Combined intramedullary and extramedullary fixation with autogenous bone grafting for the treatment of forearm nonunions with severe bone loss | ||||
| The Egyptian Orthopaedic Journal | ||||
| Volume 52, Issue 4, October 2017, Page 251-256 PDF (955.49 K) | ||||
| DOI: 10.4103/eoj.eoj_69_17 | ||||
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| Author | ||||
| Ihab Badawi | ||||
| Abstract | ||||
| Introduction Nonunions of diaphyseal forearm fractures are uncommon. They are usually associated with either a complex injury or a complication such as infection. As a result, the majorities of nonunions are atrophic and result in a defined bone defect. Aim The aim of this work was to assess the results of treatment of forearm nonunions with severe bone loss using combined intramedullary and extramedullary fixation with autologous iliac crest bone grafting. Patients and methods This study included six patients with forearm nonunions with severe bone loss treated by combined intramedullary and extramedullary fixation with autologous iliac crest bone grafting. The study included three males and three females. Their age ranged from 14 to 47 years (mean: 36.1±12.4 years). The duration of nonunion ranged from 6 to 180 ms (mean: 78±71.5 ms). A total of four (66.7%) cases had been infected previously. The number of previous surgical procedures ranged from 1 to 8 (mean: 3.5±2.5). The forearm was transformed into a single bone in three (50%) cases. Results All nonunions healed satisfactorily. The final pain scale ranged from 0 to 2 points (mean: 1.3±0.8 points). There was a slight limitation in activities of daily living in all points. The hand grip was normal in one patient, slightly weak in four patients, and moderately weak in one patient. Conclusion Combined intramedullary and extramedullary fixation with autogenous bone grafting is a reliable method of treatment of difficult forearm nonunions with significant bone loss. | ||||
| Keywords | ||||
| Bone loss; Extramedullary; forearm non-unions; intramedullary | ||||
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