Delayed or Non-Unions are usually preceded by a history of trauma or surgery. Patients present with longstanding pain, swelling and functional limitation beyond the normal healing time. Sometimes an abnormal clicking is present at the fracture/fusion site. The diagnosis is made when little or no healing is seen on serial x-rays or CT scans.
Sometimes callus formation (i.e. extra bone formation on each side of the fracture/fusion) is noted on x-ray/CT scan. Rarely, a false joint (i.e. a pseudarthrosis) can be identified as a fibrous union at the fracture/fusion site. Such pseudarthroses allow a range of motion between two bones where none should exist.
Delayed Union or Non-Union of Bone is a failure of bone healing within a normal time frame. It typically takes bone 4-6 weeks to heal following fracture or surgical fusion. When bone is unhealed beyond 90 days, it is considered a Delayed Union. When bone is unhealed beyond 6-8 mos, it is considered a Non-Union.
Smoking
Early weightbearing after injury or surgery
Infection
Soft tissue imposition between bone ends
Bone fragments are
too far apart
Fracture is not stabilized
by hardware or cast
Impaired or deficient
blood supply
May include bone stimulators or Orthobiologic treatments. Bone stimulators may emit ultrasound waves or electrical current to stimulate bone healing. Regenerative medicine procedures are replacing surgery as an alternative treatment. The aim of using Orthobiologic Treatments is to support your body’s self-healing processes, reverse disease progression and suppress inflammatory reactions that can worsen pain, leading to symptom relief and recovery of function. We utilize regenerative medicine procedures including using your own Cells to repair naturally. Regenerative cells exist in high concentrations in bone marrow which can be aspirated with minimal discomfort, and then injected into the affected area often with concentrated platelet rich plasma.
Platelet rich plasma (PRP) has a high concentration of growth factors that activate and may prompt the local cells to produce additional growth factors and anti-inflammatory cytokines, thereby changing the environment from inflammatory to healing and regenerating.
Usually involve some or all of the following: Removal of all scar tissue/cartilage from between the fracture fragments Immobilization of the fracture with internal or external fixation. Metal plates, pins, screws, and rods, that are screwed or driven into a bone, are used to stabilize the broken bone fragments.
Bone grafting. Donor bone or autologous bone (harvested from the same person undergoing the surgery) is used as a stimulus to bone healing. The presence of the bone is thought to cause stem cells in the circulation and marrow to form cartilage, which then turns to bone. Bone is the only tissue that can heal without a fibrous scar. Autologus bone graft (i.e. one’s own bone vs cadaver bone) is the “gold standard” treatment of the non union. The bone is obtained from the hip bone (iliac crest) in the pelvis or from your heel (the calcaneus bone).
Although Orthobiologic Cell Therapy is considered by some people to be experimental, various research studies show that some marrow aspirate concentrate and platelet rich plasma injections may provide excellent relief from joint and musculoskeletal pain and ongoing inflammation.
600 Worcester Rd, Ste 301,
Framingham, MA 01702
This information is for educational purposes only and is NOT intended to replace the care or advice given by your physician. Always seek the advice of your physician or other qualified health provider before starting any new treatment or with any questions you may have regarding a medical condition. For more information see our Medical Disclaimer.
