Symptoms

Delayed fracture union | Symptoms

Subjective symptoms include  pain persistence  and sometimes  swelling at the level of the outbreak of fracture. Often these symptoms occur when you load and during functional activities.



Self-healing

Delayed fracture union | Self-healing

To promote the healing of fractures is essential to ensure an adequate dietary intake. In case of fracture of long bones, there is an immediate increase in metabolic demands of the body and although the subject is immobilized, he must increase  the total calories intake.

For bone reconstruction is useful to:  



Prevention

Delayed fracture union | Prevention

Problems with healing of fractures may not always be completely prevented, because most consolidation delays depends on the severity of the fracture. Complications can be lessen by trying to promote the biological principles of healing. It is essential therefore to ensure the adequate stabilization of the fragments and their best possible realignment (often only obtainable with surgery),  to prevent infection (high risk in exposed fractures) and to manage possibly associated systemic diseases. Whenever possible, promote active muscle function with specific exercises .



Diagnosis

Delayed fracture union | Diagnosis

Diagnosis is made by clinical and radiographic testing. From a clinical point of view it is important to evaluate the persistence of pain within the  fracture site, particularly under stress, e.g. when the segment is subjected to functional activities. The consolidation delay is confirmed by specific radiographic features. Specific  x-Ray projections may be required.



Causes

Delayed fracture union | Causes

A delayed union occurs when the fractured bone healing is slowed. The fracture’s healing is influenced by many factors and passes through various stages (stage of inflammation, soft callus formation, hard callus formation, stage of remodeling) leading gradually to normal bone regeneration. Healing depends on the amount of trauma reported by the bone but also from that of the surrounding tissues, mainly, a key role is played by revascularization  which provides blood supply and the restoration of proper circulation.



Therapy

Delayed fracture union | Therapy

In case of delay of consolidation of a fracture, biological processes can still be directed toward healing, to avoid the possible evolution of the outbreak in non-union, situation only treatable surgically. Non-surgical therapies in case of delayed consolidation which have been proved effective in accelerating bone repair processes, are magnetotherapy, treatment with shock waves and, in very special cases, hyperbaric oxygen therapy. The magnetotherapy indicated for facilitating the bone repair processes  uses pulsed electromagnetic fields at low intensity (CEMP).



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