Fracture Nonunions

Approximately 5% of all fractures have some difficulty healing. Those that fail to heal are known as a fracture nonunion. Because there is persistent motion at the site of injury, a nonunion is usually associated with severe and disabling pain which greatly diminishes the patient’s quality of life.

Certain fractures are particularly prone to poor healing/nonunion.

These include:



• fractures associated with major soft tissue disruption (such as an open fracture where the bone is exposed to the outside environment)
• fractures associated with a high energy mechanism of injury (such as a motorcycle or motor vehicle accident or a fall from a height)
• fractures in the elderly or immunocompromised individuals
• fractures in patients with undiagnosed metabolic bone disease

Many factors must be considered when designing a treatment plan for a fracture nonunion. Such factors include the location (specific bone and location within that bone), type of nonunion, prior failed treatments, X-ray appearance, and a host of other patient specific characteristics. In the broadest terms, the treatment plan should include a method of stimulating the local biology at the nonunion site or improving the mechanical stability or both. Some common treatment methods of stimulating the local biology include: bone grafting, marrow grafting and the Ilizarov method. Methods of improving mechanical stability include: plate and screw fixation, intramedullary rod fixation and external fixation.

With proper treatment, even the most longstanding and disabling fracture nonunions can be healed and the patient’s quality of life can be substantially improved or returned to normal. Because of the complex nature of this area of orthopedics, choosing a surgeon with vast experience is paramount.

Read more by Dr. Brinker:  "Nonunions: Evaluation and Treatment."

7401 Main St

Houston, TX

77030