Abstract
The causes and results of non-union were investigated in 41 patients (43 non-unions) who were treated at Misasa-Onsen National Hospital during the period of 1976 to 1983.
Twenty femurs, nine tibiae and/or fibulae, eight humeri and six other bones had non-unions.
As to the causes of non-unions, the errors of indication of the management, and in the cases of open reductions, incomplete reductions, insufficiency of the internal fixations and infections were considerable in primary treatment of the fractures.
For the surgical treatment of the non-unions, hemiarthroplasty using prosthesis was performed in two cases of transcervical non-unions of the femoral neck. In the majority of other non-unions, dual plating or intramedullary nailing was tried for internal fixation after refreshing the surfaces of non-unions and bone grafting. But the transverse fixation between the distal fragment and the intramedullary nail by a screw was done in several cases that intramedullary nailing had been applied to non-unions of the shafts of the femurs by closed method. Zuggurtung method was combined with intramedullary nailing in the non-unions of the surgical neck of the humerus and the malleolus.
Hemiarthroplasty yielded acceptable results in two non-unions.
Successful union occurred in all of other 41 cases but one, which was the patient of rheumatoid arthritis with the trochanteric fracture of the femur with affected hip and osteoporosis.
