Malunion Fracture Causes

Our body has tremendous healing capacity; when a bone is broken, the body starts to heal itself and fixes the fracture. Before the healing process starts, the two broken ends of the bone need to line up correctly. By any means, if the lining of the two ends is disturbed, then the bone heals with a deformity which is called a malunion fracture.

Malunion fracture definition: Technically it is defined as follows: Healing of a fracture in an abnormal (non-anatomic) position) [1].

Malunion Fracture

Malunion fracture is a large gap between the broken ends of the bone which is filled with a new bone.

Fractures of the hand, wrist, fingers, forearm, etc., are the common malunion fractures resulting in certain angulation or bend after a broken bone heals. In most cases, malunion fractures might not interfere with the function of the limb involved; if not so, surgery is performed to correct the malunion.

Dr Vasudeva Juvvadi, one of the best doctors for malunion fractures treatment in Hyderabad, says “If the position of malunion fracture allows the limb for functional use after it heals then further correction is optional.”

Wrists fractures (distal radius), hand bone fractures (metacarpals), and fingers or thumb fractures (phalanges) are some of the common fractures of the upper extremities that might result in malunion.

Malunion Fracture Symptoms

If you have a broken bone of finger, wrist, elbow, or legs, and if the part is no longer functioning after healing, you need to consult an orthopaedic doctor who can provide the best fractures treatment. Some of the indications that the healing process of your broken bone might be incorrect include the following:

Malunion fracture type

• Angulation (bend) of the fractured bone.
• Rotation of the fractured bone
• The fractured part does not extend to allow normal use.
• The finger might cross onto or move away from the adjacent finger (In the case of finger fractures)
• Altered functions of the involved limb
• Stiffness
• In severe conditions, you may feel pain, swelling, bruising

However, malunion can be treated surgically and once treated – it will help you to regain lost functions. If left untreated, these fractures might cause impaired joint functions, osteoarthritis due to altered weight-bearing, change in posture, balance & movement, limb deformities and other such conditions that may alter your aesthetic look, and other cosmetic problems.

Read: Things to Know About Malunion Surgery? 

Malunion Fracture Causes

The causes of malunion fractures are associated with bone healing, alignment, or an infection that occurs during the healing process. It is a fracture healed with a non-anatomical position, loss of end-to-end apposition or bone shortening.

Malunion fracture treatment procedure

Some of the most significant causes of malunion fractures include:

Inaccurate reduction

When a bone is fractured, the bone fragments get displaced. To heal the broken bone without any deformity, the bony ends must be realigned to their natural position through orthopedic surgery by reduction of the displacement. If the process fails, it results in malunion [2].

Failure to hold the reduction while healing

In some cases, the reduction is managed by applying casts, traction, or with the help of plates, screws, and other implants. If such approaches fail to hold the reduction, it results in malunion.

Ineffective immobilization

The broken bone is realigned and immobilized. If the fracture is not provided with proper immobilization, the alignment of bony ends might lead to malunion.

The gradual collapse of the comminuted or osteoporotic bone

 Osteoporosis of the bone makes the bone brittle and weak; it might not withstand and it might break down.

Improproper fixation or inadequate fixation of the fracture

Fracture fixation might be either internal or external with the help of rods, plates to hold it in position. If it fails to hold the fracture properly, it can lead to malunion.

Other Risk Factors

Some other risk factors that can cause malunion are growth disturbances due to epiphyseal cartilage injury, open fractures, infections, segmental fractures, bone loss, soft tissue imposition, etc.

Malunions in Children

In children, malunion can also be caused due to partial or complete damage to the growth plate due to high-impact trauma or overgrowth of bones after the treatment.

Types of Malunions

Malunions are classified into different types based on the cause. Overriding, i.e., lengthening or shortening of the bone after fracture treatment, is seen very often. Rotatory malunion caused due to internal or external rotation of the broken bone. Angulatory malunion happens as a result of varus or valgus deformities.

Read: Best Surgeon for Malunion Fractures in Hyderabad 

Most of the malunions can be corrected. The treatment often depends on the severity of the malformation and the root cause of the injury. Osteotomy is a common surgical procedure to treat malunions. For more information, contact Dr Vasudeva Juvvadi, Consultant Orthopaedic Surgeon at Sunshine Hospitals, Hyderabad. In his 11+ years of experience as an orthopaedic doctor, he treated thousands of fracture cases, including malunion fractures, non-union fractures, complex fractures, etc.

References

1. Malunion of Hand Fracture – “Practice Essentials”; https://emedicine.medscape.com/article/1243899-overview
2. University of Michigan – “Malunion Fractures” – https://www.uofmhealth.org/conditions-treatments/cmc/fracture/malunion

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