Osteomuscular decortication for posttraumatic nonunions and delayed unions.

概要

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Osteomuscular decortication, which was advocated by R. Judet et, al, was employed for ten cases of nonunions and delayed unions at Goto Chuo Hospital from June 1983 to December 1984. Out of them eight cases were followed up until bone union. The affected sites were tibia (4 cases), radius (2 cases), fibula (1 case), and femur (1 case). This method consists in elevating cortical chips by means of a sharp chisel, the chip remaining attached to the periosteum and to the muscular tissue surrounding the pseudarthrosis site.Decortication originally does not need any additional operation, such as bone grafting. We, however, investigated the medullary cavities in all cases, and drilled out the closed cavity so as to comunicate with normal medullary cavity. Cancellous chips and or bone block wree packed up to the three cases with large bone defect. The result was that consolidation was obtained in seven cases out of eight, and the remainder (the case of femur) was permitted full weight bearing under observation. The mean period of bone union in seven cases was 4.7 months. In this series decortication seemed to be much beneficial to pseudarthrosis.
西日本整形・災害外科学会の論文