- What is a non-healing fracture?
Fusion is the joining of bones after a fracture. Malunion means the bones are not attached to the correct position. Nonunion is a condition in which the healing process of the fracture is not visible in a condition where the bone does not fuse. In the case of Nonunion, the fracture line is still visible or hardening is confirmed at the end of the broken bone.
Additionally, there may also be no expansion of bone formation. Prosthetic bone is a bone tissue that is usually formed during the process of bone fusion after a fracture, and when the bones are attached to each other, they become normal bones. Fracture fusion does not occur naturally and requires orthopedic steps such as bone grafting or surgical correction.
- Causes of bone fractures that do not heal on their own
(1) Risk factors for bone fractures
Risk factors for bone fractures include age, nutritional status, smoking, chronic alcoholism, surgical site infection, diabetes, hemiplegia, and open fractures.
(2) Causes of Malunion
Malunion can occur when bones are not aligned correctly, when the fractured area is not fixed well, when there is severe tissue damage, or when the central nervous system is damaged and is accompanied by spastic paralysis.
(3) Causes of Nonunion
Nonunion can occur when tissue is severely damaged during the fracture, when blood supply to the fracture site is inadequate, when there is infection or bone disease, when there is a fracture in the joint, when the bone is severely broken The bone mass and fragments necessary for fusion are lost, or when the fracture site continually shifts.
- Symptoms of bone fractures that do not heal on their own
(1) Symptoms of Malunion
Malunion is when a broken bone fuses again but not in its original position, leading to angulation and rotational deformity. Magnetism can cause cosmetic problems and dysfunction. Joint surface malunion can lead to serious disability.
(2) Nonunion symptoms
There may be localized swelling or redness of the broken limb. Moving or carrying a heavy part can cause pain. You can see the fracture moving. If the nonunion persists for a long time, pseudoarthrosis can form at the same site.
- Diagnosis of non-healing bone fractures
Symptoms of Malunion or Nonunion after bone fracture can be found out through X-ray, CT, etc. and blood tests can also be done to check for inflammation.
- Treatment of non-healing bone fractures
(1) Malunion treatment
Determine treatment according to rupture area and degree of deformation. If the damaged part causes abnormalities in activities of daily living, a corrective osteotomy may be performed. Corrective osteotomy is a method in which the bone is broken again to correct the angulation or rotational deformity and then fixed with metal. For about 2 ~ 3 months after surgery, you will need to wear a fixation plaster or splint. Additionally, you will need to undergo rehabilitation physical therapy. Postoperative treatment instructions may vary depending on the surgical method or patient’s condition.
(2) Nonunion treatment
The goals of nonunion treatment are to eliminate pain, restore alignment through osteosclerosis, and restore function to the injured limb. Treatment methods can be divided into non-surgical and surgical methods. It is important to choose the right treatment for each patient.
– Non-surgical methods: plaster fixation and orthopedics, electrical stimulation, ultrasound, bone marrow injection
– Surgical methods: dermabrasion, autologous bone grafting, scapular expansion, free vascular bone grafting, allograft bone grafting, bone graft replacement, metal plate fixation, intramedullary fixation, fixation device fixation external determination
