What Is Incomplete Fracture Healing?
Incomplete fracture healing refers to a fracture that has not healed fully. In this condition, the normal formation of callus—the new bone tissue that bridges the fractured ends—either remains incomplete or develops with insufficient quality and structural strength.
It can affect patients of any age, but it is more common in people with systemic conditions such as diabetes mellitus or osteoporosis, as well as in smokers, immuno-compromised patients and individuals whose fractures have not been adequately immobilised.
Typical symptoms include pain at the fracture site, tenderness on pressure and abnormal mobility, meaning movement in an area that should have become stable.
The diagnosis is confirmed by X-ray or computed tomography (CT), which may show incomplete bridging of the fracture after the expected healing period.
Characteristics of Incomplete Fracture Healing
Incomplete fracture healing differs from delayed fracture healing in terms of severity. Delayed healing means that the process is progressing more slowly than expected, whereas incomplete healing means that the process has not produced an adequate result, even after a considerable period of time.
The main characteristics of this condition include the presence of fibrous tissue instead of a solid bony callus at the fracture site, a weak or unstable connection between the bone fragments and an inability to restore full function to the affected limb.
In some cases, incomplete fracture healing may lead to permanent deformity or require surgery, such as internal fixation or bone grafting, to correct the problem.
The tissues in the affected area often have a reduced blood supply and insufficient oxygenation, both of which can further delay the body’s natural regenerative process.
Scientific Basis and Hyperbaric Oxygen Therapy
The role of oxygenation in bone regeneration has been well established for decades. Collagen synthesis by fibroblasts, osteoblast activity and neovascularisation are all essential to proper fracture healing and depend directly on an adequate local oxygen supply.
Published evidence suggests that hyperbaric oxygen therapy, when used as an adjunctive treatment in cases of incomplete or delayed fracture healing, may reactivate bone regeneration mechanisms, particularly when the underlying cause is associated with local hypoxia or vascular insufficiency.
Clinical reports have documented improvements in radiological findings and shorter recovery times in patients treated with a combined protocol of hyperbaric oxygen therapy and orthopaedic care.
Hyperbaric Oxygen Therapy for Incomplete Fracture Healing
In cases of incomplete fracture healing, hyperbaric oxygen therapy acts as a powerful biological stimulus that may help restart the process of bone regeneration. It does not replace surgery when surgical treatment is necessary, but it may be used both before surgery, to improve local blood supply and create more favorable conditions for the procedure, and after surgery, to support healing.
The primary mechanism of action in this context is the stimulation of osteoblast activity through increased oxygenation, combined with the promotion of angiogenesis at the fracture site.
The formation of new capillary blood vessels is essential because it ensures a continuous supply of nutrients and reparative cells to the fracture zone.
In addition, the anti-inflammatory effects of hyperbaric oxygen therapy may reduce perivascular inflammation, which can otherwise hinder the formation of new blood vessels, while its effect on vascular endothelial growth factor (VEGF) may accelerate the body’s natural repair process.
A typical treatment course consists of 20 to 40 sessions, depending on the severity of the incomplete healing, the bone affected and the patient’s overall health.
The decision to include hyperbaric oxygen therapy in the treatment protocol is always made in consultation with the orthopaedic specialist, based on radiological and clinical criteria.