Mini Review

Segmental fractures of the long bones and healing problems

Georgios Giovanidis^1,2, Paraskevas-Asimakis Velitsikakis^1,2

1. Postgraduate Program “Metabolic Bone Diseases”, National and Kapodistrian University of Athens, Medical School, Athens, Greece
2. Orthopedic Department, General Hospital of Halkida, Chalkida, Greece

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Keywords: Long bones, Malunion, Non-union, Segmental fractures

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Abstract

Healing problems of segmental fractures of long bones are some of the most common complications. The purpose of this study is to review the incidence and pathogenesis of healing problems of segmental fractures of long bones. This is a simple literature review using the Pubmed database. Papers were searched with the use of the following keywords: (“segmental fractures”) AND (“femur” OR “femoral” OR “tibia” OR “tibial” OR “humerus” OR “humeral” OR “forearm” OR “radius” OR “ulna). Moreover, the reference lists of the included papers were scanned for additional studies. Prospective or retrospective evaluating union rate and healing problems after the management of segmental fractures in long bones (femur, tibia, humerus, forearm) were included in this review. The search retrieved a total of 118 papers. After application of exclusion criteria, 30 studies were left in the present review. Successful healing of segmental fractures of long bones depends on the initial condition of the fracture, and surrounding soft tissues, since these high energy injuries may compromise the bone fragments blood supply. The rate of non-union is higher in open and severely comminuted fractures. Intramedullary nailing of segmental fractures of long bones seems to be the surgical option with the least healing problems.

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