Revision fixation
Loose or broken implants are removed and the fracture is fixed again with a more stable construct, such as a larger nail or an additional plate.
Complex Trauma
Non-Union & Failed Fracture Fixation TreatmentDr Hatif Siddiqui
Most fractures heal within a few months. Sometimes a fracture heals very slowly (delayed union) or stops healing altogether (non-union). The plate, rod or screws holding it can also loosen or break.
A fracture that has not healed does not usually heal by waiting longer. Finding out why it has not healed, and correcting that cause, is the key to success.
Complex Trauma & Fracture Surgery
Advanced orthopaedic care in Lucknow
- Warning sign
- Pain and movement at the fracture months later
- Key tests
- X-ray, CT scan, blood tests
- Main treatment
- Revision fixation, often with bone graft
- First step
- Find and fix the cause
Signs Your Fracture May Not Be Healing
- Pain at the fracture site months after the injury or surgery
- Pain when putting weight on the limb
- A feeling of movement or clicking at the fracture
- The limb looks bent or is becoming shorter
- A plate, rod or screw has loosened or broken on X-ray
- Redness, discharge or a wound that won't heal (possible infection)
Why Fractures Fail to Heal
Bone needs three things to heal: stability, a good blood supply and a healthy biological environment. Non-union happens when one or more of these is missing.
- Too much movement at the fracture because fixation was not stable enough
- Poor blood supply after a high-energy injury
- Infection at the fracture or around the implant
- A gap between the bone ends
- Smoking and tobacco use
- Diabetes, low vitamin D, poor nutrition or some medicines
How the Cause Is Found
X-rays over time show whether healing has progressed. A CT scan shows how much bone has bridged the fracture. Blood tests check for infection and for problems such as low vitamin D or uncontrolled diabetes. When infection is suspected, samples are taken during surgery.
Bring all your old X-rays, CT scans and previous operation notes. They help show what has already been tried.
Treatment Options
Treatment targets the specific reason the fracture has not healed.
Bone grafting
Healthy bone, often taken from the patient's own pelvis, is placed at the fracture to stimulate healing and fill gaps.
Treating infection
Infected bone and tissue are cleaned away in theatre, followed by targeted antibiotics. Fixation may be done in stages.
Correcting deformity
If the bone has healed or is healing in a bent or shortened position, alignment can be corrected during revision surgery.
Improving healing biology
Stopping smoking, controlling diabetes, correcting vitamin D and nutrition. These make a real difference to the outcome.
Recovery After Non-Union Surgery
| First weeks | Wound healing, physiotherapy for nearby joints, and protected weight bearing as advised. |
|---|---|
| 6–12 weeks | X-rays check early healing, and activity increases step by step. |
| 3–6 months and beyond | Non-unions often take longer than the original fracture to heal fully. Regular follow-up continues until the bone has united. |
Healing time depends on the bone, the cause of non-union and your general health.
Why Choose Dr Hatif Siddiqui for Revision Fracture Care
- Member of AO Trauma, the international community for fracture surgery
- Complex fracture fixation, including double plating of joint fractures (cases on his YouTube channel)
- Surgery at Medanta Lucknow, with CT scanning, ICU and physiotherapy under one roof
- Planned, staged treatment for difficult fractures, with early movement and rehabilitation
Consultation Locations
Medanta Lucknow
OPD - B Wing, 2nd Floor, Medanta, Sector A, Pocket 1, Amar Shaheed Path, Golf City, Lucknow, Uttar Pradesh 226002
Indira Nagar Clinic
1D, near Khan Dairy Road, Block A, Indira Nagar, Lucknow, Uttar Pradesh 226016
Watch Dr Hatif Siddiqui Explain
Short videos from Dr Hatif Siddiqui’s YouTube channel.
हड्डी न जुड़ना (नॉन-यूनियन) और टूटी प्लेट या रॉड का इलाज
अगर फ्रैक्चर के कई महीने बाद भी दर्द है, हड्डी हिलती महसूस होती है, या X-ray में प्लेट या रॉड टूटी या ढीली दिखे, तो हड्डी शायद जुड़ नहीं रही है। सिर्फ़ इंतज़ार करने से यह आमतौर पर ठीक नहीं होता। कारण ढूँढकर, स्थिर फिक्सेशन और ज़रूरत पड़ने पर बोन ग्राफ्ट से इलाज किया जाता है। अपने पुराने X-ray और ऑपरेशन के कागज़ साथ लाएँ।
Frequently Asked Questions
What is a non-union fracture?
A non-union is a fracture that has stopped healing and will not heal without further treatment. Delayed union means healing is happening, but more slowly than expected.
How do I know if my fracture is not healing?
Warning signs include continuing pain months after the injury, pain on weight bearing, movement at the fracture, a bending limb, or a loose or broken implant on X-ray. An X-ray and often a CT scan confirm it.
My plate or rod has broken. What now?
An implant usually breaks because the bone has not healed and the metal has been carrying the load. It needs assessment of why the bone did not heal, followed by revision surgery with more stable fixation, often with bone grafting.
Can a non-union heal without surgery?
Some delayed unions improve by correcting factors such as smoking, vitamin D or diabetes, or by adjusting weight bearing. An established non-union usually needs surgery.
Does smoking affect fracture healing?
Yes. Smoking and tobacco reduce blood flow to the bone and significantly increase the risk of non-union. Stopping completely is strongly advised.
Related Treatments
Book a Consultation with Dr Hatif Siddiqui
Medanta Lucknow and the Indira Nagar clinic. Bring your X-ray, MRI or CT scan and any previous operation notes.