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Fracture & Fusion Healing

Bone, like any other tissue within the human body, is capable of healing itself when injured or damaged. When a fracture occurs, the body produces naturally occurring electric fields that generate high metabolic activity surrounding and within the bone that help to heal the fracture.  Occasionally, the fracture may not heal normally on its own. This impaired ability to heal may result in what is called a fracture nonunion.

There are a number of underlying medical conditions and risk factors that may affect normal bone healing and result in a fracture nonunion. These include, but may not be limited to: chronic drug use, smoking, diabetes, obesity, chronic obstructive pulmonary disease (COPD), osteoporosis, renal disease, cancer, osteomyelitis (i.e., infection), rheumatoid arthritis, and hypertension.

Fracture Nonunion

A fracture nonunion is considered to be established when there are no visibly progressive signs of healing. Usually, fractured bone starts to heal immediately after a fracture occurs or after a surgeon has re-aligned and/or set the fractured bone fragments back into place.

During the following weeks or months, new bone tissue forms and continues to grow. As long as the fractured bone fragments receive an adequate supply of blood and other bio-chemical induced nutrients, newly formed bone tissue will grow and fuse together into a solid remodeled and repaired bone. The majority of bone fractures heal normally.

A fracture nonunion is a serious medical complication and may occur when the bone lacks adequate stability, weight bearing control, blood flow, or when there are other underlying medical conditions which impair normal healing.1

Failed Fusion

A failed fusion occurs when two or more bones within a joint (i.e., knee or ankle) have not fused together into a solid mass resulting in a malunion or nonunion.  When this occurs it’s likely that you will experience pain, limb-length discrepancy and/or deformity because the joint lacks optimal skeletal support and stability. A failed fusion must be confirmed radiographically through a diagnostic X-ray or scanned via MRI by a qualified radiologist.

Congenital Pseudarthrosis

Pseudoarthrosis is defined as a “false joint” or break in the bone that fails to heal on its own and usually develops within the first two years of life; however, there have been reported cases diagnosed before birth as well as later in life.  When pseudoarthrosis is diagnosed before or is present at birth, it’s referred to as congenital pseudarthrosis and can cause a variety of complications over time. The exact cause is unclear. Some believe that after the fracture occurs, there is a lack of blood supply to the outer layer of bone which promotes normal healing. This lack of blood supply results in scar tissue that forms and covers the bone which hinders proper healing.

In most cases, surgical intervention is required to correct the pseudarthrosis; however, the affected bone is susceptible to re-fracture as this condition is challenging to treat. Due to the inherent difficulty involved, it’s likely that the healthcare professional will administer additional, adjunctive therapies to treat the pseudarthrosis in an attempt to promote healing.

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