What is hypertrophic pseudarthrosis?

Pseudarthroses are classified into hypertrophic (vital) or atrophic (avital) pseudarthroses. This classification refers to the type of scar tissue that is formed by the bone during wound healing. Most cases of pseudarthrosis are hypertrophic.

This means that the bone is well supplied with blood and the healing process should actually go well. However, due to insufficient immobilization of the fracture, the fracture cannot heal completely. There is an excessive formation of scar tissue, which forms uncontrollably around the fracture site. Depending on their radiological appearance, hypertrophic pseudarthroses can be further subdivided into “elephant-foot” and “horse-foot” pseudarthroses.

What is arthrophic pseudarthrosis?

In atrophic pseudarthrosis, the bone is no longer sufficiently supplied with blood. As a result, no new bone tissue can form at the fracture site and the fracture does not heal. Infections of the bone, increased bone resorption (osteolysis) or dead (necrotic) bone material that is still in the fracture gap can cause atrophic pseudoarthrosis.

You can recognize a pseudarthrosis by these symptoms

The development of pseudarthrosis is insidious. Therefore, the symptoms also appear with a delay. Furthermore, not all of the symptoms described need to occur.

The common occurrence represents the full picture of a severe pseudoarthrosis.These include redness and swelling over the affected joint or broken bone area, pain that can occur both at rest and in motion. When moving, the pain usually occurs earlier. In advanced cases of pseudarthrosis, however, pain may also occur at rest.

If the course of pseudarthrosis is septic, i.e. if pathogens are involved, systemic symptoms such as high fever and reduction in general condition may also occur. Since the stability of the bone is sometimes greatly reduced in pseudarthrosis, it is also possible that axial deviations of the bone occur, which are also partially visible. Bone instability is also noticeable in the reduction in strength and in the manual displaceability of the affected bone segment.

Pseudarthrosis usually causes severe pain. The pain begins with the disease and improves little or not at all in the course of time without appropriate therapy. This form of pain is known as chronic.

In addition, the movement of the affected extremity is restricted, causing patients to adopt a relieving posture. This relieving posture often leads to severe muscle tension, which causes further pain. Patients who still suffer from pain after a treated fracture should consult a physician to rule out the presence of pseudarthrosis.