Compression treatment of long bone pseudarthroses.

In 122 cases of non-union and delayed union, rigid fixation with Swiss compression plates without the use of casts, produced 92.6% success with the first operation. Half of the cases, especially in the well aligned fractures with hypertrophic callus, were treated without bone grafts and without resecting the pseudarthrosis. Non-resection did not adversely affect the healing time or rate. There were 9 failures or 7.4% chiefly in the difficult hypovascular atrophic bone-grafted group. Many of these cases were treated with shingling and grafts as well; 4 cases showed signs of healing but refractured secondary to trauma; 4 of 5 failures were replated and eventually healed. About 83% of the 24 infected cases healed with one compression plate operation. All of the fractures that were dry pre- and post-operatively united. In a few with drainage and poor skin coverage or cicatrix, rigid fixation with external fixators and Steinmann pins were applied. Early active exercises with delayed weight-bearing until union, gave remarkable return of function even in the difficult metaphyseal pseudarthroses. The compression method of rigid fixation is an excellent adjuvant to pseudarthrosis therapy.