A slip-and-fall accident can lead to a fracture of one or more of your bones. Bone fractures can range in severity, but mild-to-moderate fractures often heal completely with conservative treatment, a process that can take several weeks to several months.
A bone nonunion occurs when your fracture does not heal within the expected time frame. Stat Pearls defines nonunion as a fracture that persists for at least nine months without showing healing signs for at least three months. There are several factors that can contribute to a bone nonunion.
1. Open fracture
PubMed Central identifies open fractures as a main cause of nonunion. If a fragment of bone protruded through your skin following your injury, that is an example of an open fracture.
2. Comminuted fracture
If your bone breaks into multiple fragments, it is a comminuted fracture, which can be challenging to treat because doctors must return all the bone fragments to their anatomic positions. Comminuted fractures can lead to nonunion if there is insufficient blood flow to some of the osseous fragments.
3. Underlying medical conditions
Fractured bones can only heal if they have a good blood supply. If you have certain medical conditions that affect your circulation, such as peripheral vascular disease, diabetes, renal insufficiency or vitamin D deficiency, you could be at risk for nonunion, as well as if you take medications that can reduce blood flow, such as opiates, steroids, or NSAIDs.
Tobacco use has a negative effect on blood circulation. Smoking can therefore increase your risk of bone nonunion after a fracture.
Your doctor may recommend that you quit smoking to prevent bone nonunion or to increase the chances of a successful procedure if your fracture requires surgery to treat.