Fracture healing disorders

Fracture healing disorders include :

prolonged healing;
malunion;
hinge.

Prolonged fracture healing[edit | edit source]

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[edit | edit source]

poorly healed fracture of the femur

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.

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 ).

Hypertrophic tibial arch

The fracture line is filled with fiber and surrounded by a fibrous sheath that contains fluid.

Classification according to clinical findings[edit | edit source]

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

Atrophic and necrotic joint

Classification according to Čech and Weber[edit | edit source]

Vital – insufficient stabilization and immobilization of the fracture, sufficient blood supply and tendency to healing..
- Hypertrophic ;
- normotrophic – occurs mostly in unstable osteosyntheses;
- oligotrophic – usually arises from overextended skeletal traction.
Vital - insufficient blood supply, sclerotization or osteoporosis of bone ends.
- Dystrophic ;
- necrotic ;
- defective ;
- 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.

Links[edit | edit source]

Source[edit | edit source]

PASTOR, Jan. Langenbeck's medical web page [online]. [cit. 12.4.2010]. <https://langenbeck.webs.com/>.