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- W2018293705 abstract "Ununited fractures can be divided into: (1) those in which there is still some attempt at repair of bone—delayed union; and (2) those which are in a fixed state of physiologic inertia—nonunion. The etiologic factors are local and not systemic. In cases of delayed union conservative measures may succeed in stimulating metabolism of bone at the site of fracture, but not in cases of nonunion. Operative measures, preferably the use of an autogenous bone graft, are necessary in the latter cases. Operation should not be undertaken in the face of draining sinuses or of evidence of inflammation. The bone graft should be as large as possible and must be held firmly clamped to the fragments. Multiple chips of bone packed about the site of fracture are of great aid. Fractures of the neck of the femur can be dealt with successfully without arthrotomy in cases in which fibrous union has occurred. The method consists in overcoming the shortening with traction, securing anatomic alignment, and inserting a large piece of autogenous bone, such as a fibular segment of such length that it extends from the trochanter well into the head. This procedure could be called “blind” insertion. It probably is not suitable in cases in which no fibrous union is present; then open operation is preferable. Fractures of the lower end of the humerus are the most difficult of all humeral fractures to deal with and are best treated by the “onlay massive” graft." @default.
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- W2018293705 date "1940-02-01" @default.
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- W2018293705 title "The problem of the ununited fracture" @default.
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- W2018293705 doi "https://doi.org/10.1016/s0002-9610(40)90156-8" @default.
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