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Review Article
Non-Operative Treatment of Nonunion
Oog Jin Shon, M.D., Man-Ho Lee, M.D., Hyo Sae Ahn, M.D.
Journal of the Korean Fracture Society 2014;27(4):338-347.
DOI: https://doi.org/10.12671/jkfs.2014.27.4.338
Published online: October 20, 2014

Department of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu, Korea.

Address reprint requests to: Oog Jin Shon, M.D. Department of Orthopedic Surgery, Yeungnam University Medical Center, 170 Hyeonchung-ro, Nam-gu, Daegu 705-703, Korea. Tel: 82-53-620-3640, Fax: 82-53-628-4020, maestro-jin@hanmail.net

Copyright © 2014 The Korean Fracture Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Fig. 1
Hypervascular nonunions. (A) Elephant foot. (B) Horse hoof. (C) Oligotrophic.
jkfs-27-338-g001.jpg
Fig. 2
Avascular nonunions. (A) Torsion wedge. (B) Comminuted. (C) Defect. (D) Atrophic.
jkfs-27-338-g002.jpg
Fig. 3
Classification of nonunions by Paley et al. (A) Type A nonunion. (B) Type B nonunion.
jkfs-27-338-g003.jpg
Fig. 4
EXOGEN® Smith & Nephew, Inc. USA.
jkfs-27-338-g004.jpg
Fig. 5
(A) A 64-year-old man with a right tibio-fibular shaft fracture. (B) OR/IF with tibia nail was performed. (C) Five months after the operation, nonunion had developed (arrow). (D) Dynamization was performed. (E) Eight months after the operation (arrow). (F) Computed tomography (CT) image at 13 months after the operation, nonunion was still seen. (G) After use of EXOGEN® for three months, union had progressed on the CT image. (H) Twenty months after the first operation, union was achieved.
jkfs-27-338-g005.jpg
Fig. 6
FORTEO® Lilly USA.
jkfs-27-338-g006.jpg
Fig. 7
(A) An 84-year-old woman with a left femur shaft insufficiency fracture. (B) OR/IF with femoral nail was performed. (C) With use of FORTEO®, union had progressed at two months after the operation.
jkfs-27-338-g007.jpg
Fig. 8
(A) A 25-year-old man with a left femur shaft fracture. (B) OR/IF with femoral nail was performed. (C) Seven months after the operation, nonunion was seen. (D) Dynamization was performed. (E) Two months after dynamization, callus formation was seen. (F) Finally, union was achieved.
jkfs-27-338-g008.jpg

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    Non-Operative Treatment of Nonunion
    Image Image Image Image Image Image Image Image
    Fig. 1 Hypervascular nonunions. (A) Elephant foot. (B) Horse hoof. (C) Oligotrophic.
    Fig. 2 Avascular nonunions. (A) Torsion wedge. (B) Comminuted. (C) Defect. (D) Atrophic.
    Fig. 3 Classification of nonunions by Paley et al. (A) Type A nonunion. (B) Type B nonunion.
    Fig. 4 EXOGEN® Smith & Nephew, Inc. USA.
    Fig. 5 (A) A 64-year-old man with a right tibio-fibular shaft fracture. (B) OR/IF with tibia nail was performed. (C) Five months after the operation, nonunion had developed (arrow). (D) Dynamization was performed. (E) Eight months after the operation (arrow). (F) Computed tomography (CT) image at 13 months after the operation, nonunion was still seen. (G) After use of EXOGEN® for three months, union had progressed on the CT image. (H) Twenty months after the first operation, union was achieved.
    Fig. 6 FORTEO® Lilly USA.
    Fig. 7 (A) An 84-year-old woman with a left femur shaft insufficiency fracture. (B) OR/IF with femoral nail was performed. (C) With use of FORTEO®, union had progressed at two months after the operation.
    Fig. 8 (A) A 25-year-old man with a left femur shaft fracture. (B) OR/IF with femoral nail was performed. (C) Seven months after the operation, nonunion was seen. (D) Dynamization was performed. (E) Two months after dynamization, callus formation was seen. (F) Finally, union was achieved.
    Non-Operative Treatment of Nonunion

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