Solomin Leonid N, Semenistyy Anton A, Komarov Artem V, Khominets Vladimir V, Sheridan Gerard A, Rozbruch S Robert
Department of Orthopedic Surgery, Vreden National Research Orthopedic Centre, Saint Petersburg, Russian Federation.
Department of Orthopedics and Traumatology, Faculty of Medicine, Medical University of Sofia, Sofia, Bulgaria.
Strategies Trauma Limb Reconstr. 2023 Sep-Dec;18(3):169-173. doi: 10.5005/jp-journals-10080-1597.
The management of bone union disorders is a complex problem in orthopaedics, requiring a reliable and comprehensive classification system for accurate diagnosis and treatment. Despite advances in understanding pathophysiology, diagnosis, and treatment in this area, there is no generally accepted classification system. The aim of our work was to create a comprehensive classification, which will systemize the vast majority of bone union disorders, underline their differences and form the basis for their treatment.
The key criteria for nonunion evaluation and treatment were identified based on the conducted literature review: Time from the initial event (delayed union or nonunion), location, type of pathology (A, Hypertrophic; B, Normotrophic; C, Oligotrophic) and the presence of hardware. Based on these criteria the ULBNC has been developed. Atrophic nonunions were excluded from this classification as they are considered segmental bone defects with special classification.
The ULBNC is based on the same principles of coding as the "gold standard" AO/OTA Fractures Classification system with alpha-numeric coding "from simple to complex." The choice of treatment method depends on the type, group, and subgroup of the nonunion as described.
Universal Long Bone Nonunion Classification (ULBNC) is an alphanumeric system that describes the localization, type of pathology and morphologic characteristics of a nonunion. The use of ULBNC in practice and research will optimize and standardize the treatment of various types of bone healing disorders and eventually improve clinical outcomes.
Solomin LN, Semenistyy AA, Komarov AV, . Universal Long Bone Nonunion Classification. Strategies Trauma Limb Reconstr 2023;18(3):169-173.
骨愈合障碍的处理是骨科领域的一个复杂问题,需要一个可靠且全面的分类系统以进行准确的诊断和治疗。尽管在该领域对病理生理学、诊断和治疗的认识有所进步,但尚无普遍接受的分类系统。我们工作的目的是创建一个全面的分类,该分类将使绝大多数骨愈合障碍系统化,突出它们的差异,并为其治疗奠定基础。
基于所进行的文献综述确定骨不连评估和治疗的关键标准:距初始事件的时间(延迟愈合或骨不连)、位置、病理类型(A,肥大性;B,营养正常性;C,营养不良性)以及内固定物的存在情况。基于这些标准开发了通用长骨骨不连分类(ULBNC)。萎缩性骨不连被排除在该分类之外,因为它们被视为具有特殊分类的节段性骨缺损。
ULBNC基于与“金标准”AO/OTA骨折分类系统相同的编码原则,采用字母数字编码“从简单到复杂”。治疗方法的选择取决于如所述的骨不连的类型、组和亚组。
通用长骨骨不连分类(ULBNC)是一个字母数字系统,描述了骨不连的定位、病理类型和形态学特征。在实践和研究中使用ULBNC将优化和规范各种类型骨愈合障碍的治疗,并最终改善临床结果。
索洛明LN,谢梅尼斯蒂AA,科马罗夫AV等。通用长骨骨不连分类。《创伤肢体重建策略》2023;18(3):169 - 173。