When the non-union is associated with sepsis or a deep infection of the bone and adjacent soft tissue, treatment becomes even more problematic.

It requires techniques performed in two stages, first to debride the non-union foci through total removal of the infected tissue and the application of antibiotic cement. The second operation involves arterial reconstruction through autologous, homologous bone graft, bone replacements and possible implementation of biotechnologies (growth factors and mesenchymal stromal cells.

FIG. 7

Patient affected by septic diaphyseal ulna non-union who previously underwent 4 operations.

The necrotic and infected tissue was removed and antibiotic cement was applied to debride the foci and create a useful membrane in the subsequent reconstruction phase.

The bone segment was stabilised with an angular stability plate.

After 2 months, the patient underwent cement removal and reconstruction through an autologous bone graft taken from the femur and bone growth factors maintained on site by the membrane created by the reaction of the soft tissues to the cement.

After 7 months, the CT scan already shows bone healing and ulna continuity restoration.