What is fracture nonunion and what are its clinical manifestations?

After a fracture, the fracture site may not heal for a long time after surgery. This situation is often called non-union of fracture. The following article will introduce this in detail.

What is nonunion?

Nonunion is also called bone nonunion. After the required healing time of the fracture is repeatedly extended, the fracture still does not heal, the fracture ends still have abnormal activities, and the X-ray shows that the fracture ends are separated from each other, the bone callus is scarce, the two fracture ends are atrophied and smooth, the bone marrow cavity is closed, and the bone ends are hardened. This is called bone nonunion. Clinically, it is often caused by more soft tissues between the fracture ends, or too many bone fragments are removed during open fracture debridement, resulting in bone defects. Multiple surgical reductions have destroyed the blood circulation at the fracture site. If the factors that cause delayed fracture healing are not removed in time, it may also cause bone nonunion.

Clinical manifestations of bone nonunion:

1. Abnormal movement of the fracture ends: If there is abnormal movement of the fracture ends during a fracture examination more than 6 months after the fracture, it can be diagnosed as nonunion.

2. Pain: Pain occurs when the bone ends are moved or when trying to bear weight.

3. Deformity and muscle atrophy: Unconnected fractures may have angulation, shortening and rotation deformities. Due to long-term inability to use the limbs, joint contracture deformities and muscle atrophy may occur.

4. Loss of weight-bearing function: Nonunion after diaphyseal fracture causes loss of weight-bearing function, but some femoral neck fractures cause lameness.

5. Decreased bone conduction sound: In case of nonunion or delayed union, the bone conduction sound is weaker on the healthy side.