Non-Union Fracture Treatment in Sharjah
Medically reviewed by Dar Al Kamal Team
What is non-union fracture treatment?
Non-union fracture treatment is surgery for a broken bone whose healing has stalled, leaving the two ends separate and able to move against each other. A non-union differs from a slow-healing fracture: in a delayed union the bone is still making progress, while in a non-union repeat X-rays over several months show that the healing process has stopped.
The treatment starts with one question: why has this bone stopped healing? A fracture needs three things to unite, namely stability, a good blood supply and living bone cells at the break. Non-union treatment identifies which is missing and supplies it.
Specialists describe two broad types, and the difference shapes the operation. In a hypertrophic non-union, the X-ray shows plenty of new bone flaring around the gap: the biology is working, and the fracture mainly lacks stability. In an atrophic non-union, the bone ends look thin and quiet, so the bone needs biological help, usually a bone graft, as well as firm fixation.
At Dar Al Kamal Hospital, Sharjah, non-union is treated by the orthopedic surgeons of the Orthopedics and Sports Medicine department, who also provide first-time fracture management.
Who needs it
Non-union fracture treatment is for people whose fracture is still painful or moving months after the injury, with X-rays or a CT scan showing a persistent gap between the bone ends. Typical signs are pain at the fracture when you put weight on the limb, a limb that feels unstable or bends slightly, and metalwork that has loosened or broken because the bone around it has failed to share the load.
Factors that make non-union more likely include:
- Infection at the fracture, which can be low-grade and silent
- Poor blood supply, from a high-energy injury, damaged soft tissue, or a bone with a naturally limited supply such as the scaphoid in the wrist or the lower shin bone
- Smoking and other nicotine products, including vaping
- Diabetes, particularly when blood sugar has run high
- Too much movement at the fracture, from fixation that was too flexible or weight taken on too early
- Low vitamin D, poor nutrition and some long-term medicines
The surgeon weighs the location and type of non-union, any infection, the state of the skin and your general health, and plans the treatment with you.
What happens
The work-up comes first. Blood tests look for signs of infection and check blood sugar and vitamin D, and a CT scan shows how much bone, if any, has bridged the gap. When infection is suspected, samples from the fracture are sent to the laboratory during the operation so that the right antibiotic can be chosen.
The operation is performed under general anaesthesia or a regional anaesthetic and is tailored to the cause:
- Revision fixation: loose or broken metalwork is removed and replaced with a stronger or better-placed plate or nail, giving the bone the stability it lacked.
- Bone grafting: the fibrous tissue filling the gap is cleared and the bone ends are freshened back to healthy, bleeding bone. Bone graft, often taken from your own pelvis, is packed around the fracture to supply living bone cells and a scaffold for new bone.
- External frame: rings or bars outside the limb, held by wires or pins, compress the bone ends together or bridge a shortened or infected segment, keeping the limb stable while infected bone is removed.
Two of these are often combined in one operation, for example revision fixation with a bone graft.
Preparing for it
Stopping smoking and all nicotine products is one of the most useful steps you can take, because nicotine narrows the small blood vessels that carry healing cells to the fracture. If you have diabetes, the team works with you to bring your blood sugar under good control before surgery.
Bring all X-rays, CT scans and operation notes from the first treatment, including the note describing the implant used, since this helps plan its removal. Records from another hospital or from abroad are just as useful. A pre-operative assessment, blood tests and an anaesthetic review confirm you are ready, and you receive fasting instructions and a plan for blood thinners and diabetes medicines. Around Ramadan, discuss timing early, since fasting affects blood sugar and wound healing.
Afterwards
When bone graft is taken from the pelvis, the hip is often sore for a while, and this is expected. Your surgeon sets how much weight the limb may take. Physiotherapy begins early: at Dar Al Kamal Hospital, the physical therapists work closely with the orthopedic surgeons to keep nearby joints moving and rebuild strength while the bone unites.
Follow-up X-rays, and sometimes a CT scan, track new bone bridging the gap. Keep up the habits that support healing: stay free of nicotine, keep blood sugar steady and eat enough protein and calcium. In the Sharjah heat, keep wounds and pin sites dry and drink plenty of water. Your surgeon gives you a timeline for your case and plans your return to work around your job.
Contact the hospital if the wound or a pin site becomes red, hot or starts to leak, if you develop a fever, or if pain at the fracture returns or increases. **Go to the emergency department straight away if your calf swells and hurts, you become short of breath, or your fingers or toes turn numb, pale or cold.**
Cost and insurance
Most UAE insurance plans cover non-union fracture treatment as medically necessary care, and planned surgery requires pre-approval supported by X-rays or a CT scan showing the non-union and the history of the original fracture. Implants, frames and bone graft substitutes may be assessed separately, and some plans cap physiotherapy sessions. Dar Al Kamal Hospital, Sharjah can help you check your cover on 06 599 7777.
Related services
Frequently asked questions
What is the difference between a delayed union and a non-union?
A delayed union is a fracture that is healing more slowly than expected but still making progress, while a non-union is a fracture whose healing has stopped. Repeat X-rays or a CT scan over time show which one you have, and a delayed union often needs only more time and support.
What are the risks of non-union surgery?
Non-union surgery carries risks including infection, bleeding, blood clots, a reaction to the anaesthetic, nerve or blood vessel injury, and pain where bone graft was taken. Some non-unions need more than one operation before the bone joins, and an old infection can return. Your surgeon explains how these risks apply to your fracture.
Why has my fracture not healed?
A fracture stops healing when it lacks stability, blood supply or living bone cells, or when infection, smoking, diabetes or low vitamin D slows the process. Tests before surgery look for each of these, because correcting the cause is as important as the operation itself.
Does smoking really affect bone healing?
Smoking and other nicotine products slow bone healing, because nicotine narrows the small blood vessels that supply the fracture. Stopping before and after non-union surgery gives the bone a better chance to join, and the team can support you to quit.
What is a bone graft and where does it come from?
A bone graft is bone packed around a fracture to supply living cells and a framework for new bone to grow along. It is often taken from your own pelvis through a separate small incision, and donor bone or a bone substitute may be used instead or as well.
Can a non-union heal without surgery?
A small number of stable, well-aligned non-unions heal with protected weight-bearing and correction of factors such as smoking, diabetes or low vitamin D. Most non-unions need surgery to add stability, bone graft or both, and your surgeon explains which applies to you.
Is non-union fracture treatment covered by insurance?
Most UAE insurance plans cover non-union fracture treatment as medically necessary care, with pre-approval required for planned surgery and implants. Confirm your cover with Dar Al Kamal Hospital, Sharjah on 06 599 7777.
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