Nonunion of Fractures of the Ulna and Radius Diaphyses: Clinical and Radiological Results of Surgical Treatment

Abstract

Aseptic nonunion of the radius and ulna is a major complication of forearm fractures, accounting for 2% to 10% of all forearm fractures. The aim of our study is to evaluate the functional and radiological results of surgical treatment of diaphyseal aseptic nonunion of the radius and ulna, with autologous bone grafting, decortication and internal plate fixation. A series of 21 patients (26 nonunions) was retrospectively reviewed, the average age was 35 years with a mean of 31,58 years (range 12-44 years). The fractures included isolated radius (n=6) and ulna (n=10), and both radius and ulna (n=5). The Grace and Eversmann score was used to evaluate our results. Fifteen had very good results, five good and one average. Consolidation of the two bones was attained in 6.2 months. Therefore, the functional prognosis of the upper limb imposes the need for an adequate treatment. This management strategy has enabled us to have satisfactory results. However, the best treatment of nonunion remains the preventive treatment with an optimal management and care of the forearm fractures.

Non-union ulnar fracture as a result of a remote injury

“…Paediatric and adolescent forearm diaphyseal fractures present a treatment challenge. [1][2][3] Historically, both non-surgical and surgical treatments have been performed. 1 3-5 The mainstay of the management is close clinical and radiographic follow-ups.…”

“…1 6 7 The primary goal of treatment is to restore the functional anatomy between the radius and ulna through maintaining their respective lengths and thus obtain optimum function. 1 Prolonged radial and ulnar non-union may cause significant disability due to osteoarthrosis and decreased range of motion of adjacent joints. 2 Patients with malunions and non-unions should be referred to an orthopaedic surgeon for further evaluation and treatment.…”