Emerging Techniques for Malunions and Nonunions | The Penn Orthoplastic Limb Salvage Center

(slow-paced music) – About 85% of all fractures heal, so that really means
that only 15% don’t heal. So why didn’t it happen? A malunion of a fracture is really a fracture that has healed in a way that causes functional deficit. One example I can give you
is malrotation of the femur. When the fracture was fixed, it was fixed in a way
where the leg was rotated. And it’s clear when you stand that the foot is really angled. Now there are limits to that. The body can tolerate a certain amount of rotational deformity, but if it’s too much, it’s gonna then cause a chain reaction, if you will, of the body. The nonunion of a fracture is a fracture that hasn’t healed. And the problem with a nonunion is, number one, they can be painful, and number two, they
can limit your function, typically because the pain or the instability from
the fracture still move it. Usually, the problem is
in one of four domains or some combination thereof: infection, the blood supply to the bone, the biomechanics of the fracture, and then the patient’s own host factors. Our approach is really to look at all four of those things and address those in a very systematic fashion. – We have very specialized techniques in reconstructive microsurgery. The ability to transfer living bone with its blood supply, osteotomies, in other
words, rebreaking the bone, using thin wire external fixators, the Ilizarov method. We have very, very powerful tools that are not available in other centers around the country, and they’re right here at Penn Medicine, in our Penn Orthoplastic
Limb Salvage Center. – Not all the factors I take care of here. It’s the reality of the
kind of work that we do. But there are resources
out there for providers who might see situations they
don’t do on a regular basis, and for those providers, the Penn Orthoplastic Limb
Salvage Center is a great option. We’re always available, and we’re always willing
to have that conversation to figure out what the next best thing is for both the patient and the provider.

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