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Malunion & Nonunion

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If fractures do not heal properly, let LA Orthopedic Group help.

Fractures (broken bones) normally heal properly on their own or with the right type of treatment. In some instances, a fracture won’t heal as expected. It’s important for patients to pay attention to how fractures are healing so anything out of the ordinary can be addressed.

  • Malunion is a broken bone that heals in an abnormal position
  • Nonunion is a fracture that fails to heal altogether
  • A delayed union is a broken bone that takes longer than expected to heal

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Causes of Malunions and Nonunions

Malunions and nonunions often occur when the fractured bone lacks a sufficient supply of nutrients, or if adequate stability isn’t provided to allow tissues to heal. Issues with bone healing are more likely to occur when a fracture is severe rather than minor. Bone tissue healing may also be affected by chronic high blood pressure, diabetes, and other conditions that sometimes result in poor circulation in tissues. Additional contributing factors may include:

  • Cigarette smoking or tobacco use
  • Vitamin deficiencies and poor nutrition
  • Age-related conditions
  • Certain anti-inflammatory medications
  • Infections
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Signs of a Malunion

When a bone doesn’t heal properly, the affected bone may be twisted, rotated, or in a position where it may irritate nearby nerves or impede movement. If a joint is affected by malunion, the healed tissues go beyond the surface of the joint. As a result, cartilage that prevents friction isn’t smooth, which may make the affected joint unstable or susceptible to other injuries and conditions like arthritis that may affect bones. Symptoms associated with a malunion include:

  • Pain in the affected area
  • Tenderness or swelling
  • A visible deformity
  • Trouble placing weight on the affected bone or joint

Signs of a Nonunion

With a nonunion, the site of the fracture was already treated and possibly supported with bracing or a cast to limit mobility. In some instances, a special hardware may have been placed around a severe fracture during surgery. If a nonunion occurs, the treated bone does not heal. When a patient has a nonunion, the following symptoms may be experienced:

  • Continued pain at the site of the break
  • Discomfort felt when the area of the body where the fracture occurred moves
  • Pain experienced when weight is placed on the affected area where the fractured bone is located
  • Swelling or redness around the broken bone

Diagnosis and Treatment

Malunions and nonunions are diagnosed with X-rays and other image tests that may include CT scans or MRIs. Non-surgical treatment for a nonunion may involve the use of a device called a bone stimulator that transmits ultrasonic or pulsed electromagnetic waves to the affected bone to promote healing. Surgical treatments may include an osteotomy (bone cutting) to correct misalignment from a malunion. Patients sometimes benefit from a bone graft or an internal or external fixation to stabilize a nonunion.

The way a fracture heals will depend on where it’s located and the extent of the break in the bone. Some patients with conditions that affect bones, such as osteogenesis imperfecta (OI), and osteoporosis may also have issues with fracture healing.

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Our whole family has been to Los Angeles Orthopedic Group! We love the whole staff and have been so thankful for the ways they have taken care of us.
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This center helped my teenage son when he was injured playing sports. The care that we received was compassionate and thorough.
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LA Orthopedic Group has truly changed my life. I no longer experience chronic pain and have been able to find relief with only minimally invasive treatment options.
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