Extract
The management of nonunion and malunion is more complex in the hand than it
is elsewhere in the skeleton. Good hand function depends on the gliding of
complex flexor and extensor tendon mechanisms, joint mobility, sensibility,
good skin cover, and adequate vascularity. Preexisting problems related to any
of these factors may limit the usefulness of the digit, and operative
interventions can cause additional scarring and dysfunction. Consequently, the
management of nonunions and malunions in the hand is predicated on a careful
analysis of the risks and benefits of operative intervention as well as the
functional goals and the likelihood that operative intervention can achieve
them.