Ryszard Krzykawski1, Roman Król, Adam Kamiński. 1. Department of Orthopaedics & Traumatology, Prof A Sokołowski Memorial Specialised Hospital, Szczecin-Zdunowo, Polland. dexak1972@tlen.pl
Abstract
BACKGROUND: We report our experience with the use of a full-thickness corticocancellous iliac-crest graft, 1 to 5 centimeters in length - to treat established nonunion of the radius and/or ulna. MATERIAL AND METHODS: The technique was used in 14 patients (11 men and 3 women, age 19 to 59). The graft application was combined by rigid fixation with intramedullary locking nail, permitting early active mobilisation. We treated also one patient with infection complication of nonunion radius and ulna. In this case evacuation of metal plate, sequestrectomy, fixation external then antibiotics have been applied in first stage. After curing bone infection the grafting and fixation with the use of intramedullary locking nail have been made in second stage. RESULTS. The bone union has been achieved between 26-th and 33-rd week after operation in seven patients, in four patients with nonunion of radius and ulna bone union has been achieved after 33 weeks. In another two patients with graft 5 cm in length - bone union has been achieved after 28 weeks. In one patient with bone infection the grafts were good incorporated after 40 weeks. The motion of elbow and wrist in all cases has been satisfactory. CONCLUSIONS: Intramedullary nailing in treatment for forearm bones nonunion with use corticocancellous graft is technically easy, didn't require immobilization in the cast and enable early postoperative rehabilitation.
BACKGROUND: We report our experience with the use of a full-thickness corticocancellous iliac-crest graft, 1 to 5 centimeters in length - to treat established nonunion of the radius and/or ulna. MATERIAL AND METHODS: The technique was used in 14 patients (11 men and 3 women, age 19 to 59). The graft application was combined by rigid fixation with intramedullary locking nail, permitting early active mobilisation. We treated also one patient with infection complication of nonunion radius and ulna. In this case evacuation of metal plate, sequestrectomy, fixation external then antibiotics have been applied in first stage. After curing bone infection the grafting and fixation with the use of intramedullary locking nail have been made in second stage. RESULTS. The bone union has been achieved between 26-th and 33-rd week after operation in seven patients, in four patients with nonunion of radius and ulna bone union has been achieved after 33 weeks. In another two patients with graft 5 cm in length - bone union has been achieved after 28 weeks. In one patient with bone infection the grafts were good incorporated after 40 weeks. The motion of elbow and wrist in all cases has been satisfactory. CONCLUSIONS: Intramedullary nailing in treatment for forearm bones nonunion with use corticocancellous graft is technically easy, didn't require immobilization in the cast and enable early postoperative rehabilitation.
Authors: Fernando Baldy dos Reis; Flávio Faloppa; Hélio J Alvachian Fernandes; Walter Manna Albertoni; Philip F Stahel Journal: Ann Surg Innov Res Date: 2009-05-18