Complications of Fractures
DELAYED UNION AND NONUNION
The stage of fracture healing where the affected parts of the broken bone have fused together is termed as the “union.” When the healing is not advancing at a normal rate for the location and type of fracture delayed union occurs. This condition is associated with ischemic infection and distraction or pulling apart of bone fragments. But eventually the bone heals in this case. In situations where the patient complains of persistent discomfort and pain at the fracture site, where bones are visualized in the x-ray procedure pulling apart in each ends would result to nonunion.
Union problems are due to the following factors:
- Infection at the fracture site
- Presence of tissues between the bone ends
- Presence of too much bone gap or space between bone fragments
- Insufficient time for immobilization or inadequate bone manipulation. Movement causes a disruption in callous formation in bone ends.
- Impaired blood supply
Management of Nonunion
- Bone grafting.
- Electrical Stimulation of Osteogenesis.
AVASCULAR NECROSIS OF BONE
When the bone loses its blood supply and dies, avascular necrosis of the bones occurs. Commonly affected sites of this condition are the following:
- Proximal and distal femoral heads
- Upper part of leg bone that attaches to the hip
Impaired blood supply or avascular necrosis of bone follows after the following incidences:
- Prolonged high-dose corticosteroid therapy
- Chronic renal disease
- Sickle cell anemia
- Limited movement
- X-ray reveals calcium loss and structural collapse
- Attempts to revitalize bone with bone grafts
- Prosthetic replacement or arthrodesis (joint fusion)