Gharu Eman, John Bobby
Department of Orthopaedics, Christian Medical College & Hospital, Ludhiana, Punjab, 141008 India.
Indian J Orthop. 2024 Sep 18;58(12):1680-1685. doi: 10.1007/s43465-024-01249-6. eCollection 2024 Dec.
Understanding the etiology of nonunion is crucial to its effective management. Nonunion arises from a complex interplay of biological and mechanical factors. High-velocity injuries, which are becoming more prevalent, often involve extensive soft-tissue damage and stripping compromises the vascularity of bone fragments. The lack of adequate blood supply hampers the healing process and contributes to persistence of nonunion. Such injuries often result in high levels of contamination and persistent infections, making fractures particularly difficult to manage and leading to nonunion. Despite recent advances in medical techniques and interventions, managing the problem of nonunion still remains a formidable challenge. Much effort has gone into the understanding of the problem. With this review, we have made an attempt to correlate some of the known factors and looked at the future including the possible role of genetics in predicting the problem and modifying the outcome of nonunion.
了解骨不连的病因对于其有效治疗至关重要。骨不连是由生物因素和机械因素的复杂相互作用引起的。高速损伤越来越普遍,常伴有广泛的软组织损伤,骨膜剥离会损害骨折碎片的血供。血供不足会阻碍愈合过程并导致骨不连持续存在。此类损伤常导致高度污染和持续感染,使骨折的处理尤为困难并导致骨不连。尽管近年来医学技术和干预措施取得了进展,但处理骨不连问题仍然是一项艰巨的挑战。人们已付出诸多努力来了解这一问题。通过本综述,我们试图关联一些已知因素,并展望未来,包括遗传学在预测该问题和改善骨不连治疗结果方面可能发挥的作用。