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RESEARCH ARTICLE
Year : 2018  |  Volume : 3  |  Issue : 4  |  Page : 101-106

Clinicopathological characterization of long bone non-union: a prospective cross-sectional study


1 Department of Orthopedics, UMAE “Dr. Victorio de la Fuente Narváez” IMSS-UNAM, Ciudad de México, México
2 Department of Orthopedics, Arthroscopic Surgery, Centro de Ortopedia y Medicina del Deporte, Centro Médico Puerta de Hierro, Zapopan, Jalisco, México
3 Osteoarticular Rescue Department, UMAE “Dr. Victorio de la Fuente Narváez” IMSS, México
4 Division Head of the Health Research Division, UMAE “Dr. Victorio de la Fuente Narváez” IMSS, México
5 Division Head of the Health Education and Research Division, UMAE “Dr. Victorio de la Fuente Narváez” IMSS, México

Correspondence Address:
Joel Galindo-Avalos
Department of Orthopedics, Arthroscopic Surgery, Centro de Ortopedia y Medicina del Deporte, Centro Médico Puerta de Hierro, Zapopan, Jalisco
México
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2542-4157.248607

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Background and objectives: The exact biological process that leads to a non-union remains obscure and it is well accepted that any intervention to reverse this process must be timely and well directed to re-establish both biological and mechanical deficiencies. The purpose of the present work was to identify the possible morphological patterns of bone tissue in a state of non-union and in the presence or absence of infection. Methods: A prospective, observational, cross-sectional study was performed. Bone tissue samples obtained from patients with radiologically and clinically diagnosed long bone non-union undergoing revision surgery were included, without distinction of age and sex. Histopathological analysis and semiquantitative evaluation of tissue samples were performed using conventional optical microscopy. Clinical data related to the study variables were obtained, such as type of consolidation, time of evolution, and corresponding bacteriological analysis. Results: Several morphological pattern variables such as bone quality, osteosclerosis, areas of bone devitalization, osteoclastic activity, vascularization, and in particular cell density were related to the subtype of long bone non-union. They were also associated with septic and aseptic variants of long bone non-union. Conclusion: The biological bone profiles, in particular the histomorphological characteristics, are related to the subtype of non-union and reflect the physiopathological environment that involves an anabolic and catabolic imbalance. These can be incorporated into the classification system and favor the stratification of non-union. Ethics and trial registration: This study was approved by Comité Local de Investigación y Ética en Investigación en Salud at UMAE “Dr. Victorio de la Fuente Narváez” (R-2017-3401-8) on July 19, 2017 and registered with SIRELCIS (identifier: R-2017-3401-8).


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