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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-12-2010 | Orthopaedic Surgery

Treatment of diaphyseal non-unions of the ulna and radius

Authors: Peter Kloen, Jim K. Wiggers, Geert A. Buijze

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 12/2010

Abstract

Introduction

Non-unions of the forearm often cause severe dysfunction of the forearm as they affect the interosseus membrane, elbow and wrist. Treatment of these non-unions can be challenging due to poor bone stock, broken hardware, scarring and stiffness due to long-term immobilisation.

Method

We retrospectively reviewed a large cohort of forearm non-unions treated by using a uniform surgical approach during a period of 33 years (1975–2008) in a single trauma centre. All non-unions were managed following the AO-principles of compression plate fixation and autologous bone grafting if needed.

Patients

The study cohort consisted of 47 patients with 51 non-unions of the radius and/or ulna. The initial injury was a fracture of the diaphyseal radius and ulna in 22 patients, an isolated fracture of the diaphyseal ulna in 13, an isolated fracture of the diaphyseal radius in 5, a Monteggia fracture in 5, and a Galeazzi fracture-dislocation of the forearm in 2 patients. Index surgery for non-union consisted of open reduction and plate fixation in combination with a graft in 30 cases (59%), open reduction and plate fixation alone in 14 cases (27%), and only a graft in 7 cases (14%). The functional result was assessed in accordance to the system used by Anderson and colleagues.

Results

Average follow-up time was 75 months (range 12–315 months). All non-unions healed within a median of 7 months. According to the system of Anderson and colleagues, 29 patients (62%) had an excellent result, 8 (17%) had a satisfactory result, and 10 (21%) had an unsatisfactory result. Complications were seen in six patients (13%).

Conclusion

Our results show that treatment of diaphyseal forearm non-unions using classic techniques of compression plating osteosynthesis and autologous bone grafting if needed will lead to a high union rate (100% in our series). Despite clinical and radiographic bone healing, however, a substantial subset of patients will have a less than optimal functional outcome.

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Title: Treatment of diaphyseal non-unions of the ulna and radius
Authors: Peter Kloen
Jim K. Wiggers
Geert A. Buijze
Publication date: 01-12-2010
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 12/2010
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-010-1071-x

At a glance: The STEP trials

Springer Medicine

Treatment of diaphyseal non-unions of the ulna and radius

Abstract

Introduction

Method

Patients

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Method

Patients

Results

Conclusion

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