Leczenie braku zrostu septycznych złamań kości przedramienia i kości podudzia u psów przy użyciu okólnego zewnętrznego mocowania szkieletowego – badanie retrospektywne. Cz. II
Discussion
Management of antebrachial and crural septic nonunion fractures in 23 dogs using CESF resulted in bone healing in 20 dogs, while the remaining three dogs underwent amputation. Minor complications occurred in six dogs and major complication occurred in five dogs.
In the planning of nonunion fracture treatment, the biological properties of the nonunion must be considered. Biologically active nonunion fractures have been defined as those that heal without debridement of the nonunion fracture site, provided that adequate stability of the fracture site is ensured (5). A septic biologically active nonunion fracture represents a major problem and debridement of the infected tissue must be considered to reduce the bacterial load (1, 36-39). In our experience, hypertrophic septic nonunion fractures can heal without debridement provided that fracture stabilization is adequate. However, when an open approach is required to remove loose and failed implants, we recommend debridement of the fracture site. Biologically inactive nonu-nion fractures require reactivation of the bone healing process by debridement, which can be accomplished using the traditional technique or the en bloc ostectomy. Both techniques require bone debridement until the so-called ‘paprika sign’, defined as the appearance of scattered pinpoint haemorrhage signalling good vascularity, is observed (32). Blaser and colleagues used en bloc ostectomy to treat both oligotrophic and inactive nonunion fractures, but we used the traditional technique for oligotrophic nonunion fractures and en bloc ostectomy for biologically inactive nonunion fractures [...]
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