Malunion and Nonunion Treatment

What is Malunion and Nounion fracture?

Malunion means union of bone in abnormal position that cause trouble to patient. Non union means fracture is not united in stipulated time and now no chance of union in future.

Signs and Symptoms of Malunion& nonunion fracture:

Malunion of bone fracture will present as deformity of extremity that means the patient will have an abnormal shape of limbs, it may be combined with shortening. In non-union, there will be movement at the fracture site, with or without pain. The limb will not work in a normal way in both problems.

Causes of Malunion & nonunion fracture:

Malunion occurs because of many reasons like wrong position of fractured bone, broken plate, early removal of plaster, no treatment taken by the patient. Causes of nonunion include metabolic abnormality like vitamin d, calcium, protein deficiency, osteoporosis, no treatment, implant failure, early weight bearing, de-vascularization of bone end, instability at fracture site, infection etc.

How Malunion & non union fracture is diagnosed?

Diagnosis of malunion is being made by the presence of deformity & the history of fracture. X-ray needed to confirm the diagnosis and seeing the abnormal position of united bone. Non union means fracture not united so diagnosis will be made by abnormal movement at fracture site beyond certain period of time for union. Patient may or not have pain. Most of time confirmation of diagnosis will be done by the use of X-ray. Rarely you need CT scan.

How Malunion& non union fracture can be treated?

Malunited fracture needs correction of deformity and union in normal position. If the position of the union is not acceptable, then need breaking of bone and re-position in normal position and fixation by plate/nail/wire or plaster. In children, it needs minimal fixation, but in adult it need rigid fixation. Malunion in children near the joint can remodel up-to certain extent so every mal-union in children don’t not need surgery, it need only observation. Non union in children is rare, but it occurs then need detail assessment to evaluate cause of non union so the proper planning can be done. Most of nonunion needs surgery and fixation with implant like plate, screw, k wire or ilizarov etc. Etiology of non union like infection, rigidity of fixation, blood supply of bone, implant failure or biological cause like osteoporosis, nutrition deficiency should also be taken care during treatment.

Complication:

Malunion causes the deformity of extremity so patient will not have normal functioning limbs. It this deformity is near / in the joint then joint movement will also be hampered. Patient can have pain, restriction of joint movement. Limb shortening and limping. Some time deformity and joint degeneration creates lots of trouble to child in going to mainstream. Non-union of bone cause free movement at fracture site so patient will not be able to take weight on limbs. So patient will feels lot of difficulty in performing their daily routine activity. Sometime malunion and non union also causes other problem like nerve entrapment, muscular contracture & pain.

Make an Appointment for Malunion and Nonunion fracture treatment:

Once patient develop malunion or non union of fractured bone, they need expert opinion for malunion treatment. Orthopedic Surgeon should be experienced enough in operating these difficult cases and in reconstruction of extremity. In children, they need consultation with pediatric orthopedic surgeon with long experience.

Frequently Asked Questions