Non-Union Surgery

Mr Matija Krkovic is one the UK's leading Orthopaedic & Trauma surgeons, and is based in Cambridge (UK). He specialises in treating patients who need knee replacement surgery.
Mr Matija Krkovic is one the UK's leading Orthopaedic & Trauma surgeons, and is based in Cambridge (UK). He specialises in treating patients who need non-union surgery.

What is a non-union fracture?

Most broken bones heal without any problems. After the initial treatment, usually new bone tissue forms and connects the broken bone pieces together. However, in some patients certain fractures do not heal despite medical treatment. A non-union fracture, also known as a non-healing fracture, occurs when a broken or fractured bone does not heal in the expected period of time.

The expected healing time for each bone can vary - for example, the forearm bones are expected to fully heal in 3-4 months, whereas the thigh bone can take anywhere from 6-12 months. In general, we consider the possibility of a non-union fracture if there is no sign of healing around 6-9 months after the fracture occurs.

Are non union fractures painful? / Does a non-union fracture hurt?

Non-unions usually become painful when they become unstable. This means that there is an issue with either the new bone tissue which is forming or the surgical metalwork which was inserted during the operation.

How is a non-union fracture treated?

Treatment of nonunion fractures is complex and depends on what is causing the lack of bone healing.

The surgery may involve removal of infected tissue, or we may need to stablilize the fracture or we may need to stimulate bone growth surgically. During your consultation with Mr Matija Krkovic, you will be explained in detail what the surgery will involve and which method in particular has been chosen to treat your nonunion fracture.

How long is the recovery period after non-union surgery?

Each person's recovery period will vary, based on how well their body can heal. Mr Krkovic will carry out x-rays after the surgery to assess how well the fracture is healing, and will give you an estimate of the the length of the recovery period.

How common are non-union fractures?

Non-unions of the fractures are thought to occur in 5-10% of all fractures. They are quite rare in the upper limb, but more common in the lower limb. Any fracture can end up as non-union, but certain bones are more prone to develop non-union than others. The scaphoid in the wrist and talus in the foot are two the most difficult bones to heal and two places where non-unions occur most often. So much so, that for certain types of fractures in the talus, there is an almost 100% rate of developing a non-union.

Will a non-union fracture eventually heal with time? / Can a non union fracture heal naturally?

Theoretically it is possible that non-union fractures will eventually heal on their own but this is very unlikely. The longer the bone remains broken or fractured, the less likely it is going to heal naturally. Instead, if the non-union fracture is left it can progress to pseudoarthrosis, or formation of a false joint. At the level of the non-union fracture there will be formation of a pseudo or false joint including a pseudo joint capsule, cartilage and joint fluid.

What are the types of non-union fractures?

There are generally 3 types of non-union fractures observed:

  1. Hypertrophic: caused by a lack of stability in the fixation used.
  2. Atrophic: caused by inadequate immobilization and inadequate blood supply
  3. Eutrophic: caused by a combination of factors.

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