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What is a Malunion of a Fracture?

Malunion of a fracture is a condition where the fractured ends of a bone heal in a misaligned position resulting in bone deformity. Malunions may occur in any bone fractures in the body often due to trauma. 

What are the Signs or Symptoms of a Fracture Malunion?

The common symptoms of fracture malunion include:

  • Swelling, pain, discomfort and bone tenderness
  • Inability to fully flex the affected joint
  • Stiffness in the affected area 
  • Limited functioning of the affected area
  • Bone deformity (twisted, bent, rotated, or shortened bone)

In case of a finger fracture, the malunion may result in a finger that “scissors” onto an adjacent finger. 

What if a Fracture Malunion is Left Untreated?

If not treated, the fracture malunion may lead to joint instability and degeneration, deformity, arthritis and loss of function. 

How is a Fracture Malunion Diagnosed?

The doctor may discuss the history of your injury and perform an appropriate physical exam. Imaging of the area in question may be done with X-rays. The doctor may also order a CT scan or an MRI if more details are needed. 

How is a Fracture Malunion Treated?

A surgical procedure can help reverse severe cases of malunion and ensure correct fracture healing. Osteotomy, an orthopedic surgical procedure, is commonly used to realign the bones in the correct position. The procedure may involve shortening or lengthening before the realignment.

During the procedure, the surgeon will re-break or cut the bone at or near the site of the original fracture and realign the bone.  Additionally, a bone graft may also be used to aid the healing process. Depending on the type and severity of the fracture, the ends of the fractured bone may be held together by internal or external fixation.

  • Internal fixation: To keep the straightened bone in proper alignment, the surgeon may insert screws, plates, and rods. A cast can also be used for fixation until the fracture fragments unite and heal. 
  • External fixation: A rigid frame may be placed on the outside of the injured area and attached to the bone with pins or wires. 

The surgery is normally followed by post-operative care and rehabilitation. Surgical treatment of a fracture malunion may be able to restore you to pre-fracture function as well as improve your long-term bone health. 

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