. United States. Army. Forces in the European Theater. Office of the Theater Chief Surgeon,
P E Ochsner, and R W Hügli
January 1962, Ciba symposium. [English ed.],
P E Ochsner, and R W Hügli
October 1973, Monatsschrift fur Unfallheilkunde, Versicherungs-, Versorgungs- und Verkehrsmedizin,
P E Ochsner, and R W Hügli
January 1971, Archiv fur orthopadische und Unfall-Chirurgie,
P E Ochsner, and R W Hügli
January 1976, Chirurgia narzadow ruchu i ortopedia polska,
P E Ochsner, and R W Hügli
January 1982, Archivio "Putti" di chirurgia degli organi di movimento,
P E Ochsner, and R W Hügli
October 2013, HSS journal : the musculoskeletal journal of Hospital for Special Surgery,
P E Ochsner, and R W Hügli
January 1973, Hefte zur Unfallheilkunde,
Copied contents to your clipboard!