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Septic Non-Union

The infection can complicate a fracture. This can occur in at least 3 situations:

 
 

  • after open fractures (fractures in which the bone protruding from the skin);
  • fractures with severe damage of the overlying tissues;
  • after surgical fixation of the fracture with screws, metal plates, nails or external fixators.

   

Sign of infection (pain, swelling, redness, local warmth, stiffness of the adjacet joints, fever, etc.) may become evident after weeks or months from trauma or surgery.

  

When the infection complicates a fracture, healing of the fractured bone is, usually, delayed, and sometimes can not take place.

 

If no bone healing or callus formation is seen after more than 7 months from fracture, a "nonunion" has taken place.

  

If the non-union occurs in the presence of bone infection, it is called a "septic nonunion." This condition is very serious and difficult to manage, often requiring long and complex treatments.

  


Pseudoartrosi settica di tibia 

  

  

  

    Septic Non-Union of the tibia, with external fixator in place

BIOPHYSICAL BONE HEALING STIMULATION

Beside various and often necessary surgical approach to the treatment of septic non-unions, biophysical stimulation allow to accelerate bone healing through a conservative management.

  

The electromagnetic fields , electric fields and ultrasound low energy today represent a powerful tool available to the orthopedic world to stimulate bone growth and cartilage , improving the results of surgical treatments and, sometimes, making them no longer needed.



The interest in the relationship between biological systems and electricity can be traced back to both Galvani's studies and Matteucci research, who already in 1860 had identified patterns of injury and had understood the role of electricity in the healing process.

  

 The research on the possible application of physical energy to turn the bone healing process has continued throughout the last century, with studies on magnetic fields (inductive technique) , electric fields (capacitive technique) and mechanical stimuli (ultrasounds) to facilitate the acceleration reparative osteogenesis.



The effectiveness of physical stimulation is now well documented and based on sound science as demonstrated by the results of in vitro studies, in vivo and in the clinic.



In particular treatment with low-intensity pulsed ultrasound is able to accelerate healing of fresh fractures by about 30 % and lead to consolidation fractures who have difficulty to heal in about 85 % of cases , even in the presence of infection.

  

igeafast

The low-intensity pulsed ultrasound can be used easily by following simple instructions, in their own homes, 

  

Treatment lasts 20 minutes once or twice a day for at least 30 days and is totally harmless.



The orthopedic surgeon will indicate the correct positioning of the ultrasound probe on the skin above the fracture site and control with a simple X-ray examination the effectiveness of the cure at predetermined time intervals.

 

Bone and Joint Infections

Galeazzi Institute - Milano - Italy

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