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Aseptic Both Bone Forearm Nonunion Treated by Plate and Opposite Allograft Strut

February 01, 2013

Contributors: Mohammadreza Chehrassan, MD; Matteo Nanni, MD; Maria Teresa Miscione, MD; Michele D'Amato, MD; Raffaele Borghi, MD; Alberto Corrado Di Martino, MD, PhD; Alice Bondi, MD; Constantino Errani, MD; Antonio Mazzotti, MD; Cesare Faldini, MD; Cesare Faldini, MD

Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.
Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.

Forearm nonunion frequently changes the relationship between the radius and ulna and may lead to impairment of forearm function. In a recent paper, we proposed an original surgical technique for aseptic forearm nonunion. Our technique combines a cortical bone graft strut with a metal plate. This video shows the surgical treatment of a 40-year-old-patient affected by aseptic forearm nonunion. From the previous skin incisions, both ulna and radio were exposed. The fibrous tissue was removed, the bone ends were freshened, and the medullary canals were opened to access vascularized bone tissue. A stable fixation was made by placing a plate and opposite allograft strut on the ulna and radius. At the time of surgery, we retrospectively reviewed 23 patients with a mean age of 33 years (range, 17-48 years). Minimum follow-up was 14 years (mean, 16 years; range, 14-21 years). There were no intraoperative or postoperative complications. At last follow-up, all forearm bones had remodeled. The mean visual analog pain scale was 1 (range, 0-3). Forearm function improved. Combining a cortical allograft strut with a plate led to bone healing. Surgical treatment of aseptic forearm nonunion improved forearm function, and resulted in a durable outcome with long-term follow-up.

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