The Orthobullets Podcast Basic Science | Nonunion and Bone Defects
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Oct 14, 2025 Dive into the fascinating world of nonunion and bone defects. Discover what sets nonunion apart from delayed unions and explore the risk factors like instability and infection. Learn about the various classifications including septic and hypertrophic nonunions. The role of imaging in diagnosis is highlighted, alongside innovative treatments like bone grafting and electrical stimulation. Get insights on modifiable risks, such as smoking, and how they impact healing. It’s a captivating exploration of orthopedic challenges!
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Nonunion Defined And Primary Causes
- A nonunion is an arrest in the fracture repair process and represents progressive non-healing of a fracture.
- Inadequate stabilization and poor blood supply are the most common underlying causes of nonunion.
High-Risk Sites And Patterns
- Certain anatomical locations and fracture patterns have higher nonunion risk due to tenuous blood supply or compromised intercalary segments.
- Examples include the scaphoid, distal tibia, base of the fifth metatarsal, segmental fractures, and butterfly fragments.
Nonunion Classification And Hypertrophic Type
- Nonunions are classified as septic, pseudoarthrosis, hypertrophic, atrophic, and oligotrophic.
- Hypertrophic nonunions have abundant callus but lack bridging and typically heal once mechanical stability is improved.