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A

B

Figure 10-20 • The pins were left as is, but the bones failed to heal because of regional devascularization brought about by a combination
of fragment instability and infection. A, Orientation and close-up (B) ventrodorsal views made immediately after the ineffective implants
were removed illustrate most of the features of nonhealing fractures of whatever cause, including (1) persistence and widening of fracture
lines, (2) absence of fracture-bridging calluses, (3) extensive bone deposition well away from the fracture sites, and (4) the presence of
posttraumatic osteoporosis, especially pronounced in the radial midshaft. Also, note that there is now an additional radial fracture just
below the original break. Presumably, this is an insuffi ciency fracture, an injury incurred when a structurally weakened bone is subjected to
what would otherwise be considered routine bending forces.

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