Scaphoid pseudarthrosis before and after surgical fixation Surgery Currently, there are different strategies to augment the bone-regeneration process, however, there is no standardised clinical treatment guideline yet. Surgical treatment options include: * Debridement: radical surgical removal of necrotic or infected soft tissue and bone tissue is deemed essential for the healing process. * Immobilization of the fracture with internal or external fixation. Metal plates, pins, screws, and rods, that are screwed or driven into a bone, are used to stabilize the broken bone fragments. * Bone grafting. Filling of the bone defect resulting from debridement must be performed. Autologous bone graft is the "gold standard" treatment and possesses osteogenic, osteoinductive, and osteoconductive properties, although only a limited sample can be taken and there is a high risk of side effects. *Bone graft substitutes. Inorganic bone substitutes may be used to complement or replace autologous bone grafting. The advantage is that there is no morbidity on sampling and their availability is not restricted. S53P4 bioactive glass has shown good results as a promising bone graft substitute in treatment of<unk> s, due to its osteostimulative, osteoconductive and antimicrobial properties. In simple cases, healing may be evident within 3 months. Gavriil Ilizarov revolutionized the treatment of recalcitrant<unk> s demonstrating that the affected area of the bone could be removed, the fresh ends "docked" and the remaining bone lengthened using an external fixator device. The time course of healing after such treatment is longer than normal bone healing. Usually, there are signs of union within 3 months, but the treatment may continue for many months beyond that. Bone stimulation Bone stimulation may be with either electromagnetic or ultrasound waves. Ultrasound stimulation has tentative evidence of supporting better healing in long bones that have not healed after three months. Evidence; from a Cochrane review however, does not show that ultrasound decreases rates of<unk> . Another review has, however, suggested it as an alternative to surgery.
Nonunion
Pseudofracture
Retrolisthesis
Malunion
Joint dislocation
Intraarticular fracture
Bunion
Stress fracture