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Fracture healing and bone repair

      One of the most challenging clinical problems in the trauma speciality is the management of patients with impaired fracture healing and bone defects.
      • Giannoudis P.V.
      • Kontakis G.
      Treatment of long bone aseptic non-unions: monotherapy or polytherapy?.
      • Gahukamble A.
      • Nithyananth M.
      • Venkatesh K.
      • et al.
      Open intramedullary nailing in neglected femoral diaphyseal fractures.
      The incidence of delayed union and/or non-union following fractures is thought to be increasing and this has been attributed to the improved survival rates of patients with multiple injuries. This patient population in the past would either succumb at the scene of the accident or shortly after arriving at the local hospital.
      • Giannoudis P.V.
      • Harwood P.J.
      • Court-Brown C.
      • Pape H.C.
      Severe and multiple trauma in older patients; incidence and mortality.
      • Chaudhuri K.
      • Malham G.M.
      • Rosenfeld J.V.
      Survival of trauma patients with coma and bilateral fixed dilated pupils.
      • Dewar D.
      • Moore F.A.
      • Moore E.E.
      • Balogh Z.
      Postinjury multiple organ failure.
      • Pfeifer R.
      • Tarkin I.S.
      • Rocos B.
      • Pape H.C.
      Patterns of mortality and causes of death in polytrauma patients – Has anything changed?.
      • Geeraedts Jr., L.M.
      • Kaasjager H.A.
      • van Vugt A.B.
      • Fr̈olke J.P.
      Exsanguination in trauma: a review of diagnostics and treatment options.
      • Ottochian M.
      • Salim A.
      • DuBose J.
      • et al.
      Does age matter? The relationship between age and mortality in penetrating trauma.
      • Liu C.C.
      • Wang C.Y.
      • Shih H.C.
      • et al.
      Prognostic factors for mortality following falls from height.
      • Utomo W.K.
      • Gabbe B.J.
      • Simpson P.M.
      • Cameron P.A.
      Predictors of in-hospital mortality and 6-month functional outcomes in older adults after moderate to severe traumatic brain injury.
      However, with the advances made in every discipline of medicine more and more of these severely injured patients survive their injuries and consequently they have to undergo prolonged reconstructive procedures for restoration of their associated complex upper and lower extremity injuries.
      • Giannoudis P.V.
      • Giannoudi M.
      • Stavlas P.
      Damage control orthopaedics: lessons learned.
      • Giannoudis P.V.
      • Tzioupis C.
      • Papathanassopoulos A.
      • et al.
      Articular step-off and risk of post-traumatic osteoarthritis. Evidence today.
      • Papathanasopoulos A.
      • Nikolaou V.
      • Petsatodis G.
      • Giannoudis P.V.
      Multiple trauma: an ongoing evolution of treatment modalities?.
      • Probst C.
      • Pape H.C.
      • Hildebrand F.
      • et al.
      30 years of polytrauma care: an analysis of the change in strategies and results of 4849 cases treated at a single institution.
      Besides trauma, there are also other conditions in orthopaedic and maxillofacial surgery in which bone regeneration is required such as infection, tumour resection and skeletal abnormalities.
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