Understanding Malunion and Nonunion Fractures

The Difference Between Malunion and Nonunion Fractures

When a fractured bone doesn’t heal as expected, it can lead to complications such as malunion or nonunion. A malunion fracture occurs when a broken bone heals in a different position, leading to deformity or improper alignment. This can cause discomfort, restricted movement, and reduced functionality. Surgical correction of the bone alignment is sometimes necessary.

On the other hand, nonunion occurs when the fractured bone fails to heal altogether. The broken bone remains in two separate pieces, with no progress in bone healing despite the passage of time. Some nonunions require medical and/or surgical intervention to correct the position and stimulate bone healing.

What Are the Different Types of Fractures That Can Occur?

Fractures vary in severity and type, impacting the way they heal. Common types include:

1. Simple fractures – The bone is broken but does not penetrate the skin.
2. Compound or open fractures – The broken bone pierces through the skin, creating a risk of infection.
3. Comminuted fractures – The bone is shattered into several pieces.
4. Oblique fractures – The break has a slanted or angled pattern.
5. Transverse fractures – The break is horizontal across the bone.
6. Spiral fractures – The bone has been twisted apart creating a spiral break in the bone

Any of these fractures can potentially lead to a malunion or nonunion.

What Are the Causes of Malunion and Nonunion Fractures?

A variety of factors can contribute to malunion or nonunion fractures. Some common causes include:

• Inadequate immobilization: If a broken bone isn’t properly stabilized during healing, it may heal incorrectly or fail to heal at all.
• Bone trauma severity: Severe bone trauma or multiple fractures increase the risk of complications.
• Poor blood supply: Areas with reduced blood flow, such as the wrists or ankles, are more prone to nonunion fractures.
• Infection: Open fractures or surgical interventions can sometimes lead to infection, disrupting normal bone healing.
• Underlying health conditions: Conditions like osteoporosis, diabetes, and smoking can impair the body’s ability to heal broken bones.

Signs of Malunion Fractures

Recognizing the signs of a malunion fracture is critical to getting timely treatment. Common symptoms include:

• Persistent pain at the site of the fracture, even after the bone should have healed.
• Visible deformity or abnormal bone alignment.
• Reduced range of motion in the affected joint.
• Difficulty bearing weight or using the injured limb.
• Swelling or tenderness around the site of the fracture.

Signs of Nonunion Fractures

When nonunion occurs, the signs can be subtle or obvious, but any delay in fracture healing should raise concern. Common symptoms of a nonunion fracture include:

• Persistent pain long after the expected healing time has passed.
• A sensation of instability or movement at the fracture site.
• Lack of improvement in mobility or strength.
• Swelling and tenderness that doesn’t subside over time.

If your fractured bone hasn’t healed within the usual timeframe, it’s important to seek medical advice to avoid further complications.

Treatment for Malunion and Nonunion Fractures

Treating a malunion or nonunion fracture often requires surgical intervention. Depending on the severity of the fracture and individual circumstances, different approaches can help restore proper alignment and stimulate healing:

• Realignment surgery (osteotomy): For a malunion fracture, surgeons may need to re-break the bone and realign it correctly, using plates, screws, or rods to hold the bone in place during healing.
• Bone grafting: A bone graft may be needed in cases of nonunion fractures. This involves transplanting healthy bone tissue from another part of the body to help fuse the bone fragments and promote healing.
• Bone stimulation: Electrical bone stimulators or ultrasound therapies can help stimulate bone healing in both malunion and nonunion cases.
• External fixation devices: Sometimes, external hardware is used to stabilize the bone while healing takes place.

Restoring Bone Health at Georgia Hand Shoulder and Elbow

At Georgia Hand, Shoulder & Elbow, we specialize in treating complex fractures and helping patients regain mobility and strength. If you suspect that your broken bone hasn’t healed properly or you’re experiencing ongoing pain after an injury, don’t wait—schedule an appointment with our expert orthopedic team in Atlanta or Marietta, Georgia and learn more about trauma injuries. Let us guide you through your recovery and get you back to doing what you love.