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A broken bone is no fun. It’s painful and inconvenient. Most of the time that’s the worst of it—the bone heals and you move on. But, in a few cases, the bone doesn’t heal.
Because the experts at Orthocenter treat people injured at work, playing sports, or who need joint replacement, as well as people with other conditions and injuries, we see all sorts of fractures. From minor fractures to complicated injuries, our providers offer treatment options and guidance. When a broken bone doesn’t heal, it’s called a nonunion and requires specialized care.
For a fractured bone to heal, it needs to be stable. Have you ever tried to superglue something, and the pieces you’re gluing move? Your bone needs to be in the same place long enough for healing to happen in the same way pieces being glued together need to be stable long enough for the glue to set.
Glue isn’t involved in healing bones, but a type of tissue called callus is. Callus is a new tissue that forms at the site of the fracture. The formation of the callus is a transition between the inflammatory phase of your injury to the reparative phase.
When the callus first forms, it is soft tissue, but it slowly becomes harder and stronger and eventually becomes bone.
Blood delivers nourishment to every cell in your body, and when you have an injury like a fracture, blood brings all of the important components necessary for healing. Your bones need oxygen and specialized proteins called growth factors in order to form a callus and repair.
Cardiovascular disease, diabetes, and many other chronic conditions can damage your blood vessels and make it difficult for an adequate blood supply to reach your fractured bone. Traumatic injuries, too, can limit the blood supply to the fracture and slow down healing.
“You are what you eat” is a cliche for a reason, especially when it comes to your bones. A nutritious and well-balanced diet is an important part of healing.
You especially need:
The best way to get the nutrients you need is to eat a wide variety of vegetables and fruits, focus on lean protein sources like beans, fish, and poultry, consume healthy fats from nuts and avocados, and eat whole grains. Your provider may recommend supplements based on your specific situation and blood work.
When a bone isn’t healing properly, there is a higher risk of complications, and you will probably experience pain sometimes or all the time. One of the first types of treatment is immobilization, which helps provide stability. Splints, casts, and braces are all forms of immobilization.
A small device called a bone stimulator may be used in conjunction with immobilization. It’s placed over the skin covering the fracture for a set period of time and delivers ultrasonic or pulsed electromagnetic waves to stimulate healing.
If these less invasive methods are unsuccessful, your provider may recommend surgical intervention. Bone graft, bone graft substitute, internal fixation, and external fixation are all techniques used to treat nonunions.
The treatment that’s likely to work best for you depends on a host of individual factors, including the location of your nonunion, your overall health, whether or not you have any chronic conditions, the likely cause of your inability to heal, and many others. Getting guidance and advice from a skilled, experienced orthopedist who you trust makes it far more likely you’ll experience a positive outcome.
If you have questions about a nonunion, we encourage you to schedule an appointment at one of Orthocenter's convenient locations. We’re always happy to answer them in the context of your injury and situation.
