Pseudarthrosis

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Classification according to ICD-10
M84.1 Non-union of the fracture ends (pseudarthrosis)
M96.0 Pseudarthrosis after fusion or arthrodesis
ICD-10 online (WHO version 2019)

Pseudarthrosis (from Greek ψευδής ( pseudes ) - "false" and arthrosis - " joint ") describes the failure to heal a bone fracture or an osteotomy .

term

Old forearm fracture: healed, blocking radius fracture, resulting in "hypertrophic" ulnar osteoarthritis

Synonyms of pseudarthrosis are false joint , sham joint and pseudo-joint . If the fracture healing is not completed within four to six months after the trauma , it is referred to as delayed fracture healing . If the healing takes longer than six months, one speaks of a pseudarthrosis. Bones affected by pseudarthrosis are often shaft fractures of long tubular bones (lower leg, thigh, upper arm and ulna with radius) as well as the navicular bone .

There are also congenital pseudarthroses, e.g. B. on the shin , see congenital tibial osteoarthritis and on the collarbone , see congenital clavicle osteoarthritis .

A distinction is made between two special forms:

The vital pseudarthrosis shows sufficient vascularization , but the fracture is unstable. On the other hand, avital pseudarthrosis shows, in addition to instability, an inadequate blood circulation, often also infected areas or sequesters .

causes

The following causes are considered mechanical factors for the development of pseudarthrosis:

  • Interposition of soft tissues into the fracture gap
  • low compression on the fracture gap, e.g. B. by a dynamic compression plate
  • insufficient immobilization or mobilization too early.

Favoring factors are:

Symptoms

Pseudarthroses often lead to permanent functional impairment and persistent pain. Other features include abnormal mobility and a pseudarthrosis gap with reactive sclerotherapy in the area on x-ray .

therapy

Humeral pseudarthrosis

In the case of a "hypertrophic" vital pseudarthrosis, the characteristics of which are an adequate blood supply, a wide zone of fibrous cartilage formation and a high degree of ossification , this therapy is indicated:

In the case of atrophic avital pseudarthrosis, the hallmarks of which are reduced blood flow and a lack of revascularization due to necrotic fragments, this therapy is required:

literature

  • George Chapchal (Ed.): Pseudarthroses and Their Treatment. 8th international symposium on top problems in orthopedic surgery . Thieme, Stuttgart 1983, ISBN 3-13-562801-9 .
  • Rüdiger Döhler : Pseudarthrosis. In: ders. (Ed.): Lexicon Orthopädische Chirurgie . Berlin 2003, ISBN 3-540-41317-0 , pp. 176-180. GoogleBooks

Web links

Commons : Pseudarthroses  - collection of images, videos and audio files

Individual evidence

  1. a b pseudarthrosis . In: Peter Reuter: Springer Lexicon Medicine. Springer, Berlin a. a. 2004, ISBN 3-540-20412-1 .