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What is Distal Radius Fracture Malunion?

The forearm consists of two bones, the radius, and the ulna. The radius is the larger of the two forearm bones, and the region closest to the wrist is called the distal end. A fracture or break in the distal end of the radius bone is known as a distal radius fracture.

Malunion of a fracture is a condition whereby the fractured ends of a bone heal in a misaligned position resulting in bone deformity. Malunions can occur with any fracture and is often due to trauma. It is a common complication of a distal radius fracture. 

Symptoms of a Distal Radius Fracture Malunion

The common symptoms of a distal radius fracture malunion include:

  • Swelling, pain, discomfort and bone tenderness
  • Loss of strength
  • Stiffness in the affected area 
  • Limited functioning of the affected area
  • Bone deformity (twisted, bent, rotated, or shortened bone)

Diagnosis of Distal Radius Fracture Malunion

The doctor will discuss the history of your injury and perform an appropriate physical exam. Imaging of the affected area may be done with X-rays. The doctor may also order a CT scan or MRI if more detail is needed.

Treatment for Distal Radius Fracture Malunion

Surgery can help reverse severe cases of malunion and ensure correct fracture healing. Osteotomy, an orthopedic surgical procedure, is commonly used to realign the bones in the correct position. The procedure may involve shortening or lengthening before the realignment.

During the procedure, the surgeon will re-break or cut the bone at or near the site of the original fracture to perform the realignment.  Additionally, a bone graft is sometimes used to aid the healing process. Depending on the type and severity of the fracture, the ends of the fractured bone may be held together by internal or external fixation.

  • Internal fixation: To keep the straightened bone fragments properly aligned, the surgeon may insert screws, plates, or rods. A cast can also be used for fixation until the fracture fragments unite and heal. 
  • External fixation: A rigid frame may be placed on the outside of the injured area and attached to the bone with pins or wires. 

The surgery is normally followed by post-operative care and rehabilitation. Surgical treatment of a fracture malunion may be able to restore you to pre-fracture function, as well as improve your long-term bone health.