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Non-Union Fracture

Some broken bones do not heal even when they get the best surgical or nonsurgical treatment. In some cases, certain risk factors make it more likely that a bone will fail to heal. When a broken bone fails to heal it is called a "nonunion." A "delayed union" is when a fracture takes longer than usual to heal.

Tibial fractures are the most common Non-union Fractures, although any bone fracture or break can become a Non-union. 

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A fracture is another word for a break. In some cases, the only symptom of a small fracture is a pain in the shin while walking.

Types of fracture:

Depending on the cause of the broken bone, the severity and type of fracture may vary. It may be a transverse fracture, meaning the crack is horizontal across the bone, or oblique, meaning the crack is at an angle.

Proximal fractures are those that affect the upper part of the tibia. Tibia shaft fractures occur below this area.

The tibia can have the following types of fracture:

  • Stable fracture. A stable fracture involves a crack in the bone that leaves most of the bone intact and in its normal position. The broken parts of the tibia line up and maintain their correct position during the healing process. This is called a non-displaced fracture.

  • Displaced fracture. With a displaced fracture, a crack in the bone moves part of the bone so that it is no longer aligned. Surgery is often needed to correct this type of fracture and realign the bones back together.

  • Stress fracture. Stress fractures, also called hairline fractures, are common overuse injuries. These fractures are small, thin cracks in the bone.

  • Spiral fracture. When a twisting movement causes a break, there may be a spiral-shaped fracture of the bone.

  • Comminuted fracture. When the bone fractures into three or more pieces, this is called a comminuted fracture.

Causes of tibia fractures:

Long bones in the body are resilient, but there are many ways that a person can sustain a tibia fracture. These include:

  • traumatic injuries, such as motor vehicle accidents or falls

  • sports that involve repeated impact to the shinbones, such as long-distance running

  • injuries from contact sports such as American football

  • osteoporosis, which makes the bones weaker than usual

 

Symptoms of a fractured may include:

  • localized pain in one area of the or several areas if there are multiple fractures

  • swelling

  • difficulty or inability to stand, walk, or bear weight 

  • leg deformity or uneven leg length

  • bruising or discoloration around the shinbone

  • sensation changes in the foot

  • a tent-like appearance where the skin is being pushed up by the bone

Diagnostic tests may include:

  • an X-ray to have an image of the tibia

  • a computed tomography (CT) scan, also called a CAT scan, which is more powerful than an X-ray and gives a 3-D image of the bone

  • a magnetic resonance imaging (MRI) scan for a detailed image of the muscles, ligaments, and bones around the tibia

An MRI scan is often used if the other scans have not been able to diagnose the problem.

 

Complications of a tibia fracture may include:

  • complications from surgery or the need for further surgeries

  • nerve, muscle, or blood vessel damage

  • compartment syndrome, a serious condition which there is a reduction in blood supply to the leg due to swelling

  • a bone infection called osteomyelitis

  • development of a non-union where the bone does not heal

In many cases, a tibial fracture will be successfully managed without complication.

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