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It is sometimes very difficult to be sure about union of a fracture where internal fixation has been used. Evaluation of serial X-rays may help detect subtle angulation, non-progress of bridging callus, resorption of callus, loosening of screws and bending of the nail or plate. Excessive rotation may be the only abnormal mobility in a case with intra- medullary rod in situ. Oblique views, done under fluoroscopy may show an unhealed fracture better than conventional AP and lateral X-rays. It may be possible to demonstrate mobility at the fracture by stress X-rays or weight bearing X-rays. 3-D CT scan is sometimes helpful in differentiating between delayed and non-union.
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owner: nerdparty67 - (no access) - Maheshwari Ortho-1.pdf, p66


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