Not growing together change

Description:

Not growing together change, or change with the slowed-down consolidation, is such change at which there are no expressed clinical and radiological signs of an union of fragments of bones in the maximum terms.

Symptoms of not growing together change:

Symptoms of changes with the slowed-down consolidation are moderate pain and mobility on site of the former change (mobility can be absent on a two-bone segment); the patient with great difficulty raises an extremity, cannot step on it. On the roentgenogram the crack between fragments is found, the bone callosity is absent or is poorly expressed. Marrowy channels remain still open, and the ends of fragments are not atrophied.

The reasons of not growing together change:

The following reasons can cause the slowed-down union of bones:  interposition of soft tissues between fragments, unreasonable frequent change of methods of treatment, bad food, avitaminosis, the postponed infection. However generally slowed down consolidation of fragments is caused by their insufficient immobilization. In similar cases first of all it is necessary to impose well otmodelirovanny plaster bandage creating requisite resistance and axial pressure of fragments on the long term (2-3 months). Quite often such action appears enough for an union of fragments of a bone. It especially belongs to cross fractures of a shin with favorable standing of fragments when axial pressure conducts to an union of fragments.

Treatment of not growing together change:

Proceeding from variety of the reasons for the slowed-down consolidation of fragments, treatment has to be aimed at providing both the local, and general favorable conditions promoting acceleration of processes of regeneration.
Also injections of blood of the patient in a crack between fragments and to the area of a change (5-10 ml), local introduction of various means stimulating bone formation, mud cure, use of a sollyuks, quartz radiation, etc. belong to local influences at in a slowed-up way the growing together change. Along with actions of local character use fortifying and tonics (a hemotransfusion, vitamin therapy, administration of drugs of arsenic, iron, phosphorus, calcium etc.) is shown.
At the adverse provision of fragments (not set fragments, the slanting planes of a break, etc.) at which it is impossible to carry out the alternating axial pressure should not be expected success from use of conservative actions. In such cases operational treatment (refreshing of fragments, reposition, an osteosynthesis wire seams is shown at slanting changes, an intramedullary osteosynthesis at cross changes, bone plastics, etc.). Changes with the slowed-down consolidation come to an end or an union through big term, or formation of a nearthrosis.