Fracture healing disorders

Fracture healing disorders include :


 * prolonged healing;
 * malunion;
 * hinge.

Prolonged fracture healing
The term prolonged fracture healing means that the healing time is longer than the expected fracture healing (6-8 weeks).

It is in process:


 * by prolonging immobilization ;
 * in conservatively treated fractures with operative osteosynthesis ;
 * sometimes spongioplasty is also performed.

Malunion


Malunion represents healing in a malposition.


 * It can be asymptomatic or manifest as dysfunction ;
 * arises during imperfect reposition or after unstable fixation ( redislocation - therefore repeated X-ray checks are necessary);
 * osteotomy and osteosynthesis are performed in the correct position to prevent arthrosis from improper loading.

Paklub
A knock-on ( pseudarthrosis ) is characterized as a disorder of fracture healing, when bone fragments do not fuse together even in a time twice as long as the normal course of healing (until then, we are only talking about prolonged healing ). The fracture line is filled with fiber and surrounded by a fibrous sheath that contains fluid.

Classification according to clinical findings

 * weak : unstable, with great pathological mobility, cannot bear loads
 * solid : without pathological momentum, withstands loads



Classification according to Čech and Weber

 * 1) Vital – insufficient stabilization and immobilization of the fracture, sufficient blood supply and tendency to healing.
 * 2) * Hypertrophic ;
 * 3) * normotrophic – occurs mostly in unstable osteosyntheses;
 * 4) * oligotrophic – usually arises from overextended skeletal traction.
 * 5) Vital - insufficient blood supply, sclerotization or osteoporosis of bone ends.
 * 6) * Dystrophic ;
 * 7) * necrotic ;
 * 8) * defective ;
 * 9) * atrophic.

The most serious form is an infected joint - it occurs in all the above-mentioned forms and can lead to limb amputation. A special example is the tibial joint in fractures of the lower leg, where the fibula heals earlier and acts as a spacer (similarly, earlier healing of the ulna acts in fractures of the radius ).

related articles

 * Bone
 * Prolonged fracture healing
 * Bone growth and healing

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