Nonunions: Evaluation and Treatment

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Introduction:

 

While fracture nonunions may represent a small percentage of the traumatologist's case load, they can account for a high percentage of a surgeon's stress, anxiety, and frustration. Arrival of a fracture nonunion may be anticipated following a severe traumatic injury, such as an open fracture with segmental bone loss, but may also appear following a low-energy fracture that seemed destined to heal. p0020 Fracture nonunion is a chronic medical condition associated with pain and functional and psychosocial disability. 180 Because of the wide variation in patient responses to various stresses177 and the impact that may have on the patient's family (relationships, income, etc.), these cases are often difficult to manage. p0030 Some 90 to 95 percent of all fractures heal without problems. 87,245 Nonunions are that small percentage of cases in which the biological process of fracture repair cannot overcome the local biology and mechanics of the bony injury.