Vol. 10, Issue 3 (2024)

Aim: To study the evaluation of fracture healing status: union, delayed union, and non-union in a tertiary care hospital in Bangladesh.

Materials and Methods: The study was a prospective Interventional Study conducted at Department of Orthopaedics & Traumatology, DMCH, Dhaka, Bangladesh from September, 2016 to February, 2018 (18 Months). The study was conducted on 24 patients admitted in AVBRH hospital above the age of 18 years of either sex. It comprised of 24 patients out of whom 7 patients had delayed union of a long bone, 8 patients had non-union. These patients were compared with 9 patients that had postoperative fracture union which were included as a control group who had the same risk factors for delayed union.

Results: Total 24 patients of comminuted fracture shaft of femur were selected according to the inclusion and exclusion criteria. Mean ± SD = 33.1±9.9 years, Standard Deviation=9.9 Range= 20 to 60 years. Out of 24 fourteen patients (58%) were up to 30 years old, 25% were within 30-40 years and 17% were above 40 years old. The mean age of the patients were 33 years and the lowest and highest ages were 20 and 60 years. 4 (16.6%) patients were under delayed union between score of 6 to 9, 5 (20.8%) were under non-union with >9 score, in control group patients with union 9 (37.5%) of patients were added, this study was significant correlation with p value =0.0001. In our study, out of 7 patients maximum number of patients came within 0-5 days of trauma 3 (12.5%) patients were under delayed union, 4 (16.6%) patients were under non-union and 9 (37.5%)were under union, this gave us significant with p value=0.0001. Aging, female gender, comminuted and segmental fractures, higher grades of soft tissue injury, smoking, and infection were found to be independent risk factors for delayed union in long bone fractures. Among the risk factors, smoking and infection can be controlled to decrease the prevalence of delayed union.

Conclusion: It is necessary that we create awareness about the importance of primary treatment like immobilization and wound debridement, as patients should reach as early as possible. Patient’s relative’s moral support is necessary in order to get early hospitalization so as to reduce the risk of delayed union among patients and so that appropriate modality of treatment (surgical and conservative) with use of bone regeneration substitutes such as bone grafting and PRP can be done to promote faster healing keeping infection in control.