Nonunion

• synonyms:
• ICD-9=733.82 (nonunion of fracture)
• Nonunion = no improvement clinically or radiologically in fracture healing over a 3 month period.

Nonunion Risk Factors

• Open fractrue
• tobacco use
• Diabetes
• Malnutrition
• Increased age

Nonunion Treatment

• Bone growth stimulators: Non-invasive electrical bone growth stimulation is considered medically appropriate when all of the following criteria are met:
  -At least three (3) months have passed since the date of fracture; and
  -Serial radiographs have confirmed that no progressive signs of healing have occurred; and
  -The fracture gap is one (1) cm or less; and
  -The individual can be adequately immobilized and is likely to comply with non-weight bearing.
  

Specific Nonunions

• Humeral Shaft Nonunion
• Tibial Shaft Nonunion

EBI Bone Stimulators

Exogen bone healing system

DONJOY bone stimulators

Orthofix bone stimulator

Allosoure Allofuse
Biomet ProOsteon
Biomet InterGro DBM
Biomet BonePlast
Exactech Opteform
Exactech Optefil
Exactech Optecure
Exactech OpteMx
Isotis AccellDBM
Isotis Accell Total DBM
Isotis Accell Conexus
Lifenet Optimum DBM
Lifenet IC Graft
Lifenet Cellect DBM
Lifenet OraGraft
Medtronic Infuse
Medtronic Granules
Medtronic Matrix
Medtronic Putty
Medtronic Osteofil DBM
Orthofix Osteomax
Osteotech Grafton
Stryker OP-1 implant
Stryker OP-I putty
Stryker Calstrux
Stryker Hydroset
Synthes DBX
Synthes Norian
Synthes Chronos
Wright Osteoset
Wright MIIG X3
Wright Cellplex
Wright Allomatrix
Wright Ignite
Zimmer CopiOS