Treatment For Non-union Femur Fracture
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 a pathological fracture.
Bone has the capacity to heal on its own. Orthopedic surgeons join the bone to allow proper healing. While healing, some complications arise – for instance:
- 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 a non-union fracture.
What is a Non-union Femur Fracture?
When the femur bone is involved in the fracture, and it doesn’t heal even after surgical treatment, it is termed as non-union femoral shaft fracture or Non-union femur fracture. Non-union 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 non-union 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 non-union fractures.
Treatment For Non-Union Femur Fracture
Nonunion femur fracture 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 non-union.
Nonsurgical Treatment for Nonunion 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 non-union fracture from 20min to several hours every day. This treatment will be effective when done daily.
Surgical Treatment for Nonunion Femur Fracture
Nonunion femur fracture 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 has failed. The surgical choices include:
- Bone graft
- Bone graft substitute
- Internal fixation
- External fixation
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 non-union. Like the traditional bone graft, it also provides a platform to heal the bone across the area of the non-union. 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 non-union type, a single procedure or a combination of methods might be used to fix the non-union.
Bone grafts or bone graft substitutes alone can’t provide stability to the non-union fracture site unless the non-union is naturally stable. You might also require other surgical procedures like internal or external fixation to improve stability.
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 non-union 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 also helps in stabilizing the fractured bone. 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 non-union. External fixation can treat any type of non-union, including non-union femur fracture in a patient, even with bone loss and/or infection.
The exact reason for nonunions fractures is not apparent. Experts opine that the natural chemicals in the body, called growth factors 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 non-union fractures, malunion fractures, and other bone fractures.