Fracture non union and pseudoarthrosis


Patient with right mid leg fracture nine months ago. Prior external fixation. Patient refused surgery.

Patient Data

Age: 50
Gender: Male

Right leg

There is a complete transverse fracture of the distal tibia and fibula diaphysis. 

Both fractures currently shows overlap as well as anterior and internal angulation. There is callus formation around the fracture margins, but no evidence of bridging callus formation.

Marked osteopenia and postsurgical screw tracks from external fixation.

Case Discussion

This case shows abnormal fracture healing in the tibia and fibula with pseudoarticulation formed in the tibial aspect. There is prominent callus formation ("hypertrophic") around the tibial non union and the fibular non union is oligotrophic.

Abnormal fracture healing are classified as:

  • delayed union
  • non-union (pseudoarthrosis)
  • malunion
  • refracturing

Types of pseudoarthroses include:

  • hypertrophic pseudoarthrosis
  • oligotrophic pseudoarthrosis
  • atrophic pseudoarthrosis
  • hypotrophic (non-vital) pseudoarthrosis
  • defect pseudoarthrosis
  • infected pseudoarthrosis
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Case information

rID: 37509
Published: 24th Jun 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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