Treatment of Nonunion of Forearm Bones Using Radial Forearm Bone Flap

Background: Treatment of forearm fracture nonunion is challenging. Several surgical techniques for the treatment of forearm nonunion have been reported. Objectives: The aim of this prospective study was to evaluate the effects of the radial forearm bone graft technique in cases with forearm nonunion. Patients and Methods: We treated ۷ patients with forearm nonunions via radial forearm bone flap and internal plate fixation. On the preoperative examination and last follow-up, the quick disabilities of the arm, shoulder, and hand (Q-DASH) score, elbow, forearm and wrist arches of motion and grip force were measured. At the final follow-up, radiographic union and patient satisfaction and return to work were assessed. Results: The mean follow-up duration was ۳۴ ± ۲۳ months. The Q-DASH scores improved from ۷۰ ± ۶ points preoperatively to ۱۳ ± ۱۵ points at final follow-up (P < ۰.۰۱). The preopetative range of motion (ROM) was ۱۰۱ ± ۲۶ degrees; whereas the final forearm ROM was ۱۴۰ ± ۱۷ (P = ۰.۰۱). All nonunions united uneventfully (range ۳-۶ months). At the last follow-up, the grip force was ۸۳% of uninjured extremity and all patients were satisfied with the outcome of the operation. Conclusions: Radial forearm bone flap is a safe, useful and novel technique in cases with forearm nonunion.

Keywords:

Forearm , nonunion , Microsurgery