Kompressionsmarknagelung bei Pseudarthrosen

There are many reasons for delayed union or nonunion in fracture healing. Hypertrophic nonunion following conservative fracture treatment has become rare, while delayed union is quite frequently caused by extensive soft tissue injury, bone loss, deficient blood supply to bone fragments, and inadequate stability of the primary internal fixation. Reamed intramedullary nailing of nonunion is well established since Küntscher pointed out that reaming of the medullary canal caused formation of periostal new bone. The use of interlocking compression nails in the treatment of nonunions of the femur, the tibia and the humerus yields better stability at the fracture site than conventional interlocking nailing. The compression nail combines the advantages of the compression screws used in plating and the benefits of intramedullary reaming of the nonunion and allows immediate full weight bearing on the lower extremity. Interlocking compression nailing for nonunions of the humerus has been followed by a high incidence of failure. Operative treatment of nonunions requires an exact analysis of the causality.