Malunion Fracture | Diagnosis & Treatments

How is a malunion diagnosed?

Your child’s doctor will ask you to describe how the original fracture happened and the treatment your child received. They’ll examine the affected limb and watch your child walking or using their arm (depending on the bone in question). They’ll also compare your child’s affected limb to the other leg or arm to see if there are visible differences in range of motion, function, and length.

An x-ray will help your child’s doctor look for signs of malunion and compare the length of the bones (the affected limb and the unaffected limb). Your child’s doctor may also order a CT scan to see if the bone is rotated. This information will help the doctor plan your child’s treatment.

How is a malunion treated?

If your child’s affected limb is functional, their doctor may recommend treating it without surgery. This may include a shoe lift to compensate for a limb-length discrepancy or a brace to support the limb.

If your child’s malunion is painful, if the limb is impaired, or if the malunion places the limb and surrounding joints at risk, your child’s doctor may recommend surgery to repair the bone.

The most common surgical procedure to repair a malunion is an osteotomy. A surgeon will cut the affected bone or bones and move them into a better position.

To keep the bones stable while they heal, the surgeon may attach a metal plate to the bone or insert a rod down the center of the bone. Another way to stabilize the limb is by attaching a metal frame to the outside of the limb. Your child’s doctor will discuss the options with you before the surgery and together you can decide which is a better option for your child.

If the malunion has caused your child’s limb to stop growing and resulted in a limb-length discrepancy, your child’s doctor may suggest limb-lengthening surgery. This is a complex surgery and only appropriate if the difference between your child’s limbs is significant.

What is the long-term outlook for a malunion?

Your child’s long-term outlook depends on the severity of the malunion and the treatment they receive. If left untreated, a severe malunion can lead to early onset arthritis and loss of function of the affected limb. However, with proper treatment, many children with malunions heal fully and regain much or all of the use of their arm or leg.