Description

Non-union is a fracture with no healing potential without a further surgical procedure. Diagnosis of non-union can be done in case of healing failure from 6 to 9 months after the first fracture. We consider appropriate to keep the attention of the reader on the relevance that more frequent traumatic mechanisms have in relationship with evolution and eventual failure of healing processes. In literature, non-union mean rate for tibial pilon fractures is around 5% independently from the synthesis technique used; as main causes we can recognize a significant fracture’s comminution ad eventual bone loss, vascular damage, and local infection. Risk factors can be divided into two big groups: factors proper of the patient at the moment of injury (age, diseases, drugs, smoke, etc.) and characteristics of the trauma itself (comminution and dislocation of fragments, involvement of soft tissues, topography, distance between fragments). Tibial pilon fractures are mainly caused by high-energy trauma. This kind of dynamic determines not only more serious damage to the bone, but often cause damage of the surrounding tissues. Following important lesions of the periosteum and of the vascular network and after a suboptimal synthesis caused by comminution and dislocation of fragments is frequent with the evolution toward a bad bone healing process. Bone healing was, in the last 50 years, argument of intense research activity. The incidence of non-union is growing steadily, although principles a

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