What is pseudarthrosis (false joint, neurotron): causes, treatment, complications
Pseudarthrosis as a complication after trauma
Recovery time after a bone fracture can range from 4 to 6 months, depending on the complexity of the pathology. Throughout time with the help of radiology showing signs of splicing.
In rare cases this is not enough time for rehabilitation, it is also a sign of slow consolidation.
At fracture can be used with fragments not only for external but also for internal bracing, which in turn, helps to adjust the bone fragments.
After healing the fracture line is smoothed and becomes almost invisible. But, eventually, it can slightly expand and the gaps formed bone irritationa corn, devoid of clear contours, which is called a false joint or pseudarthrosis.
Primary and secondary pseudarthrosis
Today, there is several types of reparative regeneration of bone tissue:
- What is happening in a very short time – the primary. Splicing is carried out by primary osteogenesis. Thus between fragments formed corn – intermediary. Basically this kind of pathology occurs in a compression or impacted fracture. If the debris is fixed securely and reposition happens is, the diastasis will not exceed 100 CMI.
- If the bone fuses with no cracks and only in vascular channels, this kind of is called primary-delayed splicing. Thus there is only partial fusion. For full, interosseous fusion requires the resorption of the edges of the fragments.
- This kind of disease involves the formation of several varieties of corn – endostyle, periosteal blood and parasaling. In this case the fixation of the fragments is due to the corn and not carried out by a specialist. In secondary splicing the healing process may significantly increase.
It might be associated with the development violations?
Podiatrist Dikul: «the Penny product is No. 1 to restore the normal blood supply to the joints. Back and joints will be like in 18 years, enough time in the day to smear… Read more
As already mentioned, there are congenital and acquired pseudarthrosis. While innate is extremely rare and it is due to intrauterine disruption of the formation of bone tissue or genetic disorder.
Nonunion acquired nature can develop under the influence of many factors. The most common provocateurs of pathology:
- the formation of calluses is due to the many destruction;
- in the case between the bone fragments have a diastasis and there is a shift;
- in some cases, this may be the result of a violation of osteosynthesis;
- if improperly performed the prescribed exercise or they fail to meet the occasion;
- pseudarthrosis develops when joining a secondary infection;
- impact on education may violate the blood supply.
In addition, non-accrete fractures and pseudarthrosis can be formed in the result of the following factors:
- provocateur can be a pathology of metabolic disorders (often is found in people prone to obesity);
- the breach may be the result of diseases related to endocrinology;
- infectious diseases;
- disorders associated with blood circulation, especially under heavy blood loss;
- in the case of multiple fractures;
- pseudarthrosis develops in disorders of innervation;
- in combined lesions.
Characteristics of the clinical picture
Signs of a pseudarthrosis:
- Observed mobility in those places where previously it was not. This may change the direction of motion or increased amplitude. Similar symptoms in a healthy person is impossible. Today, there are cases when the arm or leg could be rotated 360 degrees.
- A clear manifestation of violation is shortening of the limb. The difference before and after may be about 10 centimeters.
- The pathology also affects the muscles. A decrease in strength.
- About the disease may indicate loss of normal functioning of the limbs. This is especially true when given to the load, in this case to stand, walk and lean on the affected leg is impossible.
- Problems with the functioning of the true joints. This is due to missing must load.
Objectives and methods of diagnosis
In the diagnosis of pathology, it is important to consider not only collected the clinical data and other factors. It is important to consider the expected duration of the splicing bones.
Once the deadline passes, it will be clear to status damage. If the period exceeds several times, then a specialist will diagnose the formation of pseudarthrosis.
In addition, be sure the patient is x-rayed in two projections. This event is necessary for the sake of completeness, which will be made appropriate conclusions, and assigned treatment.
The fact of the fracture sets if the x-ray showed:
- the complete absence of callus, which performs a connecting role;
- if you can see the ends of fragments, and their flattened, conical or rounded form evidence about the progression of atrophic joint;
- imperforate cavities of the ends of the fragments.
If a patient develops a pseudarthrosis, the end of a fragment will have a hemispherical shape, which looks more like the articular head. While the other end may be a little concave. In this case, an x-ray will clearly show the joint formed the slit.
If necessary, clarify the intensity of bone formation, may further be performed radionuclide studies of the affected limb.
Treatment of disorders
Pseudarthrosis can only have one treatment option is surgery. And the sooner the pathology is identified and addressed, the less painful will the operation and faster healing.
If you develop a hypertrophic pseudarthrosis, before the specialist task of fragment fixation. For this you can use various methods, one of which is the osteosynthesis.
At the moment when the fragments cease to move relative to each other, the process of recovery that will give the first significant results after several weeks.
If there is development of atrophic pseudarthrosis, there is a need to remove all sections, which is bad krovosnabjaemah or does not receive proper. The fragments need to be joined, immobilize and leave in this position until complete healing.
After surgery, the patient is prescribed a course of massage and medical gymnastics, which aims at restoring the proper functioning of the extremity, vascularity and muscle strength.
Pathology, if left untreated, can lead to incorrect functioning of limbs or even complete loss of mobility.
A few words on prevention
Currently preventative measures of pseudarthrosis as there are none. If we are talking about acquired diseases, it is only about can take care of the patient is a careful attitude to their own body and prompt treatment of the fracture.
In addition, you need to follow the immobilization of the affected area. During the recovery period limb, gypsum and other methods of fixation are removed only by the expert, doing it yourself is not recommended, if you have not received such instructions from the doctor.
If earlier time to remove the retainer structure, of pain, may not follow, but there is a big chance of incorrect or incomplete fusion of bone, and with it increases the likelihood of pseudarthrosis.