Nonunion of a comminuted intra-articular wrist fracture after external fixation

Abstract

Nonunion is a very rare complication of a comminuted intra-articular wrist fracture treated by external fixation. The authors describe the likely reasons and the after-care, in order to avoid this complication.

Nonunion of a Pediatric Distal Radial Metaphyseal Fracture Following Open Reduction and Internal Fixation

“…To our knowledge and after an extensive literature search, pediatric nonunion after plate osteosynthesis at a metaphyseal level of the forearm has not been described yet. Even in adults, a nonunion after a metaphyseal forearm fracture is seldomly seen due to a good trabecular bone healing and a good nutritional blood supply of the cancellous bone in the metaphysis of the forearm [4,5,[11][12][13][14].…”

“…It is also very important to minimize the periosteal damage during an operation with a plate osteosynthesis, given the fact that a missing periost can lead to an excessive bone growth towards the opposite direction and so leading to a nonunion. It is recommended to remove a plate osteosynthesis of a diaphyseal forearm fracture between 9 and 12 months because of the risk of refracture with an early plate removal [12][13][14][15].…”