A case of pseudoarthrosis and partial resorption of the ulna in a 12-year-old girl with neurofibromatosis is described. Neurofibromatosis is a common neurocutaneous disease with characteristic osseous lesions. The pseudoarthrosis in this case developed after fracture. The bone most commonly affected is the tibia and involvement of the ulna has been reported in only a few cases. The possible cause of pseudoarthrosis, the radiographic changes, and the treatment are discussed.
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Effective treatment of scaphoid pseudoarthrosis is critical to reduce the risk of progression to the potentially debilitating scaphoid nonunion advanced collapse, including complications of persistent wrist joint instability, degenerative arthritis, decreased range of motion, chronic pain, and functional impairment. Both anatomic and fracture-related pathophysiology predispose patients to scaphoid nonunion, including limited retrograde blood flow, fracture location, and delay of appropriate treatment. Recent studies have demonstrated successful outcomes in treatment of scaphoid nonunions, with nonvascularized bone autograft, commonly from distal radius or iliac crest, as well as pedicled vascularized or free vascularized autograft with rates of union varying from 84% to 100%.
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Anatomy Department, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
Forearm non-union poses a challenge in orthopaedic surgery due to its intricate anatomy and functional significance. This review provides a comprehensive overview of the assessment, diagnosis and management of forearm non-union. Initial evaluation involves a meticulous history, physical examination and imaging studies to identify factors contributing to non-union, including infection.
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Congenital pseudarthrosis of the forearm bones (CPFBs) is rare, with only 106 reported cases, and is frequently associated with neurofibromatosis (NF). Approximately 5% of patients with NF develop pseudarthrosis, and 50% of patients with pseudarthrosis have NF. Achieving bone union is difficult in congenital pseudarthrosis.
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