Gudas C J, Cann J E
Department of Surgery, University of Chicago, Illinois.
Clin Podiatr Med Surg. 1991 Apr;8(2):321-39.
Management of malunions, delayed unions, and nonunions is a complex task that initially requires appropriate diagnosis and classification. Diagnostic modalities currently used include radiography, fluoroscopy, tomography, computed tomography, and radionucleotide evaluations. Based on these evaluations, nonunions may be classified as hypervascular or avascular in nature. Determining the presence of a synovial pseudoarthrosis or infection is also vital to nonunion management. Current treatment regimens available include combinations of cast immobilization, electrical stimulation, and surgical repair with and without bone graft. Internal and external fixation also provide rigid stability to promote healing of nonunion sites. Infected nonunions should be managed with appropriate surgical debridement and antibiotics. Internal fixation in the presence of infection may not necessarily need to be removed. There is no single best method for treatment of nonunions. Therapy must be tailored to each individual to provide a cure.
畸形愈合、延迟愈合和骨不连的处理是一项复杂的任务，首先需要进行恰当的诊断和分类。目前使用的诊断方法包括X线摄影、透视、体层摄影、计算机断层扫描和放射性核素评估。基于这些评估，骨不连在本质上可分为高血运性或无血运性。确定是否存在滑膜假关节或感染对于骨不连的处理也至关重要。目前可用的治疗方案包括石膏固定、电刺激以及有或无植骨的手术修复相结合。内固定和外固定也能提供坚强的稳定性以促进骨不连部位的愈合。感染性骨不连应通过适当的手术清创和使用抗生素来处理。存在感染时，内固定不一定需要取出。治疗骨不连没有单一的最佳方法。治疗必须因人而异以实现治愈。
