The scaphoid is the most commonly fractured bone in the carpus. Although greater than 90% of scaphoid fractures unite with cast immobilization, failure to heal remains a clinical reality, particularly when the fracture is displaced or associated with intracarpal instability [1–3]. Dabezies [4] reported a 55% incidence of nonunion and a 50% rate of proximal pole avascular necrosis (AVN) in scaph...

Primary bone healing fails to occur in 5-15 % of scaphoid bones that undergo fracture fixation. Untreated, occult fractures result in nonunion up to 12 % of the time. Conventional bone grafting is the accepted management in the treatment algorithm of scaphoid nonunion if the proximal pole is vascularized. Osteonecrosis of the proximal scaphoid pole intuitively suggests a need for transfer of th...

OBJECTIVES Mechanical complications of median sternotomy may cause significant morbidity and mortality in cardiac surgical patients. This study was aimed at assessing the role of Posthorax support vest (Epple, Inc., Vienna, Austria) in the prevention of sternal complications and the improvement of anatomical healing in patients at high risk for mechanical sternal dehiscence after cardiac surger...

BACKGROUND This is a therapeutic study to evaluate the results of the management of forearm infected nonunion using bone transport with external fixators after debridement. METHODS We have retrospectively reviewed a consecutive series of 21 patients from October 1994 to June 2010 in our institution who were treated for the forearm infected nonunion by bone transport with external fixator afte...

BACKGROUND This study was conducted to evaluate the treatment of aseptic nonunion of the humeral shaft with a dynamic compression plate (DCP) and cancellous bone graft. METHODS One hundred and five cases of nonunion of a humeral shaft fracture between 1982 and 2001 were analyzed retrospectively. The study population comprised 66 males and 39 females with an average age of 46.2 years (range, 1...

Redo open-heart surgery and sternal reentry in patients with previous deep sternal wound infection (DSWI) and absence of sternal integrity can be a delicate and morbid task due the lack of a dissection plane between the heart and the surrounding soft tissues. Delayed sternal reconstruction and osteosynthesis with horizontal titanium plating fixation (Synthes) following vacuum assisted therapy (...

[Purpose] To investigate the effects of combined chest expansion and breathing exercises in a patient with sternal pain. [Subject and Methods] The study subject was a 36-year-old female employed as a babysitter who complained of sternal pain at the T1-4 level. The subject performed the combined chest expansion and breathing exercises. [Results] The thoracic kyphosis angle after combined chest e...

BACKGROUND Although minimally invasive approaches are widely used in many areas of orthopedic surgery nonunion therapy remains a domain of open surgery. Some attempts have been made to introduce minimally invasive procedures into nonunion therapy. However, these proof of concept studies showed fusion rates comparable to open approaches never gaining wider acceptance in the clinical community. W...

Figure 1. Mediastinal defect with exposed pros-thetic aortic root graft. DESCRIPTION A 70-year-old woman with short stature and hypermastia underwent ascending aortic aneurysm repair with a prosthetic graft, complicated by postoperative mediastinitis and sternal dehiscence. She was treated with aggressive sternal debridement and negative pressure wound therapy for 1 week (Fig 1) prior to defini...