Aug fourteen, 2018

Dr. Miller: You broke a bone and now it's painful? And maybe yous're not walking on it correctly? We're going to talk about that next on Scope Radio.

Announcer: Access to our experts with in-depth information about the biggest health issues facing you lot today. The Specialists, with Dr. Tom Miller, is on The Scope.

Dr. Miller: I'k hither with Justin Haller. He's an orthopedic surgeon here at the University of Utah. Justin, tell me a niggling flake about what we call malunion or malalignment. And this occurs in patients who have had fractures and then subsequently develop pain or mechanical dysfunction because maybe the fracture just didn't heal right. Maybe they didn't have information technology set correctly, something like that. What does that mean?

Did Your Bone Heal Twisted or Crooked?

Dr. Haller: So a malunion past definition is a bone that breaks and and so heals in either a malaligned position or information technology'south malrotated, then the bone itself is twisted and heals in that position.

Dr. Miller: What's the almost common crusade of that? I mean, apparently it'due south a fracture, but so is it because it didn't receive the correct treatment or maybe they didn't follow instructions after they were casted?

Dr. Haller: The most common crusade tends to be when patients are treated non-operatively with cast or something like that, in the U.s., in the past.

Dr. Miller: So what do y'all do? How exercise you treat these? So again, what are the most common fracture sites where malalignment occurs?

Dr. Haller: So nigh commonly symptomatic malalignment occurs in the lower extremities. So either the tibia or shin bone or femur or thigh bone. And what we practise for those is start, to determine whether it's healed in a malaligned or malrotated position.

Dr. Miller: So you can run into that on X-ray. So CT scan or MRI might show you lot that?

Dr. Haller: Information technology starts with a full X-ray standing profile to see the mechanical centrality of a patient's lower extremities and using a CT scan to see if there's any rotational component to that.

Dr. Miller: Do you come across leg length discrepancy sometimes with these fractures if they've healed incorrectly?

Is I Leg Longer Than the Other?

Dr. Haller: Commonly yous do see a leg length discrepancy with these, and that'due south picked up on the long continuing Ten-ray.

Dr. Miller: What would somebody feel if i leg was a little chip shorter than the other subsequently a fracture? And I gather they don't have to be that much shorter for them to develop symptoms, possibly if yous're an athlete it'southward even more common.

Dr. Haller: Aye, actually, patients can go symptomatic for a couple centimeters of leg length discrepancy. And most commonly, the symptoms associated with that are back pain, hip pain, and if it'southward as well, information technology can get some genu pain if it's in the tibia bone or shin bone.

Dr. Miller: So how do you treat that? I mean, evidently yous don't put them on a rack and stretch out their leg. So how do you repair the leg and make the leg the right length?

Dr. Haller: Sure. And then we typically will do an osteotomy, or nosotros cut the bone or re-break the os as people will typically say, and nosotros'll realign it and fix it there with plate and screws or a rod downwards the centre of the bone.

Dr. Miller: How constructive is that? Does that work pretty well?

Dr. Haller: It works very well then long every bit patients tin heal the cutting in the bone. Normally, patient symptoms are pretty much resolved.

Dr. Miller: At present, practise you practise the aforementioned thing for a malrotation, where the os is twisted?

Dr. Haller: It's pretty like. Again, you lot do an osteotomy or a cut or re-intermission the bone and y'all can rotate the bone and set up it with plate and screws or with a rod downwards the middle of the os.

Dr. Miller: Well, final question. How would a patient detect their way to you lot if they had symptoms? What would they look for and how would they know to come to you?

Dr. Haller: Most usually people will present saying that their family unit members noticed that they accept either a limb length discrepancy or they walk funny or one leg is rotated in or out. Ordinarily it's family members that discover the about and will betoken the patient to either an orthopedic surgeon or full general practitioner to take an 10-ray. And then it tin be pretty obvious that the bone is not quite the same as the other side.

Dr. Miller: Exercise you lot think going to a specialist is a adept idea if yous demand to have this type of surgery, where you're going in and repairing a prior fracture that's been healed?

Dr. Haller: Absolutely. Orthopedic specialists, especially orthopedic trauma surgeons, are the ones who are trained to fully evaluate and empathize the malalignment that's present and and so can fully correct what's going on.

Announcer: Have a question about a medical procedure? Want to learn more than about a health condition? With over 2,000 interviews with our physicians and specialists, there's a pretty proficient gamble yous'll find what you want to know. Check information technology out at TheScopeRadio.com.


updated: August 14, 2018
originally published: November eleven, 2016

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