IL RITARDO DI CONSOLIDAZIONE DELLE FRATTURE : FATTORI MECCANICI

Fracture nonunion is a dreadful entity and can account for a high percentage of both surgeon and patient’ s stress and frustration. Fracture nonunion is often anticipated after a severe traumatic injury, such as an open fracture with segmental bone loss, but it may also make an unanticipated appearance after treatment of a low-energy fracture that seemed destined to heal. The most basic requirements for fracture healing include both biological and mechanical factors. Biological factors are distinguished as local and systemic and are physiological and pathological condition of bone and of the whole subject. Mechanicalfactors able to determine nonunion are essentially distinguished in quality of reduction, quality and quantity of fixation, devices positioning. The introduction of new surgical devices is the evidence of the understanding of biomechanical issues of bone. Those precious innovative instruments must be known by the surgeon in a theoretical mode; only respecting the biomechanical rules of bone healing and applying those to his surgical practice he could finally benefit of them and avoid the causes connected to nonunion events.