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NON-UNION

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WHAT IS A NON-UNION?

  • Most broken bones heal without any problems, with new bone forming to connect the broken bone back together.

  • Unfortunately in some patients the broken bones do not heal.

  • A fracture is considered to have a non-union when a broken or fractured bone does not heal in the expected period of time.

  • The expected healing time for each bone can vary, with bones in the lower limb taking longer than those in the upper limb.

WHAT ARE THE CAUSES OF NON-UNION?

  • There are several reasons why bones do not heal which may include:

    • Infection at the site of the fracture

    • Inadequate blood supply to the bone

    • A gap between the two ends of fractured. bone

    • Inadequate stabilisation of the bone which allows movement

WHAT IS THE DIFFERENCE BETWEEN AN ATROPHIC AND A HYPERTROPHIC NON-UNION?

  • Atrophic - minimal evidence of bony healing or callus formation on x-ray

  • Hypertrophic - evidence of large amounts of callus or attempts at bony healing on x-ray 

WHAT ARE THE SYMPTOMS ON NON-UNION?

  • Ongoing pain 

  • Swelling 

  • Deformity 

  • Instability

  • Inability to weight bear

WHAT ARE THE TREATMENT OPTIONS FOR A NON-UNION?

  • The majority of symptomatic non-unions are treated with surgery and may include:

  • Re-fixation

  • Percutaneous screws

  • Infection debridement

  • External fixation - Ilizarov or taylor spatial frame

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