Langsam heilende Femurpseudarthrosen: Messung der mechanischen Stabilität mit dem instrumentierten Implantat – 3 Fallberichte.

Introduction: This article reports on three cases of atrophic non-union of the femur after polytrauma, where the very long healing times led to postponement of an intervention. Patients and methods: In all three patients several previous operations with respect to the non-union had already taken place. All patients were treated with a telemetrically instrumented locking plate fixator for mechanical assessment of bone healing, autologous spongiosa and an chain of antibiotics. The monitoring of the healing process took place through telemetric measurements over the entire healing process. Also performed were X‑ray and computed tomography (CT) images during the course. Results: In 1 of the patients the bone healed after 29 months. In the other 2 patients revision surgery was performed after 17 and 8 months, respectively, 1 with cancellous bone grafting and the other with an additional plate. The bones of these patients then healed after 31 and 27 months, respectively. Conclusion: The usual procedure regarding a nonconsolidating non-union after 9 months in X‑ray and CT images is revision surgery, possibly with a change in procedure. The application of a telemetrically instrumented internal fixator for the monitoring of the healing process is a successful procedure to support the physician in decision making. By explanation of the measurement curves by the treating physician, the patient can comprehend that the healing takes longer but the consolidation progresses. [ABSTRACT FROM AUTHOR]