Another Screwed Up Ankle

Malunions and nonunions are going to occur. Malunions should be avoidable, but nonunions are often due to poor bone biology. On occasion, nonunions are due to poor fixation and lack of stability. Sometimes, nonunions are also a product of an underlying malunion. Often CT-SCAN's are helpful to help ascertain the relationships. Asymptomatic nonunion can be left alone, but in light of a malunion, it should be addressed. Post-traumatic DJD can occur rapidly.
Fibular nonunion	Bone grafted and plated the fibula	Utilized lag screws and plate
Looks like a malunion	T1 image	T2 image revealing some posterior drift
Fibular malunion	Just ugly!	This patient has a fibular and tibial nonunion. She also has RSD. Strike three, you are out!
Medial malleolar nonunion	Diabetic	Fibular malunion with early DJD