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In case of nonunion of femur fracture after 5-6 months of fixation with intramedullary nails n implant, what is further appropriate course of action (age 50)

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In case of nonunion of femur fracture after 5-6 months of...
Hi there There can be many factors responsible for non union of fracture like too large space for bony remodelling to bridge, Interposition of periosteum, muscle or cartilage, Bony site with limited or less blood supply and more. If fracture won't unite after 6 months it my be considered in as delayed or non union of fracture. These approaches can be effective after non union: Non-surgical approaches Early weight bearing and casting may be helpful for delayed union and non-union. Bone stimulation can sometimes be used. This delivers pulsed ultrasonic or electromagnetic waves to stimulate new bone formation. It needs to be used for up to an hour every day, and may take several weeks to be effective. Medical treatments such as teriparatide have also been used to promote fracture healing, particularly in patients with osteoporosis. Surgical approaches: Debridement to establish a healthy infection-free vascularity at the fracture site. Bone grafting to stimulate new callus formation. Bone may be taken from the patient or may be cadaveric. Bone graft substitutes/osteobiologics. Internal fixation to reduce and stabilise the fracture. Depending on the type of non-union, any combination of the above procedures.
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