NON-UNION

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 of non-union

• Ongoing pain 

• Swelling 

• Deformity 

• Instability

• Inability to weight bear

 

What are the treatment options for 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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