Deformed and Angled Fractures (Malunion)

What is a malunion?

A fracture that heals with poor alignment is called a malunion. The incorrectly positioned bones may demonstrate angulations, rotation and shortening that is not within the anatomic spectrum of normal.

There are several common reasons for the development of a malunion. These include poor alignment of the original fracture and drifting of previously well positioned bones. Additionally, shortening can develop as fractures with multiple fragments and poor quality bone undergo a gradual collapse.

How are malunions treated?

The severity of the malunion is assessed to determine the degree of abnormal weight distribution it creates and its potential to produce joint pain and arthritis. If surgical treatment is chosen, then one of several strategies can be utilized. Angled cuts (corrective osteotomy) may be created to straighten excessively curved bones followed by application of a plate and screws. Alternately, the fracture can be recreated and the bone stabilized with an intramedullary nail. When angular and rotational deformities are associated with a shortened limb then an adjustable external frame (Ilizarov device) is frequently employed.