What happens when a fracture heals wrong? What do we call it? Do the fractured bones heal wrong? Yes, occasionally broken bones can heal in an incorrect position after treatment, and it is called “malunion” or “malalignment”. These malunion bones can create problems in future and pain in the body.

A malunion fracture might occur when the space between the displaced ends of the fractured bone filled by new bone. The fractures of the Hand, Wrist or forearm result in a certain amount of angulation or bend after the bone heals.

Doctors determine whether the position of fractured bone allows for functional use after it heals. In most of the cases, when a fracture heals interfering with other bones, surgery can be performed to correct it. Some common fractures that might result in malunion include wrist fractures (distal radius), hand bone fractures (metacarpals), and fractures associated with fingers or thumbs (phalanges).

Malunion Wrist Fractures

Your wrist joint is connected to the hand and the forearm. A wrist fracture means that a person might have broken one of the small bones of the wrist joint or the distal radius – the larger bone that make up your forearm. Mostly wrist bone breaks at the lower end where it connects to the hand and thumb bones.

When you have had a wrist fracture, you might have undergone surgical treatment to fix the broken bone. Wrists are very delicate joints and after recovery, if you notice if the joint not healed in a proper direction, then it is termed as malunion wrist fractures. A wrist malunion can be extra-articular or intra-articular.

Managing malunion of hand fractures is more complex than the management of other malunion fractures in the body. Wrist fractures are the most prevalent fractures managed by trauma surgeons, wrist fractures accounting for 16% of all the distal radius fractures. Generally, patients with a distal radius fracture may recover within months after treatment. However, some patients might experience prolonged impairment of the joint.

Not only wrist fractures, if you have fractured your fingers, hand, or elbow, and after healing but not functioning properly, you should consult an orthopaedic doctor who can suggest you better.

Symptoms Of Malunion Wrist Fractures

Probably the symptoms might occur mostly after healing of the initial radial fracture/break. The symptoms include:

• Angulation, i.e. bend or rotation of the bone that is fractured
• The fractured wrist might not flex or extend to normally
• The adjacent finger might overlap or move away from one another
• Reduction in the functions of the limb involved
• Stiffness in finger, hand, wrist or elbow.

How To Diagnose Malunion Wrist Fractures?

Initially, when you meet up an orthopaedic surgeon, they will check the history patient’s treatment process provided to the fractured bone. Then the doctors suggest an X-ray to diagnose the anatomy of malunion.

Some doctors might prefer a CT scan or an MRI in the diagnosis procedure of a malunion fracture. MRI helps to find the problems associated with cartilage and ligament that might develop a malunion or misalignment of the fracture. CT scans help in finding irregular structures and also guide the placement of implants during the surgical procedure.

Treatment For Malunion Wrist Fractures

Corrective osteotomy is the surgical treatment performed to correct malunion wrist fractures. Before treating distal radius malunions, a surgeon would evaluate whether the malunion is extra-articular or intra-articular. The extra-articular malunions might be a result of non-operative management, and intra-articular malunion may occur due to both a failure to recognize unstable articular disorders in non-operative treatment and insufficient reduction and fixation of a joint in surgical treatment.

The treatment goal is reorientation and realignment of the malunion in a position that enhances the functions of the Wrist. Under anaesthesia, an orthopaedic surgeon will re-break the bone in the joint to realign the fracture. Depending on the malunion type, your bone may be trimmed for proper adjustment of the fractured ends. To keep the operated bone straight in proper alignment, the surgeon would insert metal screws, plates, and pins. Additionally, bone grafting might also be performed by the surgeon to aid in fracture healing.

Post-operative Care

After surgery, the physician will address you with specific instructions for faster recovery.

• After surgery, a post-operative splint, which you must wear for support to the hand until one of our providers visit you. The dressing needs to be CLEAN and DRY so that you can avoid the risk of infection and other healing complications.
• Our staff monitors you for the first 24 hours after surgery.
• You may be prescribed with post-operative pain medicine. You should not take along other pain medication unless advised by your doctor.
• Stop drinking alcohol and driving vehicles.
• Stop smoking or usage of nicotine gum or nicotine patches as they can limit blood flow to the surgical area.
• You must not lift weights with the surgical hand several weeks, depending on the healing or until our health care providers say that you are ok.
• At some days, your stitches might be removed, and a cast or a splint is placed if required. If the cast soaked or soiled, you need to change it as soon as possible.
• The doctor might suggest for imaging like X-rays or a CT scan to evaluate the healing of the fracture.
• Your Wrist is immobilization for several weeks, and probably you will feel stiffness and weakness in your hand and Wrist. You need to undergo, physical therapy which helps to regain functional use of the operative hand.

You no need to live with a disability of malunion, it is treatable. For more information consult Dr. Vasudeva Juvvadi, malunion fracture treatment specialist in Hyderabad.