A bone fracture or broken bone is a condition where the connection of the bone is broken. Mostly bone fractures occur due to the impact of high force or stress on the bone as a result of falls and accidents.
However, a fracture might also result from some medical conditions where the bones become weak, for instance, osteoporosis, bone cancers, or osteogenesis imperfecta (brittle bone diseases). A fracture that is caused by a medical condition is termed as a pathological fracture.
Bone has the capacity to heal on its own. Orthopaedic surgeons join the bone to allow proper healing. While healing, some complications arise such as below:-
- If the bone heals slowly, it is called delayed union.
- If it heals in the wrong direction, it is called malunion,
- If it doesn’t heal, then it is termed as a nonunion fracture.
What Is A Nonunion Femur Fracture?
When the femur bone is involved in the fracture, and it doesn’t heal even after surgical treatment, it is termed as nonunion femoral shaft fracture or Nonunion femur fracture. Nonunion of broken bones is a very uncommon situation after surgery that might happen in one or of five hundred people.
The fractures of the femur that turn into a nonunion fracture constitute even less percentage of all fractures. They are formed if the treatment provided to the fractures is exceptionally bad. However, a wide variety of treatment options are available in the modern era to treat nonunion fractures.
Treatment For Non-Union Femur Fracture
Nonunion femur fractures can be treated either surgically or nonsurgically. Each of these treatments has its own advantages and disadvantages. More than one treatment option might be suitable in some cases. Your doctor will discuss the treatment options, benefits, and risks involved in treating your nonunion.
Nonsurgical Treatment For Non-Union Femur Fracture
Some non-union fractures can be treated with conventional treatment. The bone stimulator is a standard nonsurgical treatment. The procedure involves using a small device that produces ultrasonic or pulsed electromagnetic waves to stimulate healing. The patient needs to place the stimulator device on the skin over the nonunion fracture from 20min to several hours every day. This treatment will be effective when done daily.
Surgical Treatment For Non-Union Femur Fracture
Surgery is inevitable when nonsurgical treatment methods fail to achieve desired results. You might need revision surgery if the initial surgery failed. The surgical choices are:-
- Bone graft.
- Bone graft substitute.
- Internal fixation.
- External fixation.
Bone Graft: In this procedure, a piece of bone is taken from another part of the body and grafted at the fracture site to stimulate the healing process. The bone graft provides a platform for new bone growth. Bone grafts provide new bone cells and other natural chemicals required by the body for bone healing. Although grafting the bone might be painful, the amount of bone extracted does not cause any functional, structural, or cosmetic problems.
Allograft (cadaver bone graft): An allograft (cadaver) bone graft prevents bone harvesting from the patient, i.e., the bone graft is taken from a donor(genetically non-identical donor) to treat the nonunion. Like the traditional bone graft, it also provides a platform to heal the bone across the area of the nonunion. With time the patient’s bone grows over the cadaver bone and replaces it. To avoid the risk of infection, the cadaver bone graft is sterilized.
Bone graft substitutes: These are Also called osteobiologics. Bone graft substitutes are similar to allografts that prevent the bone harvesting procedure. Although bone graft substitutes don’t provide new bone cells required for normal healing, they only provide scaffold chemicals necessary for bone growth.
Depending on the nonunion type, a single procedure or a combination of methods might be used to fix the nonunion.
Bone grafts or bone graft substitutes alone can’t provide stability to the nonunion fracture site unless the nonunion is naturally stable. You might also require other surgical procedures like internal or external fixation to improve stability.
Internal Fixation: Internal fixation can stabilize severe fractures, including nonunions. The surgeon connects metal plates and screws from outside the fracture or places a rod inside the canal of the bone. If a nonunion happens after internal fixation surgery, the patient may need to undergo another internal fixation surgery to increase stability. In the revision surgery, the surgeon might implant even more rigid device rods and plates. Internal fixation can also be done in combination with bone grafting to improve stability and stimulate healing.
External fixation: External fixation also helps to stabilize the fractured bone, as well. The surgeon fixes a stiff frame outside the broken arm or leg. The frame is a combination of wires or pins attached around the fractured bone. External fixation helps to increase the stability at the site of fracture if instability is the reason to cause nonunion. External fixation can treat any type of nonunion, including nonunion femur fracture in a patient, even with bone loss and/or infection.
The exact reason for nonunions fractures is not apparent. Experts researched over the natural chemicals in the body, called growth factors that are produced in the body for bone healing when it breaks.
However, if you are experiencing any problem associated with your bones, consult Dr Vasudeva Juvvadi, Consultant Orthopedic Surgeon at Sunshine Hospitals, Hyderabad. He has more than 10+ years of experience in handling nonunion fractures, malunion fractures and other bone fractures.