Treatment of nonunion and malunion following hand fractures.

Hand fractures account for about 1.5% of all emergency room visits and 40% of upper extremity fractures. Unfortunately, complications occur following these injuries. When the underlying osseous structure is affected with nonunion or malunion, it can further compromise hand function, therefore diagnosis and treatment of these complications is an important part of caring for patients with hand fractures. The decision to intervene must be based on the likelihood of achieving the desired correction, and improving the function, of the hand. This article reviews principles of diagnosis and treatment of nonunions and malunions, including conditions affecting the thumb and pediatric patients.