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Review paper
Received: 20.02.2019. >> Accepted: 13.05.2019. >> Published: 10.05.2019. Biochemistry
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https://doi.org/10.17392/1016-19

The challenge of nonunion and malunion in distal femur surgical revision

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Giuseppe Rollo ,
Giuseppe Rollo

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital , Lecce , Italy

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Paolo Pichierri ,
Paolo Pichierri

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital , Lecce , Italy

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Predrag Grubor ,
Predrag Grubor

School of Medicine, University of Banja Luka , Banja Luka , Bosnia and Herzegovina

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Antonio Marsilio ,
Antonio Marsilio

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital , Lecce , Bosnia and Herzegovina

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Michele Bisaccia ,
Michele Bisaccia

Department of Orthopaedics and Traumatology, Azienda Ospedaliera “Santa Maria della Misericordia” , Perugia , Italy

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Milan Grubor ,
Milan Grubor

School of Medicine, University of Banja Luka , Banja Luka , Bosnia and Herzegovina

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Valerio Pace ,
Valerio Pace

Department of Orthopaedics and Traumatology, Azienda Ospedaliera “Santa Maria della Misericordia” , Perugia , Italy

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Riccardo Maria Lanzetti ,
Riccardo Maria Lanzetti

Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre, S. Andrea Hospital, University of Rome “La Sapienza” , Rome , Italy

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Marco Giaracuni ,
Marco Giaracuni

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital , Lecce , Italy

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Marco Filipponi ,
Marco Filipponi

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital , Lecce , Italy

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Luigi Meccariello Orcid logo
Luigi Meccariello
Contact Luigi Meccariello

Department of Orthopaedics and Traumatology, Vito Fazzi Hospital , Lecce , Italy

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Abstract

Aim
 To demonstrate validity of a bio-metallic solution in bone healing combined with the quadriceps safe approach in the treatment of nonunions of distal femur while malunions were treated by metallic solution.
Methods
 We treated 57 patients with nonunion or malunion of distal femur at the Orthopaedics and Traumatology Department of a single orthopaedic trauma centre (Italy). A total of 57 patients were divided in two groups: the first (NU) group was composed of 35 patients affected; the second group (MU) was composed of 22 patients affected by malunion of distal femur. Criteria chosen to evaluate the two groups during a clinical and radiological followup were: the quality of life measured by the Short Form (12) Health Survey, the knee function and quality of life related to it measured by the Knee Injury and Osteoarthritis Outcome Score KOOS and the Knee Society Score, bone healing measured by modified Radiographic Union Score by X-rays during the follow-up and CT at one year after the surgery, the difference of the limbs length before and after the revision surgery, and postoperative complications. The evaluation endpoint was set at 12 months.
Results
There were no statistical differences between the two groups.
Conclusion
The role of bio-metallic solution in the treatment of nonunions and malunions is to recreate the knee anatomy and functionality compatible with a satisfactory quality of life.

Keywords:

femoral fractures,
internal fracture fixation,
malunited fracture,
nonunited fracture,
revision surgery

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Vol 16, Issue 2, 2019
The experience of nurse anaesthetists in assessing postoperative pain in orthopaedic patients Preventive health services utilization in patients treated by family physicians The challenge of nonunion and malunion in distal femur surgical revision Rehabilitation of patients with spondyloarthritis: a narrative review Scoliosis induced by costotransversectomy in minipigs model See full issue

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