{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:40:35Z","timestamp":1792428035672,"version":"4.5.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Unfallchirurgie"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Pseudarthrosen stellen eine multifaktorielle Komplikation der Frakturheilung dar. Eine ausschlie\u00dflich zeitbasierte Definition bildet die zugrunde liegenden Heilungsst\u00f6rungen nur unzureichend ab und bietet allein keine ausreichende Grundlage f\u00fcr die Therapieentscheidung. Entscheidend ist vielmehr die systematische Analyse der Faktoren, die eine kn\u00f6cherne Konsolidierung verhindern. Hierzu z\u00e4hlen insbesondere eine m\u00f6gliche frakturassoziierte Infektion, mechanische Defizite, ein eingeschr\u00e4nktes biologisches Heilungspotenzial sowie patientenbezogene Risikofaktoren. Auch bei klinisch aseptisch erscheinenden Pseudarthrosen muss eine okkulte Infektion ber\u00fccksichtigt werden. Mechanische Instabilit\u00e4t erfordert eine Wiederherstellung ad\u00e4quater Stabilit\u00e4t, w\u00e4hrend biologische Defizite gegebenenfalls eine gezielte Augmentation notwendig machen. Modifizierbare Patientenfaktoren sollten parallel optimiert werden. Da mehrere Ursachen gleichzeitig vorliegen k\u00f6nnen, sollte die Behandlung nicht allein an zeitlichen oder morphologischen Kriterien ausgerichtet sein, sondern an den individuellen Ursachen der ausbleibenden Frakturheilung. Ein systematisches, ursachengerichtetes Vorgehen erm\u00f6glicht damit eine gezielte und bei multifaktorieller Genese kombinierte Therapie.<\/jats:p>","DOI":"10.1007\/s00113-026-01771-2","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T09:40:58Z","timestamp":1791279658000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pseudarthrose: Ursache vor Therapie","Nonunion: cause before treatment"],"prefix":"10.1007","author":[{"given":"Houmam","family":"Anees","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thaqif","family":"El Khassawna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Heiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"1771_CR1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-025-02918-3","author":"S Vukicevic","year":"2025","unstructured":"Vukicevic\u00a0S, Peric\u00a0M, Bordukalo-Niksic\u00a0T, Blazevic\u00a0V, Durdevic\u00a0D, Ivanjko\u00a0N, Oreskovic\u00a0K, Giannoudis\u00a0PV, Windhager\u00a0R (2025) Time to consider fracture nonunion an orphan disease? An update into pathophysiology, epidemiology and therapeutic solutions. Eur J Trauma Emerg Surg. https:\/\/doi.org\/10.1007\/s00068-025-02918-3","journal-title":"European Journal of Trauma and Emergency Surgery"},{"key":"1771_CR2","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/j.injury.2020.11.029","volume":"52","author":"JA Nicholson","year":"2021","unstructured":"Nicholson\u00a0JA, Makaram\u00a0N, Simpson\u00a0AHRW, Keating\u00a0JF (2021) Fracture nonunion in long bones: A literature review of risk factors and surgical management. Injury 52:S3\u2013S11. https:\/\/doi.org\/10.1016\/j.injury.2020.11.029","journal-title":"Injury"},{"key":"1771_CR3","doi-asserted-by":"publisher","first-page":"1680","DOI":"10.1007\/s43465-024-01249-6","volume":"58","author":"E Gharu","year":"2024","unstructured":"Gharu\u00a0E, John\u00a0B (2024) Nonunion of Fractures: A\u00a0Review of Epidemiology, Diagnosis, and Clinical Features in Recent Literature. Indian J Orthop 58:1680\u20131685. https:\/\/doi.org\/10.1007\/s43465-024-01249-6","journal-title":"Indian J. Orthop"},{"key":"1771_CR4","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1007\/s00402-023-05103-6","volume":"144","author":"RK Wagner","year":"2024","unstructured":"Wagner\u00a0RK, van Trikt\u00a0CH, Visser\u00a0CE, Janssen\u00a0SJ, Kloen\u00a0P (2024) Surprise positive culture rate in the treatment of presumed aseptic long-bone nonunion: a systematic review with meta-analysis of 2397 patients. Arch Orthop Trauma Surg 144:701\u2013721. https:\/\/doi.org\/10.1007\/s00402-023-05103-6","journal-title":"Arch. Orthop. Trauma Surg"},{"key":"1771_CR5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11144106","author":"S Dimartino","year":"2022","unstructured":"Dimartino\u00a0S, Pavone\u00a0V, Carnazza\u00a0M, Cuffaro\u00a0ER, Sergi\u00a0F, Testa\u00a0G (2022) Forearm Fracture Nonunion with and without Bone Loss: An Overview of Adult and Child Populations. J. Clin. Med. https:\/\/doi.org\/10.3390\/jcm11144106","journal-title":"J. Clin. Med"},{"key":"1771_CR6","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics17111457","author":"J Wier","year":"2025","unstructured":"Wier\u00a0J, Shelby\u00a0H, Bergren\u00a0S, Patterson\u00a0JT, Lieberman\u00a0JR (2025) Modern Approaches and Emerging Biological Therapies to Treat Fracture Nonunion. Pharmaceutics. https:\/\/doi.org\/10.3390\/pharmaceutics17111457","journal-title":"Pharmaceutics"},{"key":"1771_CR7","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1002\/jum.15738","volume":"41","author":"P Palanisamy","year":"2022","unstructured":"Palanisamy\u00a0P, Alam\u00a0M, Li\u00a0S, Chow\u00a0SKH, Zheng\u00a0YP (2022) Low-Intensity Pulsed Ultrasound Stimulation for Bone Fractures Healing: A Review. J\u00a0Ultrasound Med 41:547\u2013563. https:\/\/doi.org\/10.1002\/jum.15738","journal-title":"Journal of Ultrasound in Medicine"},{"key":"1771_CR8","doi-asserted-by":"publisher","first-page":"569","DOI":"10.2147\/PGPM.S407308","volume":"16","author":"M Sadat-Ali","year":"2023","unstructured":"Sadat-Ali\u00a0M, Al-Omar\u00a0HK, Altabash\u00a0KW, Alomran\u00a0AK, Aldakheel\u00a0DA, Alsayed\u00a0HN (2023) Genetic Influence of Fracture Nonunion (FNU): A Systematic Review. Pharmgenomics. Pers. Med 16:569\u2013575. https:\/\/doi.org\/10.2147\/PGPM.S407308","journal-title":"Pharmgenomics. Pers. Med"}],"container-title":["Die Unfallchirurgie"],"original-title":[],"language":"de","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00113-026-01771-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00113-026-01771-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00113-026-01771-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:58:06Z","timestamp":1792425486000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00113-026-01771-2"}},"subtitle":["Von der Zeitdefinition zur ursachengerichteten Behandlung","From time-based definition to cause-directed treatment"],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":8,"alternative-id":["1771"],"URL":"https:\/\/doi.org\/10.1007\/s00113-026-01771-2","relation":{},"ISSN":["2731-7021","2731-703X"],"issn-type":[{"value":"2731-7021","type":"print"},{"value":"2731-703X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"11 August 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"H.\u00a0Anees, T.\u00a0El\u00a0Khassawna und C.\u00a0Heiss geben an, dass kein Interessenkonflikt besteht.","order":1,"name":"Ethics","label":"Interessenkonflikt","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}},{"value":"F\u00fcr diesen Beitrag wurden keine Untersuchungen an Menschen oder Tieren durchgef\u00fchrt und keine individuellen Patientendaten erhoben oder ausgewertet. Die dargestellten Inhalte basieren ausschlie\u00dflich auf publizierter wissenschaftlicher Literatur. Ein Ethikvotum war daher nicht erforderlich.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}}]}}