Nonunion

Definition: A nonunion occurs when a broken bone does not heal. Bones have a tremendous capacity for healing themselves, and with proper treatment, most all fractures will heal without complication. However, some fractured bones have difficulty healing. When a bone is slow to heal, we call this a "delayed union." When a bone does not heal, we call this a "nonunion."

What is the cause of a nonunion?
Determining the cause of a nonunion is critical to determining the proper treatment. The most common causes of nonunion are:

• Infection
• Inadequate blood flow to the bone
• Separation of the fractured ends of the bone
• Inadequate stabilization of the fracture

What bones are most commonly involved in nonunion?
Any broken bone can develop into a nonunion, but several bones are notorious for nonunion development. The reason is that the blood flow to these bones is poor, and therefore, they are a 'set-up' for a nonunion. These problem broken bones include:

• Scaphoid Fractures
• Talus Fractures
• Femoral Neck Fractures
• Fifth Metatarsal ("Jones") Fractures

What can be done to prevent a nonunion?
The best thing a patient can do to prevent a nonunion is to avoid smoking. Other factors that will help prevent nonunions include eating well, and adhering to your recommended treatment plan. Patients who are smokers, obese, diabetics, or have other medical conditions, may be at higher risk for developing a nonunion.

What is the treatment of a nonunion?
The treatment of a nonunion depends on the cause of the problem. Treatment may involve surgery to remove infection, to better stabilize the fracture, or to stimulate bone growth with bone graft. Only once the cause of the nonunion is understood can proper treatment be initiated.