Milgram J W
Northwestern University Medical School, Chicago, IL 60611.
Clin Orthop Relat Res. 1991 Jul(268):203-13.
Forty-one human tissue specimens from fracture nonunions in extraarticular locations demonstrated a spectrum of clefts at the site of nonunion ranging from tiny microscopic spaces within the soft tissue of the nonunion to dominant clefts that completely separated the ends of the fracture. These latter specimens were examples of frank pseudarthrosis. The soft tissues lining the large clefts were often considerably eroded. Pseudarthrosis of fracture healing may be a late manifestation of more mobile nonunions that progressively tear apart. Fifty-four additional nonunion or pseudarthrosis specimens from former intraarticular fractures demonstrated the same sequence of changes occurring in 24 of the cases. However, 30 of the intraarticular fractures demonstrated no tissues of a fibrous nonunion, which could indicate that in such locations pseudarthrosis may exist from the date of the original fracture.
41例关节外骨折不愈合的人体组织标本显示，骨折不愈合部位存在一系列裂隙，从骨折不愈合软组织内微小的微观间隙到完全分离骨折端的明显裂隙。后一种标本是典型的假关节。大裂隙内衬的软组织常被严重侵蚀。骨折愈合的假关节可能是更易活动的不愈合逐渐撕裂的晚期表现。另外54例既往关节内骨折的不愈合或假关节标本中，24例出现了相同的变化序列。然而，30例关节内骨折未显示纤维性不愈合组织，这可能表明在这些部位，假关节可能自原始骨折时就已存在。
