Where in Dubai
Dr. Subhash Ushakoyala, Specialist Orthopaedic Surgeon, sees patients with fractures that have not healed or healed out of line at Grand Infinity Medical Center in Al Muteena, Deira, Dubai. Bring every X-ray from the day of the injury onwards, and the operation note if the fracture was fixed. Comparing the images over time is how a nonunion or malunion is judged. If an operation is advised, he tells you which hospital it will be in and what your insurer needs.
What is fracture nonunion and malunion?
Most broken bones heal well. A nonunion is a break that fails to heal, and a delayed union is one that takes longer than usual. A malunion is a break that has healed, but in the wrong position, so the bone is bent, twisted or shortened. To heal, a bone needs to be held still, a good blood supply and good nutrition. A nonunion is more likely after a high-energy injury such as a road accident, an open fracture, an infection, or in someone who smokes or uses nicotine. Some bones, such as the small scaphoid bone in the wrist, have a poor blood supply. A malunion of the wrist or hand can affect how well the hand grips and turns.
Common signs
- Pain at the site of an old break, months after it should have healed.
- X-rays that still show a gap at the break after several months.
- A limb, wrist or finger that looks bent, twisted or shorter after a fracture healed.
- Weak grip, stiffness or poor turning of the wrist or hand after a fracture.
- A fracture fixed with metalwork that has loosened or broken.
How Dr. Subhash approaches it
Dr. Subhash is a specialist orthopaedic surgeon. His services list includes the treatment of fracture nonunion and malunion, within deformity correction and limb reconstruction, and of malunited wrist and hand fractures. He reviews the old and new X-rays, checks for infection and for health factors that slow healing, and measures any deformity. He then explains the options, which can include a cast or brace, an operation to fix or straighten the bone, or a bone graft.
What to expect
History and examination
He asks about the injury, earlier treatment, smoking and other health conditions, and examines the limb.
Imaging
X-rays, and sometimes a CT or MRI scan, show whether the bone has joined and in what position.
Blood tests
Blood tests can look for infection or conditions such as anaemia or diabetes that slow healing.
Treatment plan
Some nonunions heal with more time in a cast or brace. Others need surgery: new or firmer fixation, a bone graft, or an outside frame.
Correcting a malunion
Where a healed bone is out of line and affects function, the bone can be cut and reset in a better position, then held while it heals.
Follow-up
Repeat X-rays over the following months show whether the bone is joining.
Getting better
Every patient is different. These are typical milestones, not a promise; your own plan comes from your consultation.
- Healing after nonunion surgery is checked over several months, not weeks.
- Stopping smoking and all nicotine products helps the bone heal.
- A balanced diet with protein, calcium, vitamin C and vitamin D supports bone healing.
- Physiotherapy restores movement and strength once the bone is stable.
Risks to know about
- The bone may still fail to heal, and a further operation may be needed.
- Infection, especially where there was an open fracture or earlier surgery.
When to book a visit
Book a visit if a broken bone is still painful months after the injury, or your X-rays show it has not joined. Book a visit if a limb, wrist or finger has healed bent or twisted and it affects how you use it. Go to emergency care straight away if an old fracture site becomes hot, red and swollen with a fever, a wound opens over it, or a limb suddenly gives way or bends.
Where to book
Dr. Subhash sees patients at Grand Infinity Medical Center in Al Muteena, Deira, in north-east Dubai. The clinic is at Shop No. 4, next to the Grand Excelsior Hotel.
Grand Infinity Medical Center
Shop No. 4, next to Grand Excelsior Hotel, Al Muteena, Deira, Dubai, United Arab Emirates
DirectionsCall +971 58 599 7460WhatsApp
Questions patients ask
My fracture was treated in another country. Can he review it in Dubai?
Yes, you can book a review. Bring the X-rays or discs and any reports and operation notes, translated into English if you can.
How long should a broken bone take to heal?
Most take about six to twelve weeks, depending on the bone and the injury. A break that is still painful, with no healing on X-ray after several months, may be a nonunion.
Does smoking really affect bone healing?
Yes. Tobacco and nicotine in any form, including vaping and nicotine gum or patches, slow bone healing and raise the chance of a nonunion.
My wrist healed crooked. Can it be fixed?
Sometimes. If a malunited wrist limits grip or turning or causes pain, an operation to reset the bone can be considered. He explains whether it is likely to help in your case.
Book an appointment
His nurse answers the phone and WhatsApp.