Houston OfficeFondren orthopedic group
Malunion Surgery (Elbow)
What is Malunion?
Malunion, also known as crooked healing, is the failure of a fractured bone to rejoin properly due to poor alignment of the fracture fragments. The condition results in abnormality and deformity of the bone (bent or twisted bone).
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Causes of Malunion
The main causes of malunion in the elbow include:
- Imperfect alignment or positioning of the broken bones
- Improper stabilization of the fracture union during healing causing movement of the broken bones
Factors such as tobacco use, obesity and diabetes can also affect bone healing resulting in a malunion.
Symptoms of Malunion
Malunion in the elbow is characterized by:
- Rotation and/or angulation (bend) of the fractured bone
- Stiffness and difficulty flexing or extending the elbow
- Discomfort or pain in the elbow
- Swelling at the elbow
How is Malunion Diagnosed?
Malunion can be diagnosed by:
- A physical examination
- Imaging tests (X-ray, CT Scan or MRI)
What are Non-operative Options for Malunion?
Non-operative treatment options for malunion include: active exercises, splinting, passive mobilization and use of continuous passive motion machines.
What are Operative Options for Malunion?
To correct a malunion your doctor may perform a bone realignment osteotomy (correction osteotomy) and placement of bone graft.
The aim of treatment is to correct the deformity and improve function of the upper extremity. Surgery is performed under anesthesia. The bone is rebroken and the fracture fragments are realigned properly. The bone may be trimmed for proper orientation if necessary. Screws, pins or plates may be used to stabilize the fracture union as it heals. Bone graft may be placed at the site to encourage bone growth and fusion.
What Happens after Your Surgery?
After surgery, a post-operative dressing/splint is placed. Medications are prescribed for pain control. Smoking should be avoided as this can delay healing and promote malunion. You are advised not to bear weight on the arm initially and to gradually increase your activities as directed by your doctor.
Your Rehab
You may be advised to undergo physical and/or occupational therapy weeks after surgery to improve strength and function of the arm.
Frequently Asked Questions
What is a malunion of the elbow?
Malunion, sometimes called “crooked healing,” occurs when a fractured bone fails to rejoin properly because the fracture fragments healed in poor alignment. The result is an abnormal, bent, or twisted bone.
What causes an elbow malunion?
The main causes are imperfect alignment of the broken bones and improper stabilization during healing, which allows the fragments to move. Factors such as tobacco use, obesity, and diabetes can also impair bone healing and contribute to a malunion.
What are the symptoms of an elbow malunion?
Symptoms include rotation and/or angulation (bending) of the fractured bone, stiffness and difficulty flexing or extending the elbow, discomfort or pain, and swelling at the elbow.
Can a malunion be treated without surgery?
Yes, in some cases. Non-operative options include active exercises, splinting, passive mobilization, and the use of continuous passive motion machines. When these aren’t sufficient, surgery may be recommended to correct the deformity.
How is elbow malunion surgery performed?
Dr. Luo may perform a correction osteotomy, in which the bone is rebroken and the fragments are realigned properly, with the bone trimmed if needed. Screws, pins, or plates stabilize the repair, and a bone graft may be placed to encourage bone growth and fusion.
What is recovery like after malunion surgery?
After surgery, a splint is placed and medications control pain, and you should avoid smoking since it can delay healing. You’ll avoid bearing weight on the arm initially and gradually increase activity, with physical or occupational therapy beginning weeks later to improve strength and function.
Randy Y. Luo, MD, MBA
Board Certified Orthopedic Surgeon
Hand & Upper Extremity Specialist