Non-Union/Mal-Union

What is a Malunion?

“Malunion” is a clinical term used to indicate that a fracture has healed, but that it has healed in less than an optimal position. This can happen in almost any bone after fracture and occurs for several reasons.

Malunion may result in a bone being shorter than normal, twisted or rotated in a bad position, or bent. Many times all of these deformities are present in the same malunion.
Malunions can also occur in areas where a fracture has displaced the surface of the joint. When this happens, the cartilage in the joint is no longer smooth. This may cause pain, joint degeneration, “post-traumatic arthritis” or catching or “giving-way” episodes resulting from instability or incongruency of the joint

What is a Nonunion?

Every fracture carries the risk of failing to heal and resulting in a nonunion. While nonunions can occur in any bone, they are most common in the tibia, humerus, talus, and fifth metatarsal bone.

Several factors contribute to a nonunion. If the bone ends that are fractured have been stripped away from the blood vessels that provide them with nutrition, they will die. As a result, the bone ends cannot contribute to new healing, and a nonunion is more likely. Without a good blood supply and growth of new blood vessels, no new bone will form and the fracture cannot readily heal.

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