Nonunion

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(Redirected from Delayed union)

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Nonunion
Nonunion.jpg
Synonyms Pseudarthrosis
Pronounce N/A
Specialty N/A
Symptoms Persistent pain, swelling, and instability at the fracture site
Complications Chronic pain, deformity, arthritis
Onset Months after initial fracture
Duration Long-term if untreated
Types N/A
Causes Inadequate stabilization, poor blood supply, infection, smoking, diabetes
Risks Osteoporosis, obesity, malnutrition
Diagnosis X-ray, CT scan, MRI
Differential diagnosis Delayed union, malunion
Prevention Adequate fracture stabilization, healthy lifestyle
Treatment Surgical intervention, bone grafting, electrical bone stimulation
Medication N/A
Prognosis Variable, depends on treatment and patient factors
Frequency Occurs in 5-10% of fractures
Deaths N/A


Scaphoid Pseudarthrose

Nonunion is a serious complication of a fracture and is said to occur when a fracture does not heal within six months of the injury. The main symptom is persistent pain at the site of the fracture. Nonunion is more likely to occur if the bone is exposed to infection or if the fracture is open with extensive soft tissue damage.

Causes

The most common causes of nonunion are poor blood supply to the area around the fracture, infection, and inadequate immobilization of the fracture site. Other factors that can contribute to nonunion include smoking, diabetes, and certain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.

Diagnosis

Nonunion is usually diagnosed through a combination of physical examination and imaging tests. The doctor will ask about the patient's medical history and symptoms, and will examine the fracture site. Imaging tests such as X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) can provide detailed images of the bones and surrounding tissues, and can help the doctor determine whether the fracture has healed properly.

Treatment

The treatment for nonunion depends on the cause and the severity of the condition. In some cases, non-surgical treatments such as bone stimulation or medication may be effective. In other cases, surgery may be necessary to stabilize the fracture and promote healing. This can involve the use of metal plates, screws, or rods to hold the bones in place, and bone grafting to replace missing or damaged bone.

Prevention

Preventing nonunion involves managing the risk factors that can contribute to the condition. This includes quitting smoking, controlling diabetes, and avoiding certain medications if possible. It also involves proper care and management of fractures, including adequate immobilization and treatment of any infections.

See also

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Contributors: Prab R. Tumpati, MD