Un-united fractures of the distal radius: a report of 12 cases.

The treatment of 12 distal radius nonunions in 11 patients over a 24-year period is presented. The average age of the patients was 55 years (range, 35-72 years). The comorbid medical conditions in the patients with these fractures included diabetes mellitus, peripheral vascular disease, psychiatric disorders, alcoholism, peripheral neuropathy, scleroderma, and morbid obesity. Nine of the un-united fractures in 8 patients had insufficient metaphyseal bone to allow internal fixation; 6 of these fractures were treated with a wrist arthrodesis. Three un-united fractures in 3 patients had sufficient supporting bone to permit correction of the nonunion and preservation of the radiocarpal joint. Three nonunions in 3 patients were treated without further surgery. Bony union was achieved in all 9 nonunions managed operatively (6 wrist arthrodeses and 3 open reductions).