Dear Colleagues.

I would like to hear your experiences with pseudoarthritis. What happens when a large bone, such as in the arm, gets smashed in many places from an accident and then forms a 'false joint' called pseudoarthritis?

I would like to get some responses from those who have seen this in practice. thanks, Ingrid

PHOTO CREDIT: Congenital pseudarthrosis of the tibia (Case 8; a case with no prior surgery) with no other operation before VFG. Preoperation status at 6.6 years old (A). At 12.8 years old, 6.2 years after VFG (B). Sakamoto et al. Journal of Orthopaedic Surgery and Research 2008 3:13   doi:10.1186/1749-799X-3-13

pseudarthritis
[so̅o̅′därthrī′tis]
Etymology: Gk, pseudes, false, arthron, joint, itis, inflammation
musculoskeletal pain that does not involve the joints.

MEDLINE: [Extracorporeal shockwave therapy (ESWT) in orthopedic indications: a selective review] [English Abstract, Journal Article, Review]
Versicherungsmedizin 1998 Oct 1; 50(5):180-5

A search of Medline concerning the efficacy of shock wave therapy for pseudarthritis (nonunion), calcifying tendinitis of the shoulder, lateral epicondylitis and painful heel identified 25 publications describing 31 investigations. These investigations cannot be accepted as confirmative. The effects in pseudarthritis appear most promising but the cases reported need a reanalysis and thorough description before efficacy can be accepted as granted. Moreover, the indication as well as the stimulus parameters have to be specified and standardized. Published data on the other indications justify prospective, randomized, double-blind, placebo-controlled (sham treatment) trials to confirm efficacy where again the procedure and dosing of shock wave therapy need data-based, rational standardization.

MEDLINE: Jovanović V, Vukasinović Z, Seslija I, Zivković Z
[Treatment of septic pseudoarthrosis of tibia by Ilizarov method: case report]. [English Abstract, Journal Article]
Srp Arh Celok Lek 2010 Sep-Oct; 138(9-10):643-6.

Septic pseudoarthroses of the tibia represent a relatively frequent complication of open fractures with a large soft tissue damage. They may be localized: in the proximal metaphysis, between the proximal and middle thirds, between middle and distal thirds, in the distal metaphysis.A case of a 52-year-old man with open fracture of the left tibia is presented. He fell from the height of 30 meters. The external fixation according to Mitkovic was performed in another institution. The patient was referred to our hospital nine months after the accident, with clear clinical and radiological signs of septic pseudoarthrosis of the tibia. The resection of septic pseudoarthrosis was done two weeks after admission. Three weeks later, another operation was performed, bilocal alternating distractive-compressive osteosynthesis according to Ilizarov. After eleven months Ilizarov frame was removed, with clinical, radiological signs of healing of pseudoarthrosis and complete curing of the infection. Five months after removal of the frame, the patient was fully anatomically and functionally recovered.Being satisfied with the achieved results and encouraged with the data from the literature, we recommend this method as the method of choice for the treatment of pseudoarthrosis of the tibia. The advantage consists of curing the infection using the natural bactericide power of the tissue and curing the bone defect, at the same time, and finally, producing the equalization of the legs.

Experimental Shock Wave Therapy: A search of Medline concerning the efficacy of shock wave therapy for pseudarthritis (nonunion), calcifying tendinitis of the shoulder, lateral epicondylitis and painful heel identified 25 publications describing 31 investigations. These investigations cannot be accepted as confirmative. The effects in pseudarthritis appear most promising but the cases reported need a reanalysis and thorough description before efficacy can be accepted as granted. Moreover, the indication as well as the stimulus parameters have to be specified and standardized. Published data on the other indications justify prospective, randomized, double-blind, placebo-controlled (sham treatment) trials to confirm efficacy where again the procedure and dosing of shock wave therapy need data-based, rational standardization.

Source:



The Principles and practice of surgery, Volume 2  By David Hayes Agnew