The bone has healed in a malunited position causing either a cosmetic or functional impairment.
Cause
Some non-operatively treated fractures and even operatively treated fractures can heal in a non-anatomic position and if there is significant rotational deformity or angulation, this can lead to problems.
Diagnosis
Difficulty making a full fist due to crossing of the fingers
Lack of full range of movement
Obvious deformity to the shape of the hand
X-rays demonstrate the deformity, occasionally CT scans are required.
Treatment
Surgical, General Anaesthesia
Usually day surgery procedure
The bone is osteotomised with the use of a saw
The bone is then realigned into the correct anatomical alignment and rotation and held securely with small plates and screws.
Potential Complications
Infection, haematoma, neurovascular injury, scarring of surrounding tendons, stiffness of joints, failure of the osteotomy site to heal.
Post Op Care
The patient can be discharged in a plaster slab for the first few days.
To be seen by the hand therapist for formation of resting splint and usually active mobilisation will be commenced within the first week.
Specialist review at ten days, six weeks and three months
Osteotomies usually take between six weeks to three months to heal
Strengthening begins once the bone is fully united
