ABSTRACT
This chapter reviews the key complications of fracture healing with respect to epidemiology, biomechanics and management. However, the incidence of healing complications may be as high as 19 per cent, resulting in pain, disability, sequelae of recumbency and delayed return to work. Non-invasive methods to accelerate fracture healing such as low-intensity pulsed ultrasound, electromagnetic stimulation and shock-wave therapy have shown promising results. Perren's strain theory explains the effect of mechanical factors on the different stages of fracture healing, and the amount of strain dictates the tissue type formed. In cases of aseptic non-union of femoral fractures, healing rates of 96-100 per cent have been achieved with both internal and external fixation, respectively; similarly successful outcomes are reported at other sites. Radiographs may reveal impending malunion at an early subclinical stage and are the keys to early identification of displacement or malalignment during the first 3 weeks of fracture healing.
