If your fracture has healed, but is not aligned properly, or has left the bone shorter than it was, or both (commonly),
then it is said to be 'malunited'. In most cases, it is now possible to correct the deformity.
There are two main ways to do this.
Immediate correction by re-breaking the bone (osteotomy) and internal fixation.
Gradual correction by osteotomy and application of an external fixator designed to gradually realign
and restore the length.
I usually prefer the second option, because it allows for the soft tissues to adjust slowly, and can allow restoration
of length without bone graft.
My favoured means of doing this is using a device called the
Taylor Spatial Frame. (See below or click on link for more details)
This is a very clever device which allows simultaneous length, rotation and multiplanar angular deformity correction
using a series of 6 oblique struts and a sophisticated online computer programme.
Corrections of most deformites take about a month, and the frame then remains on for at least 3 months while the osteotomy
'sets'.
Distal radial fractures (especially Colles' fracture) commonly malunite. Some of these can be elegantly corrected using
the osteotomy and frame technique (see below)
