After a bone is fractured new bone tissue forms during healing, connecting the broken pieces. Non-unions occur when the bone doesn't heal properly after a break or fracture. Non-unions commonly cause lingering pain and instability in the affected limb. In some cases, the fracture may heal but in a shortened or incorrect position. This is known as malunion. Both of these issues will require reconstruction of the limb.


While most bones will heal without problems, fractures that fail to heal even with surgical or non-surgical treatment are commonly caused by poor stability, blood flow, or both. This is the risk with fractures as a result of high-energy trauma. In some cases, an infection in the fracture area may be the cause for non-union.


Symptoms of non-union can vary, and the symptoms will depend on the type of non-union and the bone affected. In most cases, those with non-union will feel pain near the fracture area long after the injury when healing should have occurred. This pain may be constant or brought about during activity.


Non-union treatment may involve electric stimulation or bracing, but in most cases, reconstructive surgery is needed. Reconstructive limb surgery by an orthopaedic surgeon such as Dr Pienaar is needed to restore damaged bone and tissue and stabilise the bone. The growth of new bone tissue to enhance the fusion of the fracture may be stimulated with bone grafts from another part of the body.

Thereafter, to stabilise the limb, internal or external fixation may be done. The internal fixation will involve metal screws attached to the bone, while external fixation involves a rigid frame being worn outside the limb, connected to the internal bone through wires and pins.    

For malunion realignment, shortening or lengthening may be needed. In some cases, the bone may need to be re-fractured to repair the alignment. Thereafter internal or external fixation may be used to stabilise the bone.