Nonsurgical Treatment for Nonhealing Fractures

Your doctor may recommend a technique called bone stimulation, which uses either a low-level electric current or low-intensity pulsed ultrasound to help speed the rate of bone healing. It is administered at the doctor’s office or at NYU Langone’s Bone Healing Center. Your doctor may also recommend a portable unit that can be used daily at home.

In electronic bone stimulation, a doctor places a small electrode or electrodes—flat discs that adhere to the skin and conduct electricity—onto your skin near the fractured bone. These electrodes are connected to a machine that sends a low electrical current to the affected bone.

This technique jump-starts the healing process by tricking the body into thinking an injury has occurred. In response, your body produces proteins that begin to repair cells at the injury site.

It’s safe to use electronic bone stimulation up to 24 hours a day. Your doctor determines the appropriate schedule based on the diagnosis. 

To perform ultrasonic bone stimulation, a doctor applies a gel to the skin that helps conduct high-frequency sound waves. These are produced by a small machine and travel through the affected bone.

Ultrasound enhances bone healing by encouraging the incorporation of calcium into the bone as well as stimulating certain proteins involved in the healing process. Bone stimulation with ultrasound is usually prescribed for 20 minutes a day.

Your doctor may recommend increasing your daily intake of vitamin D, vitamin C, or calcium if blood tests indicate you have low levels of those nutrients. This may help your bones produce new, healthy cells.

Foods rich in these nutrients include yogurt, leafy greens, and citrus fruit. Your doctor may also recommend that you take vitamin or calcium supplements.

A nutritionist at NYU Langone can help you plan meals that incorporate these important nutrients into your diet and determine the optimal daily dosage of supplements to help your bones heal. 

Anabolic medication such as teriparatide, a synthetic form of a parathyroid hormone, increases the rate of bone formation and can help acute fractures and nonunion fractures to heal. It may speed healing by increasing the concentration of calcium in the blood and stimulating bones to grow new tissue. 

Teriparatide medication is administered as a daily injection that can be done at home. Your doctor shows you the correct way to do this. Usually, people inject the medication into the thigh or abdomen. 

If teriparatide medication proves effective in helping your bone to heal, your doctor may prescribe it until the bone has healed fully. It may take 6 to 12 months for the medication to take effect. At that time, your doctor evaluates how well it is working and determines whether further treatment is needed.

A nonhealing fracture can cause pain that may persist for months or years after an injury. Our doctors understand that chronic pain can affect your emotional wellbeing and may prevent you from participating in everyday activities. They can recommend pain medication to help you remain comfortable throughout treatment.

Some over-the-counter pain relievers, such as acetaminophen, may help reduce discomfort. If a nonhealing fracture causes significant pain that prevents you from performing routine tasks, your doctor may prescribe a more potent medication. The doctor determines how long and how frequently you should take a prescription pain reliever. 

Pain medication does not help a bone to heal, and prescription pain relievers may have side effects, including nausea and dependency. Long-term use of acetaminophen is associated with liver damage.

Avoiding Anti-Inflammatory Medications

Short-term inflammation plays an important role in the body’s response to injury, and helps the body to heal. Although nonsteroidal anti-inflammatory medications, such as ibuprofen, naproxen, and aspirin, can help relieve pain, these medications work by blocking inflammation, which may prevent a fractured bone from healing.

Anti-inflammatory medications, such as corticosteroids, may also slow blood flow and delay bone healing. Doctors recommend avoiding all types of anti-inflammatory medications until a fractured bone has healed fully.