In orthopedics, fractures are a common injury, but sometimes healing after a fracture is not always smooth. When the fracture site does not heal for a long time, and the bone is not unionized, the patient will face great pain and treatment challenges. So, what exactly causes the occurrence of nonunion?
First of all, the inadequate blood supply at the fractured end is a key factor. The blood provides the necessary nutrients and oxygen for the healing of the fracture. If the fracture severely damages the surrounding blood vessels, or if the blood supply to the fracture site itself is poor, such as the middle and lower tibia and carpal scaphoid bone, it may cause the fracture to heal slowly or even non-union.
Secondly, the instability of the fixed end of the fracture is also one of the common causes. If the fixation device is not selected properly, the fixation is not firm, or the patient performs inappropriate activities too early, the fractured end will be repeatedly stressed and stimulated, affecting the formation and growth of callus, resulting in nonunion.
Infection is also a factor that cannot be ignored. Wound infection triggers a local inflammatory response that destroys tissues and cells at the end of the fracture and hinders the normal healing process. Severe infections, in particular, can lead to osteomyelitis, further complicating treatment.
The type and severity of the fracture can also affect healing. For example, comminuted fractures, large gaps at the end of the fracture, or severe soft-tissue injuries can cause fracture healing difficulties.
In addition, the patient's own physical condition also plays an important role. Poor nutrition, underlying medical conditions such as diabetes and osteoporosis, and long-term use of certain medications, such as glucocorticoids, can affect the healing of fractures.
There are also some special circumstances, such as the presence of foreign bodies at the fracture end, bone defects, etc., which can also lead to the occurrence of nonunion.
In conclusion, nonunion is a complex problem that involves multiple factors. For fracture patients, timely and standardized treatment, as well as correct postoperative care and rehabilitation training, are crucial. At the same time, regular re-examination, pay close attention to the healing of fractures, and once abnormalities are found, measures should be taken to intervene as soon as possible to avoid the adverse consequences caused by nonunion.