What are the possible causes of non-conjugated bones? Is it all clear?
Peng Zhang, Deputy Chief Physician, Department of Orthopedics and Traumatology, Dongzhimen Hospital, Beijing University of Chinese Medicine.
After a fracture, if the broken end of the fracture does not heal for a long time, why is this? In fact, even if this kind of nonunion is called nonunion, the probability of this occurrence in clinical practice is actually relatively high. How high? From a single figure, it can generally reach the level of 5% to 10% of the whole. Why does nonunion occur? Here are five main reasons for this.
The first and most important reason is that the blood circulation and blood supply at the broken end of the fracture are relatively poor. Like the fracture of the femoral neck and the fracture of the lower head of the femoral neck, the blood circulation is relatively poor, and the healing rate is relatively low. There are also fractures of the talus of the foot, and fractures of the middle and lower leg 1 3, which are often poorly healed. The main cause is the problem caused by the poor local blood supply.
The second is that the fixation is not reliable. For example, if the immobilization is unstable with a cast or surgery, it may lead to poor fracture healing and nonunion.
The third is that there is a separation of the broken ends of the fracture. For example, when the fracture is closed and reduced, the broken ends of the fracture are not together, which makes it difficult for the fracture to heal to a certain extent, and the separation is relatively large, which is easy to cause this kind of bone nonunion.
The fourth is open fracture injury, and some are even complicated by infection. If the bacteria multiply on the wound or bone, it will form local inflammation, soft tissue inflammation, osteomyelitis, which will lead to the disorder of bone growth, or stop, or even local bone destruction, which will directly affect the healing of the fracture.
The fifth factor is the other factor. For example, some patients who smoke for a long time will affect the regeneration of blood vessels and the healing of fractures.
So in general, the vast majority of people with fractures can heal smoothly, but it is true that a small number of people will have this kind of nonunion problem.