A malunion is when a fractured bone does not heal properly. Some ways that it shows is by having the bone being twisted, shorter, or bent. Malunions can occur by having the bones improperly aligned when immobilized, having the cast taken off too early, or never seeking medical treatment after the break. Malunions are painful and commonly produce swelling around the area, possible immobilization, and deterioration of the bone and tissue. Signs and symptoms
Malunions are presented by excessive swelling, twisting, bending, and possibly shortening of the bone. Patients may have trouble placing weight on or near the malunion. Diagnosis
An X-ray is essential for the proper diagnosis of a malunion. The doctor will look into the patient’s history and the treatment process for the bone fracture. Oftentimes a CT scan and probably an MRI are also used in diagnosis. MRI are used to check of cartilage and ligament issues that developed due to the malunion and misalignment. CT scans are used to locate normal or abnormal structures within the body and to help during procedures to guide the placement of instruments and/or treatments. Treatment
Once diagnosed and located, surgery is the most common treatment for a malunion. The surgery consists of the surgeon re-breaking the bone and realigning it to the anatomically correct position. There are different types and levels of severity for malunions which helps determine the treatment. Most often, either screws, plates or pins are used secure the new alignment.
These environmental changes are likely to ultimately affect the transmission of ocular infection by means of lack of facial cleanliness. Particular attention is required for environmental factors that limit clean faces. A systematic review examining the effectiveness of environmental sanitary measures on the prevalence of active trachoma in endemic areas showed that use of insecticide spray resulted in significant reductions of trachoma and fly density in some studies. Health education also resulted in reductions of active trachoma when implemented. Improved water supply did not result in a reduction of trachoma incidence. Antibiotics
WHO Guidelines recommend that a region should receive community-based, mass antibiotic treatment when the prevalence of active trachoma among one- to nine-year-old children is greater than 10%. Subsequent annual treatment should be administered for three years, at which time the prevalence should be reassessed. Annual treatment should continue until the prevalence drops below 5%. At lower prevalences, antibiotic treatment should be family-based. Management
Antibiotics
Azithromycin (single oral dose of 20 mg/kg) or topical tetracycline (1% eye ointment twice a day for six weeks). Azithromycin is preferred because it is used as a single oral dose. Although it is expensive, it is generally used as part of the international donation program organized by Pfizer. Azithromycin can be used in children from the age of six months and in pregnancy. As a community-based antibiotic treatment, some evidence suggests that oral azithromycin was more effective than topical tetracycline, but no consistent evidence supported either oral or topical antibiotics as being more effective.