Mechanobiology in the management of mobile atrophic and oligotrophic tibial nonunions

Nando Ferreira; Leonard Charles Marais; Colleen Aldous

doi:10.1016/j.jor.2015.10.012

Mechanobiology in the management of mobile atrophic and oligotrophic tibial nonunions

J Orthop. 2015 Nov 1;12(Suppl 2):S182-7. doi: 10.1016/j.jor.2015.10.012. eCollection 2015 Dec.

Authors

Nando Ferreira¹, Leonard Charles Marais¹, Colleen Aldous²

Affiliations

¹ Tumour Sepsis and Reconstruction Unit, Department of Orthopaedic Surgery, Greys Hospital, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, 3201, South Africa.
² Medical Research Scientist, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, 4051, South Africa.

Abstract

Background: Recent research indicates that atrophic nonunions are biologically active and may heal in the optimal biomechanical environment.

Methods: Thirty-three patients with mobile atrophic and oligotrophic tibial nonunions were treated with circular external fixation and functional rehabilitation. Seven patients required autogenous bone graft procedures.

Results: Bony union was achieved after the initial surgery in 31/33 (93.9%) tibias. Two persistent nonunions were successfully treated with repeat circular external fixation without bone graft. This resulted in final bony union in 33/33 (100%) patients.

Conclusion: Mechanobiological stimulation of tibial nonunions can produce union even if the biological activity appears to be low.

Keywords: Atrophic; Circular external fixator; Ilizarov; Nonunion; TrueLok.