What can be done when a broken thigh bone, already operated on, heals out of line?
Dr. Mahajan is Chairman Orthopaedics, Joint Replacement & Chief Robotic Joint Replacement at Max Smart Super Speciality Hospital, Saket.
A man in his forties, with three years of stiffness and weakness after an earlier operation for a fracture above the knee, was treated by Dr Ramneek Mahajan.
How did it start, and what did it leave the patient with?
Dr Mahajan says that four years earlier, after an accident, the patient was operated on elsewhere for a distal femur fracture, a break in the lower end of the thigh bone, just above the knee. For the last three years, the patient had scars around the knee, stiffness and loss of movement. The ankle had gradually weakened, and the power of the muscles around it was graded three plus.
Muscle power is often graded from zero to five, where five is normal strength; three means the muscles can move the joint against gravity but not against resistance, and the plus means a little more than that.
What did Dr Mahajan find, and what had to be done?
Dr Mahajan says X-rays, CT scans and MRI scans were done, and they showed the cause: a malunited fracture, a break that had healed out of line. The operation corrected the fracture with an osteotomy: the bone was opened up, cut and set straight, then fixed with an implant.
How is the patient now?
Dr Mahajan says the patient is on the road to recovery and going home.
What should someone ask when an old fracture still causes stiffness and weakness?
This is one man's story, not a promise: what treatment can do for you depends on your own case.
If stiffness and weakness last years after a fracture operation, ask whether the bone healed in the right position.
Ask which scans would show it, and whether the bone can be corrected.
What this case teaches
A malunion, a fracture that heals out of position, may cause pain, a limp or an uneven walk, a 2025 review explains.
Healing out of line matters past 5 to 10 degrees of angle, 10 of twist or 1 to 2 cm shortening, a 2025 review says.
Lower thigh-bone malunions often need a bone cut in more than one direction to restore the knee's joint line, that review says.
