Diagnosis and Interpretation of Complications Associated with Fractures

Non-Union: Pathophysiology, Risk Factors, Classification, Imaging Techniques, and Management Strategies

Fractures are complex injuries that can lead to complications, including malunion, non-union, infection, and compartment syndrome. Among these, non-union remains a significant clinical challenge.

Pathophysiology of Non-Union

Non-union occurs when a fracture fails to heal within the expected timeframe due to inadequate biological response. It can be classified as hypertrophic, atrophic, or oligotrophic, depending on the healing characteristics.

Risk Factors

• Poor vascular supply
• Inadequate immobilization
• Infection
• Systemic factors such as diabetes and smoking

Classification

Non-union is broadly categorized into viable and non-viable types. Viable non-unions show biological activity, whereas non-viable non-unions lack healing potential.

Imaging Techniques

Advanced imaging modalities aid in the diagnosis and treatment planning:

• X-ray: Initial assessment
• CT scan: Detailed fracture visualization
• MRI: Evaluation of soft tissue involvement

Management Strategies

Management involves surgical and non-surgical interventions:

• Bone grafting
• Fixation techniques
• Biological stimulators
• Pharmacological approaches

Early intervention and proper diagnosis significantly improve patient outcomes in non-union cases.