Ununited fractures may be divided into those delayed in uniting and those in a fixed state of nonunion. In the former there is still evidence of attempts at union, but in the latter all such evidence is lacking. At operation a false joint is found, many times with a sac smoothly lined and filled with amber colored, slightly viscid fluid. Delayed union may exist as long as two or three years after the original injury, and nonunion as early as a few months.
In delayed union the bones may be induced to unite by such means as weight bearing, use of the Thomas dam, pounding between tourniquets, and so forth; such methods are useless in cases of nonunion.
REVIEW OF CASES
This paper is based on a review of 221 cases of nonunion culled from approximately 1,000 cases of old fractures, consisting of malunions and delayed unions, and so forth,
HENDERSON MS. NONUNION IN FRACTURES: THE MASSIVE BONE GRAFT. JAMA. 1923;81(6):463–468. doi:10.1001/jama.1923.02650060033010
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