Any time a bone is fractured, whether due to injury or for a surgical procedure there is a chance it may not heal. A diagnosis of delayed union is made when a fracture has not advanced at an average rate of healing for that particular type of fracture or osteotomy. On average it takes bone 3-6 months to heal. A nonunion diagnosis is established after 8 months if bone healing has ceased. Both delayed union and nonunion are due to variable factors such as:
- Poor nutritional status
- Increased activity levels
- Tobacco use
- Inadequate fixation
- Impaired blood supply
Non-unions are classified into two categories based on the viability of the fracture ends. Hypertrophic or hypervascular non-unions have viable bone ends that are capable of healing. Atrophic or avascular non-unions have non-viable ends.
Treatment options for delayed unions include immobilization in a cast or CAM boot with the use of electrical bone stimulators to aid in promotion of new bone growth. Non-unions require a surgery to remove the devascularized bone ends. Once the dead ends are resected, a bone graft can be used to maintain the length of the bone. Immobilization and use of a bone stimulator will be utilized for 4 to 6 months.
For more information on bone healing come visit us at Foot & Ankle Doctors, Inc.