Classification and therapy of acquired non-unions [Classificazione delle pseudoartrosi in relazione al loro trattamento]

The authors propose a new classification of acquired non-unions, based on their etiology rather than their anatomopathological characterization. Therefore they describe five types of non-union: by insufficient or inadequate reduction, by insufficient immobilization, by bone loss, by extensive lesion of soft tissue and by infection. These types significantly differ from one another for pathogenesis and for clinical and anatomopathological characteristics, and require different management; however they cannot be considered strictly separate, but interdependent with some borderline cases in which many of the etiopathogenetic causes are associated. The practical advantage of such classification lies in the fact that the exact knowledge of the causes inhibiting fracture healing represents a guideline for an adequate therapeutic choice.