The late effects of fractures can include complications with healing and long-term functional issues. Based on the provided reference, a significant factor contributing to these late effects is the initial injury itself.
Here's a breakdown:
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Delayed Union or Non-Union: This refers to the fracture taking longer than expected to heal (delayed union) or failing to heal altogether (non-union). Extensive soft tissue damage and soft tissues trapped within the fracture site can lead to these complications, as well as the severity of the bone break (comminution) and bone loss.
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Factors affecting Union
- Extensive Soft Tissue Damage: When a fracture is accompanied by significant damage to the surrounding muscles, ligaments, and other tissues, the blood supply to the fracture site can be compromised. This hinders the healing process.
- Soft Tissue Interposition: If soft tissues become lodged between the broken bone fragments, it can physically prevent the bones from joining together correctly, leading to delayed or non-union.
- Bone Comminution and Loss: A comminuted fracture involves multiple bone fragments. If the bone is severely shattered or if bone fragments are lost, it can be more challenging for the body to bridge the gap and heal the fracture.
In summary, the extent of damage to soft tissues and bone during the initial fracture plays a crucial role in determining the likelihood of late complications such as delayed or non-union.
