Fracture nonunion in long bones: risk factors and surgical management
Nonunion is reported in approximately 2% of all fractures according to the literature reports. US FDA define nonunion as a fracture ununited for 9 months or failure of fracture union over the previous 3 months. Indicating key risk factors is a high yield topic in research. Therefore authors from UK provide the following classification: local factors (energy of the injury, associated soft tissue injury, polytrauma, excessive segment motion) and general factors (age, smoking, diabetes, obesity, numerous medications). Management guidelines state that successful union can be often achieved with surgical fixation techniques in most cases. However, biological augmentation of nonunion may be considered in atrophic bone changes cases or where there is bone loss. Check the recommendations for clavicle, forearm, tibia and femur fractures management by the link.