The Early X-ray Diagnosis Of Delayed Infected Nonunion And The Prevention

Objective: As the accelerating development of modernization processinfluence the concept of fracture treatment, more and more clinicians arewilling to accept the internal fixation surgery as a routine treatment expectingto get faster functional recovery. However a non-negligible problems is alsoarise people's attention, the incidence of nonunion is still higher, which is evenup to8%-10%, especially in our country. Somethings are extremelyaggravated this problem, such as: the large number of population andtraumatic fracture,the unequally of medical conditions and treatment offractures. Infection is a serious complication of the fracture after internalfixation and it is also a common cause of delayed union and bone nonunion. Inrecent years, the number of the delayed infected nonunion is increasedsignificantly. Because it has no obvious abnormal clinical symptoms andabnormal laboratory examinations, the diagnosis was late. It's bringspain,limb dysfunction, large of the economic cost and other various adverseoutcomes, extends the patient's sick time and also cause damage to patientswith mental,physical and economic aspects. The development of modernmedicine has improved the nonunion healing level. How can early andcorrectly diagnosis the long bone fracture fixation of delayed infectionnonunion is a difficult problem. How to take effective measures is alsobecome a modern trauma fracture's emphasis.Through observations of18cases of bone nonunion since2009to2011and the relevant foreign reports, Analysis the relationship of between theprevious X-ray and the actual confirmed infection,Summarize the earlydiagnosis of delayed infection bone with X-ray features.Method: Observation of18cases of nonunion since2009to2011in ourhospital for treatment, including10males and8females, aged17to40years, mean28.6years; The time from the operation in local hospital to operation inour hospital, the minimum time6months, up to72months, an average of17.6months;The number of previous surgery: one operation of9cases,twooperation of6cases,more then three operation of3cases; Operation method:10cases with plate and screw,5cases were fixed with interlocked nails,3cases with external fixation. Take a different surgical approach according thelocal infection of the disease. Analysis the relationship of between theprevious X-ray and the actual confirmed infection,Summarize the earlydiagnosis of delayed infection bone with X-ray features.Results: All the patients were followed up for8to24months, an averageof16.4months. All patients were involved in fracture healing, the shortesthealing time was4months and a maximum of12months,an average of12months.Conclusion: Patients who with the fracture fragments uneven boneresorption or osteoporosis,and fractures distal to the abnormal periostealreaction, is a high risk of delayed infection. The specific changes on the X-rayfilm is the strong evidence for the diagnosis of delayed infection.