Nonunion

Nonunion means a broken bone has stopped trying to heal. Fracture healing normally moves through stages: bleeding and inflammation, soft callus formation, hard callus, and then remodeling into solid bone. In a nonunion, this process stalls, often after many months, and the gap between the bone ends fills with scar tissue or stays mobile instead of turning into bone.

Several things raise the risk: smoking, poor blood supply to the area, infection, too much movement at the fracture site, certain medications, diabetes, and low vitamin D or poor nutrition. Some fracture locations, like the shin or wrist, are more prone to it. It's different from delayed union, where healing is just slower than expected but still happening, and from malunion, where the bone heals but in a crooked or shortened position.

Doctors diagnose nonunion with x-rays showing no new bone forming over time, sometimes alongside pain, swelling, or the limb still feeling unstable. Treatment options a surgeon might consider include bone grafting, revision surgery with different hardware, electrical or ultrasound stimulation, or addressing underlying issues like smoking or nutrition. Any treatment decisions belong to the orthopedic surgeon managing the fracture, based on the specific case.