Every fracture carries the risk of failing to heal and resulting in a nonunion. While nonunions can occur in any bone, they are most common in the tibia, humerus, talus and fifth metatarsal bone.
Several factors contribute to a nonunion. If the bone ends that are fractured have been stripped away from the blood vessels that provide them with nutrition, they will die. As a result, the bone ends cannot contribute to new healing, and a nonunion is more likely. Without a good blood supply and growth of new blood vessels, no new bone will form and the fracture cannot readily heal.
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The symptoms of nonunion fractures include:
Treatment for nonunions is always customized to the patient. In general, your doctor will seek to determine why the fracture did not heal. A plan is then formulated to try to eliminate or limit any physiological reason why healing has not been successful.
In some cases, union can be achieved without surgery. Several non-invasive methods are available, such as electrical stimulation or specialized braces.
Most nonunions require surgery. Surgical treatment of nonunion is usually focused on three goals:
Risks include neurovascular injury, infection, bleeding, and stiffness.
Elevate your upper body while you sleep and take acetaminophen for pain. If wearing a cast, apply heat to the injured area to improve blood circulation and promote healing. After the cast is removed, massage the injured area with ice.Finally, follow a nutritious diet and exercise the non-affected muscle groups to maintain your overall health during the recovery process. Most importantly, avoid smoking, as nicotine has shown to inhibit fracture healing. Additionally, avoid, if possible, radiation therapy, chemotherapy, NSAIDs and systemic corticosteroids, as all of these treatments are known to slow the bone-healing process.Ask your surgeon for complete post-operative instructions.
Your doctor will use an x-ray to determine whether the fracture has fully healed. This will determine the length of the recovery period.
Your doctor will provide instructions regarding weight bearing and physical therapy.
Your doctor will provide instructions regarding activity at home.
Last reviewed by a Cleveland Clinic medical professional on 11/07/2023.
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