Malunion fracture Tibia (Lower limb)

Malunion fracture definition: It is abnormal healing of bone fracture after treatment. The fracture can heal in an unnatural position; for instance, the bone might be bent, twisted, crooked, rotated, or shorter than when compared to before. Sometimes a combination of these malunions might also appear.

Some malunions might not require treatment as they don’t bother your daily activities. But those that appear in your lower limbs often result in significant functional disabilities. A malunion in the lower limb may lead to limp, pain, cosmetic deformity in the structure of the bone, and walking difficulty. The treatment for a malunion often requires surgery.

Malunion fracture symptoms

A malunion in the lower limbs can cause a limp, leading to pain and cosmetically displeasing.

Malunion treatment in lower limbs often ends up with surgical correction and aligning the misaligned bone, and improving the leg’s function.

Let’s know about Bone Healing

In a majority of cases, fractures will heal by themselves, if they meet the below conditions:

• The broken bone must be aligned and held together until it heals. Some fractures are supported with a cast’s help, while some are fixed through surgical correction using screws, plates, rods, and frames.
• The broken bones’ ends must have a proper blood supply and good nutrition (proteins, calcium, & vitamins) for faster healing.

Under these circumstances, the broken bone heals in a proper position with perfect alignment. This is termed as a union. If the broken bone doesn’t heal properly, it is termed non-union.  In some cases, the fractured bone may heel, but in an abnormal position. This condition is known as malunion.

Lower Limb Malunion Fracture

Malunion fracture Tibia (Impact of Malunion in the Lower Limb)

Any broken bone in the body may have a malunion fracture. However, many people tolerate malunion fractures better as they do not limit their mobility and also do not hamper their day-to-day activities.

Malunions in the lower limb often require treatment. The affected limb may result in one or more of the following conditions due to malunion:

•  The foot is turned outwards or inwards (rotational abnormality)
•  An inability to extend or fully flex the affected leg (flexion contracture)
•  Knock knee (when the affected knee is straightened, the knee angles are in)
•  Bowed leg (When the affected knee is straightened, the knee angles are out)
•  A shorter or longer leg (Limb length discrepancy)
•  A crooked limb

Malunion fracture causes

Some fractures may lead to malunion fractures even with proper treatment because of the fracture’s complexity or certain health conditions. In comminuted fractures, the bone breaks into many fragments, and it is challenging to put them back together. Such types of complex fractures is more likely to heal in an improper alignment. People with certain health conditions like osteoporosis, arthritis, etc., are more vulnerable to malunion fractures. When the broken tibia bone shifts position during the bone healing process, malunion fractures can occur. The possibility of a lower limb tibia fracture turning into a malunion fracture is more likely if bone fractures are treated with a cast. This type of fracture is also possible even after surgical fixation.

For detailed information about malunion causes, read: What Are The Common Causes Of Malunion Fracture?

Malunion fracture also occurs if the bone ends shift their place while healing. More likely, they appear in fractures treated with the help of casts but can again happen after surgery to fix the fracture.

Deformity Due to Lower Limb Malunion

Malunion Fracture Symptoms

Symptoms of a malunion fracture are most apparent after the healing of a fracture. However, one can be recognized early on. Symptoms depend on the affected bone, severity, and the position of malunion.

In the case of lower limbs, for example, if you have a thigh bone fracture that heals like a malunion, it may result in a limp, or your foot might be rotated internally or externally while walking. You may also have pain in your hip, knee, or ankle area, even though they are not injured.

This is because the malunion fracture manipulates your walking mechanics by pushing too much of your body weight onto other joints.

Treatment for malunion fractures

Malunion fracture treatment in the lower limbs depends on various factors, including symptoms, bone involved, the severity of the malunion, and whether the condition impacts mobility and daily functioning.

For detailed information about malunion treatment, read: Things To Know About Malunion Surgery?

Malunion fracture treatment: Malunions can be treated through:

Nonsurgical Treatment

Nonsurgical treatment for malunion is suggested if it is not painful and does not cause functional disabilities.

• Shoe lift
• Bracing

Surgical Treatment

If the malunion causes pain, and movement disabilities, then surgery is recommended to fix it.

Osteotomy is the standard surgical procedure used to fix a malunion. The process involves cutting the bone at the fracture site, then realigned into its anatomical position. Based on the fracture location and its severity, the bone may be immobilized with either internal or external fixation while healing.

• Internal fixation – The surgeon uses metal plates, screws, and rods to stabilize the bone.
• External fixation – Here, the surgeon fixes a metal frame outside the leg, and then it is attached to the broken bone with the help of pins and wires.

Distraction osteogenesis – In this procedure, the malunion is fixed either by shortening or lengthening the bone with internal lengthening rods or an external frame. This procedure will equalize the length of the affected limb over time.

Malunion fracture tibia: If you have a fracture long back that still makes you feel discomfort, then consult Dr. Vasudeva Juvvadi, one of the best orthopedic doctors for malunion fracture treatment and surgery in Hyderabad. He has more than twelve years of experience in treating various fractures and their complications after treatment.

If you are planning malunion surgery for the lower limb (tibia), contact us for the malunion surgery cost and plan.