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
- Consider evaluation for underlying metabolic disturbances (Brinker MR, JOT 2007;21:557)
- 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
Fusion / Nonunion Clinical Utility
- Amplify rhBMP-2 Matrix; Medronic: slown to decrease operative time, and blood loss and increase fusion rates compared to iliac crest graft for lumbar fusion (Dimar J, JBJS 2009;91A:1377).
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