What is pseudarthrosis?
Pseudarthrosis or nonunion is a disease that occurs when a broken bone fails to heal after a fracture unless intervention (surgery) is performed. The fracture structurally resembles a fibrous joint, and for this reason, is called “false joint” or pseudoarthrosis. It is more common in adults and usually occurs after trauma or surgery. Children can suffer from pseudoarthrosis congenitally, whereby the bone fractures spontaneously.
What are the symptoms of pseudarthrosis?
The symptoms of pseudoarthrosis are similar to those of osteoarthritis and include; lack of mobility, persistent pain, joint clicking and in some cases, redness and even fever.
What are the causes of pseudarthrosis?
The exact underlying cause of pseudoarthrosis is not known, however, scientists believe that genetic predisposition plays an important factor.
There are some risk factors that have been linked with the disease:
- Patient health status: old age, poor nutrition, alcohol consumption, smoking and hyperparathyroidism are contributing factors to the disease, as they slow down the healing process of the wound.
- Related to the fracture: pseudoarthrosis can happen if a fracture gets infected, if there is damage to the surrounding muscles, if there is bone loss and if there is a loss of blood supply to the fracture. Interruption to blood supply can lead to avascular necrosis, which is the death of bone tissue, gradually leading to pain and immobility.
- Inadequate treatment after a fracture: Lack of rest after a fracture and the improper application of fixation devices, such as metal plates to stabilize the fractured bone can cause pseudoarthrosis.
Can pseudarthrosis be prevented?
If the cause is related to the treatment of the fracture, it can be prevented by treating the wound well to prevent infection, and, if necessary, resorting to surgery before it becomes complicated.
What is the treatment for pseudarthrosis?
The main treatments used are:
- Electrical stimulation: Electromagnetic or ultrasound waves are used that cause bone cells to form the hydroxyapatite structure that prevents the bone from bending.
- Bone grafting: Bone from the patient or from a donor is used to stimulate the healing of the damaged bone.
- Fixation: Metal plates, screws, bolts or rods, can be screwed into or placed inside the fractured bone to stabilize the broken bone fragments.