Incorrect osteosynthesis as a cause of bone union disturbances.

Background: Treatment of bone union disturbances is one of the most difficult therapeutic challenges in any orthopaedic and trauma department.

Material And Methods: An analysis of causes of bone union disturbances in a series of 136 patients treated between 1999 and 2005 at the Orthopaedics and Traumatology Department of Jagiellonian University's Collegium Medicum is presented with particular regard to the type of primary stabilisation.

Results: An inappropriate primary stabilisation technique was the cause of bone union disturbances in nearly all of the patients. All errors identified in the series, such as wrong classification of fracture, failure to account for fracture biomechanics, wrong implant choice, incorrect reduction of bone fragments, wrong implant positioning and brutal surgery technique, were associated with primary stabilisation of the fractures.

Conclusions: 1. Operator errors committed during primary fracture stabilization are the most common cause of bone union disturbances. 2. Elimination of errors committed during primary stabilization is the most effective prophylaxis of bone union disturbances.