11) A head shaft angle less than 130[degrees] on initial postoperative x-rays was considered a varus malreduction and on final radiographs as a varus malunion.
Of the 16 patients with varus malunion, 10 patients had initial varus malreduction on postoperative x-rays (p < 0.
Patients who had a varus malreduction had a higher rate of healing complications than those not reduced in varus (p < 0.
Factors associated with a healing complication included Neer three- and four-part fracture types, increasing number of comorbidities, and initial varus malreduction.
22,25) Nonetheless, the surgeon should be aware of the possibility of malreduction
if submeniscal fracture lines are not adequately visualized.
1,2) Historically, varus malreduction on the anterior-posterior view of the proximal femur has been linked to the development of nonunion.
Angulation of 10[degrees] or greater in the coronal or sagittal plane was defined as malreduction.
Fractures nailed with malreduction were compared to those without.
38) In their series, the investigators reported a high rate of complications resulting from technical error, including malreduction (14%), screw perforations (11%), and implant dislocations (4.
They found that there was a statistically significant association between varus malreduction and loss of fixation (30.
30) In the face of an associated fibula fracture, restoring the fibular length is critical prior to syndesmosis fixation, as malreduction
of the syndesmosis most commonly occurs due to inadequate restoration of the fibular length.
Screw fixation for odontoid non-union still remains controversial because direct odontoid fixation is associated with a high rate of complications; a 24% incidence of major complication has been reported (11,14,20,22); the incidence of malreduction
as 19%, and pseudarthrosis as 12%, and, although infrequent, there are instances of implant failure reported in the literature.