Reconstruction and Non-union Treatment

Proper bone healing is essential after experiencing a fracture. However, due to several factors, the healing process can be hindered to create further problems for the patient. Discover the treatment options provided by our doctors for non-unions.

These days, fractures can heal without any issues due to the advancement in modern treatment methods. After treatment, the bone begins to develop new bone tissue which then connects the broken pieces. However, during this healing process, some certain risk factors make it unlikely for the bone to heal properly, causing a nonunion. It is a well-known fact, that approximately 5% of total fractures often result in nonunion. The treatment for nonunion can be difficult as it is important to deduce what problem is causing the hindrance in bone healing. Treatment may be necessary to remove any infected tissue, stimulate bone growth as well as stabilize the bone.

What Causes Non-Unions:

Nonunions often occur when there is a lack of blood flow and stability in the bone. Nonunions also have a higher chance of happening if the fracture happened due to a high-energy injury, like a car accident, since severe injuries can lead to an impaired blood supply to the fractured bone.

There are also several other factors that can increases the chances of developing a nonunion that include:

• Smoking
• Older age
• Anemia
• Diabetes
• Lack of Vitamin D
• Poor nutrition
• Hypothyroidism
• Intake of anti-inflammatory drugs
• Infection

There is a more likely chance of nonunions to occur if there is a limited blood supply to the effected area. Depending on which bone is affected, some bones, like the toe bones, have a stable blood supply and have inherent stability which is why they can heal with minimal treatment. However, certain bones, such as the shin bone, have a limited blood supply and a high-energy injury can cut-off the external blood supply by damaging the skin and muscles that are over the bone. Likewise, an injury can also disrupt the internal blood supply which is found in the marrow located at the center of the bone.

Reconstruction and Non-union Treatment at American Hospital:

Nonunions can be treated by both nonsurgical and surgical treatment options. Depending on your condition, your doctor may recommend more than one alternative. Certain nonunions can easily be treated through nonsurgical treatment by using a bone stimulator. The device uses ultrasonic or pulsed electromagnetic waves in order to stimulate healing. The stimulator is placed on the skin of the effected area for approximately 20 minutes to several hours every day. In order for the treatment to be effective, it is important that it is done daily.

In case the nonsurgical option does not suit the patient, the second option your doctor may recommend is surgery. The surgical options for nonunions can include the following:

• Bone Graft: Bone grafts can provide a scaffolding for new bone to grow. During the procedure, bone may be taken from another part of the body and transplanted to the nonunion area to begin the healing process. By using bone grafts, fresh bone cells are provided to the affected area and the body can go through its natural healing process. Often, doctors may use the rim of the pelvis to harvest healthy bone. Although the removal process can be painful, it does not affect the functionality and structure of the donor bone.
• Allograft: An allograft performs the same function of a bone graft; however, healthy bone is taken from a cadaver which helps to avoid harvesting the bone from the patient. Just like a bone graft, allograft provides a scaffold for the patient’s bone to heal properly. Overtime, the cadaver’s bone is replaced with the patient’s bone as new bone cells form. Although there can be a risk of infection, the cadaver bone graft is fully sterilized to reduce the risk.
• Osteobiologics: Bone graft substitutes, or osteobiologics, avoids the harvesting of bone. Bone graft substitutes do not provide patients with fresh bone cells, but they do provide scaffolding chemicals that are needed for growth.

Book an Appointment

The Department of Orthopedics at American Hospital is guided by the vision to provide its patients with optimal care through the use of world-class advanced technology. If you would like to visit one of our expert health practitioners, you can book an appointment through the secure online form given on our website.