LOW-GRADE INFECTION IN THE PATHOGENESIS OF PRIMARILY ASEPTICALLY CLASSIFIED NONUNION OF THE LOWER EXTREMITY: BASED ON TIBIAL SHAFT NONUNION

AimThe pathogenesis of non-union is multifactorial. Path biological factors, mechanical factors, and low-grade-infection contribute to impaired bone healing. Aim of this study was to determine the rate of low-grade-infection in patients with long bone non-union of the lower extremity without signs of acute infection, the influence of CRP (C-reactive protein), and the outcome.MethodIn a retrospective study (2003–2013), all patients who underwent surgery for treatment of tibial- or femoral-shaft-non-union without any clinical evidence of infection were assessed. Bacterial cultures harvested during non-union revision, the CRP and WBC (white blood cells) values at hospital admission, the outcome, and epidemiological data were analysed.ResultsIn 88 patients with tibial-shaft-non-union without any clinical signs of infection, bacterial samples remained negative in 51 patients (46 yr; 33% open fracture; 33% nicotine abuse; 8% diabetes mellitus; revision of non-union 10.9 months following primary osteosynthesis)....