Treatment of diaphyseal non-unions of the ulna and radius

• DOI: 10.1007/s00402-010-1071-x
• Publication Date: 2010-03-08T04:20:02Z
• Authors: Peter Kloen; Jim K. Wiggers; Geert A. Buijze
• Keywords: Bone grafting

Non-unions of the forearm often cause severe dysfunction as they affect interosseus membrane, elbow and wrist. Treatment these non-unions can be challenging due to poor bone stock, broken hardware, scarring stiffness long-term immobilisation. We retrospectively reviewed a large cohort treated by using uniform surgical approach during period 33 years (1975–2008) in single trauma centre. All were managed following AO-principles compression plate fixation autologous grafting if needed. The study consisted 47 patients with 51 radius and/or ulna. initial injury was fracture diaphyseal ulna 22 patients, an isolated 13, 5, Monteggia Galeazzi fracture-dislocation 2 patients. Index surgery for non-union open reduction combination graft 30 cases (59%), alone 14 (27%), only 7 (14%). functional result assessed accordance system used Anderson colleagues. Average follow-up time 75 months (range 12–315 months). healed within median months. According colleagues, 29 (62%) had excellent result, 8 (17%) satisfactory 10 (21%) unsatisfactory result. Complications seen six (13%). Our results show that treatment classic techniques plating osteosynthesis needed will lead high union rate (100% our series). Despite clinical radiographic healing, however, substantial subset have less than optimal outcome.