Why bones don’t heal: researchers identify risk factors for fracture nonunions

We all know the science behind the way bones heal, or at least the layperson’s version of it: the displaced halves of the bone are reset by a trained practitioner, they’re held in place with one contraption or another, and the patient is advised to keep that area as still as possible while the body does its business and naturally knits the two ends back together.

As anyone unfortunate enough to undergo such a trauma already knows, however, it’s not always as simple as that. And according to a recent study by the Louisiana State University Health Sciences Center,there are a raft of different factors that can determine whether a fractured bone will successfully be reunited, or not.

The study, which analysed the data of a mind-boggling 90.1 million patients, eventually honed in on 309,330 different cases of bone fracture.

The results: 4.93% of them resulted in fracture nonunions. The most successful reunion rates were found in the bones in the hand (with a 1.47% rate of failure) and radius bone in the forearm (2.10% rate of failure). The most problematic areas were the scaphoid bone (below the thumb – 15.46% rate of failure), the tibia and fibula (13.95%) and femur (13.86%).

The bare bones: lifestyle is key

Unsurprisingly, the study concluded that there are many factors that can determine fracture nonunions. Other ailments in the body are a prime factor: osteoarthritis, rheumatoid arthritis, and diabetes increased the odds of nonunion by at least 40%. Medications also play a part: if painkillers or insulin is a day-to-day part of your life, the risk of non-union is increased (although if you’re on anti-diabetic medication that isn’t insulin, or oral contraception, the risk is decreased).

Other factors that can have a detrimental effect on your odds of a successful reunion of a fracture are myriad, and include anticoagulant use, osteoarthritis with or without rheumatoid arthritis, anticonvulsant use with or without benzodiazepine, opioid use, diabetes, osteoporosis, smoking, obesity, antibiotic use, and Vitamin D deficiency. And if you’re male, the chances of nonunion are greater than if you’re female.

Why Vitamin D is essential for healthy bones

Obviously, doctors can put into practice a range of procedures to correct nonunion fractures, including electrical stimulation and specialised braces. In most cases, however, surgery is required – which is the last thing anyone needs, particularly if physical activity is part of your career or quality time.

While fractures can be an unavoidable fact of life, the message is obvious: your lifestyle is a huge factor in determining the success rate of the healing process, and one key factor – the correct intake of Vitamin D – is the quickest and best solution. It’s an established fact that Vitamin D helps calcium absorption in the gut, which allows for normal levels of bone growth and remodelling. Furthermore, a lack of Vitamin D can lead to brittle bones.

For more information on bone health, you can find it here. To arrange a consultation at Cathy’s Cambridge clinic, call 01223 200 595.