Ultrastructural aspects of human nonunion.

A histological study on the tissue of nonunion of tibias of two young patients was performed to evaluate the ability of cells to start the mineralization of the matrix. The observations can be summarized as follows: 1) Tissue vessels often appear occluded by thrombotic material; 2) Fibroblasts and chondrocytes found in the nonunion tissue seemed normal, with a good secretion apparatus; 3) The cell membranes were able to produce matrix vesicles; 4) Matrix vesicles and cell membrane looked positive to ALPase reaction, 5) Hydroxyapatite crystals could be observed in the cell matrix or inside matrix vesicles. It may be concluded that cells populating nonunion tissue are well equipped to induct the mineralization of the matrix, but the absence of a blood supply, enough to bring them a normal calcium amount, is the real reason for the nonunion.