Quote from: LLuser1 on June 24, 2016, 10:58:16 PMThe bone cutting technique is indeed one of the most important factors causing non union. It may occur when the fracture moves too much, has a poor blood supply or gets infected. Patients who smoke have a higher incidence of nonunion.
The reasons for non-union are
avascular necrosis (the blood supply was interrupted by the fracture)
the two ends are not apposed (that is, they are not next to each other)
infection (particularly osteomyelitis)
the fracture is not fixed (that is, the two ends are still mobile)
soft-tissue imposition (there is muscle or ligament covering the broken ends and preventing them from touching each other)
THERE ARE 2 TYPES:
Hypertrophic non-union
Callus is formed, but the bone fractures have not joined. This can be due to inadequate fixation of the fracture, and treated with rigid immobilisation.
Atrophic non-union
No callus is formed. This is often due to impaired bony healing, for example due to vascular causes (e.g. impaired blood supply to the bone fragments) or metabolic causes (e.g. diabetes or smoking). Failure of initial union, for example when bone fragments are separated by soft tissue may also lead to atrophic non-union. Atrophic non-union can be treated by improving fixation, removing the end layer of bone to provide raw ends for healing, and the use of bone grafts.
IN LL I have seen instances of both types. I won't say where because you will accuse me of spamming. Bad osteotomy was the cause in some cases, the most worrisome ones. In other cases the patient is to be blamed (smoking).
Why are you copypasting articles from the wikipedia in a 1.5 year old thread?
At least have some manners and add the source: https://en.wikipedia.org/wiki/Nonunion