DELAYED UNION

FRACTURE

DISUSUN OLEH :
Ingrid Maria K
113170038
PEMBIMBING :
dr. Nunik Royyani, Sp. Rad

Program Pendidikan Profesi Dokter Departemen Ilmu Radiologi

Rumah Sakit Umum Daerah Waled Cirebon
Universitas Swadaya Gunung Jati Cirebon
2018
 ANATOMY
HISTOLOGY
 What is delayed union ?

Fracture that has not completely healed or failed in

the expected time it should have

Callus visible Union Consolidation

2-3 weeks • 4-6 weeks for • 6-8 weeks for

Upper Limb and upper limb upper limb
Lower Limb
• 8-12 weeks for • 12-16 weeks for
lower limb lower limb
 Etiology and Patoghenesis
Systemic Factors
Smoking
 Nicotine is a powerful vasoconstrictor Metabolic Disorders
01 causing reduction in peripheral blood 04  Diabetes melitus can lead to increased ost
flow eoclasts and reduced numbers of osteobla
 carbon monoxide reduces the oxygen sts and bone formation
-carrying capacity of the blood  Hypothroid can lead to vit D deficiency

Soft Tissue Damage

02 Acute alcohol exposure resulted in
significant impairment of fracture
05 Estrogen Loss
Estrogen loss can lead to bone loss
callus tissue formation

Old Age Nutritional Status

03 decreased activity of osteoblasts 06 Vit D and Vit C deficiency
Etiology and Patoghenesis
Local Factors

Soft
Infection Tissue
Damage
01 02
Old Age Impaired
Blood
Supply
06 03
Improper Bone
Fixation
Loss
Method
05 04
 Clinical Features

Absence
Persistent of pain on Instabilty Disuse
pain at palpacition at fractue muscle
fracture of the site atrophy
site fracture
site

Fracture with impaired healing as a delayed union if any above signs were
absent at 6 months
Radiographic Criteria

Visible Fracture Line

1

2 Very little callus formation

3 Periosteal Reaction

4
Delayed union of 1/3 distal femur in 5 Months
Delayed union of both lower leg in 3 months
There is delayed union of fragments after Smith type I fracture, with
almost no callus formation and volar angulation of fragments
Delayed union of scaphoid fracture
 Treatments
Insert the title of your subtitle Here

If alignment is adequate implants are

stable but motion exists at fracture sites
Apply rigid fixation

A
If Reduction is inadequate If alignment is poor
Treat as non union. Straighten and apply rigid
fixation
C B
Thank you
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