What to do if the bone doesn't heal

During daily activities, people often encounter various accidents. For example: fractures. Fractures often require a long period of rest to heal. Some serious fractures, such as comminuted fractures, cannot be fully restored even with surgical treatment, and may cause patients to limp, have different leg lengths, etc. What if it is a common fracture but the bone does not heal?

Causes of nonunion

When a fracture has been treated for longer than the normal healing time and the treatment time is further extended (8 months after the fracture), but bone healing still cannot be achieved and the repair process completely stops, it is called non-union of the fracture.

Common causes of fracture nonunion include: poor blood supply to the fracture site, bone defects, excessive traction, etc. X-ray manifestations: little callus at the fracture ends, gaps between the bone ends, no trabeculae formation, the two broken ends are atrophied and smooth, osteoporosis, and the bone marrow cavity is filled with dense bone and is blocked. A joint-like change caused by the presence of a gap between the two ends of a fracture is called a pseudoarthrosis. Nonunion of femoral neck fracture seriously affects the function of lower limbs and is considered a serious injury.

Factors affecting fracture nonunion

1. Systemic factors

Includes the patient's metabolism, nutrition, health status and activity status. Other reports suggest that smoking is also related to it.

2. Local factors

The blood supply to the fracture, the impact of infection, the degree of soft tissue damage, the soft tissue embedment at the fracture end and the impact of treatment methods. The latter includes repeated manual reduction, incision of soft tissue and stripping of periosteum during open reduction, excessive traction during continuous bone traction, inaccurate fracture fixation, inappropriate functional exercise, and excessive removal of bone fragments during open fracture debridement.

Except for severe malnutrition, the impact of systemic factors on fracture healing is far less significant than that of local factors.

How to deal with nonunion of fractures

When the fracture is not united, there is swelling at the fracture site and pain when pressed. The patient feels soreness at the fracture site when moving the limbs, standing or walking, and sometimes there is false joint movement.

1. Patients should go to the hospital as soon as possible after a fracture, reposition and fix the affected limb, perform rehabilitation exercises during rest, and take fracture recovery medicines such as Xiuzhen Neck and Waist Kang, which can effectively reduce swelling and relieve pain, promote blood circulation and remove blood stasis, promote bone growth, and help fracture recovery to prevent non-union of fractures.

2. The fracture needs to be well reduced, and appropriate internal or external fixation materials should be selected to stably fix the fracture. The need for bone grafting should be determined based on the condition of the fracture ends: for vascular nonunion, a connection can be achieved as long as there is stable fixation, and no bone grafting is required; while for ischemic nonunion, the sclerotic bone at the fracture ends needs to be removed, the medullary cavity needs to be opened, and bone grafting needs to be performed.

3. Surgical treatment: Actively improving the patient's metabolic and nutritional status before surgery, encouraging the patient to quit smoking, using the limbs as much as possible and performing functional exercises on adjacent joints, and controlling infection will help improve the efficacy.

4. In addition, low-intensity ultrasound, electrical and electromagnetic stimulation methods can be used for treatment of some patients with bone nonunion. Traditional Chinese medicine treatment: It is a more common treatment method, mostly used in the recovery stage after fracture. External application of bone-setting and blood-activating ointment can effectively promote the healing of the fracture site and the growth of callus, and is an indispensable method to avoid fracture sequelae.