The outcome of tibial non-union treatment using a revised definition, classification system and management strategy.
| dc.contributor.advisor | Aldous, Colleen Michelle. | |
| dc.contributor.author | Ferreira, Nando. | |
| dc.date.accessioned | 2017-06-21T08:04:48Z | |
| dc.date.available | 2017-06-21T08:04:48Z | |
| dc.date.created | 2015 | |
| dc.date.issued | 2015 | |
| dc.description | Doctor of Philosophy in Orthopaedic Surgery.. University of KwaZulu-Natal, Medical School 2015. | en_US |
| dc.description.abstract | The management of tibial non-unions remains a challenge for orthopaedic surgeons. The treatment of tibial non-unions is historically based on small case series that frequently include a variety of non-union subtypes and infected cases. Fixation methods and treatment strategies also vary greatly between published series. This lack of uniformity in the available literature has rendered the establishment of evidence-based, reproducible protocols for the management of tibial non-unions difficult. Controversies regarding non-union definition and classification contribute to delays in treatment and exacerbate the morbidity that is commonly associated with non-union development. In this work we propose a new definition for non-union and introduced a novel concept of ‘potential non-union’ to emphasise the importance of early recognition and referral. The lack of reproducible, evidence-based treatment protocols, combined with the large volume of tibial non-union cases managed in KwaZulu-Natal, South Africa, lead to the development of a tibial non-union treatment algorithm. This algorithm was based on results from two retrospective audits of patients with tibial non-unions who were managed with circular external fixators over a four-year period. The algorithm classifies non-unions into four distinct groups, each with a specific treatment strategy. These reports also introduced the concept of mechano-biology to the management of tibial non-unions and were the first to use hexapod circular fixators for distraction of stiff hypertrophic tibial non-unions. Subsequently a prospective interventional study was undertaken aimed at evaluating the effectiveness of the proposed tibial non-union treatment algorithm. | en_US |
| dc.identifier.uri | http://hdl.handle.net/10413/14622 | |
| dc.language.iso | en_ZA | en_US |
| dc.subject | Tibia. | en_US |
| dc.subject | Fracture fixation -- Complications. | en_US |
| dc.subject | Fractures -- Treatment. | en_US |
| dc.subject | Bone plates (Orthopedics) | en_US |
| dc.subject | Theses -- Orthopaedic surgery. | en_US |
| dc.subject | Tibial non-union treatment. | en_US |
| dc.title | The outcome of tibial non-union treatment using a revised definition, classification system and management strategy. | en_US |
| dc.type | Thesis | en_US |