Bone Surgery for Non-Healing Fractures
There is ample evidence that the physicians of Ancient Egypt employed techniques to heal broken arms and legs more than 3 500 years ago. Furthermore, they used wooden splints wrapped in bandages and casts made from a plaster-like mixture that form the basis of methods still in use today. However, unlike today’s orthopaedic surgeons, these early bonesetters did not possess the ability to perform bone surgery when their techniques failed to heal their patient’s fractures.
While its rigid structure might suggest otherwise, bone tissue is far from static. Specialised cells are constantly breaking it down and rebuilding it. When fractures occur, these processes intensify to promote healing. Usually, it is sufficient to realign the bone fragments, stabilise them, and let nature take its course. However, new tissue fails to form on occasions, preventing the pieces from growing together or significantly delaying the healing process. The humerus and tibia are most commonly affected, and bone surgery will generally be necessary to ensure a lasting repair.
Common Causes of Non-Healing Fractures
Several factors could prevent a broken arm or leg from healing or slow the process. All growth depends on an adequate supply of raw materials, and delivering them to where they are needed requires an effective blood supply. A more severe injury will sometimes damage local blood vessels, interrupting the flow of oxygen, minerals, and other nutrients essential for growth to the fracture site and creating the need to perform bone surgery.
However, traumatic injuries are not the only cause of impaired blood circulation. Patients with diabetes may experience similar problems. In addition to affecting the body’s ability to metabolise sugar adequately, the condition can also reduce the levels of nutrients in the blood and impair its circulation. These two factors carry a heightened risk of delayed or non-union fractures in diabetic subjects.
Among the essential factors for bone growth are calcium, vitamin D, and vitamin C. Low levels of any of these can prevent new tissue formation. Once again, bone surgery might be the only viable option to achieve an effective repair.
Other factors that could lead to healing problems include infections like osteomyelitis, which can occur when bacteria gain entry via a nearby wound site. Also, corticosteroids and non-steroidal anti-inflammatory drugs such as ibuprofen and smoking cigarettes can all act to reduce blood flow and prevent fractures from healing correctly.
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Help is at Hand
When conventional methods of fracture repair fail, and the pain and swelling continue, further treatment by a skilled orthopaedic specialist will be essential. The team at Pretoria’s Life Wilgers Hospital has gained the status of a national and international referral centre for patients requiring any form of advanced bone surgery.