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January 9, 1926


JAMA. 1926;86(2):81-86. doi:10.1001/jama.1926.02670280001001

Ununited fractures are those that have failed to unite by bony union after the period normally required for repair. They may be divided into those of delayed union, and those in a fixed state of nonunion.

Delayed Union.  —Delayed union may be defined as a condition in which clinical and roentgenographic examination show that repair is going on slowly although the fracture is still ununited. As the fracture is gently manipulated, varying degrees of solidity and stiffness, and thickening due to the callus, may be noted. The roentgenogram often shows a large amount of callus; in fact, the fracture line itself may be partially obscured by this callus. The bones are generally of normal density, and one would usually hesitate to pronounce these cases ununited fractures from the roentgenogram alone (Fig. 1).

Nonunion.  —Nonunion may be said to exist when physical examination and roentgenographic study indicate that the fracture is

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