In orthopaedics, a non-union is a condition where a fracture or bone does not heal properly, resulting in a gap between the two fragments. This can occur due to various reasons such as poor blood supply, inadequate stabilization, or infection. Non-unions can be challenging to treat and may require multiple surgical interventions.
On the other hand, a malunion is a condition where a fracture or bone heals improperly, resulting in a misalignment of the bone. This can also occur due to various reasons such as poor stabilization, inadequate immobilization, or inadequate reduction. Malunions can cause significant pain, limited mobility, and functional impairment.
Non-unions and malunions are common complications in orthopaedics, particularly in the treatment of fractures, osteotomies, and bone grafts. They can occur in any bone or joint, but are more common in the upper extremities, pelvis, and acetabulum.
Causes of Non-Union:
- Poor Blood Supply : Inadequate blood supply to the bone fragments can impede the healing process.
- Inadequate Stabilization : Insufficient immobilization or internal fixation can allow the bone fragments to move and not heal properly.
- Infection
- Smoking
- Nutritional Deficiencies
- Age : Older patients may be more prone to non-unions due to decreased bone density and reduced blood supply.
Causes of Malunion:
- Poor Reduction : Inadequate reduction of the fracture or bone fragments can lead to malalignment.
- Inadequate Immobilization : Insufficient immobilization or internal fixation can allow the bone fragments to move and not heal properly.
- Infection
- Smoking
- Nutritional Deficiencies
Symptoms of Non-Union or Malunions:
- Pain : Persistent pain at the site of the fracture or bone graft.
- Limited Mobility : Decreased range of motion and limited ability to move the affected limb.
- Swelling : Swelling and inflammation at the site of the fracture or bone graft.
- Deformity : Visible deformity of the affected limb.
Treatment Options for Non-Union:
- Surgical Debridement: Removal of dead tissue and bacteria to promote healing.
- Bone Grafting : Transfer of healthy bone tissue to stimulate healing.
- Internal Fixation : Use of internal devices such as plates, screws, or rods to stabilize the bone fragments.
- External Fixation : Use of external devices such as pins or frames to stabilize the bone fragments.
- Bone Lengthening Techniques for non union : Use of techniques such as Ilizarov or distraction osteogenesis to promote lengthening and alignment of the bone.
- Physical Therapy for malunions : Rehabilitation exercises to improve range of motion and strength in the affected limb.