When a broken bone is slow to heal after a crash
What an orthopedic trauma surgeon looks for in delayed union and nonunion
Some fractures take longer than expected to heal. Doctors call this delayed union. A nonunion means the bone has failed to join. A major crash can damage the blood supply and soft tissue around a break, which makes healing harder. [1]
Lasting pain where the bone broke is worth bringing up. Pain on its own doesn’t prove a nonunion, though. An orthopedic trauma surgeon compares images over time and looks for reasons healing has slowed. [1]
See how your images change from visit to visit
Ask your surgeon to explain in plain words how the newest image compares with earlier ones. Find out whether new bone is bridging the break. Ask whether the alignment and any hardware are stable and when your next review will be. If the answer isn’t clear, ask what would change the diagnosis. The trend across several images may tell you more than any one image. [1]
Look for problems that can be treated
Bone needs stability, a good blood supply and enough nutrition to heal. Infection, diabetes, anemia and nicotine use can get in the way. Ask whether tests or a review of your medicines would make sense. Follow your weight bearing instructions even if the limb feels stronger. Don’t add supplements or stop prescribed medicines before talking through their likely benefit and risk. [1]
Weigh your treatment options
Treatment depends on the problem. It may mean more time in a cast or brace, or a bone stimulator. It may also mean surgery to make the bone more stable, sometimes with a bone graft added. Ask what each option is meant to achieve and how long it may take. Find out how the team will judge whether it worked. Promptly report new drainage, fever, a change in the limb’s shape or pain that suddenly gets worse. [1]
Questions to ask at your fracture visit
- Is this slow healing or a nonunion, and what is causing it?
- How do my images compare with last time?
- What can each treatment do, and where does it fall short?
Bring a health snapshot to your next visit
Make a list to take to your next fracture visit. Include your pain, what you can and can’t do, any nicotine exposure, your medicines and your other health conditions. [1]
Sources and further reading
This article offers general education from an orthopedic trauma surgery viewpoint. Healing time differs from person to person. Only your own clinician can read your images and decide when your treatment should change.
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