Scientific Treatment of Bone Disconnections

With the increase of car accidents and traumatic fractures, the incidence of delayed healing of fractures and bone nonunion is also increasing. Many people think that their bone scab grows slowly after fracture, so they worry a lot and put on the hat of “non-union”, spend a lot of money, and seek medical advice everywhere. As a result, all kinds of publicity and advertisements came into being: no surgery for bone fracture, herbal medicine for bone fracture, plaster for bone fracture, acupuncture for bone fracture, shockwave for bone fracture, and the patients were all dizzy. The suggestion is that the first thing that should be confirmed is whether one belongs to bone disunion or not. Some are diagnosed as bone nonunion, in fact, it is not bone nonunion at all, just the fracture end of the slow growth of the bone scab, some are not timely pressurization of the external fixation frame, the broken end of the gap, as long as the use of the external fixation frame comes with the mechanism of the broken end of the pressurization can be healed, there are some intramedullary nail fixation is not timely to change the power of the broken end of the gap, as long as the locking nails to change the power of the end of the majority of the smooth healing. Some are fixed for a short period of time, the fixation is not secure, such as navicular bone fracture, sometimes 3 months when the fracture line is still visible, at this time there is no need to panic, change the plaster to continue to fixation for 3 months is likely to be healed. Go to the local regular hospital, let the professional orthopedic surgeon for diagnosis, and then say treatment things, the advantage is neither delayed diagnosis, but also do not spend money. Secondly, there is no problem with fixation. Whether it is surgical or conservative treatment, reliable fixation is required to ensure smooth fracture healing process. Reliable fixation does not mean that surgery is necessary, not necessarily the longer the plate is better, not necessarily the bigger the operation is better. It is better to have enough. Has the fixation failed? Loose plate screws, broken plates, screws driven into the fracture line, broken ends of intramedullary nails, there is no hesitation to operate in such cases! Surgery removes the failed internal fixation and replaces it with an effective fixation, along with a bone graft. Third, actively treat other diseases. A fracture that is also infected or diabetic, or malnourished can also heal poorly. Fourth, how big is the gap between the fracture ends? When the bone is not connected, there is a certain gap between the fracture ends, in which there is dense scar tissue, little blood circulation, and the fracture ends are hardened, and the fracture gap is a “no man’s land” with poor bone formation ability. Generally, small gaps can be treated with conservative methods to promote healing, such as electrical stimulation, ultrasound, shockwave, bone marrow and bone growth factor injections, etc. For intramedullary nail fixation, the static fixation locking nails at one end can be removed, and dynamic locking nails can be retained, so as to allow the broken end to withstand a certain amount of pressure to promote healing, which is known as “change of dynamic force”. The so-called “redynamics”. If the gap is more than 5 mm, and the broken end is not stable, the effect of conservative treatment is very poor. Conservative methods such as the so-called traditional Chinese medicine, plasters and shock waves will be ineffective. At this point, surgical treatment should be used to remove the scar tissue and implant bone graft material. If bone nonunion has occurred, re-surgical bone grafting cannot be done with artificial bone, but must be done with autogenous bone, at least most of it. The situation is influenced by many factors, with commonalities and differences. The doctor should individualize the choice of treatment, which must be in accordance with medical norms and scientific principles in order to obtain perfect results.