Evaluation and Treatment of Nonunions in the Osteoporotic Patient

• Published in: Current geriatrics reports 2014-06, Vol.3 (2), p.128-134
• Main Authors: Pesántez, Rodrigo F., Olarte, Carlos Mario, Salavarrieta, Julián
• Format: Article
• Language: English
• Subjects: Bone density; Fractures; Geriatric Orthopedics (EG Meinberg; Geriatrics/Gerontology; Infections; Injuries; Leukocytes; Medicine; Medicine & Public Health; Neurology; Nonsteroidal anti-inflammatory drugs; Osteoporosis; Pain Medicine; Patients; Planning; Psychopharmacology; Quality of life; Rheumatology; Section Editor; X-rays
• ISSN: 2196-7865; 2196-7865
• DOI: 10.1007/s13670-014-0083-8

Nonunions in osteoporotic patients are rare, but the incidence of fragility fractures is increasing, and therefore they will increase over the years. History of the evolution of the nonunion as well as its treatment are of paramount importance in understanding its etiology. Evaluating patient comorbidities and habits as well as a complete physical exam, including soft tissue conditions, deformities and joint stiffness, will help to achieve treatment goals. During evaluation, the use of all x rays, full-length films and laboratory tests to rule out infection will help to plan the surgery and to have all the necessary elements for success. Treatment using the biological chamber and diamond concepts, including the signaling molecules or growth factors, osteoprogenitor cells, extracelluar matrix as scaffold and mechanical stability, are the key elements for success.