Friday, September 28, 2018

Pressure Plate Fixation according to Brunner & Weber for the Treatment of Recalcitrant Non-Union of the Femur. A Theoretical -Biomechanical Analysis-Juniper Publishers


Most femoral fractures heal well with appropriate treatment. Failure of a fracture to heal is often multifactorial. Fractures in the metaphyseal-diaphyseal transition zone that are provoked by the dissipation of high energy are notorious for their complications; such as infections, non-union, mal- union. Delayed union implies slow healing, longer than is reasonably expected for a given fracture. Non-union occurs when a fracture has ceased to show any evidence of healing, as indicated by persistent fracture lines, sclerosis at the fragment ends and hypertrophic or absent callus. ‘Wave’ plate fixation is a form of bridging plate fixation which also tries to enhance the ‘tension band'effect by increasing the offset of an appropriately contoured plate from the loading axis of the femurIn a previous study the authors reported promising results on eight cases of long standing (more than three years) non-union of the femur treated with the compression "wave " plate according to Weber and Brunner. In this study we try to substantiate the alleged benefit of using an autologous iliac strut graft beneath the contoured segment of the plate in decreasing the load on the plate.

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