Fractures are usually treated by restoring the alignment of the broken bone (reduction of the fracture) and immobilization of the bones. This may be performed either by applying a plaster cast or by surgical fixation of the fractures with rods or plates and screws. With advances in Orthopaedic knowledge, expertise and technology, most fractures heal (unite) within the expected time. However, some fractures do not heal within the expected time (Delayed Union), some fractures do not heal in normal alignment (Malunion) and some fractures do not heal at all (Non-Union).
Nonunion occurs when the bone lacks adequate stability and/or blood flow and the risk of non-union is increased by smoking and chewing tobacco, Diabetes, Anaemia, Older age, and Infection.
Most non-unions require surgery treatment which usually includes freshening the fractured ends of the bone, bone grafting and rigid fixation. Bone graft is usually harvested from the patient’s own pelvic bone. In some instances, allograft / cadaveric bone or bone graft substitutes (BMP) may be used. In cases where some length of the bone is missing, it may be replaced using a vascularised fibular graft. Depending on the type of nonunion, any of the above materials, or a combination of materials, may be used to fix the nonunion. Rigid internal fixation of the bone is achieved using either an internal fixator (plate and screw; rods etc) or an external fixator (Mono-axial fixator or Ring fixator – Illizarov frame).
The Non-union Clinic offers the following services –
1. Assessment and diagnosis
2. Counseling services including psychological counseling
3. Reconstruction surgery
4. Rehabilitation Services
The team consists of two surgeons (Dr Prashant Tejwani and Dr Purushottam Lal), qualified rehabilitation physiotherapists, counselors and nurses.