Everything You Need to Know About Nonunion

Our body is known to have the best mechanisms to tackle certain health-related conditions. If we talk about the fracture, our body is capable enough to heal that naturally. This happens in a maximum number of cases. But in some people, the natural bone healing process is either slow or doesn’t happen at all. Such cases are regarded as nonunions.

A doctor can consider a fracture case as nonunion when the fracture is at least 9 months old and has not healed, Plus, has not shown any progress in radiographic tests for 3 months. Sometimes, a fracture takes more time to heal than the usual healing period and that condition is known as a delayed union. In the case of delayed union, radiographic progression is seen over time. One of the reasons resulting in nonunion is when the fractured bone ends are stripped away from the blood vessels. Blood vessels are known to provide nutrition to bones that aid in their growth. Now, when the nutrition supply is cut, the chances of fractured bone reduce down to the minimum and that causes nonunion. External Fixator System may be used for the surgical treatment of nonunions.

Symptoms of Nonunion

Here are some of the most common symptoms seen in nonunion:

  • Swelling near the affected area
  • Pain
  • Deformity near the injured site
  • Tenderness
  • Inability to bear the weight

Risk Factors Associated with Nonunion

The risk of developing nonunion increases in certain cases:

  • Smoking
  • Consumption of NSAIDs
  • Alcohol consumption
  • Vitamin D deficiency
  • Thyroid imbalance

Classification of Nonunions

There are 5 different types of nonunions that you must know:

  • Septic nonunion
  • Pseudoarthrosis
  • Hypertrophic nonunion
  • Atrophic nonunion
  • Oligotrophic nonunion
Diagnosis of Nonunion

Diagnosis of nonunion will start with the physical examination to assess soft tissue envelop, mobility of the nonunion, and the extent to which deformity is present. After this, the doctor will perform imaging tests to see the actual nonunion condition. X-ray and CT scan are the most commonly indicated imaging tests for the diagnosis of nonunion. In certain cases, MRI scans and blood tests may also be suggested.

Treatment Procedure of Nonunion

Depending upon the severity of the condition and site of nonunion, the treatment of this condition can either be done by using a non-surgical technique or surgical technique. Let us have a look at both one by one:

Non-surgical Treatment

Bone stimulation is one of the non-operative ways used for the treatment of nonunion. Electric bone stimulation is done using electrodes that are placed on the skin near the affected area. The machine used for bone stimulation sends a low electric current to the affected bone to promote healing.

In case of non-operative treatment, the doctor may also prescribe vitamin and mineral supplements. This will generally occur when the blood report of the patient indicates low nutrient and vitamin levels. These supplements may help bone produce healthy cells. Besides this, anabolic medicines and analgesics may also be indicated.

Surgical Treatment

Open reduction and fixation technique is used in the surgical treatment of nonunion. In the case of internal fixation, orthopedic implants like Bone Screws, Titanium Bone Plates, and Rods are used to align the fractured bone fragments in their correct anatomical position. Whereas, external fixation of nonunion requires the use of External Fixation Device.

In some cases, bone grafting may also be done for the treatment of nonunion and that will depend upon the site and severity of the affected area.

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