What makes a fracture complex?
Complexity can come from joint involvement, multiple fragments, open injury, poor soft tissue, bone loss, infection, previous surgery, nonunion or associated neurovascular injury.
Treatment principles
- Restore alignment and length
- Stabilise the fracture appropriately
- Respect soft-tissue biology
- Manage infection risk
- Plan rehabilitation from the beginning
Reconstruction and nonunion
When a fracture fails to heal or heals in poor alignment, treatment may require revision fixation, bone grafting, correction of deformity or staged reconstruction depending on the cause.
Open fractures, severe deformity, numbness, loss of pulse or uncontrolled pain after trauma should be assessed urgently in an emergency department.
Frequently asked questions
What is a nonunion?
A nonunion is a fracture that has failed to progress toward healing in the expected way. Causes can include instability, poor biology, infection, smoking and other medical or mechanical factors.
Can old fractures be corrected?
Some malunions and nonunions can be corrected with reconstructive surgery, but the plan depends on deformity, joint condition, bone quality, infection and patient health.
Medical information is educational and is not a substitute for personal medical advice or an in-person assessment. Treatment depends on symptoms, examination findings, imaging when needed and individual goals.