[Corrective measures following imperfectly healed fractures]

Area of Science:

• Orthopedic surgery
• Traumatology
• Biomechanics

Background:

• Falsely healed fractures can lead to significant functional deficits and secondary complications.
• Post-traumatic arthrosis is a common sequela, particularly in weight-bearing joints.
• Upper limb malunions are less frequently associated with arthrosis compared to lower limbs.

Purpose of the Study:

• To provide an overview of falsely healed fractures and their correction methods.
• To emphasize the role of corrective osteotomy in restoring limb function and preventing arthrosis.
• To highlight the differential indications for corrective surgery in upper versus lower limbs.

Main Methods:

• Review of literature on fracture healing, malunion, and corrective osteotomy techniques.
• Analysis of clinical outcomes for corrective osteotomies in upper and lower limb fractures.
• Discussion of biomechanical principles influencing joint loading and arthrosis development.

Main Results:

• Corrective osteotomy is primarily indicated for functional improvement in upper limb malunions.
• Supracondylar humerus fractures in childhood and distal radius fractures are key indications for restorative osteotomy.
• Minimal axial deviations in lower limbs necessitate early corrective osteotomy to prevent premature joint arthrosis.

Conclusions:

• Corrective osteotomy is an effective treatment for malunited fractures, improving limb function and mitigating arthrosis.
• Early surgical intervention for lower limb malalignments is critical to preserve joint health.
• The management strategy for malunited fractures must consider the specific limb and fracture pattern.